Abstract

HALL, TC; BRAITHWAITE, BD; O'NEILL, R  and  HABIB, S. Endovenous management of chronic venous insufficiency. Angiol Cir Vasc [online]. 2019, vol.15, n.4, pp.226-230. ISSN 1646-706X.

Purpose: The efficacy of endovenous stenting for ileofemoral stenosis or occlusion in post-thrombotic syndrome (PTS) is gaining momentum with studies reporting improved clinical outcome. This study analyses the outcomes of venous stenting in PTS for patients in whom conservative and/or prior surgical treatment modalities had failed. Materials and Method: Operative and clinical records were retrospectively analysed in all patients who had endovenous stenting for PTS. Baseline demographics, procedural details and symptom severity based on CEAP and Villalta scores were collected. Stent patency was assessed by follow-up duplex ultrasound. Clinical follow-up included Villalta score and a subjective assessment of improvement. Results: Fifteen patients with a mean Villalta score of 11 were treated. Two were lost to follow-up. Technical success was 100% with no major complication. Two minor complications (self-limiting bleeding) occurred. At follow-up, stent patency, by Duplex ultrasound, was 71.4% at 13 (range 5-54) weeks. 53.8% (n=7) of patients reported subjective improvement in their symptoms, 30.8% (n=4) of patients reporting no improvement and 15.4% (n=2) of patients reporting worsening of their symptoms. The mean Villalta score at follow-up was 8.5; a significant reduction (p=0.049) from the pre-procedural score. Conclusion: Endovenous stenting for PTS can be performed safely and with a high technical success rate. Patency rates are reasonable and are associated with a significant reduction in Villalta scores.

Keywords : Angioplasty; Deep vein thrombosis; Iliac vein compression syndrome; Stents; Venous insufficiency; Peripheral vascular disease.

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