Iliac vein stenting as a durable option for residual stenosis after catheter-directed thrombolysis and angioplasty of iliofemoral deep vein thrombosis secondary to May–Thurner syndrome

Park, Jae Young; Ahn, Ji Hyun; Jeon, Yong Sun; Cho, Soon Gu; Kim, Jang Yong; Hong, Kwang Pyo

doi:10.1177/0268355513491724

Cited by 62 publications

(68 citation statements)

References 16 publications

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“…In the present study, patients with partial clot lysis and residual venous obstruction were further treated with PTA and/or proximal lower limb venous stenting. There are only few previous studies where venous stenting was done following CDT in acute proximal lower limb DVT and most of them showed acute patency rate of 90-100 % and medium or long-term patency rate also 80-100 % [5,[12][13][14][15][16]. We also had similar patency rate in our studies with early patency rate of 100 % and late patency rate at 1-year of 88 %.…”

Section: Discussionsupporting

confidence: 83%

Outcome of venous stenting following catheter directed thrombolysis for acute proximal lower limb venous thrombosis: a prospective study with venous Doppler follow-up at 1-year

Srinivas

Patra

Reddy

et al. 2015

Cardiovasc Interv and Ther

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Functional outcome of venous stent placement for the management of acute iliofemoral deep vein thrombosis (DVT) following catheter-directed thrombolysis (CDT), remain undefined. The purpose of this study was to assess immediate and intermediate term outcomes among patients treated with venous stenting following CDT in patients with proximal lower limb DVT. Thirty consecutive patients aged between 20-70 years with proximal lower limb DVT formed the study group. The mean duration of CDT done with streptokinase was 4.5 ± 1.3 days. Patients with residual venous obstruction and/or large clot burden were treated further with venous angioplasty and/or stenting. Primary endpoint was to evaluate the safety, efficacy and patency of venous stenting in the management of incomplete result following CDT. After 12 months, post-thrombotic syndrome (PTS) was assessed clinically using Villalta scale and deep venous patency was assessed through duplex ultrasound. We studied 8 (5 female and 3 male) patients with 9 (3 left and 6 right) limb involvement and 13 stent (4 balloon expandable and 9 self expandable) placement. All patients improved clinically immediately following venous stenting. Technical success was achieved in all patients. One patient developed pulmonary embolism during course of hospital stay. One patient had stent thrombosis and PTS and another patient died due to carcinoma breast during follow-up. Deep venous stenting is an effective mode of treatment in proximal acute lower limb DVT with high late patency rate up to 1-year.

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Section: Discussionsupporting

confidence: 83%

Outcome of venous stenting following catheter directed thrombolysis for acute proximal lower limb venous thrombosis: a prospective study with venous Doppler follow-up at 1-year

Srinivas

Patra

Reddy

et al. 2015

Cardiovasc Interv and Ther

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“…After screening 793 studies for eligibility, 37 studies reporting 45 treatment effects (nonthrombotic, [12][13][14][15][16][17][18][19] AT, 13,18,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] and CPT 12,14,17,30,33,34,[37][38][39][40][41][42][43][44][45][46][47][48] ) from 2869 unique patients (nonthrombotic, 1122; AT, 629; and CPT, 1118) were included in the meta-analysis. The most common reasons for study exclusion were lack of relevant stent placement outcomes (19 studies), kin relationships (18 studies), sample size <10 (16 studies), combined outcome reporting in nonthrombotic and thrombotic patients (8 studies), and combined outcome reporting in AT and CPT patients (6 studies).…”

Section: Study Selectionmentioning

confidence: 99%

Safety and Effectiveness of Stent Placement for Iliofemoral Venous Outflow Obstruction

Razavi

Jaff

Miller

2015

Circ: Cardiovascular Interventions

201

117

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Background-Endovenous recanalization of iliofemoral stenosis or occlusion with angioplasty and stent placement has been increasingly used to maintain long-term venous patency in patients with iliofemoral venous outflow obstruction. The purpose of this systematic review and meta-analysis was to determine safety and effectiveness of venous stent placement in patients with iliofemoral venous outflow obstruction. Methods and Results-We searched MEDLINE and EMBASE for studies evaluating safety or effectiveness of stent placement in patients with iliofemoral venous outflow obstruction. Data were extracted by disease pathogenesis: nonthrombotic, acute thrombotic, or chronic post-thrombotic. Main outcomes included technical success, periprocedural complications, symptom relief at final follow-up, and primary/secondary patency through 5 years. A total of 37 studies reporting 45 treatment effects (nonthrombotic, 8; acute thrombotic, 19; and chronic post-thrombotic, 18) from 2869 patients (nonthrombotic, 1122; acute thrombotic, 629; and chronic post-thrombotic, 1118) were included. Technical success rates were comparable among groups, ranging from 94% to 96%. Complication rates ranged from 0.3% to 1.1% among groups for major bleeding, from 0.2% to 0.9% for pulmonary embolism, from 0.1% to 0.7% for periprocedural mortality, and from 1.0% to 6.8% for early thrombosis. Patient symptom relief data were reported inconsistently. At 1 year, primary and secondary patency were 96% and 99% for nonthrombotic, 87% and 89% for acute thrombotic, and 79% and 94% for chronic post-thrombotic. Conclusions-Stent Methods Literature SearchThis study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses. 9 We searched MEDLINE and EMBASE for randomized or nonrandomized controlled studies and prospective or retrospective case series of stent placement for treatment of iliofemoral venous outflow obstruction by using a combination of relevant keywords. The details of the MEDLINE search strategy are listed in Table I in the Data Supplement. The syntax for EMBASE was similar, but adapted as necessary. In addition, manual searches were conducted using the Directory of Open Access Journals, Google Scholar, and the reference lists of included papers and relevant meta-analyses. No date restrictions were applied to the searches. The final search was conducted March 15, 2015. Study SelectionTwo researchers independently selected studies for inclusion in the review. Disagreements were resolved by consensus. Titles and abstracts were initially screened to exclude review articles, commentaries, letters, case reports, and obviously irrelevant studies. Full texts of the remaining articles were retrieved and reviewed. Main inclusion criteria included studies with (1) primary diagnosis of obstructive lesions of the common femoral vein, external iliac vein, and the common iliac vein, (2) stent placement in the common femoral vein, external iliac vein, common iliac vein, and the inferior vena cava, (3) outcomes reporte...

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“…Despite angioplasty, residual iliac thrombosis and stenosis demanded further considerations. There is increase evidence of stenting and early aggressive treatment of proximal iliofemoral thrombosis with good medium to long-term patency rate (84%) [9]. of note, surgical correction of iliofemoral or caval obstruction options should only be reserved for patients in whom endovascular options have failed or not feasible [10].…”

Section: Discussionmentioning

confidence: 99%

May-Thurner Syndrome, the Role of Endovascular Intervention with Review of Published Treatment and Follow up Strategies

Alfahad¹,

Lakshminarayan²

2015

J Clin Diagn Res

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May-Thurner syndrome is a unique condition that strikes mainly young people. Its prevalence is likely underestimated and perhaps ranges from 22 to 32%. May-Thurner is under reported and often miss-diagnosed in accident and emergency, which can result in long term complication (post thrombotic syndrome) with its detrimental effect in this young age group. We describe a case of May-Thurner syndrome, a near miss, with review of published treatment and follow up strategies. This includes direct catheter thrombolysis, angioplasty, stenting, and IVC filter placement. Our patient has made a good recovery on follow up.

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Iliac vein stenting as a durable option for residual stenosis after catheter-directed thrombolysis and angioplasty of iliofemoral deep vein thrombosis secondary to May–Thurner syndrome

Abstract: Iliac vein stenting showed good primary patency rate with few complications. Iliac vein stenting is a durable option for residual stenosis after catheter-directed thrombolysis treatment of acute deep vein thrombosis in May-Thurner syndrome.

Cited by 62 publications

References 16 publications

Outcome of venous stenting following catheter directed thrombolysis for acute proximal lower limb venous thrombosis: a prospective study with venous Doppler follow-up at 1-year

Outcome of venous stenting following catheter directed thrombolysis for acute proximal lower limb venous thrombosis: a prospective study with venous Doppler follow-up at 1-year

Safety and Effectiveness of Stent Placement for Iliofemoral Venous Outflow Obstruction

May-Thurner Syndrome, the Role of Endovascular Intervention with Review of Published Treatment and Follow up Strategies

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