One-Year Results of Iliocaval Stenting

The aim of the study was to assess results of interventions for iliocaval obstruction or compression in patient with acute and chronic venous disease.

Patients with chronic venous insufficiency (CVI) C3-C6 (Clinical, Etiology, Anatomy, Pathology - classification of venous insufficiency) and acute deep venous thrombosis were assessed by ultrasound scan, computed tomography, venography, and/or intravascular ultrasound, and if an obstruction in their iliocaval or iliofemoral segments were confirmed, they underwent venoplasty and stenting. Acute deep venous thrombosis cases were treated with pharmacomechanical and/or catheter-directed thrombolysis and residual obstruction was then stented.

One hundred eighteen consecutive limbs were treated between October 2011 and December 2017. Thirty-two limbs had an active ulcer (27%), 27 limbs had healed ulcer or advanced skin changes (23%), 39 limbs had swelling with or without other symptoms of CVI (33%), 15 limbs had acute symptomatic deep venous thrombosis (13%), and the residual 5 iliac vein cases were causing pelvic congestion syndrome (4%). Patency rates of the stents in acute cases were 84.6%, 76.9%, 76.9%, and in chronic cases (combined thrombotic and nonthrombotic) 93.1%, 91%, and 89.9% in 3, 6, and 12 months, respectively. A relief of symptoms was achieved in 81.5 % of limbs at some stage during the first 12 months (most of them within the first 3 months), although at the end of this period only 59.3% remained free of symptoms. There was no limb loss and no mortality within 30 days from the intervention.

Iliocaval and iliofemoral venoplasty and stenting in both acute and chronic obstruction cases can be performed safely with good patency rates and reasonable improvement of symptoms of CVI.