A systematic review of venous stents for iliac and venacaval occlusive disease.

Journal Article (Journal Article;Systematic Review)

OBJECTIVE: Endovascular stenting of the deep venous system is increasingly used to treat stenotic and occluded veins. This article reviews the efficacy and safety of venous stenting for lower extremity occlusive disease. METHODS: The Ovid portal was used to search the MEDLINE database for English-language randomized controlled trials and case series published between January 1, 2005, and December 31, 2018, involving venous stenting for lower extremity and inferior venacaval occlusive and compressive disease. Studies were eligible for inclusion if they contained at least 30 patients with at least 6 months of follow-up. Clinical outcomes, long-term patency, complications, and postoperative anticoagulation regimens were reviewed. Also included are nationally presented trial results of dedicated venous stents that may not have been formally published yet. RESULTS: Relevant studies were too heterogeneous for a formal meta-analysis to be performed. We analyzed 3812 stented limbs from 23 published studies and two national presentations. Dedicated venous stents were used in 740 patients, and standard stents were used in 3072 patients. The overall major complication rate was <1%. Median symptomatic improvement and ulcer healing were seen in 79% and 71% of the standard stented limbs, respectively. For standard stents, the median primary, assisted primary, and secondary patency rates were 71%, 89%, and 91%, respectively, with a median study follow-up of 23.5 months. Dedicated venous stents had an overall primary patency of 78.8% at 12 months, with lower patency (73%) seen in post-thrombotic vs compressive (96%) disease. CONCLUSIONS: Whereas the quality of evidence remains weak, iliocaval venous stenting appears to be a safe and effective treatment of chronic venous disease. In early results, dedicated venous stents appear safe and demonstrate results that are as good as or better than those of historically used devices.

Full Text

Duke Authors

Cited Authors

  • Williams, ZF; Dillavou, ED

Published Date

  • January 2020

Published In

Volume / Issue

  • 8 / 1

Start / End Page

  • 145 - 153

PubMed ID

  • 31699668

Electronic International Standard Serial Number (EISSN)

  • 2213-3348

Digital Object Identifier (DOI)

  • 10.1016/j.jvsv.2019.08.015

Language

  • eng

Conference Location

  • United States