Effect of Balloon Dilatation and Stent Implantation in Iliac Vein Compression Syndrome

Abstract

Objective To investigate the efficacy of balloon dilatation combined with stent implantation in the treatment of iliac vein compression syndrome (IVCS).

Methods This research was a retrospective study that enrolled 127 IVCS patients for clinical data. The patients were divided into percutaneous transluminal angioplasty (PTA) group (n = 63) and stent implantation group (n = 64). The PTA group was treated with iliac vein balloon dilatation, and the stent implantation group was treated with combined stent implantation based on the PTA group. In both the groups, the quality of life was assessed using Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ); complications occurring during the perioperative period and at postoperative follow-up were recorded; the vascular patency rate was calculated, and patient's condition was evaluated using the Villalta scale.

Results The stent implantation group exhibited lower postoperative CIVIQ scores than the PTA group, and the stent implantation group (4.60%) had lower complication rate than the PTA group (19.05%). At 2 years of follow-up, the stent implantation group (92.19%) had higher vascular patency rate than the PTA group (79.37%). Villalta scores were lower in the stent implantation group than in the PTA group at 6, 12, and 24 months postoperatively.

Conclusion Iliac vein balloon dilatation combined with stent implantation for the treatment of IVCS can improve vessel patency rates, alleviate patients' clinical symptoms, and enhance their quality of life.

Keywords

iliac vein compression syndrome - balloon dilatation - stent implantation - endovascular therapy - venous diseases - prognosis

Publikationsverlauf

Eingereicht: 26. August 2024

Angenommen: 02. Dezember 2024

Artikel online veröffentlicht:
14. Februar 2025

• References

• 1 McDermott S, Oliveira G, Ergül E, Brazeau N, Wicky S, Oklu R. May-Thurner syndrome: can it be diagnosed by a single MR venography study?. Diagn Interv Radiol 2013; 19 (01) 44-48
• 2 Brinegar KN, Sheth RA, Khademhosseini A, Bautista J, Oklu R. Iliac vein compression syndrome: clinical, imaging and pathologic findings. World J Radiol 2015; 7 (11) 375-381
• 3 Wang X, Chen X, Gao X, Feng H. Iliac vein compression syndrome caused by a large bladder diverticulum: case report and literature review. J Int Med Res 2022; 50 (09) 3000605221123670
• 4 Poyyamoli S, Mehta P, Cherian M. et al. May-Thurner syndrome. Cardiovasc Diagn Ther 2021; 11 (05) 1104-1111
• 5 Radaideh Q, Patel NM, Shammas NW. Iliac vein compression: epidemiology, diagnosis and treatment. Vasc Health Risk Manag 2019; 15: 115-122
• 6 Fereydooni A, Stern JR. Contemporary treatment of May-Thurner syndrome. J Cardiovasc Surg (Torino) 2021; 62 (05) 447-455
• 7 Li C, Zhan Y, Wang Z. et al. Effect of stent treatment on hemodynamics in iliac vein compression syndrome with collateral vein. Med Eng Phys 2023; 115: 103983
• 8 Brazeau NF, Harvey HB, Pinto EG, Deipolyi A, Hesketh RL, Oklu R. May-Thurner syndrome: diagnosis and management. Vasa 2013; 42 (02) 96-105
• 9 Funatsu A, Anzai H, Komiyama K. et al. Stent implantation for May-Thurner syndrome with acute deep venous thrombosis: acute and long-term results from the ATOMIC (AcTive stenting for May-Thurner Iliac Compression syndrome) registry. Cardiovasc Interv Ther 2019; 34 (02) 131-138
• 10 Bekken J, Jongsma H, Ayez N, Hoogewerf CJ, Van Weel V, Fioole B. Angioplasty versus stenting for iliac artery lesions. Cochrane Database Syst Rev 2015; (05) CD007561
• 11 Bozkaya H, Cinar C, Ertugay S. et al; Endovascular Treatment of Iliac Vein Compression. Endovascular treatment of iliac vein compression (May-Thurner) syndrome: angioplasty and stenting with or without manual aspiration thrombectomy and catheter-directed thrombolysis. Ann Vasc Dis 2015; 8 (01) 21-28
• 12 de Almeida ILGI, Figueiredo PHS, Silva WT. et al. Reliability and validity of specific quality of life assessment questionnaires related to chronic venous insufficiency: a systematic review. J Vasc Bras 2022; 21: e20210229
• 13 Kahn SR. Measurement properties of the Villalta scale to define and classify the severity of the post-thrombotic syndrome. J Thromb Haemost 2009; 7 (05) 884-888
• 14 Mousa AY, AbuRahma AF. May-Thurner syndrome: update and review. Ann Vasc Surg 2013; 27 (07) 984-995
• 15 Mangla A, Hamad H. May-Thurner Syndrome. Treasure Island (FL): StatPearls; 2024
• 16 Friedrich de Wolf MA, Arnoldussen CW, Grommes J. et al. Minimally invasive treatment of chronic iliofemoral venous occlusive disease. J Vasc Surg Venous Lymphat Disord 2013; 1 (02) 146-153
• 17 Thao Cuong L, Tat Bang H, Le An T, Thi Thien Nga L, Thanh Vy T. Quality of life of patients with chronic venous insufficiency of the lower extremities before and after endovascular laser ablation: a prospective pilot study using the Chronic Venous Insufficiency Quality of Life Questionnaire 20 (CIVIQ-20). Cureus 2023; 15 (07) e41854
• 18 Seager MJ, Busuttil A, Dharmarajah B, Davies AH. Editor's choice—A systematic review of endovenous stenting in chronic venous disease secondary to iliac vein obstruction. Eur J Vasc Endovasc Surg 2016; 51 (01) 100-120
• 19 Zhu R, Jin X, Shen J. Efficacy analysis of endovascular therapy for nonthrombotic iliac vein compression syndrome combined with chronic venous insufficiency. Comput Math Methods Med 2022; 2022: 2718314
• 20 Qian AM, Cai ZX, Zhang S. et al. [Endovascular treatment for non-thrombotic right iliac vein compression syndrome with intravascular ultrasound] [in Chinese]. Zhonghua Yi Xue Za Zhi 2019; 99 (46) 3633-3637
• 21 Wang S, He Y, Xin S, Zhang J. Iliac vein stenting is a safe and effective treatment for iliac vein compression syndrome: a systematic review of Chinese data. Phlebology 2020; 35 (10) 752-770