SIR 2024
Venous Interventions
Priyanka Mitta, BS
Medical Student
UAB Heersink School of Medicine
Disclosure information not submitted.
Jake DiFatta, BS
Medical Student
UAB Heersink School of Medicine
Disclosure information not submitted.
Chase K. Mahler, BS
Medical Student
UAB Heersink School of Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Andrew Gunn, MD
Program Director IR/DR
University of Alabama At Birmingham
Financial relationships: Full list of relationships is listed on the CME information page.
Junjian Huang, MD
Assistant Professor
UAB Heersink School of Medicine
Disclosure information not submitted.
Hope Wilson, MD
Assistant Professor, Pediatric Hematology/Oncology
Children's of Alabama
Disclosure information not submitted.
Junaid Raja, MD, MSPH, M.S.
Assistant Professor
University of Alabama Birmingham
Financial relationships: Full list of relationships is listed on the CME information page.
To analyze the utilization and outcomes of venous stenting in pediatric patients with deep venous disease.
Materials and Methods:
A retrospective review was conducted involving all patients up to the age of 18 diagnosed with deep venous disease who underwent venous stenting at UAB from 2013 to 2023. Baseline characteristics and imaging, classification of venous thromboembolism (VTE) or venous insufficiency, symptoms, prior therapy, and clinical outcomes were extracted from the electronic medical record. Summary and multivariate statistics were completed to analyze outcomes following intervention.
Results: Twelve pediatric patients underwent venous stenting in the study period. The most common prothrombotic risk factors were May-Thurner syndrome (75%, 8/12) and obesity (17%, 2/12). Fifty percent of patients that underwent stenting had a chronic component influencing development of VTE, while 75% were symptomatic with lower extremity pain and/or swelling prior to stent placement. Stenting was utilized secondarily to other VTE interventions in 50% (6/12) of patients and 33% (4/12) of patients underwent further VTE intervention in the future following stent placement. Such future interventions were to resolve problems including outflow obstruction, stenosis, and residual thrombosis. While a handful of patients received stents in multiple locations, 92% (11/12) received a stent in the iliac vein. All (100%, 12/12) patients were placed on anticoagulation after stent placement, with enoxaparin being the most utilized (92%, 11/12). Upon clinical follow-up, 42% of patients were asymptomatic and/or confirmed to be negative for VTE through imaging. There were no reported major post-procedural complications or major bleeding events reported.
Conclusion:
Stenting may be performed safely and effectively in pediatric patients with chronic, symptomatic VTE and flow-limiting iliac vein compression syndrome, resulting in improved vessel patency and symptom relief.