Endovascular stent placement for chronic post-thrombotic symptomatic ilio-femoral venous obstructive lesions: a single-center study of safety, efficacy and quality-of-life improvement

Quantitative Imaging in Medicine and Surgery

Christophe Galland⁵  Sylvain Favelier⁴  Romaric Loffroy⁴  Pierre Pottecher⁴  Serge Aho-Glélé¹  Marie-Tiphaine Falcoz⁴  Maxime Samson³  Emmanuel Demaistre²  Nicolas Falvo⁵  Béatrice Terriat⁵  Marco Midulla⁴  Bernard Bonnotte³  Olivier Chevallier⁴  Sylvain Audia³ 

[1] Department of Epidemiology, Statistics and Clinical Research,;Department of Biological Haemostasis and Thrombosis Treatment,;Department of Internal Medicine and Clinical Immunology, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex, FranceDepartment of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, BP 77908, 21079 Dijon Cedex, France;;Department of Angiology and Vascular Medicine,

关键词: Ilio-femoral venous obstructive lesion;    post-thrombotic syndrome (PTS);    endovascular treatment;    stent placement;    quality of life;   

DOI  :  10.21037/qims.2016.07.07

学科分类：外科医学

来源: AME Publications

【 摘 要 】

Background: Post-thrombotic syndrome (PTS) is a frequent complication of deep vein thrombosis (DVT) despite adequate treatment. Venous angioplasty and stent placement has been progressively used to restore and maintain venous patency in PTS patients. This study reports our single-center experience with the use of endovascular treatment for chronic post-thrombotic symptomatic ilio-femoral venous obstructive lesions.

Methods: A prospective mono-centric observational cohort study of PTS patients with chronic symptomatic ilio-femoral venous obstructive lesions referred for endovascular treatment was conducted from March 2012 to April 2016. Procedure consisted in recanalization, pre-dilation and self-expandable stenting of stenotic or occluded iliac and/or femoral veins. Severity of PTS, quality-of-life and treatment outcomes were assessed using Villalta scale and Chronic Venous Insufficiency Questionnaire (CIVIQ-20) at baseline and 3 months after the procedure. Imaging follow-up was based on duplex ultrasound (US) and computed tomography (CT).

Results: Twenty-one patients (11 females, 10 males; median age, 41 years; range, 32�?60) were included. Recanalization and stenting was successfully accomplished in all prime procedures, 4 patients benefitted from an additional procedure. Immediate technical success rate was 96% considering 25 procedures, performed without any complications. Median follow-up was 18 months (range, 6�?30 months) with a 90.5% stent patency rate. Villalta score significantly decreased from baseline compared with 3 months after the procedure [14 (range, 11�?22) and 5 (range, 1�?10), respectively, P<0.0001], showing a significant decrease in the severity of PTS. CIVIQ-20 score significantly decreased from baseline compared with 3 months after stenting [48.5 (range, 39�?73) and 26.5 (range, 21�?45), respectively, P<0.0001] thus showing a significant improvement of quality-of-life. Post-procedural CIVIQ-20 score was significantly associated with Villalta score (95% CI, 1.53�?2.95; P<0.0001).

Conclusions: Our results confirm the high clinical success rate and safety of endovascular PTS treatment and highlight the significant impact of stenting on the quality of life of patients with chronic symptomatic ilio-femoral venous obstructive lesions.

【 授权许可】

Unknown