Lower Extremity Venous Stent Placement: A Large Retrospective Single-Center Analysis

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Cardiology

Background:

• Venous occlusive disease significantly impacts patient quality of life.
• Stent placement is a common intervention for managing venous obstructions.
• Long-term outcomes and risk factors for venous stent patency require further investigation.

Purpose of the Study:

• To evaluate the short-term and long-term outcomes of lower extremity venous stents.
• To characterize changes in vein diameter following stent placement.
• To identify risk factors associated with venous stent patency loss.

Main Methods:

• Retrospective analysis of 1,094 lower extremity venous stents in 406 patients (1996-2018).
• Kaplan-Meier and summary statistics used to assess primary, primary assisted, and secondary patency rates at 1, 3, and 5 years.
• Cox regression analysis identified risk factors for patency loss; vein diameters and Villalta scores were compared pre- and post-procedure.

Main Results:

• Five-year patency rates were 57.3% (primary), 77.2% (primary assisted), and 80.9% (secondary) by Kaplan-Meier.
• Patients with inferior vena cava stent placement or acute thrombosis had higher risks of primary patency loss.
• Significant improvements in vein diameter and reductions in Villalta scores (from 15.7 to 7.4) were observed in patients with chronic deep vein thrombosis.

Conclusions:

• Cavo-ilio-femoral stent placement effectively treats venous occlusive disease.
• The procedure leads to improved vein disease severity scores and increased vein diameters.
• Satisfactory long-term patency rates were achieved, with low perioperative complication rates (<1% mortality, 3.7% major complications).