Clinical Outcomes of Iliac Vein Stenting: A Single-Center Retrospective Study with Extended Follow-up

Iliac vein stenting is used for the treatment of symptomatic iliofemoral venous obstruction caused by nonthrombotic iliac vein lesions, postthrombotic syndrome, and acute deep vein thrombosis. However, evidence regarding mid- to long-term clinical outcomes remains sparse.

This retrospective single-center study included consecutive patients who underwent iliac vein stenting between April 2016 and June 2023. Patients were categorized into nonthrombotic iliac vein lesion, postthrombotic syndrome, and acute deep vein thrombosis groups. Primary, assisted primary, and secondary patency were evaluated using Kaplan-Meier analysis. Clinical outcomes were assessed using the Clinical-Etiological-Anatomical-Pathophysiological (CEAP) clinical class, Venous Clinical Severity Score, and Villalta score. Adverse events, reinterventions, and device-related outcomes were recorded during follow-up.

A total of 105 patients were included, with a mean follow-up of 54 months. The cohort consisted of 44 patients with nonthrombotic iliac vein lesions, 31 with postthrombotic syndrome, and 30 with acute deep vein thrombosis. Technical success was achieved in all procedures. At 5 years, primary patency was 97.4% in the nonthrombotic iliac vein lesion group, 87.0% in the postthrombotic syndrome group, and 100% in the acute deep vein thrombosis group. Assisted primary and secondary patency rates exceeded primary patency across all groups. Clinical severity scores and CEAP classes significantly improved by the final follow-up. Reintervention was required in 4 patients. No stent fracture or migration was observed.

Iliac vein stenting was associated with sustained patency and clinical score reduction during extended follow-up in patients with different etiologies of iliofemoral venous obstruction.