Greenbelt, Md: Iliac vein stenting is a safe and well-tolerated procedure in an office-based laboratory (OBL) setting and major complications were rare, finds a recent study in the Journal of Vascular Surgery: Venous and Lymphatic Disorders. Insertion site hematomas were primarily minor complications that did not require inpatient hospitalization.
Venous stenting for iliac vein outflow obstruction is shown to be related to excellent long-term stent patency and symptom resolution. However, there is no clear-cut definition of iliac vein stenting performed in an OBL setting. Considering this, Levan Sulakvelidze, Center for Vascular Medicine, Greenbelt, Md, and colleagues aimed to determine the safety profile of iliac vein stenting in an OBL setting.
For the purpose, the researchers prospectively collected the data in the Center for Vascular Medicine electronic medical record system (NextGen Healthcare Information System, Irvine, Calif) and retrospectively analyzed. Standardized patient safety and sedation protocols were used according to the accreditation standards of the Joint Commission for Accreditation of Hospital Organizations for office-based surgery centers.
The present analysis included patient consultations, interventions, and follow-up at 1 to 6 weeks. During their procedure, all the patients had received moderate sedation. Complications requiring hospitalization were classified as major complications. Minor complications consisted of hematoma, bleeding, vasovagal response, in-stent thrombosis leading to complete occlusion of the iliac vein stent, an allergic reaction, hematemesis, hypotension, pelvic discomfort, and pseudoaneurysm.
Salient findings include:
· 1223 iliac vein stents were placed in 1104 patients (23.7% male; 76.3% female) between January 2015 and January 2019.
· A total of 90 minor complications (7.36%) and 5 major complications (0.41%) were observed.
· The major complications included the following: one allergic reaction, one episode of atrial fibrillation, one episode of supraventricular tachycardia, one episode of chest pain, and one case of acute stent occlusion.
· The minor complications were primarily insertion site hematomas.
· No complications were related to sedation or acute renal failure. No patient died.
"Our analysis has shown that iliac vein stenting in an OBL setting is a safe and well-tolerated procedure," the authors concluded.
Reference:
The study titled, Iliac vein stenting is safe when performed in an office based laboratory setting," was published in the Journal of Vascular Surgery: Venous and Lymphatic Disorders.
DOI: https://doi.org/10.1016/j.jvsv.2021.04.021