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Predictive factors of stent patency in iliofemoral venous diseases in a multicenter cohort study

Published:January 12, 2023DOI:https://doi.org/10.1016/j.ejvs.2023.01.005
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      Abstract

      Objective

      To assess predictive factors of primary stent patency in three groups of patients with history of lower limb (LL) vein thrombosis: non-thrombotic iliac vein lesion (NIVL), acute deep vein thrombosis (aDVT) and post thrombotic syndrome (PTS).

      Methods

      Consecutive patients with history of LL vein stenting from 7 hospitals were included from January 2014 to December 2020. All patients received an iliac or common femoral venous stent and had at least a 6-month follow-up available with stent imaging. The anticoagulant and antiplatelet therapy strategies employed after venous stenting are reported and compared between groups. This study included 377 patients: 134 NIVL, 55 aDVT and 188 PTS.

      Results

      Primary patency was significantly higher in the NIVL group (99.3%) compared to the PTS group (68.6%) (p <.001) and the aDVT group (83.6%) (p=.002). PTS patients received a significantly greater number of stents (p<.001) and had more stents below the inguinal ligament (p<.001). Median follow-up was 28.8 months [IQR: 16; 47]. Discontinuation of antiplatelet therapy at the last assessment was 83.6% for NIVL, 100% for aDVT and 95.7% for the PTS group (p<.001). Discontinuation of anticoagulation therapy at the last assessment was 93.2% for NIVL, 25.0% for aDVT and 70.3% for the PTS group (p<.001). The only predictor of worse primary patency in the aDVT group was long-term anticoagulation before stenting.

      Conclusion

      Patients with NIVL have better primary patency after venous stenting than patients with venous thrombotic disorders. Long-term anticoagulation before stenting was the only factor associated with poorer primary patency in patient with aDVT.

      Keywords

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