Venous recanalization by metallic stents after failure of balloon angioplasty or surgery: Four-year experience |
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Authors: | Gwen K Nazarian MD William R Austin Scott A Wegryn Haraldur Bjarnason Daniel J Stackhouse Wilfrido R Castañeda-Zúñiga David W Hunter |
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Institution: | (1) Department of Radiology, The University of Minnesota Hospital and Clinic, 420 Delaware Street S.E., Minneapolis, MN 55455-0392, USA, US |
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Abstract: | Purpose: This retrospective study describes our updated experience in treating venous stenoses and occlusions with metallic endovascular
stents.
Methods: Gianturco, Palmaz, and Wallstent stents were placed in 55 patients over a 4-year period. Stent sites included the subclavian
veins (9), innominate veins (3), superior vena cava (4), inferior vena cava (3), iliac veins (29), femoral veins (5), and
portal veins (6). The most common indications for stent placement were malignant stenoses and chronic pelvic venous occlusions.
Venoplasty and/or urokinase were used as ancillary therapy. Patients were anticoagulated for 3–6 months. Follow-up included
clinical assessment and duplex ultrasound.
Results: Lifetable analysis shows 59%, 63%, and 72% primary, primary assisted, and secondary 1-year patency rates, respectively. The
4-year primary patency rates were the same. Duration of patency depended on the venous site. Death was a complication of stent
placement in 2 patients and 12 patients died within 6 months after stent placement from primary disease progression. Although
early failures were more common in stents placed across occlusions than stenoses, 1-year secondary patency rates were comparable.
Primary patency rates were only slightly lower in patients with malignant obstruction than in patients with benign disease.
Conclusion: Endovascular stent placement provides a nonsurgical alternative for reestablishment of venous flow and symptomatic relief
in patients with benign as well as malignant venous obstruction.
Received: 0/00/00/Accepted: 0/00/00 |
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Keywords: | : Urokinase— Angiography complications— Veins transluminal angioplasty— Thrombosis venous— Veins abnormalities |
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