Abstract No. 595 Endovascular Recanalization and Reconstruction for the Treatment of Symptomatic Venous Ligation

Abstract

To report techniques, adverse events, and outcomes of endovascular recanalization and stent reconstruction for symptomatic venous ligation. Nine patients, including six (66.7%) men and three (33.3%) women, with mean age 52.9 ± 11.9 years (range, 35-69 years), underwent endovenous recanalization and stent reconstruction for symptomatic venous ligation over eight years. Five (55.6%), one (11.1%), and three (33.3%) patients presented with CEAP 3, 4, and 5 diseases, respectively. External iliac vein ligation occurred in six (66.7%) patients. Ligations were unilateral left, unilateral right, and bilateral in three (33.3%), four (44.4%), and two (22.2%) patients, respectively. Ligation etiologies included surgical injury in four (44.4%), traumatic injury in two (22.2%), chronic lower extremity venous thrombosis in two (22.2%), and malignant resection in one (11.1%) patient. Technical successes, reconstruction parameters, adverse events, hospital stay lengths, clinical outcomes, stent patencies, follow-up evaluations, and mortalities were recorded. Primary single-session recanalization was achieved in nine (100%) patients. Sharp, extravascular, techniques were required in 6 (66.7%) patients. Reconstructions were created with Wallstents, SMART stents, and cTAG devices. Mean number of stents was 2.9 ± 2.5 stents (range, 1-7 stents). Mean stent diameter was 15.5 ± 3.2-mm (range, 12-26-mm). Adverse events (AEs), according to the Society of Interventional Radiology, included one (10.0%) common iliac vein injury (major AE; class D) and one (7.7%) of neck hematoma (minor AE; class A). Mean hospitalization stay length was 1.6 ± 1.6 days (range, 1-6 days). Clinical improvement was achieved in eight (88.9%) patients with six (66.7%) patients downgraded to CEAP 0 disease. Eight (88.9%) reconstructions remained patent with a mean imaging follow-up of 466.4 ± 500.3 days (range, 17-1,400 days). One (9.1%) reconstruction became occluded within sixty days and was unable to be recanalized. Mean total follow-up was 1,086.2 ± 717.5 days (range, 47-2,707 days). Thirty day and study mortality were both zero. Endovenous recanalization and reconstruction is an effective and safe treatment for symptomatic venous ligation.