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CardioVascular and Interventional Radiology

, Volume 41, Issue 11, pp 1691–1698 | Cite as

Antiplatelet Therapy is Associated with Stent Patency After Iliocaval Venous Stenting

  • Masayuki Endo
  • Younes Jahangiri
  • Masahiro Horikawa
  • John A. Kaufman
  • Ryan C. Schenning
  • Kenneth J. Kolbeck
  • Robert E. Barton
  • Yasufumi Ohuchi
  • Keng Wei Liang
  • Khashayar Farsad
Clinical Investigation Venous Interventions
Part of the following topical collections:
  1. Venous Interventions

Abstract

Purpose

To examine the effectiveness of antithrombotic medications to prevent venous stent malfunction for iliocaval occlusive disease.

Materials and Methods

A retrospective analysis was performed on 62 patients who underwent technically successful endovascular iliocaval stent placement between May 2008 and April 2017. Clinical records were reviewed for demographic information, procedure details, post-stenting antithrombotic prophylaxis and stent patency on follow-up. Stent malfunction was defined as > 50% stenosis or occlusion at follow-up. Risk factors for stent malfunction were assessed with univariable and multiple Cox proportional hazard models.

Results

The median follow-up period was 11.6 months (range 0.1–76.4). Overall primary and secondary cumulative patency rates at 12 months were 70.0% and 92.4%, respectively. After stent placement, 97% of patients received anticoagulation with warfarin, enoxaparin or a factor Xa inhibitor. In addition, 61% received antiplatelet prophylaxis with aspirin, clopidogrel or a combination. In multiple Cox regression analysis, post-stenting antiplatelet use remained significantly associated with primary stent patency (HR = 0.28, P = 0.022).

Conclusion

After iliocaval venous stenting, stent patency was best predicted by concomitant antiplatelet and anticoagulation therapy rather than anticoagulation alone. This novel finding warrants further research underlying mechanisms leading to venous stent thrombosis, and has implications for optimal medical management after venous stenting.

Keywords

Venous stent Iliocaval Patency Antithrombotic prophylaxis Antiplatelet 

Notes

Acknowledgements

We thank Anantnoor Brar for her assistance with data gathering.

Compliance with Ethical Standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical Approval

The study is approved by the Institutional Review Board (IRB) of Oregon Health and Science University.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  • Masayuki Endo
    • 1
  • Younes Jahangiri
    • 1
  • Masahiro Horikawa
    • 1
  • John A. Kaufman
    • 1
  • Ryan C. Schenning
    • 1
  • Kenneth J. Kolbeck
    • 1
  • Robert E. Barton
    • 1
  • Yasufumi Ohuchi
    • 2
  • Keng Wei Liang
    • 1
  • Khashayar Farsad
    • 1
  1. 1.Charles T. Dotter Department of Interventional Radiology, Dotter Interventional InstituteOregon Health and Science UniversityPortlandUSA
  2. 2.Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of MedicineTottori UniversityYonagoJapan

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