Scientific Session 4: Deep Venous Disease and Stenting Outcomes

Nutcracker Syndrome and Pelvic Venous Insufficiency

Allison McKenzie’s review of 28 patients found 75 percent benefited from intervention for Nutcracker syndrome, with gonadal vein embolization and renal vein transposition both effective, while Peter Pappas found iliac vein stenting for pelvic venous insufficiency well tolerated through pregnancy.

Iliocaval Venous Anomalies in Stenting

A review of 845 stenting patients found anatomic anomalies in half, most commonly a high IVC confluence identified intraoperatively, followed by an anomalous right internal iliac vein, requiring longer stents and ultrasound to localize stenosis.

Predictors of Early Stent Thrombosis

Katie Isles’s 106 patient study of severe iliocaval occlusive disease found hypercoagulable states and complete occlusion of multiple segments predicted early re-occlusion, while low molecular weight heparin for more than ten days outperformed warfarin and factor ten inhibitors for patency.

Recanalization Innovation and Dedicated Stent Outcomes

Evan Neville reported 60 percent successful radiofrequency recanalization of chronic iliocaval occlusion after failed conventional attempts, while Brent Robertson found a dedicated venous stent achieved 100 percent six month patency matching the pivotal vernacular trial.