3:18 PM Abstract No. 353 Nitinol Self-Expanding Stents for the Treatment of Chronic Iliofemoral Veno-Occlusive Disease

To evaluate the clinical and technical outcomes of nitinol self-expanding stents for the treatment of symptomatic chronic iliofemoral veno-occlusive disease. A retrospective review was performed of 169 consecutive patients (196 limbs) treated with self-expanding nitinol stents for chronic iliofemoral veno-occlusive disease between July 2011 and June 2017. Patients treated with non-nitinol stents and patients with IVC involvement were excluded. Procedural and follow-up data were collected for assessment of technical success, clinical outcomes, safety, and patency. Technical success was defined as the ability to recanalize and stent the obstructive lesion without significant residual stenosis. Binary patency was assessed with duplex ultrasound and calculated by Kaplan Meier analysis. Clinical outcomes were evaluated utilizing CEAP and Villalta scores. A total of 378 (278 Left, 95 Right) nitinol self-expanding stents were placed with sizes ranging from 8 to 14 mm. Technical success was achieved in 195 of 196 limbs (99%). Of the 169 patients, 100, 45, and 24 presented with symptoms consistent with acute, acute on chronic, and chronic DVT, respectively. Mechanical thrombectomy was performed in 96 (49%) patients while catheter-directed thrombolysis was employed in 92 (47%) patients. Mean followup time was 9.8 months. Kaplan Meier analysis revealed a primary patency of 95%, 93%, 91%, and 91% at 6, 12, 24, and 36 months respectively. Pre- and post-CEAP or Villalta scores were available in 140 (83%) patients. CEAP and Villalta scores improved from 3.65 to 2 (-55%) and 19.15 to 8.6 (-45%), respectively. There were 5 recorded adverse events; 3 mild, 1 moderate, and 1 severe. Endovascular management of chronic iliofemoral veno-occlusive disease with self-expanding nitinol stents is a safe and durable procedure with high technical success, excellent mid-term patency, and good clinical outcomes.