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Effectiveness of Venous Stenting for the Treatment of Lower Extremity Chronic Thrombotic Venous Obstruction

Waleed E Elshinawy1, Ehab M Abdo1, Nehal Farouk1

  • 1Vascular Surgery Department, Al-Azhar University, Faculty of Medicine (for Girls), Cairo, Egypt.

Annals of Vascular Surgery
|December 29, 2022
PubMed

Insights

Endovascular venous stenting effectively treats chronic iliofemoral vein occlusions, offering high success and patency rates with minimal complications. This safe procedure is a primary option for venous hypertension management.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • Venous hypertension (HTN) significantly impacts patient morbidity and quality of life.
  • Deep venous thrombosis (DVT) and congenital defects are common causes of chronic venous HTN.
  • Venovenous bypass was the standard treatment for iliofemoral vein occlusions, but endovascular approaches are emerging.

Purpose of the Study:

  • To evaluate the effectiveness and safety of an aggressive endovascular strategy using venoplasty and stenting for chronic iliofemoral venous thrombotic occlusions.
  • To assess the technical success, patency rates, and complication rates of this endovascular approach.

Main Methods:

  • Retrospective review of medical records for 63 patients with symptomatic iliofemoral thrombotic occlusive disease treated with venous stenting from May 2019 to April 2021.
  • Analysis of procedural outcomes, including technical success, patency rates (primary, assisted primary, secondary), and complications.
  • Procedures were performed at Al-Azhar University Hospitals.

Main Results:

  • Optimal technical success was achieved in 88.9% of cases (56 out of 63 patients).
  • Twelve-month primary patency was 76.8%, with 2-year rates at 73.2%. Assisted primary and secondary patency rates remained high at 2 years (80.4% and 87.5%, respectively).
  • The procedure-related complication rate was 6.3%, including minor hematomas and early stent thrombosis in 3.2% of patients. No procedure-related mortality occurred.

Conclusions:

  • Endovascular treatment with balloon angioplasty and stenting is a safe and effective method for chronic venous thrombotic occlusions.
  • The procedure demonstrates high technical success and excellent long-term patency rates.
  • This endovascular approach should be considered a first-line treatment for symptomatic iliofemoral vein occlusion.
Abstract

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