TY - JOUR
T1 - Venous Stents Placed for Postthrombotic Syndrome
T2 - The Role of Inflow Disease on Patency
AU - Bakas, Jay M.
AU - de Wolf, Mark A.F.
AU - van den Bos, Renate R.
AU - Malskat, Wendy S.J.
AU - van Montfrans, Catherine
AU - van der Wilden, Gwendolyn M.
AU - Verhagen, Hence J.M.
AU - van Rijn, Marie Josee E.
N1 - Publisher Copyright:
© 2024 SIR
PY - 2024/12/8
Y1 - 2024/12/8
N2 - Purpose: To identify the risk of deep femoral vein (DFV) and/or femoral vein (FV) inflow disease on venous stent patency loss in postthrombotic syndrome (PTS). Materials and Methods: This single-center retrospective study included limbs with iliofemoral and iliocaval stents for PTS. Single-vessel and double-vessel inflow disease were defined on the basis of imaging of possible postthrombotic changes in the DFV/FV. Endpoints were 1-year primary patency (open stents without reintervention) and secondary patency (open stents with or without reintervention). Event-free survival was estimated using Kaplan-Meier methods (log-rank test). Univariate and multivariate binary logistic regression were conducted to estimate the effects of various covariates on the risk of primary patency loss. Results: Eighty limbs were included: 37 limbs (46%) without inflow disease, 26 limbs (33%) with single-vessel inflow disease, and 17 limbs (21%) with double-vessel inflow disease. One-year primary patency was higher for limbs without inflow disease (89.2%) than for limbs with single-vessel inflow disease (57.7%; P = .002) and double-vessel inflow disease (47.1%; P < .001). No significant differences were found for secondary patency. Inflow disease predicted 1-year primary patency loss (odds ratio [OR], 7.17; 95% CI, 2.16–23.78; P = .001; univariate). Inflow disease of the FV was the only significant predictor after multivariate analysis (OR, 10.99; 95% CI, 2.59–46.74; P = .001). Conclusions: Inflow disease increases the risk of patency loss within the first year after treatment with venous stents for PTS. Inflow should be discussed with patients to improve decision making and expectations.
AB - Purpose: To identify the risk of deep femoral vein (DFV) and/or femoral vein (FV) inflow disease on venous stent patency loss in postthrombotic syndrome (PTS). Materials and Methods: This single-center retrospective study included limbs with iliofemoral and iliocaval stents for PTS. Single-vessel and double-vessel inflow disease were defined on the basis of imaging of possible postthrombotic changes in the DFV/FV. Endpoints were 1-year primary patency (open stents without reintervention) and secondary patency (open stents with or without reintervention). Event-free survival was estimated using Kaplan-Meier methods (log-rank test). Univariate and multivariate binary logistic regression were conducted to estimate the effects of various covariates on the risk of primary patency loss. Results: Eighty limbs were included: 37 limbs (46%) without inflow disease, 26 limbs (33%) with single-vessel inflow disease, and 17 limbs (21%) with double-vessel inflow disease. One-year primary patency was higher for limbs without inflow disease (89.2%) than for limbs with single-vessel inflow disease (57.7%; P = .002) and double-vessel inflow disease (47.1%; P < .001). No significant differences were found for secondary patency. Inflow disease predicted 1-year primary patency loss (odds ratio [OR], 7.17; 95% CI, 2.16–23.78; P = .001; univariate). Inflow disease of the FV was the only significant predictor after multivariate analysis (OR, 10.99; 95% CI, 2.59–46.74; P = .001). Conclusions: Inflow disease increases the risk of patency loss within the first year after treatment with venous stents for PTS. Inflow should be discussed with patients to improve decision making and expectations.
UR - http://www.scopus.com/inward/record.url?scp=85215074649&partnerID=8YFLogxK
U2 - 10.1016/j.jvir.2024.11.030
DO - 10.1016/j.jvir.2024.11.030
M3 - Article
C2 - 39662620
AN - SCOPUS:85215074649
SN - 1051-0443
VL - 36
SP - 446
EP - 455
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 3
ER -