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Objective:
Iliac vein stenting of NIVL (nonthrombotic iliac vein lesions) is an evolving treatment option for venous insufficiency. We examined our experience with these lesions with balloon angioplasty followed by IVUS (intravascular ultrasound) before stenting.
Materials and Methods:
Over the course of 4 months, we performed 193 venograms with angioplasties and stenting of the iliac veins. The average age of patients were 65.96 years old (range 25-93, SD +/- 14.66), with 140 females and 53 males. Intraoperatively, we have used IVUS to measure and record the area of involved iliofemoral veins. The measurement of stenosis was compared with the adjacent non-stenotic iliofemoral veins. If more than 50% cross sectional area or diameter reduction was found, it was treated with appropriate balloon size (range 10x40-16x60) and stent (12-24 mm diameter by 40-90 mm length).
Results:
The average area reduction or diameter of stenotic lesion was 60.92 mm2 (range 12-177, SD +/-29.41). The post-ballooning average size of the stenotic area was 59.29 mm2 (range 9-207, SD +/-30.75) (P=0.59). The patients were classified as increased, decreased or the same area after angioplasty. In 90 patients, an average increase of 28.25% (SD +/-36.88) in cross sectional area at the site angioplasty was found, with pre-angioplasty average area of 57.71 mm2 (SD +/-28.32) and post-angioplasty 72.08 mm2 (SD +/-33.40). In 97 patients an average decrease of 23.41% (SD +/-18.01) in cross sectional area post-angioplasty was found, with pre-angioplasty average area of 64.29 mm2 (SD +/-30.81) and post-angioplasty 47.53 mm2 (SD +/-22.69). No statistically significant correlation was found between area reduction in comparison to age, gender, laterality and CEAP scores (2-6). Two patients were found to have the same area reduction pre and post angioplasty.
Conclusion:
Our preliminary data shows that no statistically significant efficacy was found in utilizing angioplasty to treat the area reduction of NIVL.