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Cardiovasc Intervent Radiol ; 44(12): 1918-1929, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34545448

RESUMEN

PURPOSE: To assess safety and patency of the Venovo venous stent for the treatment of iliofemoral vein obstruction. MATERIALS AND METHODS: Twenty-two international centers enrolled 170 patients in the VERNACULAR study (93 post-thrombotic syndrome; 77 non-thrombotic iliac vein lesions). Primary outcome measures were major adverse events at 30 days and 12-month primary patency (freedom from target vessel revascularization, thrombotic occlusion, or stenosis > 50%). Secondary outcomes included the Venous Clinical Severity Score Pain Assessment and Chronic Venous Quality-of-Life Questionnaire assessments (hypothesis tested). Secondary observations included primary patency, target vessel and lesion revascularization (TVR/TLR), and assessment of stent integrity through 36 months. RESULTS: Freedom from major adverse events through 30 days was 93.5%, statistically higher than a pre-specified performance goal of 89% (p = 0.032) while primary patency at 12 months was 88.6%, also statistically higher than a performance goal of 74% (p < 0.0001). Mean quality-of-life measures were statistically improved compared to baseline values at 12 months (p < 0.0001). Primary patency at 36 months was 84% (Kaplan-Meier analysis) while freedom from TVR/TLR was 88.1%. There was no stent embolization/migration, and no core laboratory assessed stent fractures reported through 36 months. Six deaths were reported; none adjudicated as device or procedure related. CONCLUSION: The Venovo venous stent was successfully deployed in obstructive iliofemoral vein lesions and met the pre-specified primary outcome measures through 12 months. At 3 years, primary patency was 84%, reintervention rates were low, standardized quality-of-life and pain measures improved from baseline, and there was no stent migration or fractures. LEVEL OF EVIDENCE: Level 2-prospective, multicenter, controlled clinical study without a concurrent control or randomization. Pre-specified endpoints were hypothesis-tested to performance goals derived from peer-reviewed clinical literature. REGISTRATION CLINICALTRIALS.GOV: Unique Identifier NCT02655887.


Asunto(s)
Vena Femoral , Vena Ilíaca , Vena Femoral/diagnóstico por imagen , Vena Femoral/cirugía , Humanos , Vena Ilíaca/diagnóstico por imagen , Vena Ilíaca/cirugía , Estudios Prospectivos , Estudios Retrospectivos , Stents , Resultado del Tratamiento , Grado de Desobstrucción Vascular
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