Insurance status and traumatized patients' outcomes: a report from the national trauma registry of Iran.

BACKGROUND: Trauma care is one of the most expensive medical procedures that is significantly affected by factors like insurance status. Providing medical care to injured patients has a significant impact on patients' prognosis. This study examined whether insurance status was associated with different outcomes, including hospital length of stay (HLOS), mortality, and Intensive Care Unit (ICU) admission. METHODS: This prospective study analyzed the data of traumatized patients who had been registered in the National Trauma Registry of Iran (NTRI), and hospitalized at Sina Hospital, Tehran, Iran, from March 22, 2016, to February 8, 2021. Given the type of insurance, the insured patients were classified as basic, road traffic, and foreign nationality. The outcomes of in-hospital death, ICU admission, and HLOS between insured and uninsured patients, and then different insurance statuses, were compared using regression models. RESULT: A total of 5014 patients were included in the study. 49% of patients (n = 2458) had road traffic insurance, 35.2% (n = 1766) basic insurance, 10.5% (n = 528) were uninsured, and 5.2% (n = 262) had foreign nationality insurance. The mean age of patients with basic, road traffic insurance, foreign nationality, and uninsured patients was 45.2 (SD = 22.3), 37.8 (SD = 15.8), 27.8 (SD = 13.3), and 32.4 (SD = 11.9) years, respectively. There was a statistically significant association between insurance status and mean age. Based on these results, the mean age of patients with basic insurance was higher than other groups (p < 0.001). Additionally, 85.6% of the patients were male, with male to female ratio of 9.64 in road traffic insurance, 2.99 in basic insurance, 14.4 in foreign nationality, and 16 in uninsured patients. There was no statistically significant difference between in-hospital mortality in insured and uninsured patients, 98 (2.3%) vs. 12 (2.3%), respectively. The odds of in-hospital mortality in uninsured patients were 1.04 times the odds of in-hospital death in insured patients [Crude OR: 1.04, 95%CI: 0.58 to 1.90]. Multiple logistic regression showed that after adjusting for age, sex, ISS, and Cause of trauma, the odds of in-hospital death in uninsured patients were 2.97 times the odds of in-hospital death in insured patients [adjusted OR: 2.97, 95%CI: 1.43 to 6.21]. CONCLUSION: This study shows that having insurance can change the ICU admission, death, and HLOS in traumatized patients. The results of this study can provide essential data for national health policy for minimizing the disparities among different insurance statuses and proper use of medical resources.

Comparing epidemiologic features, outcomes, and diagnostic and therapeutic procedures of traumatic patients before and during COVID-19 pandemic: Data from the National Trauma Registry of Iran.

PURPOSE: To prepare for future possible communicable disease epidemics/pandemics, health care providers should know how the COVID-19 pandemic influenced injured patients. This study aimed to compare epidemiologic features, outcomes, and diagnostic and therapeutic procedures of trauma patients admitted to a university-affiliated hospital before and during the pandemic. METHODS: This retrospective study was performed on data from the National Trauma Registry of Iran. All injured patients admitted to the hospital from July 25, 2016 to March 10, 2021 were included in the study. The patients were excluded if they had hospital length of stay less than 24 h. The injury outcomes, trauma mechanisms, and therapeutic and diagnostic procedures of the 2 periods: before (from July 25, 2016 to February 18, 2020) and during (from February 19, 2020 to March 10, 2021) COVID-19 pandemic were compared. All analyses were performed using STATA version 14.0 software (Stata Corporation, College Station, TX). RESULTS: Totally, 5014 patients were included in the registry. Of them, 773 (15.4%) were registered after the beginning of the COVID-19 pandemic on February 19, 2020, while 4241 were registered before that. Gender, education level, and cause of injury were significantly different among the patients before and after the beginning of the pandemic (p < 0.001). In the ≤ 15 years and ≥ 65 years age groups, injuries decreased significantly during the COVID-19 pandemic (p < 0.001). The frequency of intensive care unit (ICU) admission decreased from 694 (16.4%) to 88 (11.4%) (p < 0.001). The mean length of stay at the hospital (days) and at the ICU (days) declined as follow: 8.3 (SD = 17.2) vs. 5.5 (SD = 6.1), p < 0.001 and 7.5 (SD = 11.5) vs. 4.5 (SD = 6.3), p < 0.022. The frequency of diagnostic and therapeutic procedures before and during the pandemic was as follows, respectively: ultrasonography 905 (21.3%) vs. 417 (53.9%) (p < 0.001), echocardiography 313 (7.4%) vs. 107 (13.8%) (p < 0.001), angiography 1597 (37.7%) vs. 534 (69.1%) (p < 0.001), MRI 166 (3.9%) vs. 51 (6.6%) (p < 0.001), surgery 3407 (80.3%) vs. 654 (84.6%) (p < 0.001), and internal/external fixation 1215 (28.6%) vs. 336 (43.5%) (p < 0.001). CONCLUSION: The pandemic affected the epidemiology of traumatic patients in terms of gender, age, educational level, and trauma mechanism. It changed the outcomes of injured patients: ICU admission, length of stay at the hospital and ICU decreased. The patients received more diagnostic and therapeutic procedures during the pandemic. To be more precise, more research is needed on the details.

Cost-effectiveness of a population-based AAA screening program for men over 65 years old in Iran.

BACKGROUND: Screening program tend to recognized patients in their early stage and consequently improve health outcomes. Cost-effectiveness of the abdominal aortic aneurysm (AAA) screening program has been scarcely studied in developing countries. We sought to evaluate the cost-effectiveness of a screening program for the abdominal aortic aneurysm (AAA) in men aged over 65 years in Iran. METHODS: A Markov cohort model with 11 mutually exclusive health statuses was used to evaluate the cost-effectiveness of a population-based AAA screening program compared with a no-screening strategy. Transitions between the health statuses were simulated by using 3-month cycles. Data for disease transition probabilities and quality of life outcomes were obtained from published literature, and costs were calculated based on the price of medical services in Iran and the examination of the patients' medical records. The outcomes were life-years gained, the quality-adjusted life-year (QALY), costs, and the incremental cost-effectiveness ratio (ICER). The analysis was conducted for a lifetime horizon from the payer's perspective. Costs and effects were discounted at an annual rate of 3%. Uncertainty surrounding the model inputs was tested with deterministic and probabilistic sensitivity analyses. RESULTS: The mean incremental cost of the AAA screening strategy compared with the no-screening strategy was $140 and the mean incremental QALY gain was 0.025 QALY, resulting in an ICER of $5566 ($14,656 PPP) per QALY gained. At a willingness-to-pay of 1 gross domestic product (GDP) per capita ($5628) per QALY gained, the probability of the cost-effectiveness of AAA screening was about 50%. However, at a willingness-to-pay of twice the GDP per capita per QALY gained, there was about a 95% probability for the AAA screening program to be cost-effective in Iran. CONCLUSIONS: The results of this study showed that at a willingness-to-pay of 1 GDP per capita per QALY gained, a 1-time AAA screening program for men aged over 65 years could not be cost-effective. Nevertheless, at a willingness-to-pay of twice the GDP per capita per QALY gained, the AAA screening program could be cost-effective in Iran. Further, AAA screening in high-risk groups could be cost-effective at a willingness-to-pay of 1 GDP per capita per QALY gained.

Venoplasty and stenting in post-thrombotic syndrome and non-thrombotic iliac vein lesion.

Introduction: Venous outflow obstruction is a common condition among patients with chronic venous insufficiency. Endovascular treatment is favourable over open surgery. This study aimed to assess stent patency and clinical outcome in venous outflow obstruction of lower limbs, and also to compare it between post-thrombotic syndrome and non-thrombotic iliac vein lesions.Material and methods: The study was a historical cohort study. Patients with chronic deep venous insufficiency referred to our tertiary referral centre who underwent venoplasty were recruited. Patients were divided into two groups: non-thrombotic-iliac-vein-lesions and post-thrombotic syndrome. Stent patency rate, clinical improvement and risk factors were evaluated during a six-months course after venoplasty.Results: One-hundred-sixty-four patients were included. Six-months primary, assisted primary and secondary patency rates were 98.86%, 100% and100% in the non-thrombotic-iliac-vein-lesions group and 88%, 93% and 96% in the post thrombotic syndrome groups (p-value = .005, p-value = .02, and p-value = .09, respectively). Pain, claudication and edema were the most common symptoms in both groups and significantly improved after six months. Early thrombosis in the PTS group was more common (9 vs. 1, P value = .007).Conclusion: Percutaneous stenting in patients with venous outflow obstruction is safe and effective with a high patency rate and significant decrease in clinical score in both post-thrombotic syndrome and non-thrombotic-iliac-vein lesions groups.

Aortic reimplantation of the superior mesenteric artery (SMA) for SMA stenosis in a previously stented patient: New technique and a case report.

INTRODUCTION AND IMPORTANCE: Mesenteric artery stenosis leads to inadequate blood flow toward various parts of the gastrointestinal tract. Revascularization is the primary aim of treatment regardless of its approach. During the last decades, open revascularization has been replaced by endovascular-first approach. Mesenteric artery in-stent restenosis occurs in a considerable number of patients that need reintervention in up to half of them using redo endovascular revascularization or open surgery. Here, we reported a case of SMA and celiac artery stenoses treated by aortic reimplantation of the SMA. CASE PRESENTATION: A 62-year-old man with history of previous stenting of CA and SMA was referred due to chronic intermittent abdominal. CT angiography of the abdomen showed restenosis of both arteries. A transection distal part of the occlusions SMA and reimplantation of it into the SMA on the anterolateral face of the infrarenal aorta as the end-to-side anastomosis were performed resulting in resolving the patient problem. CLINICAL DISCUSSION: Chronic mesenteric ischemia can result from various medical conditions. Mesenteric vascular surgical revascularization through open laparotomy had been considered the standard of care. However, minimally invasive surgery such as endovascular therapy has attracted attention in the recent decades. There are some concerns about the difficulties of further surgery in case of re-occlusion. The end-to-side anastomosis and aortic reimplantation can be considered in patients with appropriate runoff in the remaining parts of corresponding vessels. CONCLUSION: Aortic reimplantation of the superior mesenteric artery in patients with restenosis of stents is a viable option especially in case of inappropriate iliac artery to perform retrograde mesenteric bypass.

Side effects of COVID-19 vaccines among Iranian healthcare workers: a retrospective cohort study.

INTRODUCTION: This study assessed the incidence and severity of side effects associated with coronavirus disease 2019 (COVID-19) vaccination among healthcare workers registered with the Medical Council of the Islamic Republic of Iran. METHODOLOGY: A retrospective cohort study was conducted on the healthcare workers focusing on the side-effects of COVID-19 vaccines from March to June 2021. Data were collected using online questionnaires. Multivariable logistic regression was used to assess the association between side effects of the vaccines and demographic variables, comorbidities, vaccine type, and history of COVID-19. RESULTS: Out of 42,018 people who were included, 55.85% reported at least one side effect after receiving the first vaccine dose. 4.59% of those with side effects sought diagnostic intervention or were referred to treatment centers. Multivariable logistic regression indicated that being a woman, higher education, having a history of COVID-19 infection, and having comorbidities increased the risk of side effects. The AstraZeneca vaccine significantly increased the risk of side effects compared to the Sputnik vaccine, while the Sinopharm vaccine decreased this risk. The risk of developing a side effect decreased with age. The risk of moderate and severe side effects was significantly associated with gender, younger age, comorbidities, and a history of COVID-19 infection. Moderate and severe side effects were less reported by those who received the Sinopharm vaccine. CONCLUSIONS: Clinical complications after COVID-19 vaccination, directly or indirectly caused by the vaccines, are common. However, the benefits of COVID-19 vaccines greatly outweigh the risk of reversible side effects, especially among the high-risk population.

Incidence of cancer in Iranian sulfur mustard exposed veterans: a long-term follow-up cohort study.

INTRODUCTION: It is estimated that during the Iraq-Iran war of the 1980s, over 100,000 Iranians (military or civilian) were exposed to sulfur mustard (SM), and a considerable proportion of them are still suffering with long-term consequences of exposure. The aim of the present article is to address carcinogenesis of SM following these acute exposures. METHODS: Using a cohort study, we estimated and compared the incidence rates of malignant disorders in 7,570 veterans exposed to SM and 7,595 unexposed comrades in a 25-year follow-up period. We also determined the hazard ratio of cancer occurrence for SM exposure during the follow-up period. RESULTS: Cancer incidence was significantly increased with exposure to SM. The incidence rate ratio of cancer for SM exposure was 1.81 (95 % CI 1.27-2.56), and the age-adjusted incidence rate ratio was 1.64 (95 % CI 1.15-2.34).The hazard ratio of cancer was 2.02 (95 % CI 1.41-2.88). CONCLUSION: Present study suggests carcinogenesis of SM following acute exposure during war. With respect to this finding, it is reasonable to improve care programs such as routine screening schemes for exposed veterans.

How Can Policymakers be Encouraged to Support People With Spinal Cord Injury-Scoping Review.

STUDY DESIGN: Scoping review. OBJECTIVE: Regarding that inappropriate medical care approaches, absence of rehabilitation services, and existing barriers in physical, social, and policy environments lead to poor outcomes in individuals with spinal cord injury (SCI) and provision for appropriate interventions and care must be created by health policymakers, we conducted this scoping review to investigate how policymakers can be persuaded to set new plans for individuals with SCI. METHODS: This review was performed according to Arksey and O'Malley's framework. PubMed was searched in February2019 without language limitation. We looked for other potential gray literature sources and some professional websites. References sections of selected articles were also scanned for other relevant literature. RESULTS: We included literature that met inclusion criteria to answer our research question. The literature was divided into 3 categories. The first category included economic impact of SCI. The second category included the role of research and developing research strategy. The third category included effective interaction and communication with policymakers. CONCLUSION: It is essential to consider multiple factors for influencing policymakers' decisions. These factors include knowing how to communicate with policymakers and presenting constructive ideas, providing a source of valid, reliable, and consistent data, considering the role of patients' advocacy groups and Non-Governmental Organizations (NGOs), and presentation of the importance of early intervention in reducing healthcare system costs. Ultimately, the goal is to have a comprehensive and flexible plan for influencing policymakers.

Safety and efficacy of granulocyte-colony-stimulating factor administration following autologous intramuscular implantation of bone marrow mononuclear cells: a randomized controlled trial in patients with advanced lower limb ischemia.

BACKGROUND AIMS: The aim was to investigate the therapeutic effect of granulocyte-colony-stimulating factor (G-CSF) administration following implantation of autologous bone marrow mononuclear cells (BM MNC) for patients with lower limb ischemia. METHODS: The design was a randomized controlled trial. Fifteen patients with severe chronic limb ischemia were treated with autologous BM MNC [without G-CSF (MNC-G-CSF) or combined with G-CSF administration for 5 days following transplantation (MNC+G-CSF)]. RESULTS: All clinical parameters, including ankle brachial index, visual analog scale and pain-free walking distance, showed a mean improvement from baseline, which was measured at 4 and 24 weeks after transplantation in both groups. However, in three (20%) patients, the clinical course did not improve and limb salvage was not achieved. No significant difference was observed among the patients treated in the MNC-G-CSF and MNC+G-CSF groups. No severe adverse reactions were reported during the study period. No relationship was observed between both the numbers of viable MNC or CD34+ cells and the clinical outcome. CONCLUSIONS: Autologous transplantation of BM MNC into ischemic lower limbs is safe, feasible and efficient for patients with severe peripheral artery disease. However, the administration of G-CSF following cell transplantation does not improve the effect of BM MNC implantation and therefore would not have any beneficial value in clinical applications of such cases.

Developing "Code of Ethics for Medical Professionals, Medical Council of Islamic Republic of Iran".

BACKGROUND: The medical profession has always been an inspiration for human societies throughout its diverse history. This position and historical authority in the field of ethics has had a different and higher status, in such a way that many of the norms of general ethics and professional ethics, especially principles, such as trust, confidentiality and respect for human dignity, have been developed by medical professionals. Developing guidelines of general and professional ethics is one of the inherent duties of the Medical Council of the Islamic Republic of Iran (IRIMC) as a professional organization. In this regard, the Supreme Council of IRIMC has approved the "Code of Ethics for Medical Professionals" and, in accordance with its legal authority, has annexed it to the disciplinary regulations of IRIMC. METHODS: A draft document, the result of extensive literature review, was discussed in 27 expert panel meetings and after receiving and endorsing the stakeholders' point of view, was approved by the IRIMC Supreme Council. RESULTS: The first edition of "Code of Ethics for Medical Professionals, Medical Council of Islamic Republic of Iran" was developed on July 6, 2017 by the Supreme Council of IRIMC. The guideline was set to take effect one year after its enactment. The first edition was revised and completed and final edition was adopted on August 9, 2018 by IRIMC in 13 chapters and 140 articles (original full text is available in the Supplementary file 1). CONCLUSION: According to the approved decision by the Supreme Council of IRIMC on May 10, 2018, the final edition takes effect as of October 7, 2018.

Endovenous laser ablation (EVLA) in patients with varicose great saphenous vein (GSV) and incompetent saphenofemoral junction (SFJ): an ambulatory single center experience.

OBJECTIVES: To evaluate treatment results for varicose great saphenous vein (GSV) using endovenous laser ablation (EVLA) in an ambulatory single center. MATERIAL AND METHODS: We prospectively studied 77 limbs with varicose GSV in 74 patients who were treated using 980-nm EVL with a 600-mm laser fiber and the power settings of 10-25 Watts. The patients were followed using color Doppler ultrasound. RESULTS: Continued closure of treated GSV was found in 98.3% of the legs evaluated at 3-week follow-up (n = 60). At 3- and 6-month intervals, 94.1% and 97% successful occlusion was achieved, respectively. The main complications of the procedure included prolonged leg pain (2 cases), hyperestheasia (one case) and lidocaine sensitivity (one case). CONCLUSION: EVLA treatment of the GSV is a safe and highly effective method accompanied with few complications in midterm follow-up. It is feasible in ambulatory settings and the patients return to their daily activities early after intervention.

Coil Embolization of an Iatrogenic Arteriovenous Fistula between the Superior Mesenteric Artery and Vein: A Case Report.

Superior mesenteric arteriovenous fistulae are rare. A 32-year-old woman presented with abdominal pain. The angiography showed that the superior mesenteric vein was aneurysmal. The patient underwent coil embolization, during which a balloon catheter was inflated before the fistula for the protection of coil migration with a high blood flow. After the balloon inflation, one 8-mm and two 7-mm coils were deployed at the fistula site. The final angiography showed successful embolization with no visualization of the fistula and the aneurysmal vein.

Catheter-Directed Thrombolysis in Acute Iliofemoral Deep Vein Thrombosis with or without Stenting: A Case Series.

Iliofemoral deep vein thrombosis (IFDVT) is a potentially devastating condition comprising a quarter of all cases of lower extremity DVT. It can lead to serious consequences such as pulmonary embolism, limb malperfusion, and post-thrombotic syndrome (PTS), which is a chronic sequela of IFDVT. We herewith present 18 IFDVT cases managed with catheter-directed thrombolysis at our hospital. Nine of these patients underwent stenting of the involved iliac veins. The remaining 9, who did not receive stenting, had a residual stenosis of more than 50% in the common femoral or iliac veins following the procedure. Based on a final residual stenosis of less than 50% in the iliac veins, we had 9 successful (patients with stenting) and 9 unsuccessful procedures (patients without stenting). In subsequent follow-ups at a median follow-up of 39.5 months, using the Villalta score, while only 2 out of the 9 patients who underwent stenting suffered PTS, 4 patients among the other 9 patients comprising the non-stenting group developed PTS. Our results support the notion that stenting might have a role in decreasing the PTS risk in patients undergoing catheter-directed thrombolysis.

Feasibility and Data Quality of the National Spinal Cord Injury Registry of Iran (NSCIR-IR): A Pilot Study.

BACKGROUND: Spinal cord injury (SCI) is one of the most disabling consequences of trauma with unparalleled economic, social, and personal burden. Any attempt aimed at improving quality of care should be based on comprehensive and reliable data. This pilot investigation studied the feasibility of implementing the National Spinal Cord and Column Injury Registry of Iran (NSCIR-IR) and scrutinized the quality of the registered data. METHODS: From October 2015 to May 2016, over an 8-month period, 65 eligible trauma patients who were admitted to hospitals in three academic centers in mainland Iran were included in this pilot study. Certified registered nurses and neurosurgeons were in charge of data collection, quality verification, and registration. RESULTS: Sixty-five patients with vertebral column fracture dislocations were registered in the study, of whom 14 (21.5%) patients had evidence of SCI. Mechanisms of injury included mechanical falls in 30 patients (46.2%) and motor vehicle accidents in 29 (44.6%). The case identification rate i.e. clinical and radiographic confirmation of spine and SCI, ranged from 10.0% to 88.9% in different registry centers. The completion rate of all data items was 100%, except for five data elements in patients who could not provide clinical information because of their medical status. Consistency i.e. identification of the same elements by all the registrars, was 100% and accuracy of identification of the same pathology ranged from 66.6% to 100%. CONCLUSIONS: Our pilot study showed both the feasibility and acceptable data quality of the NSCIR-IR. However, effective and successful implementation of NSCIR-IR data use requires some modifications such as presence of a dedicated registrar in each center, verification of data by a neurosurgeon, and continuous assessment of patients' neurological status and complications.

Therapeutic Effects of Successful Angioplasty on the Aorta and Lower Limb Arteries on the Healing of Chronic Ischemic Wounds.

Background: Chronic wounds are a serious problem for the patient and can increase the socioeconomic burden on the healthcare system and community. This study aimed at investigating the effect of angioplasty on chronic ischemic wound healing. Methods: This study was conducted in Sina Hospital, affiliated to Tehran University of Medical Sciences. Thirty-eight patients with chronic ischemic wounds and a suspicion of the narrowing or blockage of arteries underwent peripheral angiography. Arteries under angioplasty in different patients comprised the aorta and the iliac, superficial femoral, popliteal, and tibial arteries. The patients were evaluated in terms of wound healing in weekly and monthly visits. Wound healing was measured based on the Bates-Jensen criteria. Results: The patients were followed up at a median of 4.5 months. The mean age of the patients was 61.1 ± 7.5 years. Of 38 patients, 12 (31.6%) were female. The involvement of arteries on angiography consisted of 16 (42.2%) cases of total occlusion and 22 (57.8%) cases of stenosis. Following angioplasty, the level of the narrowing of arteries and the wound score showed a significant reduction in all the patients (p value < 0.001). Wound healing was observed in 29 (76.3%) patients. Hematoma, pseudoaneurysm, and thrombosis comprised the complications. No significant differences were observed in terms of age, gender, and history of risk factors between the 2 groups of wound healing and nonhealing. The wound evaluation scores before (p value = 0.044) and after (p value < 0.001) angioplasty were lower in the wound healing group than in the nonhealing group. Conclusion: Angioplasty of the aorta and lower limb arteries improved the healing of chronic ischemic wounds in our patients.

Safety and Efficacy of Repeated Bone Marrow Mononuclear Cell Therapy in Patients with Critical Limb Ischemia in a Pilot Randomized Controlled Trial.

BACKGROUND: Critical limb ischemia is a manifestation of peripheral arterial disease characterized by insufficient arterial blood flow for maintaining tissue viability in the lower extremities. Therapeutic angiogenesis is used for peripheral arterial disease patients who are not candidates for surgical revascularization or radiological intervention. There is accumulating evidence for the beneficial impact of autologous bone marrow mononuclear cell transplantation for treatment of critical limb ischemia in humans. This study aims to investigate the safety and efficacy of repeated bone marrow mononuclear cell injections in comparison with a single bone marrow mononuclear cell injection in critical limb ischemia patients. METHODS: Patients with critical limb ischemia (n = 22) were randomized (http://clinicaltrials.gov/ct2 show/NCT01480414) to receive either a single (n = 11) or four (n = 11) intramuscular injections of bone marrow mononuclear cells as a cell therapy product. RESULTS: There were no reported adverse events during the 24-week follow-up period after cell delivery. Efficacy assessment indicated that after cell injections, there was significant improvement in Ankle-Brachial Index, Visual Analog Scale, pain-free walking distance, and Wagner stage as well as reduction in ulcer size. There was no significant difference between the two groups in terms of clinical parameters. However, by the 24th week the pain-free walking distance improved significantly in the group who received four injections of cells. CONCLUSION: Favorable clinical outcomes strongly indicate the long-term benefit of bone marrow mononuclear cell transplantation, either as one or several injections, for retrieval from critical limb ischemia. Repeated cell injections have shown increased improvement of pain-free walking distance in patients. These findings warrant further exploration in later-phase clinical trials with repeated injections.

Venoplasty and Venous Stenting in Patients with Chronic Venous Insufficiency in the Lower Extremities.

Background: Venoplasty and stenting is a minimally invasive therapy that can be used for patients with deep venous insufficiency in the lower extremities. This study aimed at investigating the effect of venoplasty and venous stenting in patients with chronic venous insufficiency in the lower limbs. Methods: This prospective case-series study recruited patients with chronic deep venous insufficiency in the lower limbs candidated for venoplasty in the Vascular Clinic of Sina Hospital in Tehran, Iran. Venoplasty and stenting was done if the deep venous system in the lower extremities had stenosis or obstruction on venography. The patients were visited 1, 3, and 6 months after venoplasty to assess their symptoms, venous clinical severity, and venous disability. Primary and secondary patency was evaluated with Doppler ultrasound. Results: Seventy-three patients were included in the study. The follow-up of the patients' clinical symptoms showed significant improvement rates of about 90%, 88.7%, 92.5%, and 100% in claudication, edema, pain, and ulcers-respectively- only 1 month after the procedure. The stent patency rates were 93.2, 91.5, and 92.4 in the 1st, 2nd, 3rd, and 6th postprocedural months, correspondingly. The venous clinical severity score and the venous disability score before the procedure were 14.2 and 2.73, respectively, which were decreased to 5 and 1.1, correspondingly, at 6 months' follow-up (p value < 0.001). Conclusion: Venoplasty and stenting in our patients with chronic deep venous insufficiency in the lower extremities conferred a significant improvement in clinical symptoms and a high percentage of patency.