Early Outcomes Following Endoluminal Deep Venous Reconstruction Using Dedicated Venous Stents

Objectives

Evaluate early outcomes following endoluminal stenting using first-generation dedicated venous stents.

Methods

Patients undergoing deep venous reconstruction using venous stents between 2012-2015 were identified. Duplex ultrasonography was used to assess sent patency at 1d, 2wks, 3mths, 6mths and yearly following intervention. Venous Disability Scores (VDS) and Villalta Scores (VS) taken before and after intervention (6wks, 6mths, yearly) were calculated.

Results

347stents were inserted in 140pts (median age 39yrs, 80 female) with median follow-up 16mths (1-38mths). Overall 1yr primary, primary-assisted and secondary patency rates were 67%, 80% and 82% respectively. The 1yr re-intervention rate was 30% with 16% occurring within two-weeks.

57pts had stenting of residual stenoses after catheter-directed-thrombolysis for acute iliofemoral DVT. Median post-operative VDS and VS were 0 (P<0.001). 1pt developed an ulcer at 6mths.

81pts had stenting for chronic outflow obstruction after failed medical management. 77pts (95%) had occluded vessels prior to treatment. The median pre-operative VS was 14 (4-23) and 9pts had an ulcer. Following intervention, the median VS was 4 (0-22, P<0.001) and ulcer healing was achieved in 67% (n=6/9).

Conclusions

First-generation dedicated venous stents show promise at providing symptom relief in the short-term. Close surveillance is, however, required to maintain stent patency and factors that influence occlusion warrant further investigation. Long-term evaluation of these stents is required to investigate whether these encouraging early results can be maintained.