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Venous stenting

Sun-Ju Choi, Young Woo Do, Tak-Hyuk Oh, Hoseok Lee, Hyejin Cheon, Jae-Kwang Lim, Sang Yub Lee
INTRODUCTION: Central venous catheterization-induced central vein pseudoaneurysm is rare. Several treatment options have been recommended. We describe a case of central venous catheterization-induced right brachiocephalic vein pseudoaneurysm successfully treated with an uncovered self-expandable stent-assisted coil embolization and discuss the imaging findings, treatment strategy, and review of literature associated with thoracic venous pseudoaneurysm. CASE REPORT: A 77-year-old woman was referred to our trauma center to undergo treatment for central venous catheterization-induced central vein pseudoaneurysm...
March 1, 2018: Journal of Vascular Access
Kenneth Abreo, Adrian Sequeira
Stents are ubiquitously utilized in coronary and peripheral arterial disease. Interventional nephrologists, however, place stents in the venous outflow of the arteriovenous access. Stenosis is the predominant pathology that causes access dysfunction and will ultimately lead to thrombosis if uncorrected. Angioplasty and stent deployment are the current techniques available to combat stenosis. From initial bare metal stainless steel stents, the current generations of stents used are predominately covered nitinol stents...
March 1, 2018: Journal of Vascular Access
Yuki Horita
The objectives of central venous percutaneous transluminal angioplasty are to dilate the venous lesion and to extend the life of arteriovenous fistula for hemodialysis. It is reasonable to perform percutaneous transluminal angioplasty for central venous lesions if this interventional therapy is required to maintain stable dialysis therapy. However, the presence of large fresh thrombus at central venous lesion site represents a contraindication to percutaneous transluminal angioplasty unless the thrombus can first be removed by thrombectomy...
March 1, 2018: Journal of Vascular Access
William J Yoon, Pegge Halandras, Bernadette Aulivola, Paul Crisostomo
INTRODUCTION & OBJECTIVES: Cancer patients demonstrate increased risk for venous thromboembolism (VTE), VTE recurrence, and anticoagulation-associated bleeding. Pharmacomechanical thrombolysis and thrombectomy (PMT) improves venous patency, venous valve function, and quality of life in patients with acute iliofemoral deep venous thrombosis (DVT). It remains unknown whether pharmacomechanical thrombolysis can be used safely in patients with active cancer. We hypothesized that perioperative and short-term outcomes of pharmacomechanical iliofemoral DVT thrombolysis would not differ between patients with cancer and those without cancer...
March 5, 2018: Annals of Vascular Surgery
Xicheng Zhang, Zhaolei Chen, Yuan Sun, Miao Xu
PURPOSE: This study aimed to investigate the clinical efficacy of surgical thrombectomy and simultaneous iliac vein stent implantation for the treatment of phlegmasia cerulea dolens (PCD)caused by iliac vein occlusion. METHODS: From February 2014 to December 2016, five patients with secondary PCD complicated with iliac vein occlusion were treated in our centre. Thrombectomy by venous incision was performed with simultaneous iliac vein balloon dilatation and stent implantation...
March 5, 2018: Annals of Vascular Surgery
A Coelho, P Brandão, M Lobo, I Lojo, A Canedo
INTRODUCTION: Major pelvic Ilio-Iliac arteriovenous fistula (AVF) is an exceedingly rare diagnosis with only a few described cases in the literature, most of them related to congenital defects or trauma. In this case report, we aim to present a case of an ilio-iliac AVF with an atypical clinical presentation. CASE REPORT: The patient is a 77-year-old women, with a relevant medical history of a temporally remote hysterectomy. She developed an exuberant unilateral right leg oedema and was diagnosed with a femoro-iliac deep vein thrombosis (DVT) and started on anticoagulation and daily use of elastic compression stockings...
March 5, 2018: Annals of Vascular Surgery
Duarte C Rego, Ahmed Khairy Sayed Ahmed, Gerard J O'Sullivan
PURPOSE: The purpose of this work was to describe the results of a technique of simultaneous antegrade and retrograde vascular access ("criss-cross") to the popliteal vein to achieve venous recanalization in patients with acute, extensive, iliofemoral DVT with concomitant popliteal and calf vein thrombosis. MATERIALS AND METHODS: Seven patients were treated using this technique, in three patients as a bailout option after failed posterior tibial vein puncture and in four as a first option...
March 7, 2018: Cardiovascular and Interventional Radiology
Torulv Holst, Thorsten Großwendt, Majd Makarious Laham, Mehdy Roosta-Azad, Afsaneh Zandi, Markus Kamler
Endovascular stent placement for chronic postthrombotic iliofemoral venous obstructive lesions is an effective therapeutic option and might be complicated by stent migration. We report a case of a venous stent that was lost from the iliac vein into the right ventricle rescued by emergent open-heart surgery.
January 2018: Thoracic and Cardiovascular Surgeon Reports
Michael Lichtenberg, Rick de Graaf, Christian Erbel
Postthrombotic syndrome (PTS) is the most common complication after iliofemoral deep vein thrombosis. It reduces quality of life and increases deep vein thrombosis (DVT)-related costs. The clinical symptoms and severity of PTS may vary; the most common symptoms include edema, pain (venous claudication), hyperpigmentation, lipodermatosclerosis, and ulceration. PTS is based on the principle of outflow obstruction, which may be caused by venous hypertension and may lead to valvular damage and venous reflux or insufficiency...
March 8, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Timme Maj van Vuuren, Suat Doganci, Irwin M Toonder, Rick De Graaf, Cees Ha Wittens
Purpose Deep venous thrombosis causes blood flow deviation. It is hypothesized that with stent placement, developed collateral veins become redundant. This article evaluates the relation between the surface area of the collaterals and stent patency. Methods The azygos and hemiazygos veins were identified and the largest surface area was measured at thoracic level. Patency rates of stented tracts were evaluated and related to collateral vein lumen size. Results The vena cava occlusion and the azygos and hemiazygos vein surface area measurements were positive and statistically significant related (OR 1...
January 1, 2018: Phlebology
Anna K Stuck, Thomas Reich, Rolf P Engelberger, Tim Sebastian, Nils Kucher
BACKGROUND: The aim of the study was to investigate venous patency and clinical outcomes for endovascular treatment of iliofemoral venous obstruction in patients with post-thrombotic syndrome (PTS) and non-thrombotic iliac vein lesion (NIVL) with dedicated self-expanding nitinol stents. PATIENTS AND METHODS: Data were collected from the prospective Swiss Venous Stent Registry, enrolling consecutive patients with a standardized follow-up procedure since January 2008...
March 7, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Adham N Abou Ali, Efthymios D Avgerinos, Rabih A Chaer
Venous stenting for CVD is being increasingly used as more evidence accumulates supporting the open vein hypothesis and supporting the safety, efficacy, and durability of these interventions. As such, they can be offered to patients with advanced age and complex comorbidities. Future studies should focus on reporting outcomes specific to the underlying venous pathologic condition (thrombotic vs nonthrombotic and acute vs chronic) to provide better evidence for stenting in CVD, and the outcomes of new stent design with dedicated venous indications...
April 2018: Surgical Clinics of North America
Anthony N Hage, Ravi N Srinivasa, Steven D Abramowitz, Kyle J Cooper, Minhaj S Khaja, Geoff D Barnes, Jeffrey Forris Beecham Chick
Thrombosis of the inferior vena cava and iliac veins, known as iliocaval thrombosis, is a common cause of significant morbidity. Patients with chronic iliocaval obstruction often present with life-limiting occlusive symptoms secondary to recurrent lower extremity deep venous thrombosis, swelling, pain, venous stasis ulcers, or phlegmasia. Endovascular iliocaval reconstruction is a technically successful procedure that results in favorable clinical outcomes and stent patency rates with few complications and is often able to relieve debilitating symptoms in affected patients...
March 1, 2018: Vascular Medicine
Cameron M McDougall, Vin Shen Ban, Jeffrey Beecher, Lee Pride, Babu G Welch
OBJECTIVE The role of venous sinus stenting (VSS) for idiopathic intracranial hypertension (IIH) is not well understood. The aim of this systematic review is to attempt to identify subsets of patients with IIH who will benefit from VSS based on the pressure gradients of their venous sinus stenosis. METHODS MEDLINE/PubMed was searched for studies reporting venous pressure gradients across the stenotic segment of the venous sinus, pre- and post-stent pressure gradients, and clinical outcomes after VSS. Findings are reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines...
March 2, 2018: Journal of Neurosurgery
Huiying Yu, Xiaolong Du, Wendong Li, Dandan Song, Xiaoqiang Li, Peng Gao
OBJECTIVES: To evaluate the mid-term outcomes of catheter-directed thrombolysis with or without stent implantation for deep vein thrombosis in the presence of iliac vein compression. METHODS: Seventy-three patients with iliac vein compression following catheter-directed thrombolysis for acute lower extremity deep vein thrombosis from January 2009 to December 2014 were retrospectively analyzed. There were 32 males and 41 females, with average age of 53.57 ± 15.60 years (median 45 year, range 20-79 years)...
February 26, 2018: Annals of Vascular Surgery
Darius Dabir, Andreas Feisst, Daniel Thomas, Julian A Luetkens, Carsten Meyer, Ana Kardulovic, Matthias Menne, Ulrich Steinseifer, Hans H Schild, Daniel L R Kuetting
PURPOSE: Iliocaval obstruction is a substantial contributor to chronic venous insufficiency and is increasingly being treated endovascularly with angioplasty and stent placement. Utilization of an appropriate stent for treatment is pivotal; however, until today, mechanical properties of venous stents remain unknown. MATERIALS AND METHODS: We analyzed the radial resistive force, the chronic outward force, as well as the crush resistance of seven stent models [Zilver Vena (Cook, Bjaeverskov, Denmark), Sinus Venous, Sinus Obliquus and Sinus XL Flex (Optimed, Ettlingen, Germany), Vici (Veniti; St...
February 28, 2018: Cardiovascular and Interventional Radiology
Anthony N Hage, Ravi N Srinivasa, Steven D Abramowitz, Joseph J Gemmete, Shilpa N Reddy, Jeffrey Forris Beecham Chick
PURPOSE: To report global iliocaval stent reconstruction practices by interventionalists. MATERIALS AND METHODS: A 45-question survey focusing on iliocaval stent reconstruction evaluation was distributed through the Open Forum and Venous Disease Service Line of the Society of Interventional Radiology Connect website from June 20, 2017 until September 7, 2017 and the Cardiovascular and Interventional Radiological Society of Europe electronic newsletter on August 11, 2017...
February 24, 2018: Annals of Vascular Surgery
Sameer Lakha, C Y Maximilian Png, Kevin Chun, Windsor Ting
OBJECTIVE: Vascular manifestations including pulmonary artery aneurysms and venous thrombosis are seen in up to 14% of patients with Behcet's Disease. We report a patient who had recurrent deep vein thrombosis (DVT) as the presenting symptom of Behcet's Disease. METHODS: A 19-year-old male who presented with acute iliofemoral DVT, confirmed by intravascular ultrasound (IVUS) and venogram. May-Thurner syndrome was also observed. Repeated catheter-based pharmaco-mechanical thrombolysis, thrombectomy and subsequent iliac vein stenting were performed...
February 23, 2018: Annals of Vascular Surgery
Meena M Archie, Johnathon C Rollo, Hugh A Gelabert
INTRODUCTION: Surgical management of spontaneous subclavian thrombosis due to venous thoracic outlet syndrome (vTOS) results in durable relief of symptoms. The need to re-operate is rare. We report our experience with re-operation for vTOS. METHODS: Patients evaluated for vTOS between 1996 and 2016 were identified in a prospective database. Data recorded included demographics, initial presentation, initial surgery, recurrent presentation, re-operation, and final outcomes...
February 22, 2018: Annals of Vascular Surgery
Ahmad Alsheekh, Anil Hingorani, Afsha Aurshina, Pavel Kibrik, Natalie Marks, Yuriy Ostrozhynskyy, Enrico Ascher
Background There have been well-documented implications of race/ethnicity on the outcome of various vascular diseases, yet there are limited data on risk factors and outcome of lower limb swelling. While many patients improve with endovenous therapy (thermal ablation or iliac vein stenting), some patients' symptoms persist. The goal of this study was to identify clinical factors including race/ethnicity related to persistent leg swelling after treatment with both iliac vein stenting and thermal ablation. Methods From February 2012 to February 2014, this observational study analyzed data for 173 patients with chronic venous insufficiency who underwent both iliac vein stent placement as well as thermal ablation (radiofrequency ablation or endovenous laser ablation)...
January 1, 2018: Vascular
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