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Stenosis of the Inferior Vena Cava: A Murine Model of Deep Vein Thrombosis
Published on: December 22, 2017
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Factors Associated with Contralateral Deep Venous Thrombosis after Iliocaval Venous Stenting
S A Khairy1, R J Neves2, O Hartung3
1Department of Vascular and Endovascular Surgery, Assiut University Hospital, Assiut University, Assiut, Egypt.
Summary
Left common iliac vein stenting for venous obstruction has a 4% risk of contralateral deep venous thrombosis (DVT). Key risk factors include acute DVT, pre-existing internal iliac vein thrombosis, IVC filters, and poor anticoagulation compliance.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Venous Thromboembolism
Background:
- Left common iliac vein (CIV) stenting is a primary treatment for left-sided iliac venous obstructions.
- Stent placement can obstruct contralateral CIV outflow, potentially increasing thrombosis risk.
- Understanding contralateral thrombosis rates and risk factors is crucial for patient management.
Purpose of the Study:
- To determine the incidence of contralateral lower limb deep venous thrombosis (DVT) after left CIV stent placement.
- To identify factors associated with the development of contralateral DVT.
- To evaluate the outcomes of salvage revascularization for contralateral DVT.
Main Methods:
- Retrospective analysis of 376 patients with symptomatic left iliocaval venous obstruction.
- Pre- and post-operative imaging using duplex ultrasound scanning (DUS) or computed tomographic venography (CTV).
- Data collected from electronic medical records and Picture Archiving and Communication System (PACS).
Main Results:
- A cumulative incidence of 4% for contralateral DVT was observed post-stenting.
- Statistically significant risk factors for contralateral DVT included acute DVT, non-compliance with anticoagulation, pre-operative contralateral internal iliac vein (IIV) thrombosis, and IVC filter placement.
- All symptomatic contralateral iliac DVT cases were treated with acute clot removal, achieving 100% primary patency at 3 years.
Conclusions:
- Left CIV stent placement is associated with a low but significant rate of contralateral iliac vein thrombosis.
- Acute DVT, pre-operative contralateral IIV thrombosis, IVC filters, and anticoagulation non-compliance are identified as significant risk factors.
- Salvage revascularization for symptomatic contralateral DVT demonstrates excellent long-term patency.
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