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Endovascular Treatment of Post-thrombotic Venous Ilio-Femoral Occlusions: Prognostic Value of Venous Lesions Caudal to the Common Femoral Vein

  • Clinical Investigation
  • Venous Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Objectives

To propose a scale of severity for post-thrombotic venous lesions (PTVLs) after ilio-femoral deep venous thrombosis and to compare the grade with the results of endovascular treatment of ilio-femoral PTVLs.

Methods

In this retrospective monocentric observational study, we included 95 patients treated for ilio-femoral PTVLs. We proposed a four-grade scale evaluating the severity of PTVLS caudal to the common femoral vein based on CT phlebography and per-operative phlebography. For most patients, venous patency was assessed with color duplex ultrasonography and the clinical efficacy of the intervention using the Villalta and CIVIQ scores.

Results

Recanalization was successful in 100% of patients with a morbidity rate of 4%. After a mean follow-up of 21 months, the overall primary patency was 75%, the assisted primary patency 82%, and the secondary patency 93%. Secondary patency was 100% for grade 0–1, 90% for grade 2, and 63% for grade 3 (p < 0.002). There was no correlation between the extension of stenting caudally of the common femoral vein and venous patency. The mean improvements in the Villalta and CIVIQ-20 scores were, respectively, 4.6 (p < 0.0001) and 18 (p < 0.0001); scores were not correlated with the grade of PTVLs in the thigh.

Conclusion

Venous patency after endovascular treatment of ilio-femoral PTVLs was strongly linked to the severity of PTVLs caudal to the common femoral vein but not to the extent of stenting.

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Acknowledgements

We thank Alison Foote (Grenoble Alpes University Hospital) for critically editing the manuscript.

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Authors and Affiliations

  1. Department of Vascular Medicine, Grenoble Alpes University Hospital, Hôpital Albert Michallon, CS 10217, 38043, Grenoble, France

    Caroline Menez, Christophe Seinturier, Bernard Imbert, Sophie Blaise, Patrick Carpentier & Gilles Pernod

  2. Department of Medical Imaging and Radiology, Grenoble Alpes University Hospital, Hôpital Albert Michallon, CS 10217, 38043, Grenoble, France

    Mathieu Rodiere, Julien Ghelfi, Romain Perolat & Frédéric Thony

  3. Department of Medical Imaging and Radiology, Valence Hospital, 179 bd Maréchal Juin, 26953, Valence, France

    Thomas Martinelli

  4. Department of Anaesthesiology and Critical Care, Grenoble Alpes University Hospital, Hôpital Albert Michallon, CS 10217, 38043, Grenoble, France

    Pierre Bouzat

Authors
  1. Caroline Menez
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  2. Mathieu Rodiere
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  3. Julien Ghelfi
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  4. Christophe Seinturier
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  5. Thomas Martinelli
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  7. Romain Perolat
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  8. Pierre Bouzat
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  9. Sophie Blaise
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  10. Patrick Carpentier
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  11. Gilles Pernod
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  12. Frédéric Thony
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Corresponding author

Correspondence to Frédéric Thony.

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Conflict of interest

F. Thony and M. Rodiere have received grants from the following companies: Cook, Bloomington, USA, and Optimed, Ettlingen, Germany, to organize postgraduate training sessions.

Ethical Approval

Study ethics approval was obtained in February 2018 (CECIC Rhône-Alpes-Auvergne, IRB 5891).

Informed Consent

Informed consent was obtained from all subjects (patients) in this study.

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Consent for publication was obtained for every individual with personal data included in the study.

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Menez, C., Rodiere, M., Ghelfi, J. et al. Endovascular Treatment of Post-thrombotic Venous Ilio-Femoral Occlusions: Prognostic Value of Venous Lesions Caudal to the Common Femoral Vein. Cardiovasc Intervent Radiol 42, 1117–1127 (2019). https://doi.org/10.1007/s00270-019-02214-9

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  • DOI: https://doi.org/10.1007/s00270-019-02214-9

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