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Prognostic Value of a Classification System for Iliofemoral Stenting in Patients With Chronic Venous Obstruction Publisher Pubmed



Jalaie H1 ; Barbati ME1 ; Piao L1, 2 ; Doganci S3 ; Kucher N4 ; Dumantepe M5 ; Hartung O6 ; Lichtenberg M7 ; Black S8 ; Osullivan G9, 17 ; Avgerinos ED10 ; Davies AH11 ; Razavi MK12 ; Toonder IM13 Show All Authors
Authors
  1. Jalaie H1
  2. Barbati ME1
  3. Piao L1, 2
  4. Doganci S3
  5. Kucher N4
  6. Dumantepe M5
  7. Hartung O6
  8. Lichtenberg M7
  9. Black S8
  10. Osullivan G9, 17
  11. Avgerinos ED10
  12. Davies AH11
  13. Razavi MK12
  14. Toonder IM13
  15. Sebastian T4
  16. Erbel C14
  17. Moini M15
  18. De Graaf R16
  19. Morris RI8
  20. Omalley E9, 17
  21. Chaer RA18
Show Affiliations
Authors Affiliations
  1. 1. Clinic of Vascular and Endovascular Surgery, RWTH Aachen University Hospital, Aachen, Germany
  2. 2. Department of Vascular and Endovascular Surgery, Zhejiang Provincial People's Hospital, Hangzhou, China
  3. 3. Department of Cardiovascular Surgery, University of Health Sciences, Ankara, Turkey
  4. 4. Department of Angiology, University Hospital Zurich, Zurich, Switzerland
  5. 5. Department of Cardiovascular Surgery, Uskudar University School of Medicine, Istanbul, Turkey
  6. 6. Department of Vascular Surgery, Nord University Hospital of Marseille, Marseille, France
  7. 7. Department Angiology, Klinikum Hochsauerland, Arnsberg, Germany
  8. 8. Academic Department of Vascular Surgery, Cardiovascular Division, St Thomas' Hospital, King's College London, London, United Kingdom
  9. 9. University Hospital Galway, Newcastle Road, Galway, Ireland
  10. 10. Division of Vascular Surgery, University of Pittsburgh Medical Centre, Pittsburgh, PA, United States
  11. 11. Section of Vascular Surgery, Imperial College, London, United Kingdom
  12. 12. St Joseph Heart & Vascular Centre, Orange, CA, United States
  13. 13. Foundation Grave Centre of Phlebology, Grave, Netherlands
  14. 14. Department of Cardiology, Angiology, Pneumology, University Hospital Heidelberg, Heidelberg, Germany
  15. 15. Vascular Surgery Department, Sina Hospital, Tehran, Iran
  16. 16. Department of Diagnostic and Interventional Radiology, Clinic of Friedrichshafen, Friedrichshafen, Germany
  17. 17. University Hospital Galway, Newcastle Road, Galway, Ireland
  18. 18. Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States

Source: European Journal of Vascular and Endovascular Surgery Published:2025


Abstract

Objective: This retrospective, multicentre study aimed to assess the prognostic value of a proposed classification system for chronic venous obstruction (CVO) patients undergoing successful interventional procedures. Methods: This study analysed data from 13 vascular centres, including 1 033 patients with CVO treated between 2015 – 2019. The patients were classified into five category types: 1 – non-thrombotic iliac vein lesion; 2 – CVO of iliac segment; 3 – CVO of iliofemoral segment above common femoral vein confluence; 4 – CVO of iliofemoral segment extending into the femoral vein (FV) or deep femoral vein (DFV); and 5 – CVO of iliofemoral segment involving both DFV and FV. Stent deployment, complications, and follow ups were evaluated. Uni- and multivariable analyses were performed to identify predictors of primary patency loss. Results: The mean age of the patients was 44.0 ± 14.7 years, with 59.9% being women. A median of two stents was used for unilateral cases and five stents for bilateral cases. At twelve months follow up, primary patency rates for types 1 – 5 were 94.9%, 90.3%, 80.8%, 60.6%, and 39.4%, respectively. These rates were strongly correlated with the extent of CVO and showed significant differences between each type. Univariable analysis identified predictors of primary patency loss as the type of CVO, history of deep vein thrombosis, and the total number of stents. In the multivariable analysis, the significant independent predictors of primary patency loss were the type of CVO and the total number of stents. Conclusion: The proposed anatomical classification of iliofemoral CVO will help to predict intervention outcomes and facilitate comparison of stent outcomes in future studies. However, further evaluation and validation in prospective studies are needed to confirm the utility of this classification. © 2024 The Author(s)