Venous Stenting Versus Venous Ablation
Ahmad Alsheekh, M.D, Anil Hingorani, M.D, enrico ascher, M.D, Pavel Kibrik, Do, Ronak Patel, BA, Mina Gendy, BS, Viktoriya Barova, BS.
Total Vascular Care, Brooklyn, NY, USA.
Background
The minimally invasive procedures of venous ablation using endovenous techniques or the insertion of iliac vein stents are evolving options for venous insufficiency. Yet, there are no studies directly comparing the effectiveness of these procedures. Thus, the goal of this study was to identify, based on patient's symptoms, if either procedure helped and the effect of race/ethnicity on the outcome.
Method
Prospectively collected data between Jan 2012 and Jan 2016 in 531 patients who underwent both iliac vein stent placement as well as endovenous ablation were retrospectively analyzed. Patient assessment of leg swelling was recorded after completion of both procedures. All patients failed to improve swelling after conservative management. Follow-up was performed using in-person questionnaires by asking if improvement in lower extremity swelling occurred and if so, which procedure helped more. Patients were categorized into Caucasians, African American and Hispanics.
Results
Of the 531 patients that underwent endovenous closure and iliac vein stent placements, 191 of 531(36%) patients were male. The average age of our patients was 68 (± 14.2 SD) years. The presenting symptoms (C of CEAP classification) of lower extremity limb venous disease was 35%, 43%, 7%, and 15% for C3 - C6, respectively. There were a total of 960 limbs that underwent both procedures. Both interventions were completed on bilateral lower extremities in 429 of 531 patients, while the remaining 102 of 531 patients had only one limb that underwent both interventions. Patients stated the following after completion of both procedures: both procedures equally helped 100(19%), iliac vein stent superior117 (22%), endovenous ablation superior 123(23%), neither helped (15%) and not sure which procedure helped more 110(21%). Doing one way ANOVA showed that older patients responded with not sure which procedure helped more (P<.0001)
There was no significant difference in gender, CEAP scores and race between these groups.
Conclusion
In this qualitative assessment, the preliminary data suggests the comparative role of iliac vein stent versus endovenous ablation warrants further study. The data was widely distributed and neither procedure was clearly superior. In addition, approximately 16% of our patients stated that neither procedure helped.
Back to 2017 ePosters
