Medical and Economic Rationale of Venous Stenting for Chronic Obstruction

Gavrilov S.G.; Lebedev I.S.; Vasiliev A.V.; Mishakina N.Yu.

doi:https://doi.org/10.17116/flebo20231702192

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Abstract:

Considering literature and clinical data, the authors present the arguments in favor of stenting in patients with chronic venous obstructions. Modern literature devoted to stenting for chronic thrombotic and non-thrombotic obstruction of iliac veins was analyzed. Currently, classical and special venous stents are used for iliac vein stenting. The latter have greater flexibility and radial strength. They are not accompanied by such complications as stent-related occlusion of contralateral common iliac vein and cone-shaped narrowing of both ends of the stent. Literature data indicate high efficiency of stenting for recanalization of iliac veins in patients with thrombotic and non-thrombotic iliac vein obstructions. Stent patency varies from 79 to 100% within 1—3 years. Relief of edematous and pain syndrome, as well as healing of trophic ulcer occurs in 70—100% of patients. Comparison of the cost of venous stenting and standard therapy indicates that endovascular intervention is accompanied by significantly lower treatment cost and less period of temporary disability. Clinical examples demonstrate the possibilities of iliac vein stenting in patients with post-thrombotic disease, combination of May-Thurner syndrome and pelvic venous congestion. Venous stenting is effective and safe for recanalization of great veins, correction of chronic venous insufficiency and pelvic venous congestion syndrome. This approach reduces treatment cost in patients with chronic venous obstructions.

Keywords:

chronic venous obstruction

venous stenting

post-thrombotic disease

May—Thurner syndrome

economic feasibility

Authors:

Gavrilov S.G.

Pirogov Russian National Research Medical University

SPIN RSCI: 7375-4712
Scopus AuthorID: 8312153800
ResearcherID: E-6089-2016
ORCID: 0000-0002-2307-2176

Lebedev I.S.

Pirogov Russian National Research Medical University

ORCID: 0000-0001-7956-3807

Vasiliev A.V.

Pirogov Russian National Research Medical University

ORCID: 0000-0002-3881-6107

Mishakina N.Yu.

Pirogov Russian National Research Medical University

ORCID: 0000-0002-3626-0299

Received:

31.01.2023

Accepted:

15.04.2023

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References:

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