Abstract No. 64: Common Iliac Vein Stent for May-Thurner Syndrome with Acute Thrombosis: Evaluation of Patency with CT Venography

To evaluate the patency of the stent with CT venography in patients who underwent common iliac vein stent placement for May-Thurner syndrome complicated with acute iliofemoral vein thrombosis. This study was approved by our institutional review board. During the past 8 years, 30 patients (8 men and 22 women) with May-Thurner syndrome complicated with acute iliofemoral vein thrombosis have been diagnosed with CT venography, managed by endovascular interventions, and followed up with CT venography at our institution. Endovascular interventions were performed via left popliteal vein access. After catheter-directed thrombolysis using urokinase with or without aspiration thrombectomy, the iliac vein obstruction was managed with balloon angioplasty followed by stent placement. Mean stent diameter was 12.6 mm (10-16 mm) and mean stent length was 5.0 cm (4-8 cm). We reviewed medical records and imagings retrospectively. The first follow-up CT venography was performed from 4 days to 2217 days (mean: 331 days) after the procedure in all patients. Five stent occlusions and one stent collapse developed. Mild degree of neointimal thicking within the stent was found in 9 patients. All of the five stent occlusions occurred within 1 year after stent placement (mean 105.8 days). Further sequential follow-up (2 to 5 times) CT venography was done in 18 patients (mean 1062 days follow-up). All of the intimal hyperplasia observed on the first follow-up CT remained stable throughout the follow-up period and new in-stent stenoses or occlusions did not occur. In patients who underwent common iliac vein stent placement for May-Thurner syndrome complicated with acute iliofemoral vein thrombosis, stent obstruction or restenosis usually occurs during early follow-up period and initial luminal patency can be well maintained during long-term follow-up.