A retrospective controlled study on endovascular debulking technology for the treatment of iliac femoral vein stent restenosis

LYU Jia-jie; ZHANG Lin-jie; YANG Cheng-hao; YIXIZHUOMA; LI Weimin; LU Xinwu; YIN Min-yi

doi:10.19538/j.cjps.issn1005-2208.2023.12.15

Abstract：Objective To evaluate the safety and early clinical efficacy of endovascular volume reduction in the treat-ment of chronic in-stent restenosis(ISR)of the iliofemoral vein.Methods The clinical and follow-up data of 26 patients with chronic iliofemoral vein in-stent restenosis who underwent endovascular treatment at the Department of Vascular Surgery,Shanghai Ninth People's Hospital,Shanghai Jiaotong University School of Medicine from July 2022 to March 2023 were retrospectively analyzed.Seventeen patients were treated with simple balloon dilatation(control group).The technical success rate,rescue stent implantation rate,perioperative complication rate,early and mid-term follow-up stent stenosis rate,CEAP clinical classification,and Villalta score improvement were compared between the two groups.Re-sults In the experimental group,the average age was(52.9±18.7)years,a total of 10 limbs were involved,the average time of iliofemoral vein implantation was(27.2±19.9)months,and the time of clinical symptoms recurrence was(4.1±1.4)months.In the control group,the average age was(59.8±10.1)years,a total of 18 affected limbs,the average time of iliofem-oral vein implantation was(27.5±25.8)months,and the time of clinical symptoms recurrence was(3.5±1.5)months.The technical success rate of the two groups was 100％.Twenty-six patients were followed up for an average of(6.0±1.8)months.There were no significant differences in the preoperative basic data between the two groups(all P＞0.05).Com-pared with the control group,The rate of rescue stent implantation(22.2％vs.64.7％),the rate of target stent lumen stenosis(21.4％vs.28.1％),the rate of target stent stenosis at 3 months(24.8％vs.30.4％)and 6 months(26.1％vs.32.2％)were significantly lower in the experimental group(all P＜0.05).The CEAP clinical grade and Villalta score were improved in both groups,but the improvement of Villalta score in the experimental group(7.7 vs.9.4)was greater than that in the control group(P＜0.05).No amputation or death occurred during the follow-up.Conclu-sion Compared with the pure angioplasty balloon expansion,vascular volume reduction for the treatment of chronic iliac femoral venous ISR has remedial stenting rate is low,immediate postoperative early and mid-term patency rate is high,the advantages of the clinical symptoms improved obviously,long-term effect remains to be further follow-up.