Outcomes of venoplasty with stent placement for chronic thrombosis of the iliac and femoral veins: single-center experience.
OBJECTIVE
To assess retrospectively 30-day, 1-year, and 3-year patency of chronically occluded iliofemoral venous thrombotic lesions treated with stent placement in a case series from a single institution.


METHODS
Records of 189 consecutive patients treated by interventional radiology for iliofemoral venous occlusions between March 1, 2003, and December 1, 2008, were retrospectively reviewed. A total of 89 patients (27 men; median age, 46.2 y) with chronic iliac or iliofemoral deep vein thrombosis without involvement of the inferior vena cava met criteria for analysis.


RESULTS
All patients (91 limbs) successfully underwent placement of venous self-expanding stents. Patency rate at discharge was 100%. Following the index procedure, mean pressure gradient across the lesion decreased from 5.63 mm Hg (95% CI, 3.51-7.75) to 0.71 mm Hg (95% CI, 0.08-1.34; P < .0001). There were no bleeding complications. Median follow-up was 11.3 months (range, 0.8-72.4 mo). Follow-up at 30 days demonstrated 90 of 91 limbs to be patent. Primary patency rates of treated limbs at 1 and 3 years were 81% and 71%, respectively. Primary patency was lost in 17 cases (19.1%); interventions to maintain or restore stent patency were performed in 13 cases (14.6%). Primary assisted limb patency rates at 1 and 3 years were 94% and 90%, respectively; secondary patency rate was 95%.


CONCLUSIONS
Angioplasty with stent placement for treatment of chronically thrombosed iliofemoral veins is a low-risk procedure with acceptable patency rates for as long as 3 years. The outcomes in patients treated in a quaternary referral center are similar to those reported by other centers.
Division of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Andrew K
AK
Kurklinsky
Haraldur
H
Bjarnason
Jeremy L
JL
Friese
Waldemar E
WE
Wysokinski
Robert D
RD
McBane
Andrew
A
Misselt
Sigridur Margret
SM
Moller
Peter
P
Gloviczki
D000328:Adult; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation*; D016009:Chi-Square Distribution; D002908:Chronic Disease; D005260:Female; D005268:Femoral Vein / Q000503:physiopathology; D006801:Humans; D007084:Iliac Vein / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D020246:Venous Thrombosis / Q000503:physiopathology / Q000628:therapy*