First Reported Series of Iliocaval Stenting From Iraq, What Are the Earliest Lessons Publisher



Al Saffar H¹ ; Ghanaati H² ; Al Dahhan O³ ; Ghanem H⁴ Show Affiliations
Source: Acta Phlebologica Published:2022

Abstract

BACKGROUND: Venous stenting for treatment of iliocaval obstruction is a demanding type of interventions that is missing totally in Iraq. METHODS: Below an observational study on 12 patient (14 limbs) with iliocaval obstructions who treated with venous stents insertions. Age of patients was 36.33±8.02 years. Youngest was 22 and oldest was 50 years. Six patients (50%) were male and 6 (50%) were female. Ten patients (83.3%) were with left sided problem, and 2 (16.7%) were with bilateral problem. All patients were symptomatic with features of chronic venous insufficiency and ulcer was present in 4/12 patients (33.3%), 5/14 limbs (35.7%) Causes of iliocaval obstruction was post thrombotic syndrome (PTS) in 11/12 patients (91.7%), 13/14 limbs (92.8%) and May Thurner Syndrome in 1/12 patient (8.3%), 1/14 limbs (7.2%). RESULTS: Successful stenting was achieved in 9/12 of patients (75%), 10/14 of limbs (71.4%). CONCLUSIONS: Venous stentings are demanding surgeries that need theoretical knowledge that vascular surgeons are familiar with, precise equipment handling that interventional radiologists are familiar with, and well oriented post operative care that vascular surgeons are familiar with, accordingly well-coordinated teamwork is always best approach. Most of our cases are due provoked post operative deep venous thrombosis (DVT) with lack of suitable DVT prophylaxis, also good number of chronic patients are lacking precise diagnosis, which both indicate defective overall venous management, not only interventional procedures, in Iraq. It is nice to say for any new medical project to start with easy cases, but this is difficult to achieve in reality, we expected the most difficult cases to present early and we did our best in management of them. Cost of the procedure was great obstacle, which prohibited many patients from treatment. Chronicity of deep venous conditions should not be an excuse to miss recent concomitant diseases. © 2022 THE AUTHORS.