Our early experience with iliofemoral vein stenting in patients with post-thrombotic syndrome

Sarıcı, İnanç Şamil; Yanar, Fatih; Ağcaoğlu, Orhan; Uçar, Adem; Poyanlı, Arzu; Çakιr, Sibel; Aksoy, Şevki Murat; Kurtoğlu, Mehmet

doi:10.1177/0268355513477641

Cited by 42 publications

(59 citation statements)

References 24 publications

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“…Only one study was a cohort study, 27 with a control group of patients treated conservatively by elastic compression stockings, while all the other studies were case series. Quality assessment of the included studies by NOS revealed one nine star study, 27 five six star studies, 22e24,26,28 and one five star study 25 (Supplementary Table 1). Eleven relevant outcomes were analysed using the GRADE system.…”

Section: Quality Assessment Of Studies and Grading Of The Evidencementioning

confidence: 99%

Systematic Review and Meta-Analysis of Iliofemoral Stenting for Post-thrombotic Syndrome

Qiu

Zha

et al. 2019

European Journal of Vascular and Endovascular Surgery

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WHAT THIS PAPER ADDS Endovascular stenting is relevant to the management of post-thrombotic syndrome with chronic obstruction in iliofemoral venous segment. Although this systematic review demonstrates that the quality of evidence for iliofemoral stents is weak, venous stenting has the potential to be effective, with extremely rare occurrences of peri-operative complications. This review may assist in clinical decision making and guide future research. Objective: Stent placements are considered as a treatment for post-thrombotic syndrome (PTS) with iliofemoral obstruction, but the application of these iliofemoral venous stents has also caused a lot of controversy. The purpose of this systematic review and meta-analysis was to summarise the efficacy and safety of venous stents in PTS with obstruction in iliofemoral venous segments. Methods: MEDLINE, EMBASE, and the Cochrane Central Register for Controlled Trials databases and key references were searched up to 15 January 2018. The main relevant outcomes included technical success, perioperative complications, symptom resolution, a change of symptom scores, and long-term patency of the stents. Results: Overall, 504 limbs of 489 patients from seven studies were included in this study. A GRADE assessment showed the quality of the evidence was "very low" for 11 relevant outcomes. The technical success rate was 95%. The pooled rate of complications including 30 day thrombotic event, per-operative venous injury, and back pain was 3.4%, 18.14%, and 52%, respectively. The rates of ulcer healing, pain and oedema relief were 75.66%, 52%, and 42%, respectively. The primary, assisted primary and secondary patency rates were 83.36%, 90.59%, and 94.32%, respectively, at 12 months and 67.98%, 82.26%, and 86.10%, respectively, at 36 months. Conclusions: Endovenous stenting has the potential to be effective and has a low risk of peri-operative complications. The quality of evidence to support this treatment is very low. Endovenous iliofemoral stenting should be considered a treatment option for PTS with iliofemoral obstruction.

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Section: Quality Assessment Of Studies and Grading Of The Evidencementioning

confidence: 99%

Systematic Review and Meta-Analysis of Iliofemoral Stenting for Post-thrombotic Syndrome

Qiu

Zha

et al. 2019

European Journal of Vascular and Endovascular Surgery

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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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“…Sarici et al reported a significant decrease in Villalta score after stenting, from 18 (range, 7-30) at baseline to 8 (range, 4-19) at 6 months postintervention, as well as improvement in calf circumference at 1 month post-intervention. 26 Others also reported that the Villalta score decreased from 22.0 at baseline to 9.3 after stenting, 27 and from 14 (range, 11-22) at baseline to 5 (range, 1-10) at 3 months after the procedure. 24 In our study, the Villalta score improved significantly after endovascular treatment, from 9.0±3.7 (range, 5-15) at baseline to 2.9±2.1 (range, 0-7) at 6 months after procedure (P<0.001), which is consistent with previous observations.…”

Section: Grants / Conflict Of Interest / Acknowledgmentsmentioning

confidence: 96%

Beneficial Effect of Endovascular Treatment on Villalta Score in Japanese Patients With Chronic Iliofemoral Venous Thrombosis and Post-Thrombotic Syndrome

Ueda

Tsuji

Ogo

et al. 2018

Circ J

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Our early experience with iliofemoral vein stenting in patients with post-thrombotic syndrome

Abstract: Treatment of iliac venous obstruction with balloon angioplasty and stenting appears to be a minimally invasive and safe therapeutic approach in patients with PTS offering quick symptomatic relief, good patency and minimal morbidity.

Cited by 42 publications

References 24 publications

Systematic Review and Meta-Analysis of Iliofemoral Stenting for Post-thrombotic Syndrome

Systematic Review and Meta-Analysis of Iliofemoral Stenting for Post-thrombotic Syndrome

Safety and Effectiveness of Stent Placement for Iliofemoral Venous Outflow Obstruction

Beneficial Effect of Endovascular Treatment on Villalta Score in Japanese Patients With Chronic Iliofemoral Venous Thrombosis and Post-Thrombotic Syndrome

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