Reasons for clinical failure after endovascular treatment of chronic iliac vein occlusions / 中华普通外科杂志

ABSTRACT

Objective To discuss the risk factors of iliaofemoral vein restenosis after percutaneous recanalization of post-thrombotic occlusion.Method From March 2006 to December 2014,44 limbs in 41 patients with chronic post-thrombotic iliaofemoral vein occlusion underwent endovascular treatment in our hospital.Post-operative patency was evaluated by ultrasonography and anterograde veinography.Results Initial technical success was 90.2％ (37/41).During the follow-up,5 cases of reobstruction were determined,2 were caused by insufficient stent extension into the inferior vena cave.Failure in two cases of intra-stent thrombosis were found due to arbitrary discontinuity of oral anticoagulative therapy.Moreover,2 of 9 cases with venous ulcers in lower extremities were exacerbated after failure of endovascular treatment,we therefore performed surgical ligation and endovenous laser treatment of circumambient perforating veins.Conclusion Insufficient lesion cover,not enough extension to interior vena cave and unreasonable post-operative anticoagulation discontinuity are major causes of intra-stent reobstruction in iliaofemoral venous occlusion.