症状性静脈結紮の治療における再開通および再建術の技術と転帰

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

In this single-center, retrospective study, nine patients (mean age, 52.9), underwent endovenous recanalization and stent reconstruction for symptomatic venous ligation between January 2014 and January 2024. Patients presented with CEAP 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%); five 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 nine patients (100%). Ten procedures were performed, as one patient required reintervention for early thrombosis. Sharp extravascular techniques were required in six 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 one major (10.0%; SIR class D) and one minor (10.0%; SIR class A). Clinical improvement occurred in eight patients (88.9%), including complete symptom resolution in six (66.7%). No mortality occurred.

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