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OBJECTIVES:
Minimally invasive procedures are evolving options for venous insufficiency.While many patients improve with endovenous therapy(thermal ablation or iliac vein stenting),some patients’symptoms persist.Also there have been well documented implications of race on the outcome of various vascular diseases.The goal of this study was to identify clinical factors related to persistent symptoms in patients with leg swelling after treatment with both iliac vein stenting and thermal ablation.
METHODS:
From February 2012 and February 2014, 1573 patient underwent either thermal ablation(RFA, Laser)or venograms.A total of2268 endovenous ablations(649 bilateral)and1115 iliac vein stenting(408 bilateral)were performed during this time period.This observational study analyzed data for173patients who underwent both iliac vein stent placement as well as thermal ablation(either RFA or EVLT)during the same period.Patients were categorized by Caucasian(n=97),Black(n=27)or Hispanic(n=49).Follow-up was performed after completion of both procedures and inquiring for improvement of swelling.Statistical analysis performed using Chi-square and student`s T-test.
RESULTS:
Of the total 173 patients who underwent both endovenous closure and iliac vein stent placements,117(67.6%)patients were female.The average age was67(±13)years.The average CEAP score was 3.4(±1.2).The average pain score was 2.9(±3.1).The average degree of stenosis was 66.5(±13.3).56.1% were Caucasians,15.6% were Blacks and 28.3% were Hispanics.The number of patients with iliac vein stent thrombosis was 2 patients.
152(87.9%)patients stated that they had improvement in swelling after combined procedures,100(65.8%)patients were females.The average age was67.3(±13)years.The average CEAP score was 3.4(±1.2).The average pain score was 2.9(±3.1).The average degree of stenosis was 67.3(±12.8).56.6% were Caucasians,15.1% were Blacks and 28.3% were Hispanics.The number of patients with iliac vein stent thrombosis was 1.
21(12.1%)patients stated they had no improvement after both procedures,17(81%)patients of them were females(p=0.16).The average age was 68.4(±17)years(p=0.72).The average CEAP score was3(±1.1)(p=0.15).The average pain score was 3.2(±3.7)(p=0.68).The average degree of iliac vein stenosis was 60.2(±15.9)(p=0.02).52.4% were Whites,19% were Blacks and 28.6% were Hispanics(p=0.887).The number of patients with iliac vein stent thrombosis was 1 patient (p=0.1).
CONCLUSIONS:
These data suggest these clinical factors including race are not clinically significant factors in the response to swelling after combined iliac stent and endovenous ablation procedures.