Iliac vein stenting is safe when performed in an office based laboratory setting

Satwah, Ishan; Sulakvelidze, Levan; Tran, Maxwell; Lakhanpal, Sanjiv; Kennedy, Richard; Lakhanpal, Gaurav; Satwah, Vinay; Pappas, Peter J.

doi:10.1016/j.jvsv.2021.04.021

Cited by 7 publications

(2 citation statements)

References 15 publications

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“…Several techniques have been used to treat occluded stents, such as using basic guidewire and catheter techniques to mechanically recanalize stents. In recent years, numerous advanced endovascular devices have been created for treating chronic arterial blockages, employing methods like blunt microdissection, radiofrequency, and laser; however, their use has not been published widely in the literature [8][9][10][11]. We herein demonstrate an alternative method for treating chronic right iliac vein thrombosis due to an occluded stent via parallel deployment of a stent adjacent to a chronically thrombosed stent.…”

Section: Discussionmentioning

confidence: 99%

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Treating Chronic Iliac Vein Stent Occlusion in an Office-Based Lab Setting

Sangha,

Nolan,

Arous

2024

Cureus

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Iliac vein stenting is performed when sufficient venous patency is not achieved via angioplasty or lysis. Iliac vein stenting is known to be effective; however, occlusion of the stent occurs occasionally. There is a lack of effective treatment options for those with failed prior venous stents, and traditional methods may involve the removal of the stent and surgical reconstruction. We present a patient with a right leg post-thrombotic syndrome and narcotic abuse after occlusion of a previously placed right common iliac/external iliac vein stent 25 years prior. After transfer to an office-based lab (OBL), femoral vein access was achieved. Then, a second stent was deployed adjacent to the previously chronically thrombosed stent. Imaging confirmed adequate deployment of the new stent and venous flow. Treatment resulted in a significant decrease in patient pain and cessation of narcotics. We demonstrate successful recanalization of a right iliac vein thrombosis via parallel deployment of a stent adjacent to a chronically thrombosed stent.

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Section: Discussionmentioning

confidence: 99%

“…These complications occurred in 0.41% of the patients. [ 9 ]. This rate suggests that iliac vein stenting in the OBL setting is safe.…”

Section: Discussionmentioning

confidence: 99%

Treating Chronic Iliac Vein Stent Occlusion in an Office-Based Lab Setting

Sangha,

Nolan,

Arous

2024

Cureus

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Adherence to process and protocols is important in ensuring patient safety for iliac vein stenting in an office-based lab setting

Brown

2022

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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Journal of Vascular Surgery: Venous and Lymphatic Disorders – January 2022 Audiovisual Summary

Lawrence¹

2022

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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Hello! My name is Peter Lawrence and I am pleased to introduce the January issue of the Journal of Vascular Surgery: Venous and Lymphatic Disorders and highlight four outstanding papers, which are freely available for the next 2 months.The CME article for this issue is "Iliac vein stenting is safe when performed in an office based laboratory setting," by Satwah and co-authors. 1 Between 2015 and 2019, 1223 iliac vein Wall stents were placed in 1104 patients, with 24% men and 76% women. All patients received moderate sedation during iliac stenting procedures. Ninety minor complications and five major complications (7% and 0.4%, respectively) occurred. Major complications included one allergic reaction, atrial fibrillation, supraventricular tachycardia, chest pain, and acute stent occlusion, and these patients were admitted to the hospital. Minor complications were primarily related to insertion site hematomas and were managed without hospital admission. No complications were related to sedation or acute renal failure; there were no mortalities. The authors concluded that major complications are rare after iliac vein stenting in an office based setting and that minor complications were related to insertion site hematomas and did not require hospitalization.Our next highlighted article, titled "A randomized controlled trial to evaluate the safety and efficacy of transluminal injection of foam sclerotherapy compared to ultrasound-guided foam sclerotherapy during endovenous catheter ablation in patients with varicose veins," is by Watanabe and co-authors from Japan. 2 They compared the treatment of patients with both great saphenous vein incompetence and large tributary veins using either endovenous laser ablation and concurrent 1% polidocanol foam sclerotherapy through the access sheath (called transluminal injection of foam sclerotherapy [TLFS]) to those treated with endovenous laser ablation (EVLA) and concurrent direct-puncture ultrasound-guided foam sclerotherapy (UGFS) of tributaries. Both the combined TLFS with EVLA in 103 legs and UGFS with EVLA in 94 legs demonstrated 100% saphenous vein occlusion, but the venous clinical severity score was significantly improved in the TLFS group compared to the UGFS group, indicating more effective tributary treatment with transluminal foam. Multivariate analysis revealed that TLFS was the only significant factor for improved Venous Clinical Severity Score and that an additional second stage of sclerotherapy was avoided in the TLFS group.The third article, by Schafer and co-authors, is entitled "The clinical significance of ultra-high D-dimer levels." 3 Since plasma D-dimer levels greater than 5000 ng/mL are encountered in a number of conditions other than venous thromboembolism (VTE) and some have proposed plasma D-dimer levels as a prognostic indicator for COVID-19 infection, the authors studied plasma D-dimer levels >5000 ng/mL in hospitalized patients before the COVID epidemic. Over 4 years, 671 patients had a D-dimer >5000; VTE was the most common diagnosis, followed b...

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Iliac vein stenting is safe when performed in an office based laboratory setting

Cited by 7 publications

References 15 publications

Treating Chronic Iliac Vein Stent Occlusion in an Office-Based Lab Setting

Treating Chronic Iliac Vein Stent Occlusion in an Office-Based Lab Setting

Adherence to process and protocols is important in ensuring patient safety for iliac vein stenting in an office-based lab setting

Journal of Vascular Surgery: Venous and Lymphatic Disorders – January 2022 Audiovisual Summary

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