Placement of closed-cell designed venous stents in a mixed cohort of patients with chronic venous outflow obstructions - short-term safety, patency, and clinical outcomes
| Autor: | Rick G, Michael Lichtenberg, Wilhelm F Stahlhoff, Frank Breuckmann, Neglén P |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment 030204 cardiovascular system & hematology Iliac Vein Airflow obstruction Prosthesis Design 030218 nuclear medicine & medical imaging Postthrombotic Syndrome Varicose Veins 03 medical and health sciences Young Adult 0302 clinical medicine medicine May-Thurner Syndrome Humans Ultrasonography Interventional Vascular Patency Aged Retrospective Studies Aged 80 and over Venous Thrombosis Ultrasonography Doppler Duplex business.industry Endovascular Procedures Stent Phlebography Femoral Vein Middle Aged May–Thurner syndrome medicine.disease Venous stent Surgery Treatment Outcome Cohort Chronic Disease Closed cell Outflow Female Stents Cardiology and Cardiovascular Medicine business Post-thrombotic syndrome |
| Zdroj: | VASA. Zeitschrift fur Gefasskrankheiten. 47(6) |
| ISSN: | 0301-1526 |
| Popis: | Abstract. Background: To evaluate the performance of a closed-cell designed venous stent for the treatment of chronic ilio-femoral venous outflow obstruction (VOO) in the shortterm. Patients and methods: Safety, stent patency and clinical outcome after placement of the Vici Venous Stent® in patients with chronic ilio-femoral venous obstruction were assessed retrospectively. Stent patency was evaluated by duplex ultrasound scanning, and clinical outcome was determined using the revised Venous Clinical Severity score (rVCSS). Results: 75 patients (49 % female; median age 57 years; 82 limbs) with symptomatic significant VOO had stents placed in the ilio-femoral veins. Lower limb venous skin changes including ulcers (C-class in CEAP 4–6) were found in 31 patients (41 %). Nonthrombotic iliac vein lesions (NIVLs) and post-thrombotic obstruction (PTO) were found in 40 and 42 limbs, respectively. There were no safety issues. Cumulative primary, assisted-primary, and secondary stent patency in the entire cohort at 12 months were 94 %, 94 % and 96 %, respectively. Five limbs presented with stent occlusion. Two limbs had no intervention, 2/3 remained patent after reintervention. Clinical improvement (a decrease ≥ 2 rVCSS points) was observed in 81 %, 81 %, and 77 % of patients at 1 month, 6 months, and 12 months, respectively. There was a marked drop in the frequency of more marked pain and swelling (VCSS ≥ 2) from 62 % to 5 % and 93 % to 19 %, respectively. Four limbs had venous ulcers, three healed during the follow-up. Cumulative pri- mary stent patency at 12 months was 100 % and 87 % in patients with NIVL and PTO, respectively (p= 0.032). There was no statistical difference in clinical outcome between these subgroups. Conclusions: The Vici Venous Stent® placed in the ilio-femoral vein segment in patients with symptomatic VOO revealed no safety issues, had excellent primary patency and substantial symptom improvement. Long-term studies are needed to evaluate the durability of this stenting procedure. |
| Databáze: | OpenAIRE |
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