期刊
JOURNAL OF VASCULAR SURGERY-VENOUS AND LYMPHATIC DISORDERS
卷 10, 期 1, 页码 267-+出版社
ELSEVIER
DOI: 10.1016/j.jvsv.2021.04.014
关键词
Chronic deep venous disease; Deep venous thrombosis; Deep venous stenting
The study summarized the efficacy and safety of dedicated venous stenting for obstructive chronic deep venous disease, demonstrating symptomatic improvement and good patency outcomes post-stenting, with some complications to be aware of.
Objective: This review aims to summarise the efficacy and safety of dedicated venous stenting for the treatment of obstructive chronic deep venous disease. The approaches to stenting and post-procedural management of different vascular units are also highlighted. Methods: MEDLINE and Em base were searched to identify relevant literature on dedicated venous stents published from January 2010 to May 2020. The patient population and study characteristics; procedural characteristics; and outcomes related to post-stenting symptoms, health-related quality of life, patency, and complications were analyzed. Results: Sixteen single-arm observational studies were included from 2366 studies identified from key word searches. In total, 1688 patients were included, of which 70.5% had post-thrombotic syndrome and the remainder had non-thrombotic iliac vein lesions. Nine studies (n = 848) stated whether lesions were stenotic (36.6%) or occlusive (63.4%). Seven studies did not report the lesion characteristics (n = 840). Eight different dedicated venous stent brands were used. At the last follow-up, 73.4% of ulcers had healed. The remaining symptomatic changes were described narratively; sustained improvements in pain, venous claudication, and edema after stenting were observed. Significant post-stenting improvements in health-related quality of life were noted, as measured by the Chronic Venous Insufficiency Questionnaire-20 instrument. Overall, the most frequently reported complications were in-stent occlusion (n = 204), instent stenosis (n =149), and minor bleeding (n = 77). At 12 months, the primary patency ranged from 59% to 94%, whereas the secondary patency ranged 87% to 100%. The pooled primary and secondary stent patency rates at 12 months were 74.0% and 90.4%, respectively. The incidence of major and minor bleeding was 1.9% and 4.7%, respectively; bleeding complications were more common in patients undergoing hybrid interventions. Conclusions: Deep venous stenting using dedicated venous stents is a safe technique to treat obstructive chronic deep venous disease and within the limitations of this study, is associated with good patency outcomes and symptomatic improvement.
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