title: Functional outcomes following catheter-based iliac vein stent placement.
abstract: OBJECTIVE
  Although previous reports have demonstrated the efficacy of catheter-directed thrombolytic therapy and iliac vein stent placement for the management of iliofemoral deep vein thrombosis (DVT), functional outcomes remain undefined. The purpose of this study was to determine midterm outcomes and functional quality of life among patients treated with iliac vein stenting.
  
  
  METHODS
  Records of all the patients treated with iliac vein stent placement between March 2004 and March 2011 were examined for primary patency, assisted primary patency, and secondary patency. Midterm functional outcomes were measured quantitatively, including ongoing symptoms and return to work status.
  
  
  RESULTS
  Over the study interval, 32 patients (33 limbs) underwent iliac vein stent placement. In all, 72% (n = 23) of these patients were female, with an average age of 43 years. In all, 78% (n = 25) of the patients were diagnosed with acute DVT, 89% of which occurred in the left leg. Catheter-directed thrombolysis was utilized in 92% (23 of 25) of the patients with acute DVT. All patients treated with thrombolysis and stent placement presented with pain and edema in the affected limb. One-year primary, assisted primary, and secondary patencies were 75%, 96%, and 96%, respectively. Freedom from reintervention at 1 year was 83%. Treatment was associated with a sustained significant reduction in pain (91% vs 6%, P < .001) and edema (97% vs 12%, P < .001) at a mean follow-up of 29 months (range 5-83 months), at which time 89% of the patients reported to be at their pre-DVT functional status.
  
  
  CONCLUSIONS
  Aggressive therapy of symptomatic iliac vein stenosis or occlusion with venography, catheter-directed thrombolysis, and iliac vein stent placement provides durable patency and freedom from reintervention. Most patients can anticipate good functional recovery with decreased pain, decreased edema, and high likelihood of returning to work.
authors.affiliation: Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA. courtney.j.warner@hitchcock.org
authors.forename: Courtney J
authors.initials: CJ
authors.lastname: Warner
authors.forename: Philip P
authors.initials: PP
authors.lastname: Goodney
authors.forename: Jessica B
authors.initials: JB
authors.lastname: Wallaert
authors.forename: Brian W
authors.initials: BW
authors.lastname: Nolan
authors.forename: Eva M
authors.initials: EM
authors.lastname: Rzucidlo
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Powell
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Walsh
authors.forename: David H
authors.initials: DH
authors.lastname: Stone
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D004487:Edema / Q000209:etiology; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010690:Phlebography; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D062707:Return to Work; D015607:Stents; D011795:Surveys and Questionnaires; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D020246:Venous Thrombosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D055815:Young Adult
keywords: iliac vein stenting; iliofemoral deep vein thrombosis; venous thrombolysis