Stenting for chronic obstructive venous disease: A current comprehensive meta-analysis and systematic review

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Cardiovascular Medicine

Background:

• Chronic obstructive venous disease (COVD) encompasses postthrombotic syndrome (PTS) and nonthrombotic iliac vein lesions (NIVL).
• Venous stenting is an emerging endovascular treatment for COVD, but its efficacy and safety require comprehensive evaluation.

Purpose of the Study:

• To summarize the efficacy and safety of venous stents in treating COVD.
• To analyze outcomes in patients with PTS and NIVL undergoing venous stenting.

Main Methods:

• Systematic review of prospective and retrospective case series from PubMed (2000-2014).
• Analysis of perioperative complications, antithrombotic treatment, clinical outcomes, and long-term patency.
• Inclusion of 1987 patients from 14 studies.

Main Results:

• Low 30-day thrombotic event rate (2.0%), with higher incidence in PTS (4.0%) versus NIVL (0.8%).
• Access site complications (1.7%), stent migration (1.3%), and bleeding/extravasation (1.8%) were infrequent.
• High ulcer healing rate (72.1%) and low recurrence (8.7%); significant pain and edema relief.
• Excellent primary (91.4%), assisted primary (95.0%), and secondary (97.8%) patency at 12 months, sustained at 36 months (77.1%, 92.3%, 94.3%).

Conclusions:

• Venous stenting is a safe and effective option for COVD, including PTS and NIVL.
• The procedure is associated with low perioperative complications and favorable long-term patency.
• Outcomes may be superior in NIVL patients compared to those with PTS.