Late results of surgical venous thrombectomy with iliocaval stenting

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Presentation transcript:

Late results of surgical venous thrombectomy with iliocaval stenting Olivier Hartung, MD, Fares Benmiloud, MD, Pierre Barthelemy, MD, PhD, Myriam Dubuc, MD, Mourad Boufi, MD, Yves S. Alimi, MD, PhD Journal of Vascular Surgery Volume 47, Issue 2, Pages 381-387 (February 2008) DOI: 10.1016/j.jvs.2007.10.007 Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 1 Acute left femoroiliac deep vein thrombosis with stenosis of the left common iliac vein. A, Computed tomography angiography shows a stenosis of the left common iliac vein with proximal thrombosis (black arrow) and parietal enhancement; the inferior vena cava is free. B, Angiography after left iliofemoral surgical thrombectomy shows tight stenosis of the distal left common iliac vein and the presence of residual clot within the vein. C, Completion angiography after angioplasty and stenting. Journal of Vascular Surgery 2008 47, 381-387DOI: (10.1016/j.jvs.2007.10.007) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 2 Acute biiliocaval thrombosis in a patient with previous left femoroiliac and inferior vena cava thrombectomy associated with insertion of an inferior vena cava clip. A, Computed tomography angiography (CTA) scan at the level of the clip. B, In this CTA scan of the proximal inferior vena cava, acute thrombosis can be diagnosed due to parietal contrast enhancement. C, Angiography after venous thrombectomy through bilateral common femoral vein approach and thromboaspiration of the inferior vena cava shows presence of adherent clot. D, Completion angiography after iterative thromboaspiration and angioplasty and stenting of the left common iliac vein. Journal of Vascular Surgery 2008 47, 381-387DOI: (10.1016/j.jvs.2007.10.007) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 3 Acute left femoroiliac deep vein thrombosis in a patient with chronic left common iliac vein thrombosis. A, Computed tomography angiography scan shows a tight stenosis of the whole left common iliac vein (black arrow) without parietal enhancement. Ascending collateral pathways are visible. B, In this angiography after venous thrombectomy through left common femoral vein approach, the left common iliac vein is occluded and ascending and transversal collateral pathways are seen. Recanalization was performed with a 0.035-inch guidewire on a guiding catheter. C, Angiography shows the result after angioplasty and stenting. Journal of Vascular Surgery 2008 47, 381-387DOI: (10.1016/j.jvs.2007.10.007) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 4 Acute left femoral-external iliac deep venous thrombosis. A, Arteriography. B, Iliocavography after venous thrombectomy shows a major compression of the distal end of the left external iliac vein. C, Face iliocavography after stenting. D, Profile iliocavography after stenting. Journal of Vascular Surgery 2008 47, 381-387DOI: (10.1016/j.jvs.2007.10.007) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 5 Primary, assisted-primary, and secondary patency rates after venous thrombectomy and stenting of 24 patients who had venous thrombectomy (intention to treat). Standard error was >10% at 48 months for primary patency, at 69 months for assisted-primary and secondary patency (the curves are represented as dotted lines when SEM is >10%). Journal of Vascular Surgery 2008 47, 381-387DOI: (10.1016/j.jvs.2007.10.007) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions