Endovascular stent placement for chronic post-thrombotic symptomatic ilio-femoral venous obstructive lesions: a single-center study of safety, efficacy and quality-of-life improvement
Identifieur interne : 000047 ( France/Extraction ); précédent : 000046; suivant : 000048Endovascular stent placement for chronic post-thrombotic symptomatic ilio-femoral venous obstructive lesions: a single-center study of safety, efficacy and quality-of-life improvement
Auteurs : Marie-Tiphaine Falcoz [France] ; Nicolas Falvo [France] ; Serge Aho-Glélé [France] ; Emmanuel Demaistre [France] ; Christophe Galland [France] ; Sylvain Favelier [France] ; Pierre Pottecher [France] ; Olivier Chevallier [France] ; Bernard Bonnotte [France] ; Sylvain Audia [France] ; Maxime Samson [France] ; Béatrice Terriat [France] ; Marco Midulla [France] ; Romaric Loffroy [France]Source :
- Quantitative Imaging in Medicine and Surgery [ 2223-4292 ] ; 2016.
Abstract
Post-thrombotic syndrome (PTS) is a frequent complication of deep vein thrombosis (DVT) despite adequate treatment. Venous angioplasty and stent placement has been progressively used to restore and maintain venous patency in PTS patients. This study reports our single-center experience with the use of endovascular treatment for chronic post-thrombotic symptomatic ilio-femoral venous obstructive lesions.
A prospective mono-centric observational cohort study of PTS patients with chronic symptomatic ilio-femoral venous obstructive lesions referred for endovascular treatment was conducted from March 2012 to April 2016. Procedure consisted in recanalization, pre-dilation and self-expandable stenting of stenotic or occluded iliac and/or femoral veins. Severity of PTS, quality-of-life and treatment outcomes were assessed using Villalta scale and Chronic Venous Insufficiency Questionnaire (CIVIQ-20) at baseline and 3 months after the procedure. Imaging follow-up was based on duplex ultrasound (US) and computed tomography (CT).
Twenty-one patients (11 females, 10 males; median age, 41 years; range, 32–60) were included. Recanalization and stenting was successfully accomplished in all prime procedures, 4 patients benefitted from an additional procedure. Immediate technical success rate was 96% considering 25 procedures, performed without any complications. Median follow-up was 18 months (range, 6–30 months) with a 90.5% stent patency rate. Villalta score significantly decreased from baseline compared with 3 months after the procedure [14 (range, 11–22) and 5 (range, 1–10), respectively, P<0.0001], showing a significant decrease in the severity of PTS. CIVIQ-20 score significantly decreased from baseline compared with 3 months after stenting [48.5 (range, 39–73) and 26.5 (range, 21–45), respectively, P<0.0001] thus showing a significant improvement of quality-of-life. Post-procedural CIVIQ-20 score was significantly associated with Villalta score (95% CI, 1.53–2.95; P<0.0001).
Our results confirm the high clinical success rate and safety of endovascular PTS treatment and highlight the significant impact of stenting on the quality of life of patients with chronic symptomatic ilio-femoral venous obstructive lesions.
Url:
DOI: 10.21037/qims.2016.07.07
PubMed: 27709070
PubMed Central: 5009103
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Angiology and Vascular Medicine, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Aho Glele, Serge" sort="Aho Glele, Serge" uniqKey="Aho Glele S" first="Serge" last="Aho-Glélé">Serge Aho-Glélé</name><affiliation wicri:level="1"><nlm:aff id="aff3">Department of Epidemiology, Statistics and Clinical Research, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Demaistre, Emmanuel" sort="Demaistre, Emmanuel" uniqKey="Demaistre E" first="Emmanuel" last="Demaistre">Emmanuel Demaistre</name><affiliation wicri:level="1"><nlm:aff id="aff4">Department of Biological Haemostasis and Thrombosis Treatment, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Galland, Christophe" sort="Galland, Christophe" uniqKey="Galland C" first="Christophe" last="Galland">Christophe Galland</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Angiology and Vascular Medicine, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Favelier, Sylvain" sort="Favelier, Sylvain" uniqKey="Favelier S" first="Sylvain" last="Favelier">Sylvain Favelier</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country>;</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Pottecher, Pierre" sort="Pottecher, Pierre" uniqKey="Pottecher P" first="Pierre" last="Pottecher">Pierre Pottecher</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country>;</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Chevallier, Olivier" sort="Chevallier, Olivier" uniqKey="Chevallier O" first="Olivier" last="Chevallier">Olivier Chevallier</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country>;</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Bonnotte, Bernard" sort="Bonnotte, Bernard" uniqKey="Bonnotte B" first="Bernard" last="Bonnotte">Bernard Bonnotte</name><affiliation wicri:level="1"><nlm:aff id="aff5">Department of Internal Medicine and Clinical Immunology, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Audia, Sylvain" sort="Audia, Sylvain" uniqKey="Audia S" first="Sylvain" last="Audia">Sylvain Audia</name><affiliation wicri:level="1"><nlm:aff id="aff5">Department of Internal Medicine and Clinical Immunology, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Samson, Maxime" sort="Samson, Maxime" uniqKey="Samson M" first="Maxime" last="Samson">Maxime Samson</name><affiliation wicri:level="1"><nlm:aff id="aff5">Department of Internal Medicine and Clinical Immunology, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Terriat, Beatrice" sort="Terriat, Beatrice" uniqKey="Terriat B" first="Béatrice" last="Terriat">Béatrice Terriat</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Angiology and Vascular Medicine, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Midulla, Marco" sort="Midulla, Marco" uniqKey="Midulla M" first="Marco" last="Midulla">Marco Midulla</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country>;</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Loffroy, Romaric" sort="Loffroy, Romaric" uniqKey="Loffroy R" first="Romaric" last="Loffroy">Romaric Loffroy</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country>;</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27709070</idno><idno type="pmc">5009103</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5009103</idno><idno type="RBID">PMC:5009103</idno><idno type="doi">10.21037/qims.2016.07.07</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">003179</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">003179</idno><idno type="wicri:Area/Pmc/Curation">003178</idno><idno 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sort="Falcoz, Marie Tiphaine" uniqKey="Falcoz M" first="Marie-Tiphaine" last="Falcoz">Marie-Tiphaine Falcoz</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country>;</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Falvo, Nicolas" sort="Falvo, Nicolas" uniqKey="Falvo N" first="Nicolas" last="Falvo">Nicolas Falvo</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Angiology and Vascular Medicine, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Aho Glele, Serge" sort="Aho Glele, Serge" uniqKey="Aho Glele S" first="Serge" last="Aho-Glélé">Serge Aho-Glélé</name><affiliation wicri:level="1"><nlm:aff id="aff3">Department of Epidemiology, Statistics and Clinical Research, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Demaistre, Emmanuel" sort="Demaistre, Emmanuel" uniqKey="Demaistre E" first="Emmanuel" last="Demaistre">Emmanuel Demaistre</name><affiliation wicri:level="1"><nlm:aff id="aff4">Department of Biological Haemostasis and Thrombosis Treatment, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Galland, Christophe" sort="Galland, Christophe" uniqKey="Galland C" first="Christophe" last="Galland">Christophe Galland</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Angiology and Vascular Medicine, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Favelier, Sylvain" sort="Favelier, Sylvain" uniqKey="Favelier S" first="Sylvain" last="Favelier">Sylvain Favelier</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country>;</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Pottecher, Pierre" sort="Pottecher, Pierre" uniqKey="Pottecher P" first="Pierre" last="Pottecher">Pierre Pottecher</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country>;</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Chevallier, Olivier" sort="Chevallier, Olivier" uniqKey="Chevallier O" first="Olivier" last="Chevallier">Olivier Chevallier</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country>;</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Bonnotte, Bernard" sort="Bonnotte, Bernard" uniqKey="Bonnotte B" first="Bernard" last="Bonnotte">Bernard Bonnotte</name><affiliation wicri:level="1"><nlm:aff id="aff5">Department of Internal Medicine and Clinical Immunology, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Audia, Sylvain" sort="Audia, Sylvain" uniqKey="Audia S" first="Sylvain" last="Audia">Sylvain Audia</name><affiliation wicri:level="1"><nlm:aff id="aff5">Department of Internal Medicine and Clinical Immunology, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Samson, Maxime" sort="Samson, Maxime" uniqKey="Samson M" first="Maxime" last="Samson">Maxime Samson</name><affiliation wicri:level="1"><nlm:aff id="aff5">Department of Internal Medicine and Clinical Immunology, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Terriat, Beatrice" sort="Terriat, Beatrice" uniqKey="Terriat B" first="Béatrice" last="Terriat">Béatrice Terriat</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Angiology and Vascular Medicine, François-Mitterrand Teaching Hospital, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Midulla, Marco" sort="Midulla, Marco" uniqKey="Midulla M" first="Marco" last="Midulla">Marco Midulla</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country>;</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Loffroy, Romaric" sort="Loffroy, Romaric" uniqKey="Loffroy R" first="Romaric" last="Loffroy">Romaric Loffroy</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, BP 77908, 21079 Dijon Cedex,<country>France</country>;</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">Quantitative Imaging in Medicine and Surgery</title><idno type="ISSN">2223-4292</idno><idno type="eISSN">2223-4306</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Post-thrombotic syndrome (PTS) is a frequent complication of deep vein thrombosis (DVT) despite adequate treatment. Venous angioplasty and stent placement has been progressively used to restore and maintain venous patency in PTS patients. This study reports our single-center experience with the use of endovascular treatment for chronic post-thrombotic symptomatic ilio-femoral venous obstructive lesions.</p></sec><sec><title>Methods</title><p>A prospective mono-centric observational cohort study of PTS patients with chronic symptomatic ilio-femoral venous obstructive lesions referred for endovascular treatment was conducted from March 2012 to April 2016. Procedure consisted in recanalization, pre-dilation and self-expandable stenting of stenotic or occluded iliac and/or femoral veins. Severity of PTS, quality-of-life and treatment outcomes were assessed using Villalta scale and Chronic Venous Insufficiency Questionnaire (CIVIQ-20) at baseline and 3 months after the procedure. Imaging follow-up was based on duplex ultrasound (US) and computed tomography (CT).</p></sec><sec><title>Results</title><p>Twenty-one patients (11 females, 10 males; median age, 41 years; range, 32–60) were included. Recanalization and stenting was successfully accomplished in all prime procedures, 4 patients benefitted from an additional procedure. Immediate technical success rate was 96% considering 25 procedures, performed without any complications. Median follow-up was 18 months (range, 6–30 months) with a 90.5% stent patency rate. Villalta score significantly decreased from baseline compared with 3 months after the procedure [14 (range, 11–22) and 5 (range, 1–10), respectively, P<0.0001], showing a significant decrease in the severity of PTS. CIVIQ-20 score significantly decreased from baseline compared with 3 months after stenting [48.5 (range, 39–73) and 26.5 (range, 21–45), respectively, P<0.0001] thus showing a significant improvement of quality-of-life. Post-procedural CIVIQ-20 score was significantly associated with Villalta score (95% CI, 1.53–2.95; P<0.0001).</p></sec><sec><title>Conclusions</title><p>Our results confirm the high clinical success rate and safety of endovascular PTS treatment and highlight the significant impact of stenting on the quality of life of patients with chronic symptomatic ilio-femoral venous obstructive lesions.</p></sec></div></front></TEI><affiliations><list><country><li>France</li></country></list><tree><country name="France"><noRegion><name sortKey="Falcoz, Marie Tiphaine" sort="Falcoz, Marie Tiphaine" uniqKey="Falcoz M" first="Marie-Tiphaine" last="Falcoz">Marie-Tiphaine Falcoz</name></noRegion><name sortKey="Aho Glele, Serge" sort="Aho Glele, Serge" uniqKey="Aho Glele S" first="Serge" last="Aho-Glélé">Serge Aho-Glélé</name><name sortKey="Audia, Sylvain" sort="Audia, Sylvain" uniqKey="Audia S" first="Sylvain" last="Audia">Sylvain Audia</name><name sortKey="Bonnotte, Bernard" sort="Bonnotte, Bernard" uniqKey="Bonnotte B" first="Bernard" last="Bonnotte">Bernard Bonnotte</name><name sortKey="Chevallier, Olivier" sort="Chevallier, Olivier" uniqKey="Chevallier O" first="Olivier" last="Chevallier">Olivier Chevallier</name><name sortKey="Demaistre, Emmanuel" sort="Demaistre, Emmanuel" uniqKey="Demaistre E" first="Emmanuel" last="Demaistre">Emmanuel Demaistre</name><name sortKey="Falvo, Nicolas" sort="Falvo, Nicolas" uniqKey="Falvo N" first="Nicolas" last="Falvo">Nicolas Falvo</name><name sortKey="Favelier, Sylvain" sort="Favelier, Sylvain" uniqKey="Favelier S" first="Sylvain" last="Favelier">Sylvain Favelier</name><name sortKey="Galland, Christophe" sort="Galland, Christophe" uniqKey="Galland C" first="Christophe" last="Galland">Christophe Galland</name><name sortKey="Loffroy, Romaric" sort="Loffroy, Romaric" uniqKey="Loffroy R" first="Romaric" last="Loffroy">Romaric Loffroy</name><name sortKey="Midulla, Marco" sort="Midulla, Marco" uniqKey="Midulla M" first="Marco" last="Midulla">Marco Midulla</name><name sortKey="Pottecher, Pierre" sort="Pottecher, Pierre" uniqKey="Pottecher P" first="Pierre" last="Pottecher">Pierre Pottecher</name><name sortKey="Samson, Maxime" sort="Samson, Maxime" uniqKey="Samson M" first="Maxime" last="Samson">Maxime Samson</name><name sortKey="Terriat, Beatrice" sort="Terriat, Beatrice" uniqKey="Terriat B" first="Béatrice" last="Terriat">Béatrice Terriat</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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