Treating Chronic Iliac Vein Stent Occlusion in an Office-Based Lab Setting.

Area of Science:

• Vascular Surgery
• Interventional Radiology

Background:

• Iliac vein stenting is a common treatment for venous insufficiency when angioplasty or lysis is insufficient.
• Stent occlusion is a known complication, with limited options for failed prior stents.
• Chronic iliac vein thrombosis presents a significant challenge, often requiring complex surgical reconstruction.

Observation:

• A patient with a 25-year-old thrombosed iliac vein stent and post-thrombotic syndrome was treated.
• Femoral vein access was obtained in an office-based lab setting.
• A second stent was deployed in parallel to the occluded stent.

Findings:

• Successful deployment of the adjacent stent was confirmed by imaging.
• Restored venous flow was achieved.
• The patient experienced significant pain reduction and cessation of narcotic use.

Implications:

• Parallel stenting offers a viable alternative for treating chronically occluded iliac vein stents.
• This minimally invasive approach can improve patient outcomes and quality of life.
• Further research into parallel stenting for complex venous occlusions is warranted.