# 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.

## Key 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.