Which criteria demand additive stenting during catheter-directed thrombolysis?

Bækgaard, N; Just, Sven; Foegh, Pia

doi:10.1177/0268355514528842

Cited by 11 publications

(6 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is no consensus on the indications for stenting, but the current guideline recommends stenting for short-segment iliocaval stenosis. 19,20 Stent placement was reported to improve patency rates in the National Multicenter Registry including 303 limbs treated with CDT. 21 In a recent studies by Engelberger et al., 22,23 stent placement was performed in 80% of patients, and the incidence of PTS after 12 months was less than 12%.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the development of post-thrombotic syndrome in patients with iliofemoral deep venous thrombosis who underwent catheter-directed thrombolysis

et al. 2020

View full text Add to dashboard Cite

Objective To identify predictors of post-thrombotic syndrome in patients with iliofemoral deep venous thrombosis who underwent catheter-directed thrombolysis. Methods Fifty-two consecutive patients who underwent catheter-directed thrombolysis were included in this retrospective study. In addition to catheter-directed thrombolysis, aspiration thrombectomy or stent placement was performed if needed. At six months, duplex ultrasound was performed to assess iliofemoral patency and deep venous reflux. Post-thrombotic syndrome was assessed using the clinical, etiologic, anatomic, and pathophysiologic classification (post-thrombotic syndrome present ≥3 on a scale from 0 to 6). Univariate analysis and multivariate logistic regression were used to identify predictors of post-thrombotic syndrome. Results Median follow-up was 52 months and post-thrombotic syndrome developed in nine patients (17.3%). In univariate analysis, stent placement (odds ratio 0.16, p = 0.022) was negatively associated with post-thrombotic syndrome, whereas iliofemoral venous obstruction with reflux at six months (OR 6.08, p = 0.037) was positively associated with post-thrombotic syndrome. Multivariate analysis indicated that stent placement was associated with reduced risk of post-thrombotic syndrome (OR 0.17, p = 0.043), and iliofemoral obstruction with reflux was associated with increased risk (OR 6.67, p = 0.046). Conclusion Stent placement and iliofemoral venous obstruction with reflux, respectively, were important protective and risk factors for post-thrombotic syndrome in patients who underwent catheter-directed thrombolysis.

show abstract

Section: Discussionmentioning

confidence: 99%

Factors associated with the development of post-thrombotic syndrome in patients with iliofemoral deep venous thrombosis who underwent catheter-directed thrombolysis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…18 In addition, veins tolerate extensive dilatation without clinical rupture, and the diseased wall remains elastic despite extrinsic compression. 19 Large stent diameters are required (up to 25 mm or greater in the IVC) with increased crush resistance throughout the stent length to address the significant recoil and fibrous nature of thrombotic veins. High stent flexibility is also required, so that the stents within the venous segment can adapt to the anatomic course of the veins during movement: for example, in the region of the confluence of the internal and external iliac veins, angulation up to 90 � occurs during sitting.…”

Section: 'Ideal' Venous Stent Designmentioning

confidence: 99%

Clinical outcomes and overview of dedicated venous stents for management of chronic iliocaval and femoral deep venous disease

et al. 2021

View full text Add to dashboard Cite

Objectives Venous stenting of the lower extremities has grown in popularity and is now considered a key component of the primary treatment strategy for the management of pathologically obstructive or stenotic lesions of the deep venous system. This review aims to provide an overview of the role of venous stenting in the management of chronic conditions affecting the deep venous system of the lower limbs. Methods An overview of venous stents design and current role of stenting procedure in individuals presenting with Chronic Venous Insufficiency (CVI) and presenting the current trials of dedicated venous stenting in management of chronic deep venous lesions. This review provides a focused insight on venous stent design, physical properties and the available dedicated venous stents selected studies with their related patency outcome based on selective literature search of the PubMed database and Cochrane library. Conclusions Dedicated venous stent technology is advancing at a rapid pace alongside the increased undertaking of endovascular deep venous stent reconstruction in the management of iliocaval vein pathologies. The ideal design(s) for venous stents remain unknown, although it is hoped that the presence of new dedicated venous stents in clinical practice will allow the generation of experience and data to advance our understanding in this area.

show abstract

“…Residual venous stenoses that develop after standard or pharmacomechanical CDT for proximal DVT are common, but the indications for adjunctive venous stent placement performed in conjunction with either CDT procedure are poorly defined (39), and the rates of stent placement vary widely between studies. Current guidelines suggest that short-segment stenoses in iliocaval vessels are appropriate targets for stent placement (34,40), whereas femoropopliteal stenoses should be addressed with angioplasty alone.…”

Section: Stent Placementmentioning

confidence: 99%

Role of Catheter-directed Thrombolysis in Management of Iliofemoral Deep Venous Thrombosis

Chen¹,

Sudheendra²,

Stavropoulos³

et al. 2016

RadioGraphics

View full text Add to dashboard Cite

The treatment for iliofemoral deep venous thrombosis (DVT) is challenging, as the use of anticoagulation alone can be insufficient for restoring venous patency and thus lead to prolongation of acute symptoms and an increased risk of chronic complications, including venous insufficiency and postthrombotic syndrome (PTS). In these cases, earlier and more complete thrombus removal can ameliorate acute symptoms and reduce long-term sequelae. Endovascular therapies involving the use of pharmacologic, mechanical, and combined pharmacomechanical modalities have been developed to achieve these goals. The most frequently used of these techniques, catheter-directed thrombolysis (CDT), involves the infusion of a thrombolytic agent through a multiple-side-hole catheter placed within the thrombosed vein to achieve high local doses and thereby break down the clot while minimizing systemic thrombolytic agent exposure. Randomized controlled trial results have indicated decreased PTS rates and improved venous patency rates in patients treated with CDT compared with these rates in patients treated with anticoagulation. The use of newer pharmacomechanical techniques, as compared with conventional CDT, reduces procedural times and thrombolytic agent doses and is the subject of ongoing investigations. Endovascular thrombus removal techniques offer a means to improve venous valvular function and decrease the risk of debilitating long-term complications such as PTS and are a promising option for treating patients with iliofemoral DVT. (©)RSNA, 2016.

show abstract

Which criteria demand additive stenting during catheter-directed thrombolysis?

Cited by 11 publications

References 21 publications

Factors associated with the development of post-thrombotic syndrome in patients with iliofemoral deep venous thrombosis who underwent catheter-directed thrombolysis

Factors associated with the development of post-thrombotic syndrome in patients with iliofemoral deep venous thrombosis who underwent catheter-directed thrombolysis

Clinical outcomes and overview of dedicated venous stents for management of chronic iliocaval and femoral deep venous disease

Role of Catheter-directed Thrombolysis in Management of Iliofemoral Deep Venous Thrombosis

Contact Info

Product

Resources

About