Evaluation of anticoagulant and antiplatelet therapy after iliocaval stenting: Factors associated with stent occlusion

Autor: Robert R. Attaran, I-Hsin Lin, Carlos Mena-Hurtado, Denizhan Ozdemir, Alexandra J. Lansky
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
Time Factors
medicine.drug_class
medicine.medical_treatment
Deep vein
Vena Cava
Inferior
Iliac Vein
030204 cardiovascular system & hematology
Prosthesis Design
Postthrombotic Syndrome
03 medical and health sciences
0302 clinical medicine
Recurrence
Interquartile range
May-Thurner Syndrome
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Vascular Patency
Aged
Retrospective Studies
Venous Thrombosis
business.industry
Endovascular Procedures
Anticoagulant
Anticoagulants
Stent
Middle Aged
equipment and supplies
medicine.disease
May–Thurner syndrome
Thrombosis
Surgery
Venous thrombosis
Treatment Outcome
medicine.anatomical_structure
Female
Stents
Cardiology and Cardiovascular Medicine
business
Platelet Aggregation Inhibitors
Post-thrombotic syndrome
Zdroj: Journal of Vascular Surgery: Venous and Lymphatic Disorders. 7:527-534
ISSN: 2213-333X
DOI: 10.1016/j.jvsv.2019.01.058
Popis: Objective Iliocaval stenting has gained increased use over recent years for a variety of indications, including May-Thurner syndrome (MTS), post-thrombotic syndrome (PTS), and acute deep vein thrombosis (DVT). Methods A retrospective review of 155 patients undergoing iliocaval venous stenting at a large teaching hospital was performed. Clinical and procedural data, mode and duration of anticoagulation or antiplatelet therapy, and outcomes were recorded. Results Forty-five patients were treated for MTS, 49 for PTS. and 61 for acute DVT. The median follow-up was 19 months (interquartile range, 9-30 months). Primary patency rates were 97.8% in the MTS group, 85.7% in PTS, and 85.2% for the acute DVT group. Stent restenosis or occlusion occurred in one patient with MTS (2.2%), seven patients with PTS (14%), and nine patients with acute DVT (15%). An ipsilateral DVT recurred in 7 patients with PTS (14%) and 15 patients with acute DVT (25%). The stents that occluded had a tendency toward longer length (162.2 vs 125.2 mm; P = NS) and extension into the common femoral vein (18.8 vs 5.3%; P = NS). The patent stent group had statistically larger nominal diameter stents (P = .013). The duration of anticoagulation did not seem to be a significant factor in stent patency. Conclusions Stent diameter has a significant influence on iliocaval stent patency rates.
Databáze: OpenAIRE
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