Techniques and Outcomes of Recanalization and Reconstruction for Treatment of Symptomatic Venous Ligation

To report techniques, adverse events, and outcomes of endovascular recanalization and stent reconstruction for symptomatic venous ligation.

In this single-center retrospective study, 9 patients (mean age, 52.9), underwent endovenous recanalization and stent reconstruction for symptomatic venous ligation between January 2014 and January 2024. Patients presented with clinical-etiology-anatomy-pathophysiology 3 (55.6%), 4 (11.1%), and 5 (33.3%) disease. Ligation sites commonly involved the external iliac (66.7%) or femoral veins (44.4%); 5 patients had multisegment ligation. Etiologies included surgical injury (44.4%), trauma (22.2%), chronic venous thrombosis (22.2%), and malignant resection (11.1%). Procedural techniques, recanalization methods, stent selection, adverse events, patency, and clinical outcomes were recorded.

Primary single-session recanalization was achieved in 9 patients (100%). Ten procedures were performed, as 1 patient required reintervention for early thrombosis. Sharp extravascular techniques were required in 6 procedures (60%). Twenty-six stents were deployed (Wallstents, cTAG devices, SMART stents), with a mean of 2.9 ± 2.5 stents per patient and mean stent diameter of 15.5 ± 3.2 mm. One patient (11.1%) developed early stent occlusion and was unable to be recanalized. All other reconstructions remained patent (primary/secondary patency 88.9%). Mean imaging follow-up was 466.4 ± 500.3 days, and mean clinical follow-up was 1,086.2 ± 717.5 days. Adverse events included 1 major (10.0%; Society of Interventional Radiology (SIR) class D) and 1 minor (10.0%; SIR class A). Clinical improvement occurred in 8 patients (88.9%), including complete symptom resolution in 6 (66.7%). No mortality occurred.

Endovenous recanalization and reconstruction is a safe and effective treatment for symptomatic venous ligation.