Chronic iliac vein occlusion: midterm results of endovascular recanalization.
OBJECTIVE
To evaluate patency and clinical outcome in patients treated with endovascular recanalization and stent placement for chronic iliac vein occlusions.


METHODS
During a 14-year period (1994-2008), 59 (38 women; median age 39 years) of 62 patients with chronic occlusion of the iliac vein segment in 66 limbs were successfully treated with endovascular recanalization and stent placement. A prospectively maintained database was analyzed retrospectively to obtain information on clinical details, endovascular techniques, and outcome.


RESULTS
Three (5%) procedures failed for technical reasons. Three (5%) complications occurred, 2 (3%) of which were perforations requiring transfusion and procedure termination. Initial clinical success after 6 months was achieved in 49 (83%) of the 59 patients successfully treated initially. Primary patency after a median imaging follow-up of 25 months was 67% (44/66), assisted primary patency was 75% (49/66), and secondary patency was 79% (52/66). Fifteen (23%) of 66 limbs were asymptomatic after a median clinical follow-up of 32 months, 34 (52%) limbs were improved, 13 (20%) were unchanged, and 4 (6%) were worse compared to before intervention. Actuarial primary, assisted primary, and secondary patency rates using Kaplan-Meier survival analysis were 70%, 73%, and 80%, respectively, at 5 years.


CONCLUSIONS
Endovascular recanalization and stent placement is a safe and effective treatment for occluded iliac veins and adjacent segments. Clinical midterm results are encouraging. Recanalized and stented segments remain patent in the majority of patients after 2 years. Endovascular treatment can ease symptoms and prevent further deterioration of patients with post-thrombotic syndrome.
Kölbel
Tilo
T
Vascular Center, Malmö University Hospital, Malmö, Sweden. tilokoelbel@googlemail.com
Lindh
Mats
M
Akesson
Michael
M
Wassèlius
Johan
J
Gottsäter
Anders
A
Ivancev
Krassi
K
D000328:Adult; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D002908:Chronic Disease; D003251:Constriction, Pathologic; D019992:Databases as Topic; D005260:Female; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D054070:Postthrombotic Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*