Impact of stent compression in patients with non-thrombotic iliac vein lesions on iliac vein blood flow and related symptoms

Abstract

Objectives To study outcomes in patients with non-thrombotic iliac vein lesions (NIVLs) treated by stents. Methods We performed a retrospective study that collected 109 patients from January 2016 to August 2020 diagnosed with symptomatic NIVLs. The patients underwent endovenous stenting using the Wallstents. Clinical severity was assessed using the venous clinical severity score and the Villalta scores. The patency was assessed using duplex ultrasound, while the diameters and the blood flow velocities (BFVs) in the proximal, middle, and distal stented segments were recorded simultaneously. Results A total of 128 stents were placed in 115 limbs (median age, 61 years), with a mean follow-up of 32 months. At 36 months, the Villalta scores went from 12.17 to 3.64 ( p < .001). The VCSS went from 9.41 to 3.31 ( p < .001). The mean diameters in the proximal, middle, and distal stented segments were 8.52 ± 2.15 mm, 10.13 ± 1.75 mm, and 10.17 ± 1.69 mm in the first month, while the mean BFVs were 31.17 ± 13.66 cm/s, 31.07 ± 11.90 cm/s, and 36.39 ± 18.41 cm/s, respectively. Repeated-measures analysis in 55 consecutive patients from 1 month to 3 years after procedure revealed a decrease of the stent diameter in the proximal stented segment ( p = .004); a stabilization of the stent diameter in the middle ( p = .43) or distal ( p = .45) stented segment; a steadiness of the BFVs in the proximal ( p = .40), middle ( p = .93), and distal ( p = .25) stented segments; and an improvement in the VCSS ( p = .03) and Villalta scores ( p = .006). Conclusions BFVs in stented segments remained steady and the symptoms in lower extremities improved after surgery, while stent compression was observed in the diameter of the proximal stented segment, with no impact on BFVs or symptoms.