Author + information
- Tien Yu Wu1
Venous hypertension is one of the main reasons of venous insufficiency, which may lead to extremity swelling, ulceration, and venous claudication. The possible causes of venous hypertension include venous obstruction and compression. Iliac vein stenting is one of the treatment options for venous hypertension that has become popular in the recent years. However, the clinical evidence for iliac vein stenting remains limited in the literature. Patients who were treated for symptomatic iliac vein with intravascular ultrasound (IVUS)-guided stenting demonstrate the potential of such technique and its superiority over traditional treatment.
A cohort of 129 patients was treated for symptomatic iliac vein hypertension with IVUS-guided stenting from 2012 to 2015 by the same physician. The 129 patients were categorized into groups with acute deep vein thrombosis (DVT) (20 patients, 15.5%), sub-acute DVT (20 patients, 15.5%), post-thrombotic syndrome (35 patients, 27.0%), and May–Thurner Syndrome (54 patients, 42.0%). The clinical, etiological, anatomical, and pathological (CEAP) classification was recorded before and after the intervention.
The average improvement in CEAP grade was 2.66 after intervention. All the patients underwent vascular ultrasound follow-up at 1, 3, 6, 9, 12, 15, 18, 21, and 24 months after intervention. A total of 26 patients underwent follow-up IVUS-guided venography after 6 months. The midterm patency rate of the iliac vein stents was 94.5%.
IVUS-guided iliac vein stenting is effective and beneficial for treating venous hypertension secondary to iliac vein diseases. Compared with the results of iliac vein stenting without IVUS guidance presented in the literature, higher patency rates demonstrate the viability of this new treatment option.
ENDOVASCULAR: Peripheral Vascular Disease and Intervention