Primary patency after venous stenting best in NIVL patients, study finds

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A recent study concludes that non-thrombotic iliac vein lesion (NIVL) patients have better primary patency after venous stenting than patients with venous thrombotic disorders. Olivier Espitia, MD, from CHU de Nantes in Nantes, France, and col­leagues report this main finding from a multicenter cohort study in the European Journal of Vascular and Endovascular Surgery (EJVES).

The authors detail that it was their aim to assess primary stent patency predictive factors in three groups of patients with history of lower limb vein thrombosis: NIVL, acute deep vein thrombosis (aDVT) and post-thrombotic syndrome (PTS).

The investigators included consecutive patients from January 2014 to December 2020 from seven hospitals. The team reported the anticoagulant and antiplatelet therapy strategies employed after venous stenting and compared these between the three patient groups. In their results, Espitia et al state that the study included 377 patients in total, comprising 134 in the NIVL group, 55 in the aDVT group and 188 PTS patients, and that medi­an follow-up was 28.2 months.

The authors report in EJVES that primary paten­cy was statistically significantly higher in the NIVL group (99.3%) compared with the PTS group (68.6%; p<0.001) and the aDVT group (83.6%; p=0.002). In addition, the researchers note that PTS patients received a statistically significantly greater number of stents and had more stents below the inguinal ligament.

Finally, Espitia et al report that discontinuation of antiplatelet therapy at the last assessment was 83.6% for NIVL, 100% for aDVT, and 95.7% for the PTS group (p<0.001). Discontinuation of anticoagulation therapy was 93.2% for NIVL, 25% for aDVT, and 70.3% for the PTS group (p<0.001). “The only predictor of worse primary patency in the aDVT group was long-term anticoagulation before stenting,” they write.

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