Skip to main content
Erschienen in: CardioVascular and Interventional Radiology 8/2019

06.05.2019 | Clinical Investigation

Endovascular Treatment of Post-thrombotic Venous Ilio-Femoral Occlusions: Prognostic Value of Venous Lesions Caudal to the Common Femoral Vein

verfasst von: Caroline Menez, Mathieu Rodiere, Julien Ghelfi, Christophe Seinturier, Thomas Martinelli, Bernard Imbert, Romain Perolat, Pierre Bouzat, Sophie Blaise, Patrick Carpentier, Gilles Pernod, Frédéric Thony

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 8/2019

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To propose a scale of severity for post-thrombotic venous lesions (PTVLs) after ilio-femoral deep venous thrombosis and to compare the grade with the results of endovascular treatment of ilio-femoral PTVLs.

Methods

In this retrospective monocentric observational study, we included 95 patients treated for ilio-femoral PTVLs. We proposed a four-grade scale evaluating the severity of PTVLS caudal to the common femoral vein based on CT phlebography and per-operative phlebography. For most patients, venous patency was assessed with color duplex ultrasonography and the clinical efficacy of the intervention using the Villalta and CIVIQ scores.

Results

Recanalization was successful in 100% of patients with a morbidity rate of 4%. After a mean follow-up of 21 months, the overall primary patency was 75%, the assisted primary patency 82%, and the secondary patency 93%. Secondary patency was 100% for grade 0–1, 90% for grade 2, and 63% for grade 3 (p < 0.002). There was no correlation between the extension of stenting caudally of the common femoral vein and venous patency. The mean improvements in the Villalta and CIVIQ-20 scores were, respectively, 4.6 (p < 0.0001) and 18 (p < 0.0001); scores were not correlated with the grade of PTVLs in the thigh.

Conclusion

Venous patency after endovascular treatment of ilio-femoral PTVLs was strongly linked to the severity of PTVLs caudal to the common femoral vein but not to the extent of stenting.
Literatur
1.
2.
Zurück zum Zitat Mavor GE, Galloway JM. Collaterals of the deep venous circulation of the lower limb. Surg Gynecol Obstet. 1967;125:561–71.PubMed Mavor GE, Galloway JM. Collaterals of the deep venous circulation of the lower limb. Surg Gynecol Obstet. 1967;125:561–71.PubMed
3.
4.
Zurück zum Zitat Neglén P, Thrasher TL, Raju S. Venous outflow obstruction: an underestimated contributor to chronic venous disease. J Vasc Surg. 2003;38:879–85.CrossRefPubMed Neglén P, Thrasher TL, Raju S. Venous outflow obstruction: an underestimated contributor to chronic venous disease. J Vasc Surg. 2003;38:879–85.CrossRefPubMed
5.
Zurück zum Zitat Kahn SR, Shrier I, Julian JA, Ducruet T, Arsenault L, Miron M-J, et al. Determinants and time course of the postthrombotic syndrome after acute deep venous thrombosis. Ann Intern Med. 2008;149:698–707.CrossRefPubMed Kahn SR, Shrier I, Julian JA, Ducruet T, Arsenault L, Miron M-J, et al. Determinants and time course of the postthrombotic syndrome after acute deep venous thrombosis. Ann Intern Med. 2008;149:698–707.CrossRefPubMed
6.
Zurück zum Zitat Douketis JD, Crowther MA, Foster GA, Ginsberg JS. Does the location of thrombosis determine the risk of disease recurrence in patients with proximal deep vein thrombosis? Am J Med. 2001;110:515–9.CrossRef Douketis JD, Crowther MA, Foster GA, Ginsberg JS. Does the location of thrombosis determine the risk of disease recurrence in patients with proximal deep vein thrombosis? Am J Med. 2001;110:515–9.CrossRef
7.
Zurück zum Zitat Enden T, Haig Y, Kløw N-E, Slagsvold C-E, Sandvik L, Ghanima W, et al. Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial. Lancet Lond Engl. 2012;379:31–8.CrossRef Enden T, Haig Y, Kløw N-E, Slagsvold C-E, Sandvik L, Ghanima W, et al. Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial. Lancet Lond Engl. 2012;379:31–8.CrossRef
8.
Zurück zum Zitat Delis KT, Bountouroglou D, Mansfield AO. Venous claudication in iliofemoral thrombosis: long-term effects on venous hemodynamics, clinical status, and quality of life. Ann Surg. 2004;239:118–26.CrossRefPubMedPubMedCentral Delis KT, Bountouroglou D, Mansfield AO. Venous claudication in iliofemoral thrombosis: long-term effects on venous hemodynamics, clinical status, and quality of life. Ann Surg. 2004;239:118–26.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Neglén P, Hollis KC, Olivier J, Raju S. Stenting of the venous outflow in chronic venous disease: long-term stent-related outcome, clinical, and hemodynamic result. J Vasc Surg. 2007;46:979–90.CrossRef Neglén P, Hollis KC, Olivier J, Raju S. Stenting of the venous outflow in chronic venous disease: long-term stent-related outcome, clinical, and hemodynamic result. J Vasc Surg. 2007;46:979–90.CrossRef
10.
Zurück zum Zitat Bergqvist D, Jendteg S, Johansen L, Persson U, Odegaard K. Cost of long-term complications of deep venous thrombosis of the lower extremities: an analysis of a defined patient population in Sweden. Ann Intern Med. 1997;126:454–7.CrossRefPubMed Bergqvist D, Jendteg S, Johansen L, Persson U, Odegaard K. Cost of long-term complications of deep venous thrombosis of the lower extremities: an analysis of a defined patient population in Sweden. Ann Intern Med. 1997;126:454–7.CrossRefPubMed
11.
Zurück zum Zitat Oguzkurt L, Tercan F, Ozkan U, Gulcan O. Iliac vein compression syndrome: outcome of endovascular treatment with long-term follow-up. Eur J Radiol. 2008;68:487–92.CrossRefPubMed Oguzkurt L, Tercan F, Ozkan U, Gulcan O. Iliac vein compression syndrome: outcome of endovascular treatment with long-term follow-up. Eur J Radiol. 2008;68:487–92.CrossRefPubMed
12.
Zurück zum Zitat Raju S, Neglén P. Percutaneous recanalization of total occlusions of the iliac vein. J Vasc Surg. 2009;50:360–8.CrossRefPubMed Raju S, Neglén P. Percutaneous recanalization of total occlusions of the iliac vein. J Vasc Surg. 2009;50:360–8.CrossRefPubMed
13.
Zurück zum Zitat Alhadad A, Kölbel T, Herbst A, Holst J, Alhadad H, Gottsäter A. Iliocaval vein stenting: long term survey of postthrombotic symptoms and working capacity. J Thromb Thrombolysis. 2011;31:211–6.CrossRefPubMed Alhadad A, Kölbel T, Herbst A, Holst J, Alhadad H, Gottsäter A. Iliocaval vein stenting: long term survey of postthrombotic symptoms and working capacity. J Thromb Thrombolysis. 2011;31:211–6.CrossRefPubMed
14.
Zurück zum Zitat Rosales A, Sandbaek G, Jørgensen JJ. Stenting for chronic post-thrombotic vena cava and iliofemoral venous occlusions: mid-term patency and clinical outcome. Eur J Vasc Endovasc Surg Off J Eur Soc Vasc Surg. 2010;40:234–40.CrossRef Rosales A, Sandbaek G, Jørgensen JJ. Stenting for chronic post-thrombotic vena cava and iliofemoral venous occlusions: mid-term patency and clinical outcome. Eur J Vasc Endovasc Surg Off J Eur Soc Vasc Surg. 2010;40:234–40.CrossRef
15.
Zurück zum Zitat Ye K, Lu X, Jiang M, Yang X, Li W, Huang Y, et al. Technical details and clinical outcomes of transpopliteal venous stent placement for postthrombotic chronic total occlusion of the iliofemoral vein. J Vasc Interv Radiol JVIR. 2014;25:925–32.CrossRefPubMed Ye K, Lu X, Jiang M, Yang X, Li W, Huang Y, et al. Technical details and clinical outcomes of transpopliteal venous stent placement for postthrombotic chronic total occlusion of the iliofemoral vein. J Vasc Interv Radiol JVIR. 2014;25:925–32.CrossRefPubMed
16.
Zurück zum Zitat Alhalbouni S, Hingorani A, Shiferson A, Gopal K, Jung D, Novak D, et al. Iliac-femoral venous stenting for lower extremity venous stasis symptoms. Ann Vasc Surg. 2012;26:185–9.CrossRefPubMed Alhalbouni S, Hingorani A, Shiferson A, Gopal K, Jung D, Novak D, et al. Iliac-femoral venous stenting for lower extremity venous stasis symptoms. Ann Vasc Surg. 2012;26:185–9.CrossRefPubMed
17.
Zurück zum Zitat Hartung O, Otero A, Boufi M, De Caridi G, Decaridi G, Barthelemy P, et al. Mid-term results of endovascular treatment for symptomatic chronic nonmalignant iliocaval venous occlusive disease. J. Vasc. Surg. 2005;42:1138–44 (discussion 1144).CrossRefPubMed Hartung O, Otero A, Boufi M, De Caridi G, Decaridi G, Barthelemy P, et al. Mid-term results of endovascular treatment for symptomatic chronic nonmalignant iliocaval venous occlusive disease. J. Vasc. Surg. 2005;42:1138–44 (discussion 1144).CrossRefPubMed
18.
Zurück zum Zitat de Graaf R, de Wolf M, Sailer AM, van Laanen J, Wittens C, Jalaie H. Iliocaval confluence stenting for chronic venous obstructions. Cardiovasc Intervent Radiol. 2015;38:1198–204.CrossRefPubMedPubMedCentral de Graaf R, de Wolf M, Sailer AM, van Laanen J, Wittens C, Jalaie H. Iliocaval confluence stenting for chronic venous obstructions. Cardiovasc Intervent Radiol. 2015;38:1198–204.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Nayak L, Hildebolt CF, Vedantham S. Postthrombotic syndrome: feasibility of a strategy of imaging-guided endovascular intervention. J Vasc Interv Radiol JVIR. 2012;23:1165–73.CrossRefPubMed Nayak L, Hildebolt CF, Vedantham S. Postthrombotic syndrome: feasibility of a strategy of imaging-guided endovascular intervention. J Vasc Interv Radiol JVIR. 2012;23:1165–73.CrossRefPubMed
20.
Zurück zum Zitat Seager MJ, Busuttil A, Dharmarajah B, Davies AH. Editor’s choice—a systematic review of endovenous stenting in chronic venous disease secondary to iliac vein obstruction. Eur J Vasc Endovasc Surg Off J Eur Soc Vasc Surg. 2016;51:100–20.CrossRef Seager MJ, Busuttil A, Dharmarajah B, Davies AH. Editor’s choice—a systematic review of endovenous stenting in chronic venous disease secondary to iliac vein obstruction. Eur J Vasc Endovasc Surg Off J Eur Soc Vasc Surg. 2016;51:100–20.CrossRef
21.
Zurück zum Zitat Neglén P, Tackett TP, Raju S. Venous stenting across the inguinal ligament. J Vasc Surg. 2008;48:1255–61.CrossRefPubMed Neglén P, Tackett TP, Raju S. Venous stenting across the inguinal ligament. J Vasc Surg. 2008;48:1255–61.CrossRefPubMed
22.
Zurück zum Zitat Yin M, Shi H, Ye K, Lu X, Li W, Huang X, et al. Clinical assessment of endovascular stenting compared with compression therapy alone in post-thrombotic patients with iliofemoral obstruction. Eur J Vasc Endovasc Surg Off J Eur Soc Vasc Surg. 2015;50:101–7.CrossRef Yin M, Shi H, Ye K, Lu X, Li W, Huang X, et al. Clinical assessment of endovascular stenting compared with compression therapy alone in post-thrombotic patients with iliofemoral obstruction. Eur J Vasc Endovasc Surg Off J Eur Soc Vasc Surg. 2015;50:101–7.CrossRef
23.
Zurück zum Zitat Launois R, Reboul-Marty J, Henry B. Construction and validation of a quality of life questionnaire in chronic lower limb venous insufficiency (CIVIQ). Qual Life Res Int J Qual Life Asp Treat Care Rehabil. 1996;5:539–54.CrossRef Launois R, Reboul-Marty J, Henry B. Construction and validation of a quality of life questionnaire in chronic lower limb venous insufficiency (CIVIQ). Qual Life Res Int J Qual Life Asp Treat Care Rehabil. 1996;5:539–54.CrossRef
24.
Zurück zum Zitat Mahnken AH, Thomson K, de Haan M, O’Sullivan GJ. CIRSE standards of practice guidelines on iliocaval stenting. Cardiovasc Intervent Radiol. 2014;37:889–97. Mahnken AH, Thomson K, de Haan M, O’Sullivan GJ. CIRSE standards of practice guidelines on iliocaval stenting. Cardiovasc Intervent Radiol. 2014;37:889–97.
Metadaten
Titel
Endovascular Treatment of Post-thrombotic Venous Ilio-Femoral Occlusions: Prognostic Value of Venous Lesions Caudal to the Common Femoral Vein
verfasst von
Caroline Menez
Mathieu Rodiere
Julien Ghelfi
Christophe Seinturier
Thomas Martinelli
Bernard Imbert
Romain Perolat
Pierre Bouzat
Sophie Blaise
Patrick Carpentier
Gilles Pernod
Frédéric Thony
Publikationsdatum
06.05.2019
Verlag
Springer US
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 8/2019
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-019-02214-9

Weitere Artikel der Ausgabe 8/2019

CardioVascular and Interventional Radiology 8/2019 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.