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• W4212815900 abstract "Active venous leg ulcers (VLUs) caused by lower extremity venous insufficiency indicate a high disease burden and risk of infection. Our objective was to compare the clinical outcomes and need for reoperation after iliac vein stenting for patients with VLU vs those without VLU (non-VLU). A single-institution database of patients who had undergone iliac vein stenting from August 2011 to June 2021 was analyzed. The symptoms were quantified using the venous clinical severity score (VCSS) and clinical assessment score. The patients in the VLU cohort had had an active VLU at the initial iliac vein stent procedure. Major reoperation was defined as any procedure using venography. Minor reoperations were defined as endovenous laser ablation and sclerotherapy. Among 784 patients, we identified 67 (8.5%) with a VLU and 717 (90.4%) without a VLU. The VLU cohort had a higher prevalence of hypertension (74.6% vs 48.4%; P = .001), coronary artery disease (30.6% vs 10.2%; P < .001), and smoking history (35.8% vs 19.8%; P = .038) compared with the non-VLU cohort. The VLU cohort was older (mean age, 67.1 vs 61.0 years; P = .001) and were more likely to be men (55.2% vs 41.7%; P = .031). Ethnicity also differed significantly between these two cohorts (P < .001; Table). On univariable analysis, the VLU cohort was more likely to have undergone a major reoperation (odds ratio, 1.98; 95% confidence interval, 1.03-3.63; P = .032). However, on multivariable analysis, this difference was not significant (odds ratio, 1.28; 95% confidence interval, 0.59-2.65; P = .521). Additionally, the VLU cohort had required a significantly higher mean number of total reoperations (1.4 vs 1.0; P = .012) compared with the non-VLU cohort. Comparatively, for patients who had undergone at least one reoperation, the difference in the mean total number of reoperations was even larger for the VLU cohort (2.6 vs 1.8; P = .001). The log-rank test revealed no differences in the intervention-free survival time (P = .44). Changes in the VLU clinical assessment score at postoperative follow-up of 30 days, 90 days, and 6 months are listed in the Table. Although many patients had experienced resolution of VLUs after iliac vein stenting, this cohort was more likely to undergo major reoperation and, on average, had required more total reoperations.TableDemographics, comorbidities, perioperative details, and outcomes of iliac vein stenting stratified by VLUVariableVLU (n = 67)No VLU (n = 717)P valueDemographics and comorbidities Age, years67.1 ± 13.261.0 ± 13.1.001 Male sex34 (56.7)298 (41.7).045 Ethnicity<.001Asian20 (29.9)571 (79.7)Black8 (11.9)33 (4.6)Hispanic7 (10.4)49 (6.8)Other8 (11.9)23 (3.2)White24 (35.8)40 (5.6) DM23 (34.3)150 (20.9).017 HTN50 (74.6)347 (48.4)<.001 CAD19 (30.6)67 (10.2)<.001 Smoking history24 (35.8)142 (19.8).004 Cancer history17 (26.6)68 (10.0)<.001 BMI, kg/m228.2 ± 7.626.2 ± 5.3.039 DVT history19 (28.4)99 (13.8).003Perioperative details VCSS composite18.1 ± 4.69.9 ± 3.1<.001 Intraoperative DVT found22 (32.8)188 (26.2).305 Stent position.004Unilateral37 (55.2)261 (36.4)Bilateral30 (44.8)456 (63.6) Stents placed, No.1.9 ± 1.02.3 ± 1.0.001Postoperative outcomes Follow-up, days801.1 ± 776.7764.3 ± 671.3.701 Interval to reoperation, days393.5 ± 501.7303.0 ± 365.4.167 Total reoperations, No.1.4 ± 1.91.0 ± 1.3.012 Reoperations for patients with ≥1 reoperation2.6 ± 1.81.8 ± 1.2.001 Univariate OR, major operation1.98 (1.03-3.63).032 Multivariate OR, major operation1.79 (0.93-3.35).072 30-Day postoperative VLU CASFull resolution11 (26.8)NASignificant change8 (19.5)NAMild change7 (17.1)NANo change13 (31.7)NAWorse2 (4.9)NA 90-Day postoperative VLU CASFull resolution12 (31.6)NASignificant change13 (34.2)NAMild change9 (23.7)NANo change3 (7.9)NAWorse1 (2.6)NA 6-Month postoperative VLU CASFull resolution10 (26.3)NASignificant change12 (31.6)NAMild change6 (15.8)NANo change7 (18.4)NAWorse3 (7.9)NABMI, Body mass index; CAD, coronary artery disease; CAS, clinical assessment score; DVT, deep vein thrombosis; HTN, hypertension; NA, not applicable; VCSS, venous clinical severity score; VLU, venous leg ulcer.Data presented as mean ± standard deviation or number (%). Open table in a new tab" @default.
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• W4212815900 date "2022-03-01" @default.
• W4212815900 modified "2023-10-01" @default.
• W4212815900 title "Patients With Active Venous Leg Ulcers at Iliac Vein Stenting Required More Reoperations" @default.
• W4212815900 doi "https://doi.org/10.1016/j.jvs.2021.12.042" @default.
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