ORIGINAL ARTICLE   

Acta Phlebologica 2024 April;25(1):35-46

DOI: 10.23736/S1593-232X.23.00581-7

Copyright © 2023 EDIZIONI MINERVA MEDICA

language: English

Evaluation of iliocaval venous stenting in management of patients with chronic venous obstructions

Eslam M. BARSIM ¹ ✉, Ahmed H. EL BARBARY ², Gerard J. O’SULLIVAN ³, Said I. EL MALLAH ¹, Hasan ABDELATY HASAN ², Adel H. KAMHAWY ²

¹ Vascular Surgery Unit, General Surgery Department, Menofia University, Menofia, Egypt; ² Vascular and Endovascular Surgery Department, Tanta University, Tanta, Egypt; ³ Intervention Radiology Department, University College Hospital, Galway, Ireland

BACKGROUND: Recanalization and stenting of deep venous blockages is a minimally invasive approach that has been established to be secure, efficient, low-risk, and yields considerable therapeutic benefit. For these reasons, it has essentially supplanted open surgery over the last two to three decades. Long-term stent patency rates vary substantially between different clinical reports. There are a number of potential explanations for this variation including differences in stent technology, which has changed rapidly in recent years, and comparison of different stents in different clinical situations is somewhat limited.
METHODS: This is a prospective multicenter study done on 30 patients (20 female, age 50.0±12.0 years), 19 malignant patients (63.3%) with venous stents represented at Tanta, Menofia and Galway university hospitals during the period from (May 2020) to (April 2023). Venous stents were evaluated according its patency within 6 months follow-up period. Patients were assessed according improvement in CEAP and VCSS scores.
RESULTS: At one month, three months, and six months follow-up periods, the entire primary patency rate was 96.6%, 89.6%, and 82.4% consecutively. The assisted primary patency was 100% at 1 month, 96.5% at 3 months, and 96.5% at 6 months. Immediately post-stenting, VCSS mean was improved to 8.7±1.7. The mean VCSS score significantly improved immediately after the procedure when compared with the pre-stenting value (P=0.013).
CONCLUSIONS: Improvement in patency and clinical outcome in deep venous reconstruction with introduction of IVUS and dedicated venous stents.

KEY WORDS: Stents; Venous thromboembolism; Blood vessel prosthesis