VENOUS RECANALIZATION BY METALLIC STENTS AFTER FAILURE OF BALLOON ANGIOPLASTY OR SURGERY - 4-YEAR EXPERIENCE

Purpose: This retrospective study describes our updated experience in treating venous stenoses and occlusions with metallic endovascular ste nts. Methods: Gianturco, Palmaz, and Wallstent stents were placed in 5 5 patients over a 4-year period, Stent sites included the subclavian v eins (9), innominate veins (3), superior vena cava (4), inferior vena cava (3), iliac veins (29), femoral veins (5), and portal veins (6). T he most common indications for stent placement were malignant stenoses and chronic pelvic venous occlusions. Venoplasty and/or urokinase wer e used as ancillary therapy, Patients were anticoagulated for 3-6 mont hs, Follow-up included clinical assessment and duplex ultrasound. Resu lts: Lifetable analysis shows 59%, 63%, and 72% primary, primary assis ted, and secondary 1-year patency rates, respectively. The 4-year prim ary patency rates were the same. Duration of patency depended on the v enous site. Death was a complication of stent placement in 2 patients and 12 patients died within 6 months after stent placement from primar y disease progression. Although early failures were more common in ste nts placed across occlusions than stenoses, 1-year secondary patency r ates were comparable, Primary patency rates were only slightly lower i n patients with malignant obstruction than in patients with benign dis ease. Conclusion: Endovascular stent placement provides a nonsurgical alternative for reestablishment of venous flow and symptomatic relief in patients with benign as well as malignant venous obstruction.