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Patency and Clinical Outcomes of a Dedicated, Self-Expanding, Hybrid Oblique Stent Used in the Treatment of Common Iliac Vein Compression
Purpose: To investigate the clinical outcomes of a dedicated hybrid oblique nitinol stent that has been specifically designed to treat common iliac vein compression. Methods: The Bern Venous Stent Registry database was interrogated to identify all patients who had at least 6-month follow-up after tr...
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| Published in: | Journal of endovascular therapy 2017-02, Vol.24 (1), p.159-166 |
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| container_title | Journal of endovascular therapy |
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| creator | Stuck, Anna K. Kunz, Samuel Baumgartner, Iris Kucher, Nils |
| description | Purpose: To investigate the clinical outcomes of a dedicated hybrid oblique nitinol stent that has been specifically designed to treat common iliac vein compression. Methods: The Bern Venous Stent Registry database was interrogated to identify all patients who had at least 6-month follow-up after treatment with the sinus-Obliquus hybrid stent for common iliac vein compression. The search identified 24 patients (mean age 39±18 years; 20 women) who matched the search criteria. Ten patients had postthrombotic syndrome (PTS), another 10 patients had acute iliofemoral thrombosis after catheter-directed therapy, and 4 patients had nonthrombotic iliac vein compression. Primary treatment success was defined as antegrade flow and stenosis |
| doi_str_mv | 10.1177/1526602816676803 |
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Methods: The Bern Venous Stent Registry database was interrogated to identify all patients who had at least 6-month follow-up after treatment with the sinus-Obliquus hybrid stent for common iliac vein compression. The search identified 24 patients (mean age 39±18 years; 20 women) who matched the search criteria. Ten patients had postthrombotic syndrome (PTS), another 10 patients had acute iliofemoral thrombosis after catheter-directed therapy, and 4 patients had nonthrombotic iliac vein compression. Primary treatment success was defined as antegrade flow and stenosis <30% on venography and evidence of a spontaneous Doppler signal in the treated segment. Stent patency was assessed using duplex ultrasound. Clinical outcomes were evaluated using a clinical symptom score (Villalta) and the revised venous clinical severity score (rVCSS) at 3, 6, and 12 months in follow-up. Results: Primary treatment success was achieved in all patients. Mean follow-up was 10±3 months. Primary patency estimates by Kaplan-Meier analysis were 92% at 6 months [95% confidence interval (CI) 71% to 98%] and 83% (95% CI 54% to 95%) at 10 months. Three symptomatic patients underwent reintervention for early and late stent thromboses and the third for in-stent restenosis, resulting in secondary patency of 100%. Overall, all patients had clinical improvement at the latest follow-up; 50% reported complete resolution of symptoms. In patients with PTS, the Villalta score decreased by 6±6 points (p=0.02) and the rVCSS score by 3±1 points (p=0.05). Among deep vein thrombosis patients, none developed PTS. Conclusion: In patients with common iliac vein compression, the oblique hybrid nitinol stent appears to provide excellent early patency and clinical outcomes.</description><identifier>ISSN: 1526-6028</identifier><identifier>EISSN: 1545-1550</identifier><identifier>DOI: 10.1177/1526602816676803</identifier><identifier>PMID: 27831483</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adolescent ; Adult ; Aged ; Alloys ; Angiography, Digital Subtraction ; Endovascular Procedures - adverse effects ; Endovascular Procedures - instrumentation ; Female ; Humans ; Iliac Vein - diagnostic imaging ; Iliac Vein - physiopathology ; Kaplan-Meier Estimate ; Male ; May-Thurner Syndrome - diagnostic imaging ; May-Thurner Syndrome - physiopathology ; May-Thurner Syndrome - therapy ; Middle Aged ; Phlebography - methods ; Prosthesis Design ; Recurrence ; Registries ; Self Expandable Metallic Stents ; Switzerland ; Time Factors ; Treatment Outcome ; Ultrasonography, Doppler, Duplex ; Vascular Patency ; Young Adult</subject><ispartof>Journal of endovascular therapy, 2017-02, Vol.24 (1), p.159-166</ispartof><rights>The Author(s) 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c379t-b309cd0332ed07bffc074aff7feb42456235a843333770a77553186291729a3d3</citedby><cites>FETCH-LOGICAL-c379t-b309cd0332ed07bffc074aff7feb42456235a843333770a77553186291729a3d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925,79364</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27831483$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stuck, Anna K.</creatorcontrib><creatorcontrib>Kunz, Samuel</creatorcontrib><creatorcontrib>Baumgartner, Iris</creatorcontrib><creatorcontrib>Kucher, Nils</creatorcontrib><title>Patency and Clinical Outcomes of a Dedicated, Self-Expanding, Hybrid Oblique Stent Used in the Treatment of Common Iliac Vein Compression</title><title>Journal of endovascular therapy</title><addtitle>J Endovasc Ther</addtitle><description>Purpose: To investigate the clinical outcomes of a dedicated hybrid oblique nitinol stent that has been specifically designed to treat common iliac vein compression. Methods: The Bern Venous Stent Registry database was interrogated to identify all patients who had at least 6-month follow-up after treatment with the sinus-Obliquus hybrid stent for common iliac vein compression. The search identified 24 patients (mean age 39±18 years; 20 women) who matched the search criteria. Ten patients had postthrombotic syndrome (PTS), another 10 patients had acute iliofemoral thrombosis after catheter-directed therapy, and 4 patients had nonthrombotic iliac vein compression. Primary treatment success was defined as antegrade flow and stenosis <30% on venography and evidence of a spontaneous Doppler signal in the treated segment. Stent patency was assessed using duplex ultrasound. Clinical outcomes were evaluated using a clinical symptom score (Villalta) and the revised venous clinical severity score (rVCSS) at 3, 6, and 12 months in follow-up. Results: Primary treatment success was achieved in all patients. Mean follow-up was 10±3 months. Primary patency estimates by Kaplan-Meier analysis were 92% at 6 months [95% confidence interval (CI) 71% to 98%] and 83% (95% CI 54% to 95%) at 10 months. Three symptomatic patients underwent reintervention for early and late stent thromboses and the third for in-stent restenosis, resulting in secondary patency of 100%. Overall, all patients had clinical improvement at the latest follow-up; 50% reported complete resolution of symptoms. In patients with PTS, the Villalta score decreased by 6±6 points (p=0.02) and the rVCSS score by 3±1 points (p=0.05). Among deep vein thrombosis patients, none developed PTS. Conclusion: In patients with common iliac vein compression, the oblique hybrid nitinol stent appears to provide excellent early patency and clinical outcomes.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Alloys</subject><subject>Angiography, Digital Subtraction</subject><subject>Endovascular Procedures - adverse effects</subject><subject>Endovascular Procedures - instrumentation</subject><subject>Female</subject><subject>Humans</subject><subject>Iliac Vein - diagnostic imaging</subject><subject>Iliac Vein - physiopathology</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>May-Thurner Syndrome - diagnostic imaging</subject><subject>May-Thurner Syndrome - physiopathology</subject><subject>May-Thurner Syndrome - therapy</subject><subject>Middle Aged</subject><subject>Phlebography - methods</subject><subject>Prosthesis Design</subject><subject>Recurrence</subject><subject>Registries</subject><subject>Self Expandable Metallic Stents</subject><subject>Switzerland</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Ultrasonography, Doppler, Duplex</subject><subject>Vascular Patency</subject><subject>Young Adult</subject><issn>1526-6028</issn><issn>1545-1550</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNp1kU1v3CAQhlGVqknT3HOqOOYQtwwYYx-jTdpEirSV8nG1MAwpkQ0bsKXuT-i_LqtNeqhULqCXZx4NDCGnwL4AKPUVJG8axltoGtW0TLwjRyBrWYGU7GB35k21uz8kH3N-ZowDB_hADrlqBdStOCK_f-gZg9lSHSxdjT54o0e6XmYTJ8w0OqrpJdqSzmjP6R2Orrr6tSm0D0_n9Ho7JG_pehj9y4L0rrhm-pDRUh_o_BPpfUI9T7u0qFZxmmKgN6PXhj5iQUqySZizj-ETee_0mPHkdT8mD9-u7lfX1e36-83q4rYyQnVzNQjWGcuE4GiZGpwzTNXaOeVwqHktGy6kbmtRllJMKyWlgLbhHSjeaWHFMTnbezcplp7z3E8-GxxHHTAuuYdWdABCSFZQtkdNijkndP0m-UmnbQ-s3w2g_3cApeTzq30ZJrR_C95-vADVHsj6CfvnuKRQXvt_4R_CvIxQ</recordid><startdate>201702</startdate><enddate>201702</enddate><creator>Stuck, Anna K.</creator><creator>Kunz, Samuel</creator><creator>Baumgartner, Iris</creator><creator>Kucher, Nils</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201702</creationdate><title>Patency and Clinical Outcomes of a Dedicated, Self-Expanding, Hybrid Oblique Stent Used in the Treatment of Common Iliac Vein Compression</title><author>Stuck, Anna K. ; Kunz, Samuel ; Baumgartner, Iris ; Kucher, Nils</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c379t-b309cd0332ed07bffc074aff7feb42456235a843333770a77553186291729a3d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Alloys</topic><topic>Angiography, Digital Subtraction</topic><topic>Endovascular Procedures - adverse effects</topic><topic>Endovascular Procedures - instrumentation</topic><topic>Female</topic><topic>Humans</topic><topic>Iliac Vein - diagnostic imaging</topic><topic>Iliac Vein - physiopathology</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>May-Thurner Syndrome - diagnostic imaging</topic><topic>May-Thurner Syndrome - physiopathology</topic><topic>May-Thurner Syndrome - therapy</topic><topic>Middle Aged</topic><topic>Phlebography - methods</topic><topic>Prosthesis Design</topic><topic>Recurrence</topic><topic>Registries</topic><topic>Self Expandable Metallic Stents</topic><topic>Switzerland</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Ultrasonography, Doppler, Duplex</topic><topic>Vascular Patency</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stuck, Anna K.</creatorcontrib><creatorcontrib>Kunz, Samuel</creatorcontrib><creatorcontrib>Baumgartner, Iris</creatorcontrib><creatorcontrib>Kucher, Nils</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of endovascular therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stuck, Anna K.</au><au>Kunz, Samuel</au><au>Baumgartner, Iris</au><au>Kucher, Nils</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patency and Clinical Outcomes of a Dedicated, Self-Expanding, Hybrid Oblique Stent Used in the Treatment of Common Iliac Vein Compression</atitle><jtitle>Journal of endovascular therapy</jtitle><addtitle>J Endovasc Ther</addtitle><date>2017-02</date><risdate>2017</risdate><volume>24</volume><issue>1</issue><spage>159</spage><epage>166</epage><pages>159-166</pages><issn>1526-6028</issn><eissn>1545-1550</eissn><abstract>Purpose: To investigate the clinical outcomes of a dedicated hybrid oblique nitinol stent that has been specifically designed to treat common iliac vein compression. Methods: The Bern Venous Stent Registry database was interrogated to identify all patients who had at least 6-month follow-up after treatment with the sinus-Obliquus hybrid stent for common iliac vein compression. The search identified 24 patients (mean age 39±18 years; 20 women) who matched the search criteria. Ten patients had postthrombotic syndrome (PTS), another 10 patients had acute iliofemoral thrombosis after catheter-directed therapy, and 4 patients had nonthrombotic iliac vein compression. Primary treatment success was defined as antegrade flow and stenosis <30% on venography and evidence of a spontaneous Doppler signal in the treated segment. Stent patency was assessed using duplex ultrasound. Clinical outcomes were evaluated using a clinical symptom score (Villalta) and the revised venous clinical severity score (rVCSS) at 3, 6, and 12 months in follow-up. Results: Primary treatment success was achieved in all patients. Mean follow-up was 10±3 months. Primary patency estimates by Kaplan-Meier analysis were 92% at 6 months [95% confidence interval (CI) 71% to 98%] and 83% (95% CI 54% to 95%) at 10 months. Three symptomatic patients underwent reintervention for early and late stent thromboses and the third for in-stent restenosis, resulting in secondary patency of 100%. Overall, all patients had clinical improvement at the latest follow-up; 50% reported complete resolution of symptoms. In patients with PTS, the Villalta score decreased by 6±6 points (p=0.02) and the rVCSS score by 3±1 points (p=0.05). Among deep vein thrombosis patients, none developed PTS. Conclusion: In patients with common iliac vein compression, the oblique hybrid nitinol stent appears to provide excellent early patency and clinical outcomes.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>27831483</pmid><doi>10.1177/1526602816676803</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Alloys Angiography, Digital Subtraction Endovascular Procedures - adverse effects Endovascular Procedures - instrumentation Female Humans Iliac Vein - diagnostic imaging Iliac Vein - physiopathology Kaplan-Meier Estimate Male May-Thurner Syndrome - diagnostic imaging May-Thurner Syndrome - physiopathology May-Thurner Syndrome - therapy Middle Aged Phlebography - methods Prosthesis Design Recurrence Registries Self Expandable Metallic Stents Switzerland Time Factors Treatment Outcome Ultrasonography, Doppler, Duplex Vascular Patency Young Adult |
| title | Patency and Clinical Outcomes of a Dedicated, Self-Expanding, Hybrid Oblique Stent Used in the Treatment of Common Iliac Vein Compression |
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