127 - In-Stent Restenosis of Iliac Venous Stent on Computed Tomography Venography is a Significant Predictor of Subsequent Patency Loss: Propensity Score Matching Analysis.

Monday, March 31, 2025

12:10 PM – 1:10 PM CT

Location: Music City Center, Expo Poster Area

Poster Presenter(s)

HT

Hideyuki Torikai, MD

Fellow in Radiology
University of Virginia, United States

Author/Co-author(s)

John Matson, MD (he/him/his)

Assistant Professor of Vascular & Interventional Radiology
University of Virginia, United States
AS

Aditya Sharma, MD, MBBS, RPVI

Director of Vascular Medicine, Program Director of Vascular Medicine Associate Professor of Medicine
University of Virginia Health, United States
Luke R. Wilkins, MD, FSIR

Associate Professor
University of Virginia, United States
J. Fritz F. Angle, MD

Director of Interventional Radiology
Department of Radiology and Medical Imaging, University of Virginia, United States

Purpose: Computed tomography venography (CTV) has been a useful modality to assess in-stent restenosis (ISR) of iliac venous stents; however, the clinical impact of the ISR on stent patency remains unclear. This retrospective study analyzes the association between ISR observed on CTV and subsequent loss of stent patency.

Materials and Methods: From February 2008 to November 2023, 444 limbs that received iliac venous stent placements were reviewed. Of these, 223 limbs were enrolled that underwent iliac venous stent placement for either a de novo or ISR iliac venous lesion with initial follow-up CTV (baseline) demonstrating patent iliac venous stents (with or without ISR) without any percutaneous re-intervention to maintain stent patency. These limbs were divided into ISR and non-ISR groups. From these, 57 limbs in each group were extracted through propensity score matching to minimize the effect of estimated confounding. The 1- and 2-year stent patency rates were the primary outcomes without percutaneous intervention, and percutaneous endovenous interventions to maintain patency were defined as censoring events. The stent patency was assessed by either ultrasound, CTV or magnetic resonance venography.

Results: There was no statistical difference in the timing of the CTVs between the ISR and non-ISR group (170 days and 110 days p=0.383The mean 1- and 2-year stent primary patency rates, with 95 % confidence interval, in the non-ISR and ISR groups were 0.974 (0.828-0.996) vs. 0.827 (0.666-0.915) and 0.936 (0.763-0.984) vs. 0.748 (0.561-0.865), respectively. The primary patency was significantly higher in the non-ISR group than in the ISR group (p-value = 0.008).

Conclusion: ISR of the iliac venous stent observed on a baseline post-stent CTV is a significant predictor of patency loss at 1 and 2 years. These findings may underscore the utility of CTV in aiding clinicians to tailor follow-up schedules based on the initial CTV results.