AVF Roundtable: Venous Stent Data and Inguinal Ligament Crossing

Three-Year Venous Stent Trial Data and Ligament Extension

Zilver Vena three year outcomes showed 93 percent freedom from any reintervention and sustained clinical improvement, and a cohort analysis found that extending stents below the inguinal ligament for severe post-thrombotic disease produced nearly equivalent patency despite treating longer, more severe lesions.

Comparing FDA-Approved Venous Stents

Presenters reviewed properties and trial patency of the Wallstent, Bard, Boston Scientific, Zilver Vena, and Abre stents, noting recalls and withdrawals, flared-end sizing pitfalls near the confluence, and that 14 and 16 millimeter diameters are most commonly used.

Assessing Inflow and Crossing the Inguinal Ligament

IVUS identified a healthier, lower landing zone than venogram in about half of cases, and residual untreated disease below a stent, not stent length or ligament crossing, drives occlusion, so covering all disease into the common femoral vein is safe with current stents.

Complex Recanalization Case and Panel Pearls

A case with a retained needle fragment required sharp Chiba needle recanalization, and the panel debated anticoagulation regimens, relining chronically occluded stents, bilateral double-barrel stenting, and balloon entrapment complications.