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SIR 2025

Venous Interventions

Traditional Poster

Session: Traditional Poster Presentations

128 - Post-Deployment Diameter Change After Endovascular Inferior Vena Cava Reconstruction Using Venous Stents

Monday, March 31, 2025
12:10 PM – 1:10 PM CT
Location: Music City Center, Expo Poster Area
Purpose: Inferior vena cava (IVC) obstruction can be caused by filter-associated iliocaval thrombosis, non-thrombotic obstruction or deep venous thrombosis. Greater utilization of venous stents has altered the course of IVC reconstruction. Stent recoil and finalized IVC diameter pose a challenge for clinicians. This study aims to compare nominal vs post-stent deployment diameter in endovascular IVC reconstruction with venous stents. 

Materials and Methods: This is a retrospective review of patients undergoing IVC vein stenting with Abre (Medtronic, Minneapolis, MN) and Venovo (BD, Franklin Lakes, NJ) stents from 2020 to 2024 at a single institution. Intraoperative stent diameters were measured with intravascular ultrasound (IVUS) in their peripheral and central aspects. These measurements were compared to nominal package stent diameter using paired T-test and multiple linear regression was performed using an ordinary least squares method. 

Results: The study consists of 13 subjects and 23 stents (mean age 49.6 ± 21.0; 30.8% female). Overall, immediate-deployment diameters decreased by 7.0% (p=0.07) on average compared to nominal package diameters. 14 mm inferior vena cava (IVC) stents expanded to 14.5 mm (n=9, 3.3% change; p</span>=0.125) whereas 20 mm stents recoiled to 17.1 mm (n=13, 14.6%; p</span>=0.04) respectively. No significant differences were found in p</span>ost-deployment diameter recoil due to underlying pathology (non-thrombosis: 10.1%, p=0.272; acute thrombosis: 4.8%, p=0.380). No significant differences were found between Abre and Venovo stents in terms of diameter recoil (4.3% vs 8.1% change; p=0.63). Patency for IVC stents was 100% at first follow-up (mean 25.7 days). 

Conclusion: 20 mm stents in the IVC had a significant rate of recoil post deployment, while 14 mm stents trended towards mild expansion post deployment. Stent brand or underlying pathology had no significant impact on stent recoil rates in the IVC. Utilization of IVUS allowed for optimization of anatomy and reconstruction choices. When considering venous stent size in IVC reconstruction, clinicians should be aware of possible stent diamater change to ensure effective treatment.