Chronic Iliac Vein Occlusion:Midterm Results of Endovascular Recanalization
| Autor: | Michael Åkesson, Anders Gottsäter, Krassi Ivancev, Mats Lindh, Tilo Kölbel, Johan Wassélius |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry medicine.medical_treatment Stent medicine.disease Inferior vena cava Magnetic resonance angiography Vein occlusion Surgery medicine.anatomical_structure medicine.vein Angioplasty medicine Vascular Patency Radiology Nuclear Medicine and imaging Radiology Cardiology and Cardiovascular Medicine business Vein Post-thrombotic syndrome |
| Zdroj: | Journal of Endovascular Therapy. 16:483-491 |
| ISSN: | 1545-1550 1526-6028 |
| DOI: | 10.1583/09-2719.1 |
| Popis: | PURPOSE:To evaluate patency and clinical outcome in patients treated with endovascular recanalization and stent placement for chronic iliac vein occlusions. METHODS:During a 14-year period (1994-2008), 59 (38 women; median age 39 years) of 62 patients with chronic occlusion of the iliac vein segment in 66 limbs were successfully treated with endovascular recanalization and stent placement. A prospectively maintained database was analyzed retrospectively to obtain information on clinical details, endovascular techniques, and outcome. RESULTS:Three (5%) procedures failed for technical reasons. Three (5%) complications occurred, 2 (3%) of which were perforations requiring transfusion and procedure termination. Initial clinical success after 6 months was achieved in 49 (83%) of the 59 patients successfully treated initially. Primary patency after a median imaging follow-up of 25 months was 67% (44/66), assisted primary patency was 75% (49/66), and secondary patency was 79% (52/66). Fifteen (23%) of 66 limbs were asymptomatic after a median clinical follow-up of 32 months, 34 (52%) limbs were improved, 13 (20%) were unchanged, and 4 (6%) were worse compared to before intervention. Actuarial primary, assisted primary, and secondary patency rates using Kaplan-Meier survival analysis were 70%, 73%, and 80%, respectively, at 5 years. CONCLUSION:Endovascular recanalization and stent placement is a safe and effective treatment for occluded iliac veins and adjacent segments. Clinical midterm results are encouraging. Recanalized and stented segments remain patent in the majority of patients after 2 years. Endovascular treatment can ease symptoms and prevent further deterioration of patients with post-thrombotic syndrome. |
| Databáze: | OpenAIRE |
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