Venous stenting across the inguinal ligament

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Presentation transcript:

Venous stenting across the inguinal ligament Peter Neglén, MD, PhD, T. Paul Tackett, BS, Seshadri Raju, MD Journal of Vascular Surgery Volume 48, Issue 5, Pages 1255-1261 (November 2008) DOI: 10.1016/j.jvs.2008.06.035 Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 1 Anterior-posterior view of a transfemoral antegrade venogram including the left half of the pelvis. The line indicates the course of the inguinal ligament (see text). Journal of Vascular Surgery 2008 48, 1255-1261DOI: (10.1016/j.jvs.2008.06.035) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 2 Transfemoral venograms showing an obstruction of the common and proximal external iliac vein (left) and the outflow after placement of braided stainless steel stents (middle) (plain x-ray; right). The stented area terminates well above the inguinal ligament and the distal external iliac vein is normal. Journal of Vascular Surgery 2008 48, 1255-1261DOI: (10.1016/j.jvs.2008.06.035) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 3 Transfemoral venogram showing an extensive postthrombotic iliofemoral venous obstruction (left). The proximal nitinol stent is placed, but there is a remaining stenosis of the common femoral vein (middle). The stenting is extended underneath the inguinal ligament covering the entire common femoral vein (right). The upper and lower ends of the nitinol stent are shown by radiopaque markers (line of dots). Journal of Vascular Surgery 2008 48, 1255-1261DOI: (10.1016/j.jvs.2008.06.035) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 4 Secondary patency rates in all limbs with iliofemoral stenting terminating cephalad and caudad to the inguinal ligament (ing lig). The lower numbers represent total limbs at risk for each time interval (SEM <10%). Journal of Vascular Surgery 2008 48, 1255-1261DOI: (10.1016/j.jvs.2008.06.035) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 5 Secondary patency rates in limbs treated for thrombotic obstruction with iliofemoral stenting terminating cephalad and caudad to the inguinal ligament (ing lig). The lower numbers represent total limbs at risk for each time interval (SEM <10%). Journal of Vascular Surgery 2008 48, 1255-1261DOI: (10.1016/j.jvs.2008.06.035) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 6 Secondary patency rates of stents placed in thrombotic limbs for non-occlusive obstruction and occlusion with stenting terminating cephalad and caudad to the inguinal ligament (ing lig). The lower numbers represent total limbs at risk for each time interval (± SEM). Journal of Vascular Surgery 2008 48, 1255-1261DOI: (10.1016/j.jvs.2008.06.035) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 7 Secondary patency rates in limbs stented across the inguinal ligament for nonthrombotic obstruction, non-occlusive thrombotic obstruction, and thrombotic occlusion. The lower numbers represent total limbs at risk for each time interval (SEM <10%). NIVL, non-thrombotic iliac vein lesion. Journal of Vascular Surgery 2008 48, 1255-1261DOI: (10.1016/j.jvs.2008.06.035) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 8 Cumulative rate of in-stent recurrent stenosis (≥20% and ≥50%) in limbs with stenting terminating cephalad and caudad to the inguinal ligament (ing lig). The lower numbers represent total limbs at risk for each time interval (SEM <10%). Journal of Vascular Surgery 2008 48, 1255-1261DOI: (10.1016/j.jvs.2008.06.035) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 9 Cumulative rate of in-stent recurrent stenosis (≥20% and ≥50%) in limbs treated for non-thrombotic and thrombotic obstructions. The lower numbers represent total limbs at risk for each time interval (SEM <10%). ISR, in-stent recurrent stenosis. Journal of Vascular Surgery 2008 48, 1255-1261DOI: (10.1016/j.jvs.2008.06.035) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions