title: Safety and Effectiveness of Stent Placement for Iliofemoral Venous Outflow Obstruction: Systematic Review and Meta-Analysis.
abstract: 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.
  
  
  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 placement for iliofemoral venous outflow obstruction results in high technical success and acceptable complication rates regardless of cause of obstruction.
authors.affiliation: From the Heart and Vascular Center, St. Joseph Hospital, Orange, CA (M.K.R.); Fireman Vascular Center, Massachusetts General Hospital, Boston (M.R.J.); and Miller Scientific Consulting, Inc, Asheville, NC (L.E.M.). mrazavi@pacbell.net.
authors.forename: Mahmood K
authors.initials: MK
authors.lastname: Razavi
authors.affiliation: From the Heart and Vascular Center, St. Joseph Hospital, Orange, CA (M.K.R.); Fireman Vascular Center, Massachusetts General Hospital, Boston (M.R.J.); and Miller Scientific Consulting, Inc, Asheville, NC (L.E.M.).
authors.forename: Michael R
authors.initials: MR
authors.lastname: Jaff
authors.affiliation: From the Heart and Vascular Center, St. Joseph Hospital, Orange, CA (M.K.R.); Fireman Vascular Center, Massachusetts General Hospital, Boston (M.R.J.); and Miller Scientific Consulting, Inc, Asheville, NC (L.E.M.).
authors.forename: Larry E
authors.initials: LE
authors.lastname: Miller
mesh_terms: D000818:Animals; D019917:Blood Vessel Prosthesis Implantation; D005268:Femoral Vein / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007084:Iliac Vein / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D015607:Stents / Q000706:statistics & numerical data; D016019:Survival Analysis; D016896:Treatment Outcome; D014654:Vascular Patency; D020246:Venous Thrombosis / Q000401:mortality / Q000601:surgery*
keywords: angioplasty; meta-analysis; pulmonary embolism; stents; venous thrombosis