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Stent Compression in Iliac Vein Compression Syndrome Associated with Acute Ilio-Femoral Deep Vein Thrombosis.

Cho H, Kim JW, Hong YS, Lim SH, Won JH - Korean J Radiol (2015)

Bottom Line: The proportion of limbs showing significant stent compression was 33%.Fifty-six percent of limbs in the significant stent compression group developed stent occlusion.On the other hand, only 9% of limbs in the insignificant stent compression group developed stent occlusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Ajou University School of Medicine, Suwon 443-380, Korea.

ABSTRACT

Objective: This study was conducted to evaluate stent compression in iliac vein compression syndrome (IVCS) and to identify its association with stent patency.

Materials and methods: Between May 2005 and June 2014, after stent placement for the treatment of IVCS with acute ilio-femoral deep vein thrombosis, follow-up CT venography was performed in 48 patients (35 women, 13 men; age range 23-87 years; median age 56 years). Using follow-up CT venography, the degree of the stent compression was calculated and used to divide patients into two groups. Possible factors associated with stent compression and patency were evaluated. The cumulative degree of stent compression and patency rate were analyzed.

Results: All of the stents used were laser-cut nitinol stents. The proportion of limbs showing significant stent compression was 33%. Fifty-six percent of limbs in the significant stent compression group developed stent occlusion. On the other hand, only 9% of limbs in the insignificant stent compression group developed stent occlusion. Significant stent compression was inversely correlated with stent patency (p < 0.001). The median patency period evaluated with Kaplan-Meier analysis was 20.0 months for patients with significant stent compression. Other factors including gender, age, and type of stent were not correlated with stent patency. Significant stent compression occurred most frequently (87.5%) at the upper end of the stent (ilio-caval junction).

Conclusion: Significant compression of nitinol stents placed in IVCS highly affects stent patency. Therefore, in order to prevent stent compression in IVCS, nitinol stents with higher radial resistive force may be required.

No MeSH data available.


Related in: MedlinePlus

Follow-up CT image shows significant stent compression and occlusion.On axial images, stent was compressed by crossing iliac artery at ilio-caval junction (A). On curved planar images, degree of stent compression was measured with caliper and calculated as diameter of stent at narrowest/widest point (bidirectional arrows) of stent × 100%. In this patient, stent was compressed more than 50% by crossing iliac artery at ilio-caval junction (B).
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Figure 1: Follow-up CT image shows significant stent compression and occlusion.On axial images, stent was compressed by crossing iliac artery at ilio-caval junction (A). On curved planar images, degree of stent compression was measured with caliper and calculated as diameter of stent at narrowest/widest point (bidirectional arrows) of stent × 100%. In this patient, stent was compressed more than 50% by crossing iliac artery at ilio-caval junction (B).

Mentions: On follow-up CT venography, the degree of stent compression was assessed by calculating the percentage of diameter reduction of the stent lumen (diameter of the stent at the narrowest segment/diameter of the stent at the widest segment × 100%). According to the degree of stent compression, the limbs were categorized into either "significant" (luminal collapse at 50% or more) or "insignificant" (luminal collapse under 50%) stent compression groups. Thirty-nine of 45 patients underwent follow-up CT venography, while the remaning six patients had CT scans (which included venous phase of contrast enhancement) that had been performed for other reasons such as abdominal or pelvic pain. Two interventional radiologists reviewed the CT venography images including multi-planar or curved planar reformations which had been acquired using software for three-dimensional reconstruction (Rapidia, Infinitt, Seoul, Korea). The location of stent compression was documented (Fig. 1).


Stent Compression in Iliac Vein Compression Syndrome Associated with Acute Ilio-Femoral Deep Vein Thrombosis.

Cho H, Kim JW, Hong YS, Lim SH, Won JH - Korean J Radiol (2015)

Follow-up CT image shows significant stent compression and occlusion.On axial images, stent was compressed by crossing iliac artery at ilio-caval junction (A). On curved planar images, degree of stent compression was measured with caliper and calculated as diameter of stent at narrowest/widest point (bidirectional arrows) of stent × 100%. In this patient, stent was compressed more than 50% by crossing iliac artery at ilio-caval junction (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499535&req=5

Figure 1: Follow-up CT image shows significant stent compression and occlusion.On axial images, stent was compressed by crossing iliac artery at ilio-caval junction (A). On curved planar images, degree of stent compression was measured with caliper and calculated as diameter of stent at narrowest/widest point (bidirectional arrows) of stent × 100%. In this patient, stent was compressed more than 50% by crossing iliac artery at ilio-caval junction (B).
Mentions: On follow-up CT venography, the degree of stent compression was assessed by calculating the percentage of diameter reduction of the stent lumen (diameter of the stent at the narrowest segment/diameter of the stent at the widest segment × 100%). According to the degree of stent compression, the limbs were categorized into either "significant" (luminal collapse at 50% or more) or "insignificant" (luminal collapse under 50%) stent compression groups. Thirty-nine of 45 patients underwent follow-up CT venography, while the remaning six patients had CT scans (which included venous phase of contrast enhancement) that had been performed for other reasons such as abdominal or pelvic pain. Two interventional radiologists reviewed the CT venography images including multi-planar or curved planar reformations which had been acquired using software for three-dimensional reconstruction (Rapidia, Infinitt, Seoul, Korea). The location of stent compression was documented (Fig. 1).

Bottom Line: The proportion of limbs showing significant stent compression was 33%.Fifty-six percent of limbs in the significant stent compression group developed stent occlusion.On the other hand, only 9% of limbs in the insignificant stent compression group developed stent occlusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Ajou University School of Medicine, Suwon 443-380, Korea.

ABSTRACT

Objective: This study was conducted to evaluate stent compression in iliac vein compression syndrome (IVCS) and to identify its association with stent patency.

Materials and methods: Between May 2005 and June 2014, after stent placement for the treatment of IVCS with acute ilio-femoral deep vein thrombosis, follow-up CT venography was performed in 48 patients (35 women, 13 men; age range 23-87 years; median age 56 years). Using follow-up CT venography, the degree of the stent compression was calculated and used to divide patients into two groups. Possible factors associated with stent compression and patency were evaluated. The cumulative degree of stent compression and patency rate were analyzed.

Results: All of the stents used were laser-cut nitinol stents. The proportion of limbs showing significant stent compression was 33%. Fifty-six percent of limbs in the significant stent compression group developed stent occlusion. On the other hand, only 9% of limbs in the insignificant stent compression group developed stent occlusion. Significant stent compression was inversely correlated with stent patency (p < 0.001). The median patency period evaluated with Kaplan-Meier analysis was 20.0 months for patients with significant stent compression. Other factors including gender, age, and type of stent were not correlated with stent patency. Significant stent compression occurred most frequently (87.5%) at the upper end of the stent (ilio-caval junction).

Conclusion: Significant compression of nitinol stents placed in IVCS highly affects stent patency. Therefore, in order to prevent stent compression in IVCS, nitinol stents with higher radial resistive force may be required.

No MeSH data available.


Related in: MedlinePlus