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Sullivan PM, Ing FF. Systemic Central Venous Rehabilitation in Congenital Heart Disease. Interv Cardiol Clin 2024; 13:439-450. [PMID: 38839176 DOI: 10.1016/j.iccl.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
Chronic venous obstructions resulting from indwelling lines, surgery and instrumentation, and congenital anomalies are increasingly common in patients with congenital heart disease (CHD) and other chronic illnesses. Venous obstruction results in threatened long-term vascular access and congestive symptoms. Endovascular therapies are safe and can be effective at rehabilitating obstructed and even occluded veins. The risk of recurrent obstruction is high, however. Post-rehabilitation monitoring and anticoagulation therapy are important, and reinterventions are common. Here, the authors describe techniques to address a variety of venous obstruction lesions that may be encountered in CHD patients and provide illustrative cases.
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Affiliation(s)
- Patrick M Sullivan
- USC Keck School of Medicine, Los Angeles, CA, USA; Children's Hospital Los Angeles Heart Institute, 4650 Sunset Boulevard #34, Los Angeles, CA 90027, USA.
| | - Frank F Ing
- UC Davis School of Medicine, Pediatric Heart Center, UC Davis Children's Hospital, 2516 Stockton Boulevard TICON II, Sacramento, CA 95817, USA
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2
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Liu Q, Liu F, Lü P, Wu HX, Ye P, You Y, Yao Z. Current Status and Prospect of Stent Placement for May-Thurner Syndrome. Curr Med Sci 2021; 41:1178-1186. [PMID: 34918176 DOI: 10.1007/s11596-021-2481-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 11/18/2021] [Indexed: 11/28/2022]
Abstract
Stent implantation has been proven to be safe and has become the first-line intervention for May-Thurner syndrome (MTS), with satisfactory mid-term patency rates and clinical outcomes. Recent research has demonstrated that catheter-directed thrombolysis is the preferred strategy when MTS is combined with deep vein thrombosis after self-expanding stent placement. However, the stent used for the venous system was developed based on the experience obtained in the treatment of arterial disease. Consequently, relatively common corresponding complications may come along later, which include stent displacement, deformation, and obstruction. Different measures such as adopting a stent with a larger diameter, improving stent flexibility, and increasing stent strength have been employed in order to prevent these complications. The ideal venous stent is presently being evaluated and will be introduced in detail in this review.
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Affiliation(s)
- Qin Liu
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Fang Liu
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Ping Lü
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Hong-Xiao Wu
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Pin Ye
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yun You
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Zhong Yao
- Donnelly Centre for Cellular and Biomolecular Research, University of Toronto, Toronto, Ontario, M5S 2E8, Canada
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3
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Pillai A, Kathuria M, Bayona Molano MDP, Sutphin P, Kalva SP. An expert spotlight on inferior vena cava filters. Expert Rev Hematol 2021; 14:593-605. [PMID: 34139952 DOI: 10.1080/17474086.2021.1943350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Introduction: Inferior vena cava (IVC) filters are mechanical filtration devices designed as an alternative to surgical ligation/plication of the IVC. Their use has been controversial, especially with the introduction of retrievable filters and expanded/prophylactic indications.Areas covered: Authors discuss the types of available IVC filters, indications for placement, evidence on their effectiveness in general and specific patient populations, procedural considerations, off-label use, complications, and filter retrieval. This review is based on manuscripts/abstracts published from 1960 to 2021 on venous thromboembolism and IVC filters.Expert opinion: Despite the limited data on their effectiveness and survival benefit, IVC filters continue to play an important role in the treatment of patients with venous thromboembolism (VTE) who cannot receive standard anticoagulation. There is no role of IVC filters in patients without VTE. While retrievable filters are desirable for short-term use, a dedicated team-based approach, and advanced training are required for their successful removal. Newer devices are promising in improving patient safety . The device manufacturers and regulatory agencies should consider specific approaches to track device-related adverse events. Population-based studies are required to establish optimal patient population who would benefit from these devices. .
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Affiliation(s)
- Anil Pillai
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Manoj Kathuria
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Patrick Sutphin
- Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital, Boston, USA.,Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sanjeeva P Kalva
- Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital, Boston, USA.,Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
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4
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Klein-Weigel PF, Elitok S, Ruttloff A, Reinhold S, Nielitz J, Steindl J, Lutfi P, Rehmenklau-Bremer L, Hillner B, Fuchs H, Wrase C, Herold T, Beyer L. Inferior vena cava-syndrome. VASA 2021; 50:250-264. [PMID: 33459041 DOI: 10.1024/0301-1526/a000919] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Inferior vena cava syndrome (IVCS) is caused by agenesis, compression, invasion, or thrombosis of the IVC, or may be associated with Budd-Chiari syndrome. Its incidence and prevalence are unknown. Benign IVCS is separated from malignant IVCS. Both cover a wide clinical spectrum reaching from asymptomatic to highly symptomatic cases correlated to the underlying cause, the acuity, the extent of the venous obstruction, and the recruitment and development of venous collateral circuits. Imaging is necessary to determine the underlying cause of IVCS and to guide clinical decisions. Interventional therapy has changed the therapeutic approach in symptomatic patients. This article provides an overview over IVCS and focuses on interventional therapeutic methods and results.
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Affiliation(s)
- Peter Franz Klein-Weigel
- Angiology - Interdisciplinary Center of Vascular Diseases, Ernst von Bergmann Klinikum Potsdam, Germany
| | - Saban Elitok
- Nephrology, Endokrinology/Diabetology, Ernst von Bergmann Klinikum Potsdam, Germany
| | - Andreas Ruttloff
- Angiology - Interdisciplinary Center of Vascular Diseases, Ernst von Bergmann Klinikum Potsdam, Germany
| | - Sabine Reinhold
- Angiology - Interdisciplinary Center of Vascular Diseases, Ernst von Bergmann Klinikum Potsdam, Germany
| | - Jessica Nielitz
- Angiology - Interdisciplinary Center of Vascular Diseases, Ernst von Bergmann Klinikum Potsdam, Germany
| | - Julia Steindl
- Angiology - Interdisciplinary Center of Vascular Diseases, Ernst von Bergmann Klinikum Potsdam, Germany
| | - Philippe Lutfi
- Angiology - Interdisciplinary Center of Vascular Diseases, Ernst von Bergmann Klinikum Potsdam, Germany
| | | | - Birgit Hillner
- Institute of Radiodiagnostic, Helios Klinikum Buch, Berlin, Germany
| | - Heiko Fuchs
- Diagnostic and Interventionel Radiology, Ernst von Bergmann Klinikum Potsdam, Germany
| | - Christian Wrase
- Diagnostic and Interventionel Radiology, Ernst von Bergmann Klinikum Potsdam, Germany
| | - Thomas Herold
- Institute of Radiodiagnostic, Helios Klinikum Buch, Berlin, Germany
| | - Lukas Beyer
- Diagnostic and Interventionel Radiology, Ernst von Bergmann Klinikum Potsdam, Germany
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5
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Delayed Yet Successful Mechanical Thrombectomy for Phlegmasia Cerulea Dolens in a Limb with Severe Arterial Disease and May-Thurner Syndrome. Case Rep Vasc Med 2020; 2020:8866030. [PMID: 33204571 PMCID: PMC7652628 DOI: 10.1155/2020/8866030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 10/11/2020] [Accepted: 10/20/2020] [Indexed: 11/19/2022] Open
Abstract
Phlegmasia cerulea dolens (PCD) is a rare but life-threatening complication of acute deep venous thrombosis that lacks consensus regarding the approach to management. We present a case of PCD developing shortly after a spinal surgery and manifesting as acute swelling and discoloration in a leg with existing severe atherosclerotic arterial disease. The patient's critical limb ischemia was completely and rapidly reversed by percutaneous mechanical thrombectomy using the ClotTriever device despite a delay in treatment. An underlying iliac vein compression “May-Thurner” syndrome was discovered using intravascular ultrasound and treated with angioplasty. This case identifies mechanical thrombectomy using the ClotTriever system as a possible effective and safe treatment for PCD.
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6
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ZHONG W, LOU Y, QIU C, LI D, ZHANG H. [Antithrombotic therapy after iliac vein stenting]. Zhejiang Da Xue Xue Bao Yi Xue Ban 2020; 49:131-136. [PMID: 32621412 PMCID: PMC8800714 DOI: 10.3785/j.issn.1008-9292.2020.02.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Stenting for iliac vein stenosis or compression has become a common therapeutic approach in recent years. The antithrombotic therapy after the stent deployment, however, reaches no consensus. Medications strategies and patients' prognoses differ in non-thrombotic, acute thrombotic and chronic thrombotic these three circumstances. Non-thrombotic patients usually possess satisfactory stent patency whatever antithrombotic therapy is used. Anticoagulant is the basic medication for acute thrombotic patients, benefits from additional antiplatelet drug remains to be clarified. In terms of chronic thrombotic patients, their prognoses are unsatisfactory under all antithrombotic therapies. In this review, we outlined the recent progress of antithrombotic therapy after iliac vein stenting, aiming to provide feasible medication plans for each circumstance.
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Schwartz C, Hafez A, Lönnrot K, Rezai Jahromi B, Lappalainen K, Lehecka M, Siironen J, Niemelä M. Microsurgical removal of a misplaced intraspinal venous stent in a patient with inferior vena cava atresia. J Neurosurg Spine 2020; 32:763-767. [PMID: 31952036 DOI: 10.3171/2019.11.spine191220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 11/20/2019] [Indexed: 11/06/2022]
Abstract
Inferior vena cava atresia (IVCA) is a rare vascular condition that may be treated by venous stenting. The authors report on the microsurgical removal of an intraspinally misplaced stent causing nerve root compression and neurological deficits.A 42-year-old patient with IVCA and painful cutaneous collaterals had been scheduled for treatment by stenting of the iliocaval confluence and associated venous collaterals. Initial stenting of the right iliac vein was successful; however, during recanalization of the left paravertebral plexus, the stent entered the spinal canal via extraspinal-to-intraspinal venous collaterals. Because of the use of monoplanar angiography, the stent misplacement was not seen during the procedure. Postinterventionally, the patient experienced a foot elevation weakness (grade 1/5) as well as pain and hypesthesia corresponding to the L5 dermatome. Ultrasonography ruled out a lumbosacral plexus hematoma. CT angiography showed that a stent had entered the spinal canal through the left S1 neuroforamen causing nerve root compression. The intraspinal portion of the stent was removed piecemeal via a left-sided hemilaminectomy. Venous bleeding due to the patient's anticoagulation therapy, the stent's sharp mesh wire architecture, and the proximity to nerve roots complicated the surgery. Postoperatively, the foot elevation improved to grade 4/5.
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Affiliation(s)
- Christoph Schwartz
- 1Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Finland
- 2Department of Neurosurgery, University Hospital Salzburg, Paracelsus Medical University Salzburg, Austria; and
| | - Ahmad Hafez
- 1Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Finland
| | - Kimmo Lönnrot
- 1Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Finland
| | - Behnam Rezai Jahromi
- 1Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Finland
| | - Kimmo Lappalainen
- 3Department of Radiology, HUS Medical Imaging Center, Helsinki University Hospital, University of Helsinki, Finland
| | - Martin Lehecka
- 1Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Finland
| | - Jari Siironen
- 1Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Finland
| | - Mika Niemelä
- 1Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Finland
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8
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Madden NJ, Calligaro KD, Troutman DA, Maloni K, Dougherty MJ. Giant renal vein aneurysm. J Vasc Surg Cases Innov Tech 2019; 5:365-368. [PMID: 31440715 PMCID: PMC6699197 DOI: 10.1016/j.jvscit.2019.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 06/19/2019] [Indexed: 11/25/2022] Open
Abstract
A 37-year-old asymptomatic man presented with incidentally identified intra-abdominal venous aneurysms. Workup, which included venography, demonstrated an absent segment of the inferior vena cava between the inferior right and superior left renal vein, resulting in a 4.4-cm right renal vein aneurysm, dilated common iliac veins, and left external iliac vein aneurysm. Collateralization was robust. Given the limited natural history data and complexities of open reconstruction, we opted to observe this asymptomatic patient with serial imaging, which demonstrated no interval change. We present our case and a review of the literature pertaining to intra-abdominal venous aneurysms.
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McDevitt JL, Srinivasa RN, Hage AN, Bundy JJ, Gemmete JJ, Chick JFB. Lower extremity endovenous reconstruction for symptomatic occlusive disease in pediatric patients: techniques, clinical outcomes, and long-term stent patencies. Pediatr Radiol 2019; 49:808-818. [PMID: 30852651 DOI: 10.1007/s00247-019-04357-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 01/14/2019] [Accepted: 02/14/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Endovascular stent reconstruction is the standard of care for chronic venous occlusive disease in adults, but it has not been reported in pediatric patients. OBJECTIVE This study reports the technical success, complications, clinical outcomes, and stent patency of iliocaval stent reconstruction for chronic iliocaval thrombosis in pediatric patients. MATERIALS AND METHODS Fourteen patients, 13 (93%) male with a mean age of 16.4 years (range: 8-20 years), underwent iliocaval stent reconstruction for chronic iliocaval thrombosis. The mean number of prothrombotic risk factors was 2.5 (range: 0-4), including 7 (50%) patients with inferior vena cava atresia. At initial presentation, the Clinical, Etiology, Anatomy, and Pathophysiology classification (CEAP) score was C3 in 2 (14%) patients, C4 in 11 (79%) patients, and C6 in 1 (7.1%) patient. Time course of presenting symptoms included chronic (>4 weeks) (n=7; 50%) and acute worsening of chronic symptoms (2-4 weeks) (n=7; 50%). Aspects of recanalization and reconstruction, stenting technical success, complications, clinical outcomes and stent patency were recorded. Clinical success was defined as a 1-point decrease in the CEAP. Primary, primary-assisted, and secondary patency were defined by Cardiovascular and Interventional Radiological Society of Europe guidelines. RESULTS Most procedures employed three access sites (range: 2-4). Intravascular ultrasound was employed in 11 (79%) procedures. Blunt and sharp recanalization techniques were used in 12 (86%) and 2 (14%) patients, respectively. Stenting technical success was 100%. Two (14%) minor adverse events occurred and mean post-procedure hospitalization was 2.8 days (range: 1-8 days). Clinical success rates at 2 weeks, 6 months and 12 months were 85%, 82%, and 83%, respectively. At a mean final clinical follow-up of 88 months (range: 16-231 months), clinical success was 93%. Estimated 6- and 12-month primary stent patencies were 86% and 64%, respectively. Six- and 12-month primary-assisted and secondary stent patency rates were both 100%. CONCLUSION Iliocaval stent reconstruction is an effective treatment for symptomatic chronic iliocaval thrombosis in pediatric patients with high rates of technical success, 6- and 12-month clinical success, and 6- and 12-month primary-assisted and secondary patency rates.
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Affiliation(s)
- Joseph L McDevitt
- Department of Radiology, Division of Vascular and Interventional Radiology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ravi N Srinivasa
- Department of Radiology, Division of Interventional Radiology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Anthony N Hage
- Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Jacob J Bundy
- Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Joseph J Gemmete
- Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Jeffrey Forris Beecham Chick
- Cardiovascular and Interventional Radiology, Inova Alexandria Hospital, 4320 Seminary Road, Alexandria, VA, USA.
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McDevitt JL, Srinivasa RN, Hage AN, Bundy JJ, Gemmete JJ, Srinivasa RN, Chick JFB. Total endovenous recanalization and stent reconstruction for naïve non-inferior vena cava filter-associated chronic iliocaval occlusive disease: Placement of 352 venous stents in 69 debilitated patients. Vasc Med 2019; 24:349-358. [PMID: 30905267 DOI: 10.1177/1358863x19834354] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this study was to report the technical success, adverse events, clinical outcomes, and long-term stent patency of iliocaval stent reconstruction for naïve, non-inferior vena cava (IVC) filter-related, chronic iliocaval thrombosis. A total of 69 patients, including 47 (68%) men, with a mean age of 36 years (range: 8-71 years), underwent first-time iliocaval stent reconstruction for non-IVC filter-associated iliocaval thrombosis. The mean number of prothrombotic risk factors was 2.2 (range: 0-5), including 30 (43%) patients with IVC atresia. Upon initial presentation, the Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) classification was C3 in 55 (80%) patients, C4 in four (5.8%) patients, C5 in one (1.4%) patient, and C6 in seven (10%) patients. Technical aspects of stent reconstruction, technical success, adverse events, 2-week and 6, 12, and 24-month clinical response, and 6, 12, and 24-month primary, primary-assisted, and secondary stent patency rates were recorded. Technical success was defined as recanalization and stent deployment. Adverse events were reported according to the Society of Interventional Radiology classification system. Clinical success was defined as a 1-point decrease in CEAP classification and stent patency was defined by the Cardiovascular and Interventional Radiological Society guidelines. The technical success rate was 100%. There were 352 venous stents deployed during stent reconstructions. One (1.4%) severe, four (5.8%) moderate, and four (5.8%) minor adverse events occurred and median post-procedure hospitalization was 1 day (range: 1-45 days). Clinical success at 2 weeks and 6, 12, and 24 months was 76%, 85%, 87%, and 100%, respectively. The estimated 6, 12, and 24-month primary patency rates were 91%, 88%, and 62%, respectively. The estimated 6, 12, and 24-month primary-assisted patency rates were 98%, 95%, and 81%, respectively. The estimated 6, 12, and 24-month secondary-assisted patency rates were all 100%. In conclusion, iliocaval stent reconstruction is an effective treatment for non-IVC filter-associated chronic iliocaval thrombosis with high rates of technical success, clinical responses, and stent patency.
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Affiliation(s)
- Joseph L McDevitt
- 1 Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, Ann Arbor, MI, USA.,2 Department of Radiology, Division of Vascular and Interventional Radiology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ravi N Srinivasa
- 3 Department of Interventional Radiology, University of California Los Angeles, Los Angeles, CA, USA
| | - Anthony N Hage
- 4 Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Jacob J Bundy
- 1 Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Joseph J Gemmete
- 1 Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Rajiv N Srinivasa
- 1 Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, Ann Arbor, MI, USA
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Chick JFB, Gemmete JJ, Hage AN, Bundy JJ, Brewerton C, Fenlon JB, Abramowitz SD, Coleman DM, Srinivasa RN, Williams DM. Stent Placement Across the Renal Vein Inflow in Patients Undergoing Venous Reconstruction Preserves Renal Function and Renal Vein Patency: Experience in 93 Patients. J Endovasc Ther 2019; 26:258-264. [PMID: 30681021 PMCID: PMC6431779 DOI: 10.1177/1526602818806653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Purpose: To determine if stent placement across the renal vein inflow affects kidney function and renal vein patency. Methods: Between June 2008 and September 2016, 93 patients (mean age 39 years, range 15–70; 54 women) with iliocaval occlusion underwent venous stent placement and were retrospectively reviewed. For this analysis, the patients were separated into treatment and control groups: 51 (55%) patients had suprarenal and infrarenal iliocaval venous disease requiring inferior vena cava stent reconstruction across the renal vein inflow (treatment group) and 42 (45%) patients had iliac vein stenting sparing the renal veins (control group). Treatment group patients received Wallstents (n=15), Gianturco Z-stents (n=24), or suprarenal and infrarenal Wallstents such that the renal veins were bracketed with a “renal gap” (n=12). Stenting technical success, stent type, glomerular filtration rate (GFR), and creatinine before and after stent placement were recorded, along with renal vein patency and complications. Results: All procedures were technically successful. In the 51-patient treatment group, 15 (29%) patients received Wallstents and 24 (47%) received Gianturco Z-stents across the renal veins, while 12 (24%) were given a “renal gap” with no stent placement directly across the renal vein inflow. In the control group, 42 patients received iliac vein Wallstents only. Mean prestent GFR was 59±1.8 mL/min/1.73 m2 and mean prestent creatinine was 0.8±0.2 mg/dL for the entire cohort. Mean prestent GFR and creatinine values in the Wallstent, Gianturco Z-stent, and “renal gap” subgroups did not differ from the iliac vein stent group. Mean poststent GFR and creatinine values were 59±3.3 mL/min/1.73 m2 and 0.8±0.3 mg/dL, respectively. There were no differences between mean pre- and poststent GFR (p=0.32) or creatinine (p=0.41) values when considering all patients or when comparing the treatment subgroups and the control group. There were no differences in the poststent mean GFR or creatinine values between the Wallstent (p=0.21 and p=0.34, respectively) and Gianturco Z-stent (p=0.43 and p=0.41, respectively) groups and the “renal gap” group. One patient with a Wallstent across the renal veins developed right renal vein thrombosis 7 days after the procedure. Conclusion: Stent placement across the renal vein inflow did not compromise renal function. A very small risk of renal vein thrombosis was seen.
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Affiliation(s)
| | - Joseph J Gemmete
- 2 Department of Radiology, Division of Vascular and Interventional Radiology, Michigan Health System, Ann Arbor, MI, USA
| | - Anthony N Hage
- 2 Department of Radiology, Division of Vascular and Interventional Radiology, Michigan Health System, Ann Arbor, MI, USA
| | - Jacob J Bundy
- 2 Department of Radiology, Division of Vascular and Interventional Radiology, Michigan Health System, Ann Arbor, MI, USA
| | - Charles Brewerton
- 3 Western Michigan University School of Medicine, Kalamazoo, MI, USA
| | - Jordan B Fenlon
- 3 Western Michigan University School of Medicine, Kalamazoo, MI, USA
| | - Steven D Abramowitz
- 4 Department of Surgery, Division of Vascular Surgery, Medstar Washington Hospital Center, Washington, DC, USA
| | - Dawn M Coleman
- 5 Department of Surgery, Division of Vascular Surgery, University of Michigan Health System, Ann Arbor, MI, USA
| | - Ravi N Srinivasa
- 6 Department of Interventional Radiology, University of California Los Angeles, CA, USA
| | - David M Williams
- 2 Department of Radiology, Division of Vascular and Interventional Radiology, Michigan Health System, Ann Arbor, MI, USA
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Cooper KJ, Chick JFB, Srinivasa RN, Luhar A, Liles A, Moriarty JM. Retrieval of symptomatic Gianturco-Roehm Bird's Nest inferior vena cava filters using rigid endobronchial forceps. Diagn Interv Imaging 2018; 99:829-830. [PMID: 30539726 DOI: 10.1016/j.diii.2018.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/25/2018] [Accepted: 07/27/2018] [Indexed: 01/10/2023]
Affiliation(s)
- K J Cooper
- Department of Radiology, Loma Linda University, 11234 Anderson Street, Room B623, Loma Linda, CA 92354 , USA
| | - J F B Chick
- Cardiovascular and Interventional Radiology, Inova Alexandria Hospital, 4320 Seminary road, Alexandria, VA 22304, USA.
| | - R N Srinivasa
- Department of Interventional Radiology, University of California, Los Angeles, 757 Westwood Plaza, Los Angeles, CA 90095, USA
| | - A Luhar
- Department of Interventional Radiology, University of California, Los Angeles, 757 Westwood Plaza, Los Angeles, CA 90095, USA
| | - A Liles
- Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Medical Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109 USA
| | - J M Moriarty
- Department of Interventional Radiology, University of California, Los Angeles, 757 Westwood Plaza, Los Angeles, CA 90095, USA
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13
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Bundy J, Srinivasa RN, Gemmete JJ, Hage AN, Chick JF. Regarding “Outcomes of endovascular reconstruction of the inferior vena cava with self-expanding nitinol stents”. J Vasc Surg Venous Lymphat Disord 2018; 6:679-680. [DOI: 10.1016/j.jvsv.2018.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 04/19/2018] [Indexed: 11/25/2022]
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