Abstract No. 392 Patency of Iliocaval and Iliofemoral Venous Stenting

The purpose of this study was to review outcomes in treatment of iliocaval/iliofemoral venous disease using stents with and without a specific venous indication and identify factors that may impact patency. An institutional review board–approved retrospective review of patients with iliocaval/iliofemoral venous stent placement for both acute and chronic thrombosis between 2011 and 2022 was performed. Cases of stents placed only in the IVC or in the upper extremity/chest were excluded. Demographics, laboratory values, imaging findings, procedural details, prescription medication, stent patency, clinical symptoms, and re-intervention data were obtained. Baseline descriptive statistics were performed. Primary patency was evaluated using regression analyses. 74 patients (21 M) with median age 45 years (range: 18-82 years) underwent iliocaval/iliofemoral venous reconstruction with stenting. 66/74 (89.1%) patients were treated for chronic post-thrombotic disease. Comorbid etiologies included May-Thurner Syndrome (42/74, 56.8%), hormone use (18/74, 24.3%), and pro-thrombotic conditions (18/74, 24.3%). The median length of follow-up was 502 days (range: 4-4051 days). Stents with a specific venous indication were used in 18/74 (24.3%). Median primary patency for stents with a specific venous indication was 162.5 days (2-617 days). Median primary patency for stents without a specific venous indication was 341 days (range 1-4051 days). Rate of failure was not significantly different between stents with and without specific venous indication (6/18 (33.3%) vs. 13/56 (23.2%), p=0.39). Female patients were at a significantly higher risk of venous stent thrombosis (HR: 6.05, 95% CI: 1.35-27.10, p=0.02). Anticoagulation was associated with significantly less stent thrombosis while controlling for antiplatelet medication use (HR: 0.24, 95% CI 0.07-0.82, p=0.02). Anticoagulation regimen and female gender appear to be significantly associated with stent patency. Stent patency between FDA-approved venous stents and stents without a specific venous indication does not appear significantly different, although long-term follow-up is needed.