Treating Chronic Iliac Vein Stent Occlusion in an Office-Based Lab Setting

TL;DR

A patient with a long-term blocked vein stent was successfully treated in an office-based lab by placing a new stent next to the old one, reducing pain and stopping narcotic use.

Contribution

Demonstrates a novel, minimally invasive approach for treating chronic iliac vein stent occlusion using parallel stent deployment in an office-based lab.

Findings

Parallel stent deployment successfully restored venous flow in a chronically thrombosed iliac vein.

The procedure significantly reduced patient pain and eliminated the need for narcotics.

The treatment was performed in an office-based lab, avoiding traditional surgical reconstruction.

Abstract

Iliac vein stenting is performed when sufficient venous patency is not achieved via angioplasty or lysis. Iliac vein stenting is known to be effective; however, occlusion of the stent occurs occasionally. There is a lack of effective treatment options for those with failed prior venous stents, and traditional methods may involve the removal of the stent and surgical reconstruction. We present a patient with a right leg post-thrombotic syndrome and narcotic abuse after occlusion of a previously placed right common iliac/external iliac vein stent 25 years prior. After transfer to an office-based lab (OBL), femoral vein access was achieved. Then, a second stent was deployed adjacent to the previously chronically thrombosed stent. Imaging confirmed adequate deployment of the new stent and venous flow. Treatment resulted in a significant decrease in patient pain and cessation of narcotics. We demonstrate successful recanalization of a right iliac vein thrombosis via parallel deployment of a stent adjacent to a chronically thrombosed stent.

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