Arshpreet Singh Badesha1, Prab Rajan Singh Bains2, Bal Rajan Singh Bains2, Taha Khan3. 1. Manchester Medical School, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom. Electronic address: arshpreet.badesha@student.manchester.ac.uk. 2. Manchester Medical School, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom. 3. Department of Vascular Surgery, Manchester Vascular Service, Manchester, United Kingdom.
Abstract
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 Embase 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 nonthrombotic 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), in-stent 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.
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 Embase 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 nonthrombotic 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), in-stent 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.
Authors: Christina G Antipova; Yulia M Parunova; Maria V Vishnevskaya; Sergey V Krasheninnikov; Ksenia I Lukanina; Timofei E Grigoriev; Sergei N Chvalun; Pavel M Gotovtsev Journal: Heliyon Date: 2022-03-29
Authors: Matthew Ka Ki Law; Hoi Kevin Chin; Chi Yeung Chu; Yip Kan Kendrick Tang; Kam Wing Leung; Wai Kuen Kan Journal: J Clin Imaging Sci Date: 2022-08-25