Underexpansion of Wallstents® in the Treatment of Nonthrombotic Iliac Vein Lesions

Annals of Vascular Surgery
Jacob E MandelEnrico Ascher

Abstract

Iliac vein stenting is increasingly being used in the treatment of chronic venous insufficiency caused by nonthrombotic iliac vein lesions (NIVL). We have noticed that many stents do not deploy to the expected stent area (ESA) as designated by the manufactured stent diameter (MSD). The purpose of this study was to identify factors predictive of Wallstent® underexpansion in the iliocaval venous system. Retrospective analysis of all patients with NIVL who were treated with iliac vein stenting using Wallstents® was performed. None of the patients in this study underwent pre-or post-stenting balloon angioplasty. Multiway analysis of variance and multiple linear regression analysis were performed to examine the effects of gender, age, stent laterality, location of stenosis, and CEAP (clinical, etiology, anatomy, and pathophysiology) score at presentation on the proportion of observed stent area (OSA) to ESA. Two-hundred three patients (64 male and 139 female; mean age: 68 ± 13.9 years) underwent 242 treatments between December 2012 and January 2016. Disease severity based on CEAP score were: C1 (0), C2 (0), C3 (n = 59, 24%), C4 (n = 148, 61%), C5 (n = 4, 2%), and C6 (n = 31, 13%). On average, stents deployed to 69.58% of the ESA (ra...Continue Reading

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