Short term diameter change in iliofemoral venous stents

ObjectivesThis study analyzed the maintenance of venous caliber compared to nominal package values following the deployment of venous-specific stents.MethodsThis is a retrospective review of patients undergoing iliac vein stenting with Venovo (BD, Franklin Lakes, NJ) at a single institution. Stent diameters were measured with fluoroscopy, IVUS, and 1-month post-operative duplex sonography. These measurements were compared to nominal package stent diameter.ResultsThe study consists of 35 subjects with 75 stents deployed in the common iliac, external iliac, and/or the common femoral veins. Indications for treatment included post-thrombotic syndrome (57%), non-thrombotic venous obstruction (24%), and acute deep vein thrombosis (16%). For all stents, immediate post-deployment diameter, compared to nominal package diameter, changed by 5.2% by fluoroscopy (p = .01) and 4.4% by IVUS (p < .001). After deployment and venoplasty, post-deployment diameter for 16 mm stents was 14.8 mm by fluoroscopy (7.2% change; p = .004) and 15.0 mm by IVUS (6.3% change; p < .001) and 13.4 mm by fluoroscopy (4.1% change, p = .008) and 13.7 mm by IVUS for 14 mm stents (2.2% change, p = .307). Diameter at 1 month compared to immediate post-procedure stent diameter demonstrates a 5.1 % change (p = .16) and 4.4% change (p = .06).ConclusionVenous-specific stents demonstrate a 4.4% to 5.2% diameter decrease immediately post-deployment for 16 mm stents with no significant further reduction at 1 month. Optimal stent sizing to match expected venous diameters based on patient size is important to consider during venous reconstruction to prevent diameter reduction or stent recoil.