title: Technique and Clinical Outcomes of Combined Stent Placement for Postthrombotic Chronic Total Occlusions of the Iliofemoral Veins.
abstract: OBJECTIVE
  To evaluate the technical aspects and early clinical results of combined stent placement for the management of postthrombotic syndrome (PTS) in chronic total occlusions (CTOs) of the iliofemoral veins.
  
  
  METHODS
  A total of 81 consecutive patients (mean age, 57 y; 37 men; 81 limbs; 65 left limbs) with postthrombotic CTO of the iliofemoral veins treated with combined stent placement in a single institution from January 2013 to December 2014 were retrospectively analyzed. Wallstents were used for femoral inflow and E-Luminexx stents for iliac outflow. Technical aspects, quality of life (QOL), stent patency, and Villalta scores were recorded at follow-up. Primary, primary assisted, and secondary patency rates were estimated with Kaplan-Meier methods with the log-rank test.
  
  
  RESULTS
  Percutaneous recanalization was successful in 77 of 81 limbs (95.1%). Stents were deployed in all iliofemoral occlusions, with two stents in 63 lesions (77.8%) lesions and three stents in 18 lesions (22.2%). Venous perforation occurred in 32 patients (37.4%) and was resolved in all cases after stent placement. Back pain occurred during balloon angioplasty (93.8%) and persisted after stent placement in 56.8% of patients. However, the symptoms were self-limiting without further therapy. QOL and Villalta scores were significantly improved during a median follow-up of 19 months (range, 1-38 mo; P < .01). The 2-year primary, primary assisted, and secondary cumulative stent patency rates were 81.5%, 91.4%, and 93.8%, respectively.
  
  
  CONCLUSIONS
  Combined stent placement is an effective, safe, and feasible method of management of PTS in iliofemoral CTO until commercial venous stents designed for PTS become available.
authors.affiliation: Department of Vascular Surgery and Vascular Center of Shanghai Jiao Tong University, School of Medicine, Shanghai 9th People's Hospital Affiliated to Shanghai Jiao Tong University,639 Zhi Zao Ju Rd., Shanghai200011, China.
authors.forename: Wang
authors.initials: W
authors.lastname: Ruihua
authors.affiliation: Department of Vascular Surgery and Vascular Center of Shanghai Jiao Tong University, School of Medicine, Shanghai 9th People's Hospital Affiliated to Shanghai Jiao Tong University,639 Zhi Zao Ju Rd., Shanghai200011, China.
authors.forename: Wang
authors.initials: W
authors.lastname: Xin
authors.affiliation: Department of Vascular Surgery and Vascular Center of Shanghai Jiao Tong University, School of Medicine, Shanghai 9th People's Hospital Affiliated to Shanghai Jiao Tong University,639 Zhi Zao Ju Rd., Shanghai200011, China.
authors.forename: Liu
authors.initials: L
authors.lastname: Guang
authors.affiliation: Department of Vascular Surgery and Vascular Center of Shanghai Jiao Tong University, School of Medicine, Shanghai 9th People's Hospital Affiliated to Shanghai Jiao Tong University,639 Zhi Zao Ju Rd., Shanghai200011, China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Kaichuang
authors.affiliation: Department of Vascular Surgery and Vascular Center of Shanghai Jiao Tong University, School of Medicine, Shanghai 9th People's Hospital Affiliated to Shanghai Jiao Tong University,639 Zhi Zao Ju Rd., Shanghai200011, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Jinbao
authors.affiliation: Department of Vascular Surgery and Vascular Center of Shanghai Jiao Tong University, School of Medicine, Shanghai 9th People's Hospital Affiliated to Shanghai Jiao Tong University,639 Zhi Zao Ju Rd., Shanghai200011, China.
authors.forename: Yin
authors.initials: Y
authors.lastname: Minyi
authors.affiliation: Department of Vascular Surgery and Vascular Center of Shanghai Jiao Tong University, School of Medicine, Shanghai 9th People's Hospital Affiliated to Shanghai Jiao Tong University,639 Zhi Zao Ju Rd., Shanghai200011, China.
authors.forename: Li
authors.initials: L
authors.lastname: Weimin
authors.affiliation: Department of Vascular Surgery and Vascular Center of Shanghai Jiao Tong University, School of Medicine, Shanghai 9th People's Hospital Affiliated to Shanghai Jiao Tong University,639 Zhi Zao Ju Rd., Shanghai200011, China.
authors.forename: Liu
authors.initials: L
authors.lastname: Xiaobing
authors.affiliation: Department of Vascular Surgery and Vascular Center of Shanghai Jiao Tong University, School of Medicine, Shanghai 9th People's Hospital Affiliated to Shanghai Jiao Tong University,639 Zhi Zao Ju Rd., Shanghai200011, China.
authors.forename: Huang
authors.initials: H
authors.lastname: Xintian
authors.affiliation: Department of Vascular Surgery and Vascular Center of Shanghai Jiao Tong University, School of Medicine, Shanghai 9th People's Hospital Affiliated to Shanghai Jiao Tong University,639 Zhi Zao Ju Rd., Shanghai200011, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Min
authors.affiliation: Department of Vascular Surgery and Vascular Center of Shanghai Jiao Tong University, School of Medicine, Shanghai 9th People's Hospital Affiliated to Shanghai Jiao Tong University,639 Zhi Zao Ju Rd., Shanghai200011, China. Electronic address: luxinwu@shsmu.edu.cn.
authors.forename: Lu
authors.initials: L
authors.lastname: Xinwu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D002681:China; D002908:Chronic Disease; D000072226:Computed Tomography Angiography; D003251:Constriction, Pathologic; D005240:Feasibility Studies; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D054070:Postthrombotic Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D015641:Radiography, Interventional; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency