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Recanalization of totally occluded iliac and adjacent venous segments

Seshadri Raju1, Susan McAllister, Peter Neglen

  • 1University of Mississippi Medical Center and River Oaks Hospital, Jackson, USA. rajumd@earthlink.net

Journal of Vascular Surgery
|November 8, 2002
PubMed

Insights

Percutaneous recanalization of totally occluded iliac veins and inferior vena cava using stents is a safe and effective short-term treatment. The procedure significantly reduced pain and swelling, with good stent patency rates.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • Chronic venous occlusive disease affects the iliac veins and inferior vena cava, leading to significant morbidity.
  • Percutaneous recanalization offers a minimally invasive approach to restore venous flow.

Purpose of the Study:

  • To evaluate the safety and efficacy of percutaneous recanalization of totally occluded iliac veins and inferior vena cava.
  • To report outcomes including patency rates and symptom resolution.

Main Methods:

  • 38 limbs underwent iliac vein recanalization; 9 also required inferior vena cava recanalization.
  • Large-caliber, self-expanding stents were deployed, often extending into the common femoral vein and inferior vena cava.
  • Intravascular ultrasound was utilized; a median of 3 stents were placed per patient.

Main Results:

  • No procedural morbidity or mortality was observed.
  • Actuarial 24-month patency rates were 49% (primary), 62% (primary assisted), and 76% (secondary).
  • Significant reductions in pain (median 4 to 0) and swelling were achieved; 66% of stasis ulcers resolved.

Conclusions:

  • Percutaneous recanalization with stent placement is a successful short-term treatment for occluded iliac veins and inferior vena cava.
  • The procedure demonstrates good patency and significant improvement in patient symptoms.
  • Minimal morbidity associated with the intervention supports its clinical utility.
Abstract

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