Indications, technical aspects, and outcomes of stent placement in chronic iliofemoral venous obstruction

J Vasc Surg Venous Lymphat Disord. 2024 May 15:101904. doi: 10.1016/j.jvsv.2024.101904. Online ahead of print.

Abstract

Background: Iliofemoral Venous Stent Placement (IVS) has evolved to a well-established endovascular treatment modality for chronic iliofemoral venous obstruction (CIVO). Dedicated venous stents gained FDA approval in 2019 and solidified IVS as a defined intervention with clear indications, contraindications, risks, benefits, and procedural management principles. This review focuses on the indications, technical aspects and outcomes of stenting for CIVO. Other aspects pertaining to IVS are covered in manuscripts that are part of this series.

Methods: This study conducted a literature search limited to English articles. Three search strategies were employed, and references were managed in Covidence software. Four investigators independently screened and evaluated articles, excluding meta-analyses, clinical trial protocols, and non-relevant studies. Eligible studies, focused on clinical outcomes and stent patencies, underwent thorough review.

Results: The literature search yielded 1,704 studies, with 147 meeting eligibility criteria after screening and evaluation. Exclusions were based on duplicates, irrelevant content, and non-iliac vein stent placement.

Conclusion: Successful IVS for CIVO relies on meticulous patient selection, consistent use of IVUS during procedures, and attention to the technical details of IVS.

Keywords: Abre; May-Thurner syndrome; Optimed; Venovo; Wallstent; Zilver; iliac vein; iliofemoral; non-thrombotic iliac vein lesion; venous obstruction; venous stent.

Publication types

  • Review