A meta-analysis of the medium- to long-term outcomes in patients with chronic deep venous disease treated with dedicated venous stents.
J Vasc Surg Venous Lymphat Disord
; 12(3): 101722, 2024 May.
Article
em En
| MEDLINE
| ID: mdl-38104855
ABSTRACT
OBJECTIVE:
This review summarizes the safety profile, stent patency, and clinical effectiveness of dedicated venous stents for the treatment of chronic deep venous disease. The approaches to stenting and post-procedural management of different vascular units are also explored.METHODS:
The MEDLINE and Embase databases were searched for pertinent literature published from January 2010 to January 2023. Outcomes related to post-stenting symptoms and health-related quality of life were described narratively. A meta analysis was conducted to evaluate stent patency, ulcer healing, bleeding, and 30-day stent thrombosis, and these outcomes were presented as proportion event rates.RESULTS:
Seventeen studies were identified comprising of 2218 patients. 62.7% of individuals had post-thrombotic stenosis or occlusion. The majority of patients (78.6%) were noted to have complete occlusions of their deep veins before stenting. Eleven different dedicated venous stents were deployed. At 12 months, the primary patency rate was 83% (95% confidence interval [CI] 76%-90%), the primary-assisted patency rate was 90% (95% CI 85%-96%), and the secondary patency rate was 95% (95% CI 92%-98%). A significant improvement in health-related quality of life was demonstrated after intervention. In total, 68.8% (95% CI 52.0%-83.7%) of ulcers healed at the last follow-up. The remaining symptomatic changes were described narratively; improvements in pain, venous claudication, and edema after stenting were observed. Seventeen deaths occurred, but none were linked to the stenting procedures. A total of 159 cases (7.2% of patients) of in-stent stenosis were observed, whereas 110 stents (5.0% of patients) were occluded. The incidence of major and minor bleeding was 1.7% (95% CI 1.0%-2.5%) and 3.2% (95% CI 1.3%-5.6%), respectively, more commonly seen in patients undergoing hybrid intervention.CONCLUSIONS:
Deep venous stenting using dedicated venous stents is a safe technique to treat chronic deep venous stenosis and/or occlusion. Within the limitations of this study, deep venous stenting is associated with good patency rates and symptomatic improvement.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Qualidade de Vida
/
Claudicação Intermitente
Tipo de estudo:
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
J Vasc Surg Venous Lymphat Disord
Ano de publicação:
2024
Tipo de documento:
Article