Abstract No. 592 Two steps forward, one step back: development of contralateral DVT following left common iliac vein stenting

Abstract

Treatment of iliac vein narrowing/thrombosis necessitates stent deployment which typically extends into the inferior vena cava (IVC). The purpose of this study is to determine whether stent placement into the left iliac vein leads to future contralateral deep vein thrombosis (DVT). A retrospective analysis of 93 consecutive patients that underwent left common iliac vein stent placement between July 2008 and August 2017 was performed. In addition to demographic data the following was collected: proximal and distal stent landing zones, quantification of stent extension into the IVC, etiology of vein stenosis/thrombosis, presence of an IVC filter, incidence of ipsilateral and contralateral DVT, anticoagulation status, risk factors for DVT after stent placement, and reintervention rates. Pre procedural and post-procedure clinic visits were performed on all patients that had a stent deployed. A multiple logistic regression model was used for analysis. 93 patients (67 female, 26 male) underwent stent placement for left common iliac vein stenosis/thrombosis with an average follow-up of 826 days. Contralateral DVT developed in 9/93 (9.68%) with 8/9 developing after 30 days and 1/9 less than 30 days. Clinical symptoms necessitated reintervention on the ipsilateral side in 30/93 (32.29%) patients with 19/30 after 30 days and 11/30 within 30 days. Stent extension into the inferior vena cava was 24.3 ± 13.6 mm. Stent extension into the IVC in patients that developed contralateral DVT was 26.7 ± 18.0 mm. Mean stent diameter placed into the left common iliac vein was 14 mm for all patients. The upper landing zone/ extent of stent extension into the IVC did not carry an association with contralateral DVT formation (p=0.17) or rate of ipsilateral reintervention (p=0.07). Presence of an IVC filter (p=0.22) and stent diameter (p=0.13) did not correlate with contralateral DVT development. Contralateral DVT formation was a frequent finding in this study population but did not reach statistical significance. Further studies are warranted to elucidate potential etiologies for contralateral DVT formation in this patient population.