Stent extension into a single inflow vessel is a valuable option after endophlebectomy

Timme M. A. J. van Vuuren*, Ralph L. M. Kurstjens, Mark A. F. de Wolf, Jorinde H. H. van Laanen, Cees H. A. Wittens, Rick de Graaf

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Web of Science)

Abstract

Background Venous stenting with an endophlebectomy and arteriovenous fistula can be performed in patients with extensive post-thrombotic changes. However, these hybrid procedures can induce restenosis, sometimes requiring stent extension, into a single inflow vessel. This study investigates the effectiveness of stenting into a single inflow vessel. Methods All evaluated patients had temporary balloon occlusion of the arteriovenous fistula to evaluate venous flow into the stents. When stent inflow was deemed insufficient, AVF closure was postponed and additional stenting was performed. Patency rates and clinical outcomes were evaluated. Results Twenty-four (38%) of 64 patients had additional stenting. The primary, assisted primary and secondary patency were 60 %, 70% and 70% respectively. Villalta score reduced by 6.1 points (p<0.001), and venous clinical severity score by 2.7 points (p=0.034). Conclusion Stenting through the femoral confluence into a single inflow vessel is a feasible bailout option if primary hybrid intervention fails with relative high patency rates and clinical improvement.
Original languageEnglish
Pages (from-to)610-617
Number of pages8
JournalPhlebology: The Journal of Venous Disease
Volume33
Issue number9
DOIs
Publication statusPublished - 1 Oct 2018

Keywords

  • Chronic venous disease
  • endovenous technique
  • post-thrombotic syndrome
  • venous obstruction
  • venous thromboembolism
  • CHRONIC VENOUS DISEASE
  • UIP CONSENSUS DOCUMENT
  • COMMON FEMORAL VEIN
  • ARTERIOVENOUS-FISTULA
  • DUPLEX ULTRASOUND
  • LOWER-LIMBS
  • RECANALIZATION
  • OBSTRUCTION
  • ENDOVENECTOMY
  • SYMPTOMS
  • GEOMETRY

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