The role and principles of stenting in acute iliofemoral venous thrombosis

Journal of Vascular Surgery Venous and Lymphatic Disorders, vol. 12, pp. 101868

Abstract

Catheter-directed interventions for acute iliofemoral deep venous thrombosis (DVT) have been increasingly used over the past 15 years to target severe symptomatology and prevention of post-thrombotic syndrome incidence or reduce its severity if it were to develop. Aside from successful thrombus removal, adjunctive stents are frequently required to treat an uncovered lesion or significant residual thrombus to ensure quality of life improvement besides retarding DVT recurrence and post-thrombotic syndrome. As the evidence is mounting, the need and role for stenting, as well as the principles of an optimal technique, in the acute DVT setting are now better understood. Accumulating experience appears to favor stenting in the acute setting. The diameter of the stent, the length, the extent of overlapping, and the landing zones are crucial determinants of a successful durable outcome. This article endeavors to guide the interventionalist on stenting when encountering a patient with acute symptomatic iliofemoral DVT with concerns of quality of life impairment.

Authors 4

1. Efthymios D. Avgerinos corresponding

   National and Kapodistrian University of Athens · University General Hospital Attikon · Athens Medical Center

   Affiliation as printed

   Department of Vascular Surgery, Attikon Hospital, University of Athens, Athens, Greece; Athens Medical Center, Clinic of Vascular and Endovascular Surgery, Athens, Greece. Electronic address: eavgerinos@vascularhealth.gr

   Athens Medical Center, Clinic of Vascular and Endovascular Surgery, Greece

   Department of Vascular Surgery, Attikon Hospital, University of Athens, Greece

2. Stephen Black

   King's College London · Guy's and St Thomas' NHS Foundation Trust · St Thomas' Hospital

   Affiliation as printed

   Department of Vascular Surgery, Guy's and St Thomas' Hospital and Kings College, London, United Kingdom

   Department of Vascular Surgery, Guy's and St Thomas' Hospital and Kings College, London

3. Marie Josee van Rijn

   Erasmus MC · Erasmus University Rotterdam

   Affiliation as printed

   Department of Vascular and Endovascular Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands

4. Houman Jalaie Aachen Department of Vascular Surgery European Venous Center

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Vascular Surgery, European Venous Center, University Hospital RWTH Aachen, Aachen, Germany

   European Venous Center, Department of Vascular Surgery, University Hospital RWTH Aachen, Germany