Intravascular Ultrasound Guided Venous Stenting in Single Center Experience

Abstract

Background: Intravascular ultrasound (IVUS) is known to be more effective in iliac vein stenting than venography. IVUS provides much more sufficient information for decision making and malposition of stent around narrow lesion. Material and Method: We retrospectively reviewed data of patients who underwent pharmacomechanical catheter directed thrombolysis (PCDT) or manual aspiration thrombectomy for acute iliofemoral deep vein thrombosis (DVT) from Aug 2016 to Feb 2019. The treatment procedures and outcomes of patients who underwent iliac vein stenting under IVUS guidance was evaluated. Result: A total of 18 patients underwent endovascular treatment under IVUS guidance for acute proximal DVT. 16 of 18 patients underwent PCDT. 17 patients underwent iliac vein stenting. In one case, there was no localized narrow lesion in IVUS, which was observed without stenting. The stent patency at 6 months was 93.8%. IVUS found residual thrombus in 3 cases, which needed additional PCDT. There was incomplete apposition of iliac vein stenting to vein wall in 2 patients, which needed additional balloon angioplasty. Conclusion: The IVUS can localize the narrow lesion and measure the vein diameter for vein stenting and evaluate post stenting wall apposition, which support early technical success and possible long term patency. (Ann Phlebology 2020;18:8-11)