ILIOFEMORAL VENOUS STENOSES - EFFECTIVENESS OF TREATMENT WITH METALLIC ENDOVASCULAR STENTS

PURPOSE: To assess effectiveness of metallic endovascular stents in tr eatment of venous stenoses and occlusions. MATERIALS AND METHODS: Sten ts were placed intravenously in 56 patients (59 stenoses or occlusions ) over a 6-year period. Stent sites included the inferior vena cava (n = 10) and common iliac (n = 31), external iliac (n = 46), common femo ral (n = 27), and superficial femoral veins (n = 4). Indications for s tent placement included stenoses from pelvic malignancy and its treatm ent; trauma, surgery, or pregnancy; and idiopathic stenoses. Patients underwent anticoagulation therapy for 3-6 months after stent placement . Follow-up was performed with duplex ultrasound. RESULTS: With use of life-table analysis, overall primary and secondary 1-year patency rat es were 50% and 81%, respectively. Primary and secondary 4-year patenc y rates were and 50% and 75%, respectively. Five patients died of prim ary disease progression within 6 months after stent placement. Major c omplications occurred in 6.8% of cases. One-year secondary patency rat es were statistically significantly lower (P =.05) for patients with m alignant disease, although primary patency rates were comparable. Over all sustained decrease in symptoms (P <.0001) was observed 1 year late r. CONCLUSION: Endovascular stent placement is a nonsurgical alternati ve for reestablishment of venous now and sustained relief of symptoms in patients with malignant or benign pelvic venous flow and sustained relief of symptoms in patients with malignant or benign pelvic venous disease.