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Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis

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Percutaneous therapy for deep vein reflux.

Dusan Pavcnik¹, John Kaufman, Lindsay Machan

¹Dotter Interventional Institute, Oregon Health Sciences University, Portland, Oregon.

Seminars in Interventional Radiology

|February 18, 2011

Summary

Artificial venous valves show promise for treating deep venous insufficiency. Early patient results indicate symptom improvement and valve patency, though proper sizing and placement are critical for optimal function.

Keywords:

Venous valve biomaterial deep venous insufficiency experimental interventional procedures stents and prostheses

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Area of Science:

Vascular Surgery
Biomaterials Science
Medical Devices

Background:

Chronic venous insufficiency of the deep venous system lacks effective treatments.
Artificial venous valves are under development to restore venous function.
The small intestinal submucosa square stent bicuspid venous valve (BVV) is a novel artificial valve.

Purpose of the Study:

To evaluate the efficacy and safety of the bicuspid venous valve (BVV) for deep venous insufficiency.
To assess the long-term function and patency of implanted BVVs.
To identify critical factors for successful BVV implantation and function.

Main Methods:

Experimental implantation of BVVs in sheep jugular veins.
Long-term functional assessment of implanted valves in animal models.
Clinical implantation of BVVs in three human patients with follow-up data collection.

Main Results:

88% of experimentally implanted BVVs in sheep showed good function.
12% of experimental valves had reduced function due to tilting, with 4% experiencing partial thrombosis.
BVVs implanted in three patients remained patent for over 3 years, with two patients reporting decreased symptoms.

Conclusions:

The bicuspid venous valve (BVV) demonstrates promising results as an artificial venous valve for deep venous insufficiency.
Proper sizing and placement are crucial for optimal BVV function and to prevent complications like tilting.
A second-generation BVV has been developed to address issues of valve tilting observed in the original design.