Presentation is loading. Please wait.

Presentation is loading. Please wait.

Reinterventions for nonocclusive iliofemoral venous stent malfunctions

Published byDalila Belmonte Modified over 5 years ago

Similar presentations

Presentation on theme: "Reinterventions for nonocclusive iliofemoral venous stent malfunctions"— Presentation transcript:

1 Reinterventions for nonocclusive iliofemoral venous stent malfunctions
Seshadri Raju, MD, Paul Tackett, BS, Peter Neglen, MD, PhD  Journal of Vascular Surgery  Volume 49, Issue 2, Pages (February 2009) DOI: /j.jvs Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

2 Fig 1 Distal migration of braided stent (left) because the stent was not extended adequately into the inferior vena cava. The stent is gradually “squeezed” distally by the constricting lesion, resulting in recurrence. The stent should be extended well into the vena cava to avoid this problem (right). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

3 Fig 2 Reintervention in a limb that continued to be symptomatic following correction of proximal NIVL with a stent (left). A distal lesion was discovered and stented. The distal lesion may be obscured even on IVUS as it sits close to the hypogastric vein orifice. Routine balloon ‘sizing’ (1 atm) of the entire iliac-femoral segment is recommended in all cases. A retroinguinal lesion (right) uncovered by balloon ‘sizing.' Venography alone is unreliable as retroinguinal narrowing may be normally present in some patients due to collapse of the vein in recumbent position in this location. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

4 Fig 3 The nature of the denovo lesion is obscure but is exclusively confined to the external iliac vein and occurs below a previously placed stent after a period of time. It presents as a smooth, tapered stenosis with no special characteristic features on IVUS examination. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

5 Fig 4 Reintervention for residual symptoms in a postthrombotic limb. On table venography appeared unremarkable (left). A postthrombotic stenosis of the inferior vena cava with fibrosis and trabeculae above the stent was found on IVUS examination (middle). A stent was placed extending up to the renal vein orifice (right). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

6 Fig 5 Layering of thrombus within the stent due to stenosis of inflow below the stent (left). This type of soft instent lesion (middle) responds well to balloon dilatation (right), but requires simultaneous correction of associated inflow/outflow problems for maintenance. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

7 Fig 6 A ‘hard’ instent lesion without evident inflow/outflow problems has a prediclection for the external iliac vein. The common iliac vein and the femoral vein are less frequently involved and less profusely; the inferior vena cava portion of the stent is seldom affected. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

8 Fig 7 External compression of the stent by recoil/recurrent fibrosis of the lesion. A 16 mm diameter stent has been compressed to about 9 mm. Note the absence of ISR within the stent itself. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

9 Fig 8 The proximal NIVL can involve the distal end of the inferior vena cava which can be masked in frontal projection (left) but evident in lateral projection (right). IVUS is more reliable in uncovering such lesions while minimizing radiation exposure. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

10 Fig 9 Placement of undersized stents can result in persistent symptoms due to inadequate decompression of the limb (left) or outright stent occlusion (right). In both cases, 10 mm stents were placed in the common iliac vein (desirable size 16). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

Download ppt "Reinterventions for nonocclusive iliofemoral venous stent malfunctions"

Similar presentations

Persistent sciatic artery: Embryology, pathology, and treatment

Persistent sciatic artery: Embryology, pathology, and treatment
Factors affecting outcome of open and hybrid reconstructions for nonmalignant obstruction of iliofemoral veins and inferior vena cava  Nitin Garg, MBBS,

Factors affecting outcome of open and hybrid reconstructions for nonmalignant obstruction of iliofemoral veins and inferior vena cava  Nitin Garg, MBBS,
Gregory J. Nadolski, MD, S. William Stavropoulos, MD 

Gregory J. Nadolski, MD, S. William Stavropoulos, MD 
Kathleen M. Lamb, MD, Julia Glaser, MD, Phillip Dowzicky, MD, Paul J

Kathleen M. Lamb, MD, Julia Glaser, MD, Phillip Dowzicky, MD, Paul J
Diagnosis and treatment of venous lymphedema

Diagnosis and treatment of venous lymphedema
Seshadri Raju, MD, Kathryn Hollis, BA, Peter Neglen, MD, PhD 

Seshadri Raju, MD, Kathryn Hollis, BA, Peter Neglen, MD, PhD 
Iliac vein stenting in postmenopausal leg swelling

Iliac vein stenting in postmenopausal leg swelling
Bedside vena cava filter placement with intravascular ultrasound: A simple, accurate, single venous access method  Donald L. Jacobs, MD, Raghunandan L.

Bedside vena cava filter placement with intravascular ultrasound: A simple, accurate, single venous access method  Donald L. Jacobs, MD, Raghunandan L.
Khanjan Baxi, BS, Samir K. Shah, MD, Daniel G. Clair, MD 

Khanjan Baxi, BS, Samir K. Shah, MD, Daniel G. Clair, MD 
Single-session total endovascular iliocaval reconstruction with stent grafting for the treatment of inferior vena cava agenesis and concurrent iliac venous.

Single-session total endovascular iliocaval reconstruction with stent grafting for the treatment of inferior vena cava agenesis and concurrent iliac venous.
A case of external iliac arteriovenous fistula and high-output cardiac failure after endovenous laser treatment of great saphenous vein  Scott J. Ziporin,

A case of external iliac arteriovenous fistula and high-output cardiac failure after endovenous laser treatment of great saphenous vein  Scott J. Ziporin,
Venous stenting across the inguinal ligament

Venous stenting across the inguinal ligament
Successful thrombolysis, angioplasty, and stenting of delayed thrombosis in the vena cava following percutaneous vertebroplasty with polymethylmethacrylate.

Successful thrombolysis, angioplasty, and stenting of delayed thrombosis in the vena cava following percutaneous vertebroplasty with polymethylmethacrylate.
Successful endovascular management of an acute iliac venous injury during lumbar discectomy and anterior spinal fusion  Joseph R. Schneider, MD, PhD,

Successful endovascular management of an acute iliac venous injury during lumbar discectomy and anterior spinal fusion  Joseph R. Schneider, MD, PhD,
Iliac-caval stenting in the obese

Iliac-caval stenting in the obese
Factors affecting outcome of open and hybrid reconstructions for nonmalignant obstruction of iliofemoral veins and inferior vena cava  Nitin Garg, MBBS,

Factors affecting outcome of open and hybrid reconstructions for nonmalignant obstruction of iliofemoral veins and inferior vena cava  Nitin Garg, MBBS,
Managing iliofemoral deep venous thrombosis of pregnancy with a strategy of thrombus removal is safe and avoids post-thrombotic morbidity  Santiago Herrera,

Managing iliofemoral deep venous thrombosis of pregnancy with a strategy of thrombus removal is safe and avoids post-thrombotic morbidity  Santiago Herrera,
Pharmacomechanical thrombectomy for treatment of symptomatic lower extremity deep venous thrombosis: Safety and feasibility study  Ruth L. Bush, MD, Peter.

Pharmacomechanical thrombectomy for treatment of symptomatic lower extremity deep venous thrombosis: Safety and feasibility study  Ruth L. Bush, MD, Peter.
Brian G. Peterson, MD, Jon S. Matsumura, MD 

Brian G. Peterson, MD, Jon S. Matsumura, MD 
Iliofemoral venous thrombosis from external compression by a vesical diverticulum  Varun Gupta, MD, Imtiazuddin Shaik, MD, Jihad Abbas, MD, Munier Nazzal,

Iliofemoral venous thrombosis from external compression by a vesical diverticulum  Varun Gupta, MD, Imtiazuddin Shaik, MD, Jihad Abbas, MD, Munier Nazzal,

Similar presentations

Ads by Google