SIR 2024
Venous Interventions
Lawrence Lin, MD
Resident Physician
Medical College of Wisconsin
Financial relationships: Full list of relationships is listed on the CME information page.
Philip T. Skummer, MD, MPH
Resident Physician
Medical College of Wisconsin
Financial relationships: Full list of relationships is listed on the CME information page.
Amanda R. Smolock, MD, PhD
Assistant Professor
Medical College of Wisconsin
Disclosure information not submitted.
Robert A. Hieb, MD, FSIR
Physician
Medical College of Wisconsin
Disclosure information not submitted.
Eric J. Hohenwalter, MD, FSIR
Professor, Chief of Vascular and Interventional Radiology
Medical College of Wisconsin
Disclosure information not submitted.
Brandon M. Key, MD
Assistant Professor - Vascular and Interventional Radiology
Medical College of Wisconsin
Financial relationships: Full list of relationships is listed on the CME information page.
William S. Rilling, MD, FSIR
Professor of Radiology & Surgery; Vice Chair, Clinical Operations, Image-Guided Interventions
Medical College of Wisconsin
Financial relationships: Full list of relationships is listed on the CME information page.
Matthew J. Scheidt, MD, FSIR
Associate Professor of Radiology
Medical College of Wisconsin
Financial relationships: Full list of relationships is listed on the CME information page.
Sarah B. White, MD, MS, FSIR
Professor
Medical College of Wisconsin
Disclosure information not submitted.
Parag J. Patel, MD, MS, FSIR
Professor of Radiology & Surgery, Program Director, IR Residency
Medical College of Wisconsin
Financial relationships: Full list of relationships is listed on the CME information page.
The purpose of this study was to review outcomes in treatment of iliocaval/iliofemoral venous disease using stents with and without a specific venous indication and identify factors that may impact patency.
Materials and Methods:
An IRB-approved retrospective review of patients with iliocaval/iliofemoral venous stent placement for both acute and chronic thrombosis between 2011 and 2022 was performed. Cases of stents placed only in the IVC or in the upper extremity/chest were excluded. Demographics, laboratory values, imaging findings, procedural details, prescription medication, stent patency, clinical symptoms, and re-intervention data were obtained. Baseline descriptive statistics were performed. Primary patency was evaluated using regression analyses.
Results:
74 patients (21 M) with median age 45 years (range: 18-82 years) underwent iliocaval/iliofemoral venous reconstruction with stenting. 66/74 (89.1%) patients were treated for chronic post-thrombotic disease. Comorbid etiologies included May-Thurner Syndrome (42/74, 56.8%), hormone use (18/74, 24.3%), and pro-thrombotic conditions (18/74, 24.3%). The median length of follow-up was 502 days (range: 4-4051 days). Stents with a specific venous indication were used in 18/74 (24.3%). Median primary patency for stents with a specific venous indication was 162.5 days (2-617 days). Median primary patency for stents without a specific venous indication was 341 days (range 1-4051 days). Rate of failure was not significantly different between stents with and without specific venous indication (6/18 (33.3%) vs. 13/56 (23.2%), p=0.39). Female patients were at a significantly higher risk of venous stent thrombosis (HR: 6.05, 95% CI: 1.35-27.10, p=0.02). Anticoagulation was associated with significantly less stent thrombosis while controlling for antiplatelet medication use (HR: 0.24, 95% CI 0.07-0.82, p=0.02).
Conclusion:
Anticoagulation regimen and female gender appear to be significantly associated with stent patency. Stent patency between FDA-approved venous stents and stents without a specific venous indication does not appear significantly different, although long term follow-up is needed.