International Angiology 2021 Feb 26

DOI: 10.23736/S0392-9590.21.04589-2

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Endovascular treatment of iliofemoral vein obstruction below the inguinal ligament using a new-dedicated stent: early experience from a single center

Domenico BACCELLIERI, Vincenzo ARDITA ✉, Luca APRUZZI, Niccolò CARTA, Victor BILMAN, Germano MELISSANO, Roberto CHIESA

Vascular Surgery Unit, Hospital S. Raffaele, Vita-Salute University, Milan, Italy

BACKGROUND: The aim of this study was to assess our experience with a new commercially available venous stent as an extension below the inguinal ligament in patients with iliofemoral venous outflow obstruction involving the common femoral vein.
METHODS: We treated 16 patients with iliofemoral venous outflow occlusion and postthrombotic syndrome (PTS) (mean age: 52.5±20.2; female: 87.5%) with the Blueflow Venous Stent between 2019 and 2020. All patients had unilateral venous disease with > 50% stenosis in the iliofemoral veins. The primary endpoints assessed were technical success, primary and secondary patency rate at 1 year of follow-up, respectively. Clinical improvement was assessed with the Villalta scale, revised venous clinical severity score (rVCSS) classification and visual analog-scale (VAS) respectively.
RESULTS: The technical success rate was 100%. No intraoperative and 30-days post-operative complications were documented. The primary and secondary patency rates were 80.2% and 100% respectively, at 1 year of follow-up. One in-stent occlusion and two in-stent restenosis were detected during follow-up. Stent fracture and/or migration were not observed during follow-up. A significant improvement in the Villalta scale and rVCSS score was documented with a median score of 3 (IQR: 2-6) and 2.5 (IQR: 1-5) versus baseline at the last follow-up. A pain reduction of 18 mm on the VAS scale was documented at 1-year follow-up.
CONCLUSIONS: In this cohort of patients, the Blueflow Venous Stent across the inguinal ligament was safe and effective for the treatment of symptomatic iliofemoral venous disease, with a high primary patency rate at 1-year of follow-up. However, longer follow-up and larger cohorts are still needed.

KEY WORDS: Deep vein thrombosis; Venous stent; Post-thrombotic syndrome; Recanalization