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Purpose <p>To investigate the impact of post-stent placement inflow vein diameter on iliac vein stent patency in patients with thrombotic iliac vein lesions.</p> Methods <p>This is a single-center retrospective study examining consecutive patients who received primary iliac vein stent placement between January 2014 and February 2024. Inflow vein to stent diameter mismatch (ISM) was defined as the mismatch percentage of narrowed adjacent vein (NAV) diameter to stent peripheral edge diameter. The receiver operator characteristic (ROC) curve was used to assess the predictive performance of NAV and ISM on stent patency loss. Cox regression models were used to determine the predictive factors for stent patency loss. Restricted cubic spline (RCS) was used to assess the association between ISM and patency loss on a continuous scale.</p> Results <p>Seventy-three patients with 77 limbs (acute deep vein thrombosis, <i>n</i> = 44; post-thrombotic syndrome, <i>n</i> = 33) were included. During a median follow-up of 22.9&#xa0;months (IQR 5.6–50.4&#xa0;months), the primary stent patency rate was 67.5%. ISM had a satisfactory predictive performance (area under curve = 0.85) for stent patency loss. NAV &lt; 6.5&#xa0;mm (adjusted HR 3.01; <i>p</i> = .009) and ISM &gt; 21.8% (adjusted HR 6.69; <i>p</i> = .001) were significantly associated with an increased risk of stent patency loss. RCS revealed that an increasing ISM was consistently associated with an increasing risk of patency loss (<i>p</i> = .005).</p> Conclusion <p>NAV and ISM by venography at the time of stent placement for thrombotic iliac vein lesions may be associated with patency loss.</p> Level of Evidence <p>Level 4, Case Series.</p> Graphical Abstract <p></p>

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Impact of Diameter Mismatch Between the Inflow Vein and Stent on Patency in Thrombotic Iliac Vein Lesions

  • 期刊论文

  • 发表日期：

    2025年10月23日

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  • Yadong Shi,
  • Harneet Sangha,
  • Ningcheng Li,
  • Ramsey A. Al-Hakim,
  • John A. Kaufman,
  • Khashayar Farsad

摘要

Purpose

To investigate the impact of post-stent placement inflow vein diameter on iliac vein stent patency in patients with thrombotic iliac vein lesions.

Methods

This is a single-center retrospective study examining consecutive patients who received primary iliac vein stent placement between January 2014 and February 2024. Inflow vein to stent diameter mismatch (ISM) was defined as the mismatch percentage of narrowed adjacent vein (NAV) diameter to stent peripheral edge diameter. The receiver operator characteristic (ROC) curve was used to assess the predictive performance of NAV and ISM on stent patency loss. Cox regression models were used to determine the predictive factors for stent patency loss. Restricted cubic spline (RCS) was used to assess the association between ISM and patency loss on a continuous scale.

Results

Seventy-three patients with 77 limbs (acute deep vein thrombosis, n = 44; post-thrombotic syndrome, n = 33) were included. During a median follow-up of 22.9 months (IQR 5.6–50.4 months), the primary stent patency rate was 67.5%. ISM had a satisfactory predictive performance (area under curve = 0.85) for stent patency loss. NAV < 6.5 mm (adjusted HR 3.01; p = .009) and ISM > 21.8% (adjusted HR 6.69; p = .001) were significantly associated with an increased risk of stent patency loss. RCS revealed that an increasing ISM was consistently associated with an increasing risk of patency loss (p = .005).

Conclusion

NAV and ISM by venography at the time of stent placement for thrombotic iliac vein lesions may be associated with patency loss.

Level of Evidence

Level 4, Case Series.

Graphical Abstract