Department of Radiology, University Hospitals Leuven, Leuven, Belgium.
Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.
Cardiovasc Intervent Radiol. 2024 Sep;47(9):1200-1209. doi: 10.1007/s00270-024-03820-y. Epub 2024 Aug 12.
To retrospectively analyze the technical and long-term clinical outcome of angioplasty and stenting using the Venovo™ venous stent for the treatment of malignant and benign superior vena cava (SVC) occlusive disease.
Consecutive patients treated with the Venovo™ venous stent for SVC occlusive disease were included. SVC obstruction symptoms were classified according to the Kishi score. The Wilcoxon signed-rank test was used for testing significance of changes. Technical success, defined as correct placement of the stent, completely covering and re-expanding the obstruction, between groups was tested using the Fisher exact test. Overall survival was calculated using the Kaplan-Meier method.
Fifty-five patients underwent stent insertion for symptomatic benign (n = 13; 24%) or malignant (n = 42; 76%) SVC occlusive disease. A significant drop in Kishi score, mean 3.91 before versus mean 1.02 after the procedure (P < 0.0001), was observed. In one patient (1.8%), an additional balloon-expandable stent was needed to manage incomplete expansion of the nitinol stent. In one patient, a procedure-related lung embolic complication was noted. Early thrombotic occlusion of the stent occurred in one patient. Late symptomatic restenosis occurred in 3 patients. Overall primary stent patency and primary-assisted stent patency were 86% (95% CI 66-95) and 97% (95% CI 83-100) at 1-year follow-up and 98% (95% CI 87-100), 98% (87-100) at 2-year follow-up, respectively.
In this retrospective analysis, angioplasty and stent placement using the Venovo™ venous stent is safe and clinically effective for the treatment of both benign and malignant SVC occlusive disease. Reintervention for symptomatic restenosis is rare.
回顾性分析使用 Venovo™ 静脉支架治疗恶性和良性上腔静脉（SVC）闭塞性疾病的技术和长期临床结果。
纳入接受 Venovo™ 静脉支架治疗 SVC 闭塞性疾病的连续患者。根据 Kishi 评分对 SVC 阻塞症状进行分类。使用 Wilcoxon 符号秩检验测试组间变化的显著性。使用 Fisher 确切检验测试技术成功率，定义为支架正确放置、完全覆盖和再扩张阻塞。使用 Kaplan-Meier 方法计算总生存率。
55 例患者因症状性良性（n=13；24%）或恶性（n=42；76%）SVC 闭塞性疾病接受支架置入。观察到 Kishi 评分显著下降，术前平均 3.91 分，术后平均 1.02 分（P<0.0001）。在 1 例患者（1.8%）中，需要额外的球囊扩张支架来处理镍钛诺支架不完全扩张的问题。在 1 例患者中，观察到与手术相关的肺栓塞并发症。1 例患者支架早期发生血栓性闭塞。3 例患者出现晚期症状性再狭窄。1 年随访时，总支架通畅率和辅助支架通畅率分别为 86%（95%CI 66-95）和 97%（95%CI 83-100），2 年随访时分别为 98%（95%CI 87-100）和 98%（87-100）。
在这项回顾性分析中，使用 Venovo™ 静脉支架进行血管成形术和支架置入术治疗良性和恶性 SVC 闭塞性疾病是安全且有效的。有症状的再狭窄再介入治疗罕见。
