Recanalization of totally occluded iliac and adjacent venous segments

Abstract

Purpose: The purpose of this study was to report our experience with percutaneous recanalization of totally occluded iliac veins and inferior vena cava. Material and Methods: Recanalization of the iliac vein was performed in 38 limbs. In nine limbs, recanalization of the inferior vena cava was also necessary (two with filter). In 28 of 38 limbs, the stent was extended below the groin crease into the common femoral vein segment. Large-caliber (14 or 16 mm for iliac vein) flexible self-expanding stents were used. Stents were routinely extended for a short distance into the inferior vena cava to forestall development of iliocaval stenosis. Intravascular ultrasound scan was a valuable tool in the procedure. The median length of the recanalized segment was long (22 cm), and multiple stents (median, n = 3) were necessary in most patients. Forty-five percent of the patients had coagulation abnormalities. Results: No morbidity or mortality was seen. Actuarial primary, primary assisted, and secondary patency rates of the stents at 24 months were 49%, 62%, and 76%, respectively. Median pain level decreased significantly (level 4 to level 0; P