Double-barrel iliocaval reconstruction using closed-cell dedicated venous stents.

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Venous Thromboembolism

Background:

• Iliocaval deep venous thrombosis and iliac vein compression syndrome significantly impact lower extremity health.
• Current treatment options for extensive venous disease require effective reconstructive techniques.

Purpose of the Study:

• To evaluate the outcomes of double-barrel iliocaval reconstruction using closed-cell dedicated venous stents.
• To assess the efficacy and safety of this technique for treating iliocaval venous disease.

Main Methods:

• Retrospective search of endovascular procedural reports from May 2019 to April 2021.
• Identified 22 consecutive patients undergoing double-barrel iliocaval stenting for chronic or acute-on-chronic venous disease.
• Manual review of clinical and procedural data, with a mean follow-up of 7.1 months.

Main Results:

• The cohort (59.1% female, median age 59) primarily presented with lower extremity swelling (90.9%) and post-thrombotic syndrome (72.7%).
• Freedom from reintervention was 90.9%, with 20 of 22 patients experiencing symptom improvement or resolution.
• Major adverse event rate was 9.1%, primarily access site complications.

Conclusions:

• Double-barrel iliocaval reconstruction with closed-cell venous stents is technically feasible.
• This approach is clinically effective for post-thrombotic syndrome and iliac vein compression syndrome.
• The technique demonstrates a low reintervention rate and favorable patient outcomes.