Revascularization of chronic iliiac vein obstruction

Revascularization strategy of a chronic iliofemoral DVT in a 45 year old female patient with venous claudication and persistent swelling of left leg.


    June 15, 2018

    Nice case Michael. Can you make some comments regarding your access strategy? I would access PV or combine JV access for precise distal positioning of the stent. One more question is overlapping contralateral side since it’s givving me bad dreams; you do have significant number of the cases- what is the incidence of the contralateral thrombosis as the consequence of compromised flow in your cohort? Have you considered other tactic (Oblique stent, Gianturco Z stent)?

    Dr. Theodosios Bisdas
    June 15, 2018

    Dear Michael! Thank you for the nice case! What are you doing, if the IVUS shows a recoil of the stent? Repeat-PTA, Stent-in-Stent or your give time to the stent to work on the lesion? Finally, can you provide us your algorithm about anticoagulation?

    Dr Michael Lichtenberg
    June 15, 2018

    Great question Theo.
    I recommend to use IVUS always also after venous stent implantation to proof Aspect Ratio = 1.
    If AR is > 1 another post dilatation must be done to achieve good flow and long term patency (for more details see uploaded paper on lumen quality).

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