Joyce D P, Morris R I, Black S A, Desai K R, O'Sullivan G J
Department of Interventional Radiology, Galway University Hospital, Galway, Ireland.
Department of Vascular Surgery, St Thomas' Hospital, London, UK.
Cardiovasc Intervent Radiol. 2024 Dec;47(12):1677-1684. doi: 10.1007/s00270-024-03843-5. Epub 2024 Aug 30.
Deep venous stent placement has developed into a primary treatment modality for venous obstruction in recent decades. Reported rates of complications are low in the literature and are based mainly on case reports and single-centre cohorts. Interventionalists performing these procedures must be aware of the occurrence of complications associated with stent placement to counsel patients adequately and promote avoidance through optimal procedural approach. This study aims to determine the incidence of serious complications associated with iliocaval and iliofemoral stent placement in a cohort of patients from 3 major tertiary deep venous referral centres.
Data were collated from January 2014 to September 2023. The following major complications were included in the analysis: death, major bleeding requiring transfusion, massive pulmonary embolism, any complication which required endovascular or open surgical intervention, vessel rupture, acute kidney injury requiring dialysis, stent crushing, fracture, migration, involution or erosion.
One thousand eight hundred fourteen (1814) patients were treated for acute or chronic deep venous pathology during the 9-year study period. Sixty-one patients (3.3%) experienced a major stent-related complication. The most frequently reported complication was stent crushing (n = 18, 29.5%), followed by stent fracture (n = 10, 16.4%) and erosion of the stent through the vessel wall (n = 8, 13.1%). Death was a rare event (0.2%).
Deep venous stent placement is a safe procedure with low rates of major complications. It is incumbent upon operators to be aware of the risks associated with these procedures, however, rare, so that they may obtain fully informed consent from patients.
近几十年来，深静脉支架置入术已发展成为治疗静脉阻塞的主要治疗方式。文献报道的并发症发生率较低，且主要基于病例报告和单中心队列研究。进行这些手术的介入医生必须了解与支架置入相关的并发症的发生情况，以便充分告知患者并通过优化手术方法来避免并发症。本研究旨在确定来自3个主要三级深静脉转诊中心的一组患者中与髂股静脉和髂总静脉支架置入相关的严重并发症的发生率。
收集2014年1月至2023年9月的数据。分析中纳入了以下主要并发症：死亡、需要输血的大出血、大面积肺栓塞、任何需要血管内或开放手术干预的并发症、血管破裂、需要透析的急性肾损伤、支架挤压、骨折、移位、退化或侵蚀。
在9年的研究期间，1814例患者接受了急性或慢性深静脉疾病的治疗。61例患者（3.3%）发生了与支架相关的主要并发症。最常报告的并发症是支架挤压（n = 18，29.5%），其次是支架骨折（n = 10，16.4%）和支架穿透血管壁侵蚀（n = 8，13.1%）。死亡是罕见事件（0.2%）。
深静脉支架置入术是一种安全的手术，主要并发症发生率较低。然而，手术医生有责任了解这些手术相关的风险，尽管这些风险罕见，以便他们能够获得患者的充分知情同意。
