• T M A J van Vuuren, de Wolf M A F MAF Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands; Cardiovascular Research Institute Ma, Arnoldussen C W K P CWKP Department of Radiology, Maastricht University Medical Centre, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands; Department of Radiology, Vi, Kurstjens R L M RLM Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands; Cardiovascular Research Institute , van Laanen J H H JHH Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands., H Jalaie, R de Graaf, and Wittens C H A CHA Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands; Cardiovascular Research Institute Ma.
• Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: timme.van.vuuren@mumc.nl.
• Eur J Vasc Endovasc Surg. 2017 Oct 1; 54 (4): 495-503.

Objective/BackgroundDeep venous obstruction is relatively prevalent in patients with chronic venous disease. Endovascular treatments and hybrid interventions can be used to relieve venous outflow obstructions. This paper assesses mid-term clinical outcomes and patency rates in a large cohort after percutaneous and hybrid interventions.MethodsThis was a prospectively analysed cohort study. Patients with symptomatic deep venous obstruction who presented at a tertiary referral hospital were divided into three groups: patients who underwent percutaneous stenting for non-thrombotic iliac vein compression syndrome (IVCS group); patients with post-thrombotic syndrome (PTS) treated by percutaneous stent placement (P-PTS group); and PTS patients with obstruction involving the veins below the saphenofemoral junction in which a hybrid procedure was performed, combining stenting with open surgical disobliteration (H-PTS group). Patency rates, complications, and clinical outcomes were analysed.ResultsA total of 425 lower extremities in 369 patients were treated. At 60 months, primary patency, assisted primary patency, and secondary patency rates were 90%, 100%, and 100% for IVCS, and 64%, 81%, and 89% for the P-PTS group, respectively. The H-PTS group, showed patency rates of 37%, 62%, and 72%, respectively, at 36 months. Venous claudication subsided in 90%, 82%, and 83%, respectively. At the 24 month follow-up, mean Venous Clinical Severity Score decreased for all patients and improvement in Villalta score was seen in post-thrombotic patients. The number of complications was related to the extent of deep venous obstruction in which patients in the H-PTS group showed the highest complication rates (81%) and re-interventions (59%).ConclusionPercutaneous stent placement to treat non-thrombotic iliac vein lesions, and post-thrombotic ilio-femoral obstructions are safe, effective, and showed patency rates comparable with previous research. Patients with advanced disease needing a hybrid procedure showed a lower patency rate and more complications. However, when successful, the clinical outcome was favourable at mid-term follow-up and the procedure may be offered to selected patients.Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

25 keywords...

hide…