Addressing the Impact of Deep Venous Stenting on the Management of Venous Ulcer

Abstract

IntroductionVenous ulcers are a late and severe form of CVI and account for 70% of all etiologies that cause leg ulcers in the lower limb and they account for 20% of the 2.5 million cases complaining of chronic venous disease. Our study aims to investigate the effect of venous stenting of the deep veins on the healing of the venous ulcer. MethodsThis is a single-center, retrospective study conducted on prospectively recorded medical records of 78 patients with chronic deep venous diseases – C6 (either non-occlusive iliac venous lesion or post-thrombotic syndrome). Our lesion involved May-Thurner lesions, occlusions, insufficiencies, or stenoses owing to an affection of the venous outflow segment. All our patients underwent endovascular management, and those who did not respond successfully were transitioned to compression therapy. We then compared the outcomes of both groups in terms of ulcer healing and quality of life. ResultsA total of 78 patients (78 limbs), with a mean age of 39.6 ± 8.06 (range; 22-60) years, were treated. 54 patients (67.9%) were males, and 24 (32.1%) were female. The etiology was primary non-occlusive iliac venous lesion (NIVL) in 12 limbs (16.2%) and secondary (post-thrombotic) PTS in 66 (83.7%). Follow-up of the ulcer with compliance to compression therapy and standard care of the ulcer, sustained ulcer healing (reduction in ulcer area) was achieved in 60% of limbs, and most of non-occlusive the healing occurred within the first 3 months (p<0.01) ConclusionsOur results show that deep venous stenting is associated with high wound healing rates. This rate reaches a statistically significant difference in 3 months but this difference doesn't reach statistical significance at six months, with less recurrence, and improved quality of life with a high cumulative patency rate and that compression therapy is the mainstay of the conservative management of venous ulceration.