Long-term outcome of dedicated venous stents in management of chronic iliofemoral obstruction

To study the long-term outcomes in patients with occlusive Iliofemoral chronic venous insufficiency of benign etiology treated by dedicated venous stents (Zilver Vena stents; Cook, Bloomington, IN, USA) placed at a single center MATERIALS AND METHODS: Retrospective analysis of prospectively collected data from 58 patients with symptomatic benign lower limb chronic venous insufficiency during the period from January 2013 to October 2020. Patients underwent recanalization using Zilver Vena stents at Ain Shams University hospitals. We excluded Patients requiring stenting after intervention for acute DVT, CVI due to malignancy or vascular malformations, previous ipsilateral venous interventions, or CVI due to non-obstructive pathology (reflux). Patients were clinically classified at enrollment by CEAP class, VDS (venous disability score) and Villalta score. Primary, Primary assisted and Secondary stent patency were assessed. Patients were followed clinically and by duplex, at 1, 3, 6, 12 months and annually for five years RESULTS: There were 31 males and 27 females, with ages ranging between 25 to 60 years (mean 43.84 years). All patients had Post Thrombotic Syndrome (PTS) with a mean Villalta score of 16.8 (range 10-31).Patients were treated with dedicated venous stents and had median follow up of 60 months. Median VDS was 3 at the start of the study with a significant decrease to 1 at 5 year follow up (p < 0.001). 12-month primary patency, assisted primary patency, and the secondary patency were 91.4%, 96.6%, and 98.3%. At the five-year follow-up, primary patency 60.3%, assisted primary patency 65.5%, and secondary patency was 81%. There were no instances of stent fracture, migration, or structural deformities CONCLUSIONS: Treating diseased Iliofemoral venous occlusive disease with a dedicated venous stent is an excellent choice for occlusive post-thrombotic syndrome patients. The technique has good 1-year and 5-year patency and is associated with significant clinical improvement and few complications.