Iliac venous stenting for outflow obstruction does not significantly change the quality of life of patients with severe chronic venous insufficiency.

CEAP 5 and 6 Iliac venous stenting chronic venous insufficiency outflow obstruction quality of life

Journal

JRSM cardiovascular disease
ISSN: 2048-0040
Titre abrégé: JRSM Cardiovasc Dis
Pays: England
ID NLM: 101598607

Informations de publication

Date de publication:
Historique:
received: 06 02 2019
revised: 24 09 2019
accepted: 01 11 2019
entrez: 17 12 2019
pubmed: 17 12 2019
medline: 17 12 2019
Statut: epublish

Résumé

Percutaneous endovenous iliac stenting has emerged as a new modality in the treatment of advanced chronic venous insufficiency with outflow obstruction. However, the effect of this intervention on the quality of life remains unclear. We examined the impact of iliac venous stenting for outflow obstruction as compared to conservative medical management on the quality of life in severe chronic venous insufficiency patients. Medical records of all patients with CEAP class 5 and 6 disease (N = 172) who underwent ilio-caval venography with intravascular ultrasonography (IVUS) at a single institution over a seven-year period, were reviewed for this case-control study. Quality of life evaluation was performed utilizing the Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ-20) one year after the index procedure. Of the 172 severe chronic venous insufficiency patients, 109 were stented and 63 patients were treated medically based on their venography and IVUS results. The indication for stenting was confirmation of IVUS determined surface area or diameter outflow stenosis of greater than 50% within the common or external iliac venous systems. Eighty patients (47%) responded with completed CIVIQ-20 questionnaires for analysis. Of these, 47 were from the stented group and 33 from the non-stented group. At least moderate persistent pain or discomfort post-procedure was reported by 20 (43%) stented group patients and 19 (58%) non-stented group patients. Scores for all the other criteria in the CIVIQ-20 were similar between the groups. The mean total CIVIQ-20 score was 45.23 and 47.13, respectively, in stented group and non-stented group patients. ( There was no significant difference in the quality of life reported by CEAP 5 and 6 patients who underwent iliac venous stenting versus those who were treated medically for presumed iliac outflow obstruction. Prospective studies are needed to determine the true value of iliac venous stenting based on IVUS criteria in the management advanced chronic venous insufficiency.

Identifiants

pubmed: 31839939
doi: 10.1177/2048004019890968
pii: 10.1177_2048004019890968
pmc: PMC6893555
doi:

Types de publication

Journal Article

Langues

eng

Pagination

2048004019890968

Commentaires et corrections

Type : CommentIn

Informations de copyright

© The Author(s) 2019.

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Auteurs

Alexander Shiferson (A)

Department of Surgery, Division of Vascular Surgery, Maimonides Medical Center, Brooklyn, NY, USA.

Edouard Aboian (E)

Department of Surgery, Division of Vascular Surgery, Maimonides Medical Center, Brooklyn, NY, USA.

Michael Shih (M)

Department of Surgery, Division of Vascular Surgery, Maimonides Medical Center, Brooklyn, NY, USA.

Qinghua Pu (Q)

Department of Surgery, Division of Vascular Surgery, Maimonides Medical Center, Brooklyn, NY, USA.

Theresa Jacob (T)

Department of Surgery, Division of Vascular Surgery, Maimonides Medical Center, Brooklyn, NY, USA.

Robert Y Rhee (RY)

Department of Surgery, Division of Vascular Surgery, Maimonides Medical Center, Brooklyn, NY, USA.

Classifications MeSH