Patrick Muck, MD, from Cincinnati, Ohio, provided a state of the venous stent landscape during IVC 2024. The TriHealth vascular surgery program director ran through the key differences between the venous-specific stents currently available and how he goes about selecting which one to deploy in specific scenarios.
Within the last four years, the Venovo (BD), Vici (Boston Scientific), Zilver Vena (Cook), Abre (Medtronic) and Duo (Philips) venous stents have all been approved for use by the Food and Drug Administration (FDA). “I’ve been fortunate enough to use all of the [currently available stents on the market] besides the Duo so far,” Muck told the audience.
Muck outlined a particular scenario during which he deployed the Abre in a patient who had a history of varicose vein surgery decades ago. When the patient saw Muck, multiple issues needed to be addressed, and, discovering a femoral vein occlusion, he placed the Abre stent, with the patient doing well years down the road, Muck reported.
Muck then turned to the Zilver Vena and a post-thrombotic syndrome patient who had an iliofemoral deep vein thrombosis (DVT) during pregnancy: Nine months after giving birth, “I put a 16, 60 Zilver Vena in,” he described, reflecting that, today, he would place a longer one. “What I like about all these stents is the thumb wheel for the Venovo and the Abre, and the pinch-and-pull for the Zilver Vena, which means you can place it precisely where you need to.”
The Duo stent, recently approved by the FDA, has emerged as “very flexible and very strong,” Muck added. “Ultimately, there’s no head-to-head. You have to individualize each patient based on their scenario as well as their IVUS. Then you can decide which stent is best for you.”
