Stent Patency in Patients With Advanced Chronic Venous Disease and Nonthrombotic Iliac Vein Lesions

Abstract

Midterm patency results of iliac vein stents placed for nonthrombotic iliac vein lesions (NIVL) are not known. Two published large series of patients with iliac vein stent placement have not differentiated the outcomes between thrombotic and nonthrombotic lesions. To further study this issue, we reviewed our series of 170 iliac vein stents placed for NIVL. Retrospective analysis was performed of 126 patients who underwent common or external iliac vein angioplasty and stent placement between January 2013 and December 2014. Only patients with CEAP scores of C3, C4, or C5 were included. Patients were excluded if they had either active ulcer disease or signs of post-thrombotic lesions at initial venography. Duplex was performed postoperatively and at follow-up visits. Length of follow-up and stent patency were based on the last previous duplex available. A total of 170 procedures were performed in 126 patients. Stent placement was needed in bilateral lower extremities in 122 patients. A total of 112 of 170 procedures (66%) were performed on female patients. The average age of our patients was 72 (SD ± 13.4) years. A total of 90 of 170 procedures (53%) were performed on the left lower extremity. CEAP classification of lower extremity venous disease was 59%, 31%, and 9% for C3, C4, and C5, respectively. Our average follow-up period was 437 days (median, 460 days; range, 1 to 943 days). We had a postprocedure follow-up time of >6 months, 1 year, and 2 years of 70%, 52%, and 22%, respectively. During this period, 4 of 170 limbs (2.35%) experienced in-stent thrombosis. Primary stent patency of 99.4%, 98.8%, and 97.6% was noted at 6 months, 1 year, and 2 years of follow-up, respectively. The midterm patency results for iliac vein stents placed in patients for advanced chronic venous disease is excellent (97%).