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Predictive Factors of Stent Patency in Iliofemoral Venous Diseases in a Multicentre Cohort Study

Olivier Espitia1, Frédéric Douane2, Jeanne Hersant3

  • 1Nantes Université, CHU Nantes, Department of Internal and Vascular Medicine, Nantes, France.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|January 15, 2023
PubMed

Insights

Patients with non-thrombotic iliac vein lesions (NIVL) show superior primary stent patency after venous stenting compared to those with acute deep vein thrombosis (aDVT) or post-thrombotic syndrome (PTS). Long-term anticoagulation prior to stenting was linked to worse outcomes in the aDVT group.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Thrombosis Research

Background:

  • Lower limb (LL) deep vein thrombosis can necessitate venous stenting.
  • Predictive factors for stent patency in different patient groups remain crucial for optimizing outcomes.

Purpose of the Study:

  • To assess primary stent patency predictive factors in patients undergoing LL venous stenting.
  • To compare outcomes among patients with non-thrombotic iliac vein lesions (NIVL), acute deep vein thrombosis (aDVT), and post-thrombotic syndrome (PTS).

Main Methods:

  • Retrospective analysis of 377 patients from seven hospitals (2014-2020) with LL venous stenting.
  • Inclusion criteria: history of LL vein thrombosis, iliac or common femoral venous stent, and ≥6-month follow-up with imaging.
  • Comparison of anticoagulant and antiplatelet therapy strategies and outcomes across NIVL, aDVT, and PTS groups.

Main Results:

  • Primary patency was significantly higher in NIVL (99.3%) versus PTS (68.6%, p < .001) and aDVT (83.6%, p = .002).
  • PTS patients required more stents, with more placed below the inguinal ligament (p < .001).
  • Long-term anticoagulation before stenting was the sole predictor of worse primary patency in the aDVT group.

Conclusions:

  • Non-thrombotic iliac vein lesions are associated with better primary patency after venous stenting compared to venous thrombotic disorders.
  • Pre-stenting long-term anticoagulation is identified as a negative predictor for primary patency in acute deep vein thrombosis patients.
Abstract

Keywords:
AnticoagulationDeep vein thrombosisMay-Thurner syndromeNon-thrombotic iliac vein lesionPost-thrombotic syndromeVenous stent

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