Optimal sizing of iliac vein stents

2017 ◽  
Vol 33 (7) ◽  
pp. 451-457 ◽  
Author(s):  
Seshadri Raju ◽  
William J Buck ◽  
William Crim ◽  
Arjun Jayaraj
Keyword(s):  
Therapeutic Option ◽  
Femoral Vein ◽  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Initial Procedure ◽  
The Common ◽  
The Right ◽  
Vein Stenosis ◽  
Scaling Rule

Background Iliac vein stenting has emerged as a therapeutic option in chronic venous disease. The optimal stent size is unknown but should match normal caliber at a minimum. Methods Teleology: The iliac-femoral outflow caliber was measured by Duplex in healthy volunteers to determine normal caliber. Patient IVUS data: The distribution curve of IVUS planimetry data in 345 chronic venous disease limbs was analyzed: values at the right tail end of the curve should approach normal values according to distribution theory. The optimal stent size was also projected using Poiseuille equation and Young’s scaling rule. Results The optimal stent sizes in the common iliac, external iliac, and common femoral vein segments are: 16, 14, and 12 mm diameters, respectively. Conclusion Stent correction of iliac vein stenosis should aim to restore the lumen to the minimum recommended caliber during the initial procedure and later re-interventions.

Human iliac vein replacement with a tissue-engineered graft

VASA ◽  
2009 ◽  
Vol 38 (1) ◽  
pp. 60-65 ◽  
Author(s):  
Teebken ◽  
Puschmann ◽  
Rohde ◽  
Burgwitz ◽  
Winkler ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Great Saphenous Vein ◽  
Therapeutic Option ◽  
Iliac Vein ◽  
Unknown Primary ◽  
Prosthetic Replacement ◽  
Carcinoma Of Unknown Primary ◽  
Arterial Allograft ◽  
The Right ◽  
Vein Stenosis

The modification of a previously described technique to generate venous conduits in a lamb model from a decellularised matrix and autologous cells and its application to human tissue is described. A 49-year-old woman underwent surgery for a large malignant pelvic tumour (carcinoma of unknown primary) involving the right iliac artery and vein. The right iliac artery was reconstructed with a cryopreserved human arterial allograft. For iliac vein reconstruction a tissue-engineered neo-vein was developed utilising a decellularised cryopreserved vein allograft that was reseeded in a bioreactor with autologous endothelial cells derived from the recipient’s great saphenous vein. Both interposition grafts were patent initially, after 3, 6, 12, and 24 months, but the tissue-engineered neo-vein had become obstructed due to evolving disease four month postoperatively. Tissue engineered neo-veins may be a therapeutic option in selected cases with symptomatic vein stenosis or obstruction not curable with interventional methods or standard prosthetic replacement.

Computed tomography venography versus intravascular ultrasound in the diagnosis of iliofemoral vein stenosis

VASA ◽  
2021 ◽  
Vol 50 (1) ◽  
pp. 38-44
Author(s):  
Ming Ren Toh ◽  
Karthikeyan Damodharan ◽  
Han Hui Mervin Nathan Lim ◽  
Tjun Yip Tang
Keyword(s):  
Computed Tomography ◽  
Diagnostic Performance ◽  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Diagnostic Tools ◽  
Venous Disease ◽  
Significant Stenosis ◽  
Vein Segment ◽  
Vein Stenosis ◽  
Computed Tomography Venography

Summary: Background: Iliofemoral vein stenosis can cause debilitating chronic venous disease. Diagnostic tools include both computed tomography venography (CTV) and intravascular ultrasonography (IVUS). We aim to compare the diagnostic performance of CTV and IVUS. Patients and methods: We performed a retrospective study of patients with chronic venous disease presenting with iliac vein compression or post-thrombotic limb symptoms, excluding those with acute deep vein thrombosis, high anaesthesia risk, or who had contrast allergy. All patients received CTV before IVUS, as part of the diagnostic work-up and intervention. The cross-sectional area (CSA) of iliofemoral vein segments obtained from both studies were compared against reference CSAs to derive percentage stenosis. A 50% reduction in CSA was considered significant. Results: We studied 50 patients between May 2018 and April 2019. 58% of patients had severe disease CEAP C5-6. 48% of patients had at least one vein segment with significant stenosis. The left proximal common iliac vein was the most commonly stenosed vein segment (n = 12, 24% on IVUS). CSA measurements from CTV were greater than those of IVUS, with a correlation coefficient of 0.57 (p < 0.005). Conversely, percentage stenosis measured on CTV was lower than on IVUS, with approximately one-third of significant stenosis missed on CTV (58 veins from CTV vs. 78 from IVUS, p < 0.005). With IVUS as the gold standard, CTV has low sensitivity (37.2%, 95% CI 26.5–48.9) and high specificity (92.5%, 95% CI 89.3–94.9) in detecting significant stenosis. Conclusions: CTV has limited diagnostic performance in identifying iliofemoral vein stenosis. Patients with normal CTV findings should proceed with IVUS imaging if the clinical features are supportive of iliofemoral vein stenosis.

scholarly journals Diosmin Alleviates Venous Injury and Muscle Damage in a Mouse Model of Iliac Vein Stenosis

2022 ◽  
Vol 8 ◽  
Author(s):  
Zhiye Guo ◽  
Xiaolong Du ◽  
Yihua Zhang ◽  
Chunwan Su ◽  
Feng Ran ◽  
...  
Keyword(s):  
Mouse Model ◽  
Therapeutic Effect ◽  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Sequencing Analysis ◽  
Venous Injury ◽  
Venous Diseases ◽  
Vein Stenosis ◽  
Dose Dependent

Chronic venous disease (CVD) is a progressive inflammatory disease that increases in prevalence with age. Elucidating the underlying molecular mechanism of CVD development is essential for disease prevention and treatment. This study constructed a mouse model of iliac vein stenosis to explore the mechanism of the CVD disease progression, and diosmin was administered as a positive control (as recommended by clinical practice). The mouse model was established successfully with iliac vein stenosis, leading to the expansion of the intercellular space and venous leakage. Conversely, micronized diosmin showed a dose-dependent therapeutic effect for these manifestations. Concerning the mechanism, iliac vein stenosis caused an inflammatory response in veins, while diosmin suppressed this increase. Furthermore, RNA sequencing analysis indicated that diosmin significantly improved muscle function through actin filament organization and muscle contraction. These results indicated that the mouse model of iliac vein stenosis is a reliable model to study venous diseases. Furthermore, the dose-dependent therapeutic effect of diosmin on stenosis (without toxic side-effects) suggests greater protection against venous diseases at higher doses of diosmin.

Endovenous stenting in chronic venous disease secondary to iliac vein obstruction

2019 ◽  
Vol 26 (2) ◽  
Author(s):  
Mohamed A. Taha ◽  
Tristan Lane ◽  
Joseph Shalhoub ◽  
Alun H. Davies
Keyword(s):  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Venous Disease

CHIVA strategy in chronic venous disease treatment: instructions for users

2014 ◽  
Vol 30 (3) ◽  
pp. 157-171 ◽  
Author(s):  
S Gianesini ◽  
S Occhionorelli ◽  
E Menegatti ◽  
M Zuolo ◽  
M Tessari ◽  
...  
Keyword(s):  
Clinical Data ◽  
Therapeutic Option ◽  
Cochrane Review ◽  
Recurrence Risk ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Disease Treatment ◽  
Flow Restoration

Along the years, scientific clinical data have been collected concerning the possible saphenous flow restoration without any ablation and according with the CHIVA strategy. Moreover, in 2013 a Cochrane review highlighted the smaller recurrence risk following a CHIVA strategy rather than a saphenous stripping. Nevertheless, the saphenous sparing strategy surely remains a not-so-worldwide-spread and accepted therapeutic option, also because considered not so immediate and easy to perform. Aim of this paper is to provide an easily accessible guide to an everyday use of a saphenous sparing strategy for chronic venous disease, highlighting how even apparently too complicated reflux patterns classifications can be fastly and successfully managed and exploited for a hemodynamic correction.

scholarly journals Considerations on the caliber of the internal iliac vein

2015 ◽  
Vol 21 (1) ◽  
pp. 12-16 ◽  
Author(s):  
Oana Popa ◽  
P. Bordei ◽  
C. Ionescu ◽  
D.M. Iliescu
Keyword(s):  
Iliac Vein ◽  
Statistical Distribution ◽  
Common Iliac Vein ◽  
Internal Iliac Vein ◽  
Distribution Of Values ◽  
Internal Iliac ◽  
The Common ◽  
The Right

Abstract The diameter at the origin of the internal iliac vein was found between 4.7 to 9.9 mm; for the right internal iliac vein between 4.7 to 9.7 mm; the statistical distribution groups value in ascending order being as follows: 4.7 to 5.5 mm: 4 cases (22.22% of cases); 6.9 to 7.8 mm: 6 cases (33.33% of cases); 8.4-8.8 mm: 4 cases (22.22% of cases); 9.1 to 9.7 mm: 4 cases (22.22% of cases). The diameter at the origin of the left internal iliac vein was between 4.8 to 9.9 mm, while the distribution statistics on groups of values, in ascending order, being as follows: 4.8-5.2 mm: 4 cases (22.22 % of cases); 6.8-7.1 mm: 8 cases (44.44% of cases); 8.3 to 9.9 mm: 6 cases (33.33% of cases). The diameter at the end of the internal iliac vein was between 5.9 to 10.2 mm; the diameter at the end of the right internal iliac vein was between 6.1 to 10.2 mm, the statistical distribution of values groups in ascending order being follows: 6.1 to 7.5 mm: 6 cases (33.33% of cases); 8.4 to 8.7 mm: 8 cases (44.44% of cases); 9.3 to 10.2 mm: 4 cases (22.22% of cases). The diameter at the end of the left internal iliac vein was between 5.9 to 9.9 mm, while the distribution statistics on groups of values in ascending order being as follows: 5.9 to 6.2 mm: 4 cases (22.22 % of cases); 7 to 7.6 mm: 3 cases (16.67% of cases); 8.3-8.4 mm: 5 cases (27.28% of cases); 9.1 to 9.9 mm: 6 cases (33.33% of cases). Comparing the common iliac vein caliber of the two, right and left, we found that in 10 cases (55.56% of cases), the right internal iliac vein has a greater diameter than the left one by 0.3 mm. In 8 cases (44.44% of cases), the left internal iliac vein has a larger diameter than the right one with 0.1-0.6 mm; between the two values there is a difference of 0.5 mm

scholarly journals Acute Stent Migration into the Right Ventricle in a Patient with Iliac Vein Stenting

2018 ◽  
Vol 07 (01) ◽  
pp. e7-e8 ◽  
Author(s):  
Torulv Holst ◽  
Thorsten Großwendt ◽  
Majd Laham ◽  
Mehdy Roosta-Azad ◽  
Afsaneh Zandi ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Heart Surgery ◽  
Therapeutic Option ◽  
Open Heart Surgery ◽  
Iliac Vein ◽  
Stent Migration ◽  
Endovascular Stent ◽  
Effective Therapeutic Option ◽  
Endovascular Stent Placement ◽  
The Right

AbstractEndovascular stent placement for chronic postthrombotic iliofemoral venous obstructive lesions is an effective therapeutic option and might be complicated by stent migration. We report a case of a venous stent that was lost from the iliac vein into the right ventricle rescued by emergent open-heart surgery.

scholarly journals A Systematic Review of Endovenous Stenting in Chronic Venous Disease Secondary to Iliac Vein Obstruction

2016 ◽  
Vol 63 (2) ◽  
pp. 555-556 ◽  
Author(s):  
M.J. Seager ◽  
A. Busuttil ◽  
B. Dharmarajah ◽  
A.H. Davies
Keyword(s):  
Systematic Review ◽  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Venous Disease

Anatomy of the lymph node venous networks of the groin and their investigation by ultrasonography

2015 ◽  
Vol 31 (5) ◽  
pp. 334-343 ◽  
Author(s):  
Jean Francois Uhl ◽  
Miguel Lo Vuolo ◽  
Nicos Labropoulos
Keyword(s):  
Lymph Node ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Femoral Vein ◽  
Normal Subjects ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Anatomical Dissection ◽  
Anatomical Finding

Objective To describe the anatomy of the lymph node venous networks of the groin and their assessment by ultrasonography. Material and methods Anatomical dissection of 400 limbs in 200 fresh cadavers following latex injection as well as analysis of 100 CT venograms. Routine ultrasound examinations were done in patients with chronic venous disease. Results Lymph node venous networks were found in either normal subjects or chronic venous disease patients with no history of operation. These networks have three main characteristics: they cross the nodes, are connected to the femoral vein by direct perforators, and join the great saphenous vein and/or anterior accessory great saphenous vein. After groin surgery, lymph node venous networks are commonly seen as a dilated and refluxing network with a dystrophic aspect. We found dilated lymph node venous networks in about 15% of the dissected cadavers. Conclusion It is likely that lymph node venous networks represent remodeling and dystrophic changes of a normal pre-existing network rather than neovessels related to angiogenic factors that occur as a result of an inflammatory response to surgery. The so-called neovascularization after surgery could, in a number of cases, actually be the onset of dystrophic lymph node venous networks. Lymph node venous networks are an ever-present anatomical finding in the groin area. Their dilatation as well as the presence of reflux should be ruled out by US examination of the venous system as they represent a contraindication to a groin approach, particularly in recurrent varicose veins after surgery patients. A refluxing lymph node venous network should be treated by echo-guided foam injection.

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