Clinical Experiences of Venous Stent for Deep Vein Thrombosis in the Lower Extremity

ABSTRACT

PURPOSE: To evaluate the efficacy of venous stenting in the treatment of venous obstruction or stenosis of symptomatic deep vein thrombosis (DVT). METHOD: Eight consecutive patients with lower extremity DVT underwent venous stenting. The duration of symptoms were 20 days or less in 6 cases (acute) and above than 20 days in 2 cases (chronic). The cause of DVT was venous thrombophlebitis in 7 cases and extrinsic compression in 1 case. The indication of venous stenting is venous obstruction or stenosis after aspiration thrombectomy and direct catheter thrombolysis. The exclusion criteria were successful treatment of DVT with aspiration thrombectomy, direct catheter thrombolysis and percutaneous angioplasty. The follow-up examination was performed 1 week, 2~3 month interval by Doppler ultrasound, which was evaluated thrombi formation and patency of venous stenting. If the lesion detect in Doppler, second intervention was performed. RESULT: The venous stenting was successfully performed in all cases. Initial aspiration thrombectomy was performed in all cases. The urokinase was performed in 4 cases which was 500,000~750,000 IU (mean, 675,000) during from 2 to 8 hours (mean, 4). After that, the venous stenting was performed at the site of the venous occlusion and stenosis. The direct venography after stenting showed good reconstruction of vein and adequate restoration of venous flow. Seven patients relieved from lower extremity swelling without recurrence. One patient had re-thrombosis after venous stenting, which was successfully treated with percutaneous angioplasty. The follow-up duration was from 3 to 14 months (mean, 8 months). There were no thrombi in follow-up Doppler and normal regular life was resumed without lower extremity swelling. CONCLUSION: Venous stenting in the treatment of deep vein thrombosis is an effective and safe treatment method in the venous obstructive or stenotic remnant lesion despite following aspiration thrombectomy, direct catheter thrombolysis and percutaneous angioplasty.