Endovascular Iliocaval Stent Reconstruction for Inferior Vena Cava Filter-Associated Iliocaval Thrombosis: Approach, Technical Success, Safety, and Two-Year Outcomes in 120 Patients.
Citation: Journal of Vascular & Interventional Radiology. 28(7):933-939, 2017 JulPMID: 28527883Institution: MedStar Washington Hospital CenterDepartment: Surgery/Vascular SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Stents | *Vena Cava Filters | *Venous Thrombosis/th [Therapy] | Adult | Aged | Aged, 80 and over | Constriction, Pathologic | Device Removal | Endovascular Procedures | Female | Humans | Iliac Vein | Male | Middle Aged | Registries | Retrospective Studies | Risk Factors | Thrombolytic Therapy | Treatment Outcome | Vascular Patency | Vena Cava, InferiorYear: 2017Local holdings: Available online through MWHC library: 2002 - 2006, Available in print through MWHC library: 1999 - 2006ISSN:- 1051-0443
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
---|---|---|---|---|---|---|
Journal Article | MedStar Authors Catalog | Article | 28527883 | Available | 28527883 |
Available online through MWHC library: 2002 - 2006, Available in print through MWHC library: 1999 - 2006
CONCLUSIONS: Iliocaval stent reconstruction is an effective treatment for filter-associated thrombosis with 100% technical success and 96% clinical success at 6 months. Technical and clinical outcomes in patients who underwent filter retrieval versus filter exclusion were similar.
Copyright � 2017 SIR. Published by Elsevier Inc. All rights reserved.
MATERIALS AND METHODS: A total of 120 patients with 123 IVC filters and symptomatic iliocaval thrombosis underwent stent reconstruction. Mean patient age was 55 years (range, 19-88 y). Filters included 70 (57%) retrievable and 53 (43%) permanent filters. Symptoms included lower extremity swelling or pain (n = 93), ulcers (n = 8), phlegmasia (n = 7), back pain (n = 5), shortness of breath (n = 4), worsening renal function (n = 2), and stenosis identified during translumbar catheter placement (n = 1). Clinical success was defined as decrease in clinical, etiology, anatomy, and pathophysiology (CEAP) score of at least 1; resolution of presenting symptoms; or normalization of renal function in patients with juxtarenal or suprarenal thrombosis on presentation. Technical aspects of reconstruction, technical success, complications, 6-month clinical response, and 6-, 12-, and 24-month primary, primary-assisted, and secondary stent patency rates were recorded.
PURPOSE: To report technical success, outcomes, and patency of iliocaval stent reconstruction for inferior vena cava (IVC) filter-bearing iliocaval thrombosis.
RESULTS: Stent reconstruction was technically successful in all 120 patients, 63 of whom (53%) underwent thrombolysis. Thirty filters (24%) were retrieved, and 93 (76%) were excluded with stent placement across the indwelling filter. Six minor and 2 major complications occurred. Clinical success was achieved in 115 patients (96%) at 6 months. Six-, 12-, and 24-month primary iliocaval stent patency rates were 96.4%, 94.8%, and 87.2%, respectively. Twenty-four month primary-assisted and secondary patency rates were 90.3% and 94.2%, respectively.
English