Iliocaval Skip Stent Reconstruction Technique for Chronic Bilateral Iliocaval Venous Occlusion

Barbati, Mohammad E.; Gombert, Alexander; Toonder, Irwin M.; Schleimer, Karina; Kotelis, Drosos; Graaf, Rick de; Doğancı, Suat; Razavi, Mahmood K.; Jalaie, Houman

doi:10.1016/j.jvir.2020.08.021

Cited by 13 publications

(12 citation statements)

References 11 publications

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“…A small skip lesion (iliocaval skip stent reconstruction technique) was left between the stents at the junction between the IVC and the common iliac veins to avoid stenosis and kinking. 5 Postdilatation was performed with the Atlas Gold ® 16/60. Phlebography at the end of the procedure showed good venous outflow.…”

Section: Case Reportmentioning

confidence: 99%

Endovenous Iliocaval Revascularization for Transplant Kidney Salvage

et al. 2022

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Purpose: We report the case of a venous iliocaval recanalization to preserve a transplant kidney. Case Report: A young patient with a nephrotic syndrome caused by focal segmental glomerulosclerosis (FSGS) underwent a robot-assisted living-donor kidney transplant. The postoperative course was uneventful; serum creatinine at discharge was 1.51 mg/dL (normal range = 0.72–1.17 mg/dL). In the course of the following months, the patient was readmitted repeatedly due to acute kidney failure not related to rejection, recurrent FSGS, or anastomotic stenosis. All episodes started after prolonged standing and renal function improved after bed rest. Several hospital admissions and investigations later, phlebography revealed an occlusion of the inferior vena cava (IVC) and both common iliac veins with large collateral vessels through the azygos system. An endovenous recanalization of the iliocaval tract was performed, with subsequent normalization of transplant kidney function. Conclusion: Vascular complications after renal transplantation are an important cause of graft loss. We present an endovenous treatment option for a chronic occlusion of the IVC and common iliac vein with intermittent venous congestion as a cause of transplant failure.

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Section: Case Reportmentioning

confidence: 99%

Endovenous Iliocaval Revascularization for Transplant Kidney Salvage

et al. 2022

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“…18 The previously described “skip stent” technique in which nonoverlapping stents were placed in chronically occluded bilateral iliac veins and IVC have had a 4% rate of early iliac vein thrombosis (<30 days), and primary, assisted primary, and secondary patency rates at 30 months were 74, 83, and 97%, respectively. 19 In regard to anticoagulation and antiplatelet regimens, consensus guidelines overall suggest that anticoagulation and antiplatelet therapy should be considered in all of these patients. The consensuses described are based on smaller scale, often retrospective, studies.…”

Section: Discussionmentioning

confidence: 99%

“…However, this method is preferred by some operators due to the risk of compression of one stent by another stent, particularly if the superior aspects are not accurately lined up. 19 After stent deployment, postdilation of the stents with balloon angioplasty allows for full stent expansion. 17 Finally, repeat visualization using IVUS is recommended after all stents are deployed, to confirm wall apposition of the stents, equal diameter of the superior aspects of the kissing iliac stents, and patency of the inflow vessels.…”

Section: Skip Stentmentioning

confidence: 99%

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Iliocaval Reconstruction: Review of Technique, Challenges, and Outcomes

Kinariwala

Liles

Williams

et al. 2022

Semin intervent Radiol

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Iliocaval thrombosis is a major source of morbidity for patients, with a range of clinical presentations, including recurrent lower extremity deep venous thrombosis and postthrombotic syndrome. Endovascular reconstruction of chronic iliocaval occlusion has been demonstrated to be a technically feasible procedure that provides long-lasting symptom relief in combination with antithrombotic therapy and close clinical monitoring. Herein, we describe the etiologies of iliocaval thrombosis, patient assessment, patient management prior to and after intervention, procedural techniques, and patient outcomes.

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“…b Situs nach Endophlebektomie der V. femoralis communis vor Durchführung einer Patch-Erweiterungsplastik.implantiert. Mit einer minimalen Distanz ("skip") hierzu werden simultan die beiden iliakalen Stents freigesetzt[24] (▶ Abb. 4).DieSkipped-Technik hat folgende Vorteile: 1.…”

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Endovenöse Therapie chronisch venöser Obstruktionen

et al. 2021

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ZusammenfassungBei der chronisch venösen Obstruktion (CVO) liegt ein Abstromhindernis vor, welches eine venöse Hypertension im betroffenen Bein verursacht. Die CVO tritt vornehmlich auf dem Boden eines postthrombotischen Syndroms (PTS) oder eines May-Thurner-Syndroms (MTS) auf. Die CVO kann zu einer deutlichen Einschränkung des täglichen Lebens führen und hat erhebliche sozioökonomische Konsequenzen. Bei der endovenösen Rekanalisation zur Behandlung einer symptomatischen CVO handelt es sich um eine relativ neue therapeutische Option, die mittlerweile generell als Behandlung der ersten Wahl akzeptiert ist. Seit Verwendung spezieller venöser Stents können auch ausgedehntere Befunde, die eine anspruchsvollere Rekonstruktion erforderlich machen, erfolgreich therapiert werden.Damit nach einer venösen Rekanalisation keine Stase des Blutstroms und ein Primärverschluss auftreten, müssen ein suffizienter Ein- und Ausstrom gewährleistet sein. Zur Verbesserung des Einstroms werden Hybrideingriffe mit Endophlebektomie der Vena femoralis communis und AV-Fistel-Anlage, zur Ausstromverbesserung werden spezielle Rekonstruktionen der Vena-cava-inferior-Konfluenz, z. B. die Skipped-Technik, empfohlen.

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Iliocaval Skip Stent Reconstruction Technique for Chronic Bilateral Iliocaval Venous Occlusion

Cited by 13 publications

References 11 publications

Endovenous Iliocaval Revascularization for Transplant Kidney Salvage

Endovenous Iliocaval Revascularization for Transplant Kidney Salvage

Iliocaval Reconstruction: Review of Technique, Challenges, and Outcomes

Endovenöse Therapie chronisch venöser Obstruktionen

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