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Venous recanalization by metallic stents after failure of balloon angioplasty or surgery: Four-year experience

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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.

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Author information

Author notes

  1. William R. Austin

    Present address: , 50 East Bannack Street, P.O. Box 469, 59725, Dillon, MT, USA

  2. Scott A. Wegryn

    Present address: Fort Sanders Radiology, P.C., 2001 Laurel Avenue, Suite N-304, 37916, Knoxville, TN, USA

  3. Daniel J. Stackhouse

    Present address: Department of Radiology, Duke University Medical Center, Box 3808, 27710, Durham, NC, USA

  4. Wilfrido R. Castañeda-Zúñiga

    Present address: Department of Radiology, Louisian State University Medical Center, 1542 Tulane Avenue, 70112-2822, New Orleans, LA, USA

Authors and Affiliations

  1. Department of Radiology, The University of Minnesota Hospital and Clinic, 420 Delaware Street S.E., 55455-0392, Minneapolis, MN, USA

    Gwen K. Nazarian M.D., William R. Austin, Scott A. Wegryn, Haraldur Bjarnason, Daniel J. Stackhouse, Wilfrido R. Castañeda-Zúñiga & David W. Hunter

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  1. Gwen K. Nazarian M.D.
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Nazarian, G.K., Austin, W.R., Wegryn, S.A. et al. Venous recanalization by metallic stents after failure of balloon angioplasty or surgery: Four-year experience. Cardiovasc Intervent Radiol 19, 227–233 (1996). https://doi.org/10.1007/BF02577640

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