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• W2567671567 abstract "Symptomatic May-Thurner syndrome (MTS) patients undergo stenting of the iliac vein for compressive pathologic changes. The impact of the degree of stenosis on clinical presentation and outcomes after stenting is unknown and examined in our study. Retrospective review of 202 patients who underwent stenting for MTS between 1999 and 2011 was performed. Classification into three groups based on luminal area obtained by intraoperative intravascular ultrasound interrogation of the involved femoroiliocaval segment was carried out. The mild (>90% compression), moderate (60%-89% compression), and severe (>90% compression) groups were observed after stenting to assess outcomes. Kaplan-Meier analysis was done to assess primary, primary assisted, and secondary patencies. The visual analog scale for pain score and grade of swelling (grades 1 to 4 based on severity) before stenting and at 6, 24, and 48 months after intervention were analyzed using analysis of variance and Tukey multiple comparison test. There were 55 patients with mild, 87 with moderate, and 60 with severe iliac vein compression. Baseline demographic characteristics and comorbidities were similar across all groups. In addition, there was no statistically significant difference in median baseline visual analog scale score or swelling among the groups. Compression was treated with angioplasty and stenting encompassing all areas of disease as determined by intravascular ultrasound. Stent technique involved use of Wallstent (Boston Scientific, Marlborough, Mass) only in 183 patients and Wallstent/Z-stent (Cook Medical, Bloomington, Ind) combination in the remainder. No difference in median patency was noted on follow-up (Table I). At 48 months, recurrence of pain and swelling was noted clinically in the severe stenosis group but not in the other two groups (Table II). Severity of MTS stenosis is not a predictor of initial clinical presentation. In the long term, patients with >90% initial MTS stenosis experience recurrence of symptoms. Degree of iliac venous stenosis in MTS does not appear to have an impact on stent patency on long-term follow-up. Further study is required to clarify these findings.Table IPatency after stenting for May-Thurner syndrome (MTS) based on degree of initial stenosisVariable<60% stenosis60%-89% stenosis≥90% stenosisPrimary patency, months88 ± 17.093 ± 13.096 ± 21.0Primary assisted patency, months35 ± 7.438 ± 6.547 ± 5.7Secondary patency, months8 ± 2.620 ± 9.038 ± 5.0Data are presented as mean values ± standard error. Open table in a new tab Table IIComparison of scores before and after iliac vein stenting for May-Thurner syndrome (MTS) based on degree of initial stenosisVariable<60% stenosis6 months24 months48 monthsBeforeAfterPBeforeAfterPBeforeAfterPVAS score1.420.11<.0011.420.00<.0011.420.21<.001Grade of swelling2.260.68<.0012.260.90<.0012.260.74<.001Variable60%-89% stenosis6 months24 months48 monthsBeforeAfterPBeforeAfterPBeforeAfterPVAS score1.430.25<.0011.430.50<.0011.430.45<.001Grade of swelling1.860.56<.0011.860.92<.0011.860.95<.001Variable≥90% stenosis6 months24 months48 monthsBeforeAfterPBeforeAfterPBeforeAfterPVAS score1.480.31<.0011.480.44<.011.480.88>.05Grade of swelling2.000.79<.0012.001.00<.052.001.25>.05VAS, Visual analog scale (for pain). Open table in a new tab" @default.
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• W2567671567 date "2017-01-01" @default.
• W2567671567 modified "2023-09-28" @default.
• W2567671567 title "Impact of Degree of Stenosis in May-Thurner Syndrome on Iliac Vein Stent Outcomes" @default.
• W2567671567 doi "https://doi.org/10.1016/j.jvsv.2016.10.019" @default.
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