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Circ Cardiovasc Interv. 2015 Oct;8(10):e002772. doi: 10.1161/CIRCINTERVENTIONS.115.002772.

Safety and Effectiveness of Stent Placement for Iliofemoral Venous Outflow Obstruction: Systematic Review and Meta-Analysis.

Author information

1
From the Heart and Vascular Center, St. Joseph Hospital, Orange, CA (M.K.R.); Fireman Vascular Center, Massachusetts General Hospital, Boston (M.R.J.); and Miller Scientific Consulting, Inc, Asheville, NC (L.E.M.). mrazavi@pacbell.net.
2
From the Heart and Vascular Center, St. Joseph Hospital, Orange, CA (M.K.R.); Fireman Vascular Center, Massachusetts General Hospital, Boston (M.R.J.); and Miller Scientific Consulting, Inc, Asheville, NC (L.E.M.).

Abstract

BACKGROUND:

Endovenous recanalization of iliofemoral stenosis or occlusion with angioplasty and stent placement has been increasingly used to maintain long-term venous patency in patients with iliofemoral venous outflow obstruction. The purpose of this systematic review and meta-analysis was to determine safety and effectiveness of venous stent placement in patients with iliofemoral venous outflow obstruction.

METHODS AND RESULTS:

We searched MEDLINE and EMBASE for studies evaluating safety or effectiveness of stent placement in patients with iliofemoral venous outflow obstruction. Data were extracted by disease pathogenesis: nonthrombotic, acute thrombotic, or chronic post-thrombotic. Main outcomes included technical success, periprocedural complications, symptom relief at final follow-up, and primary/secondary patency through 5 years. A total of 37 studies reporting 45 treatment effects (nonthrombotic, 8; acute thrombotic, 19; and chronic post-thrombotic, 18) from 2869 patients (nonthrombotic, 1122; acute thrombotic, 629; and chronic post-thrombotic, 1118) were included. Technical success rates were comparable among groups, ranging from 94% to 96%. Complication rates ranged from 0.3% to 1.1% among groups for major bleeding, from 0.2% to 0.9% for pulmonary embolism, from 0.1% to 0.7% for periprocedural mortality, and from 1.0% to 6.8% for early thrombosis. Patient symptom relief data were reported inconsistently. At 1 year, primary and secondary patency were 96% and 99% for nonthrombotic, 87% and 89% for acute thrombotic, and 79% and 94% for chronic post-thrombotic.

CONCLUSIONS:

Stent placement for iliofemoral venous outflow obstruction results in high technical success and acceptable complication rates regardless of cause of obstruction.

KEYWORDS:

angioplasty; meta-analysis; pulmonary embolism; stents; venous thrombosis

[Indexed for MEDLINE]

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