PC180. Iliac-femoral Post-Thrombotic Syndrome: Three-Dimensional CT Venography for Preintervention Evaluation and Midterm Stent Patency Follow-up

Abstract

The study aimed to evaluate the imaging quality of three-dimensional computed tomography venography (3D-CTV) for iliac-femoral post-thrombotic syndrome (IFPTS) and midterm patency after stent angioplasty. A retrospective analysis of postthrombotic patients with iliac-femoral vein obstruction was conducted in a single institution from January 2013 to December 2014. 3D-CTV and digital subtraction angiography (DSA) were performed in 79 suspected IFPTS cases with Villalta score ≥10. The potential role of 3D-CTV in morphologic diagnosis was evaluated compared with DSA. Cumulative primary and secondary patency rates were followed up after stent angioplasty with 3D-CTV. 3D-CTV represents a sensitivity of 92.3% and a specificity of 71.4% for IFPTS morphologic diagnosis compared with DSA. The overall quality of 3D volume-rendered images (Fig 1) in the visualization of iliac-femoral vein was excellent in 82.2% of patients, fair in 12.7%, and poor in 5.1%. Percutaneous iliofemoral venous stenting (Fig 2) was successful in 63 of 65 patients (96.9%). Follow-up was a median of 21 months (range, 12-36 months). Cumulative primary and secondary stent patency rates at 2 years were 75.6% and 94.6%, respectively. Most of the stent restenosis/occlusion occurred at the 1 month follow- up after stent angioplasty (11 of 15 [73.3%]). 3D-CTV demonstrated satisfactory sensitivity and image quality for evaluating IFPTS and venous patency after stent angioplasty. Although most of stent restenosis or occlusion occurred in the early follow-up, initial luminal patency was well maintained during midterm follow-up.Fig 2View Large Image Figure ViewerDownload Hi-res image Download (PPT)