Clinical Outcomes of Venous Self-Expanding Stent Placement for Ilio-femoral Venous Outflow Obstruction

Abstract Objective This study aimed to evaluate the feasibility of a self-expanding venous stent for treating ilio-femoral venous obstruction. Methods This retrospective study reviewed 49 patients who underwent Zilver® VenaTM stent placement for treatment of ilio-femoral venous obstruction from September 2017 to March 2019. All patients received follow-up examination with Duplex ultrasound to assess stent patency, and Villalta scores and venous clinical severity scores (VCSS) were further calculated to stratify the post-operative improvement of diseases. Results Among the 49 patients, 19 were diagnosed with acute deep venous thrombosis, 7 presented with non-thrombotic iliac venous lesions, and the remaining 23 presented with post-thrombotic syndrome. One year after Zilver® VenaTM stent placement, primary, assisted primary, and secondary patency rates were calculated as 93.8%, 95.9%, and 97.9%, respectively. Based on the pretreatment baseline measurements, the median Villalta score for the post-thrombotic syndrome patients was 19 (range, 11 - 30), and the median VCSS for the post-thrombotic syndrome and non-thrombotic iliac venous lesions patients was 11 (ranging between 6 - 25). One year after stent placement, the median Villalta score for the post-thrombotic syndrome patients was 4.0 (range, 2 - 18), and the median VCSS for the post-thrombotic syndrome and non-thrombotic iliac venous lesions patients was 3.0 (range, 2 - 12). Conclusion Venous placement of self-expanding stents offered excellent one-year patency rates and improved the outcomes of patients with ilio-femoral venous obstructions caused by acute deep venous thrombosis, non-thrombotic iliac venous lesions, and post-thrombotic syndrome.