https://doi.org/10.4081/vl.2021.9739
What are the ideal characteristics of a venous stent?
Submitted: 9 March 2021
Accepted: 15 June 2021
Published: 18 June 2021
Accepted: 15 June 2021
Abstract Views: 2127
PDF: 598
HTML: 164
HTML: 164
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Historically, the stents used in the venous system were not dedicated scaffolds. They were largely adapted arterial stents. An essential feature of a venous stent is compliance, in order to adapt its crosssectional area to the vein. It should also be crush resistant, corrosion resistant and fatigue resistant. The material should be radiopaque, for follow-up. Another characteristic of the ideal venous stent is flexibility, to adapt its shape to the vein, not vice versa. The scaffold should be uncovered too, in order to avoid the occlusion of collaterals. The ideal venous stent should not migrate, so it is necessary a large diameter and a long length. The radial force is important to prevent migration. However, current stents derived from arterial use display high radial force, which could affect the patency of the thin venous wall. Alternatively, if the stent has an anchor point, that permits a passive anchoring, the radial force required to avoid migration will be lower. Dedicated venous stents were not available until very recently. Furthermore, there is a preclinical study about a new compliant nitinol stent, denominated Petalo CVS. Out of the commonest causes of large veins obstruction, dedicated venous stent could also treat other diseases described more recently, such as the jugular variant of the Eagle syndrome, JEDI syndrome and jugular lesions of the chronic cerebrospinal venous insufficiency that result unfavorable for angioplasty according to Giaquinta classification.
Zamboni P, Tavoni V, Sisini F, et al. Venous compliance and clinical implications. Veins and Lymphatics 2018;7:7367.
DOI: https://doi.org/10.4081/vl.2018.7367
Schwein A, Georg Y, Lejay A, et al. Endovascular treatment for venous diseases: where are the venous stents? Methodist Debakey Cardiovasc J. 2018;14:208-13.
DOI: https://doi.org/10.14797/mdcj-14-3-208
Raju S, Neglén P. Percutaneous recanalization of total occlusions of the iliac vein. J Vasc Surg 2009;50:360-8.
DOI: https://doi.org/10.1016/j.jvs.2009.01.061
Shamini-Noori SM, Clark TWI. Venous stents: current status and future directions. Tech Vasc Interv Radiol 2018;21:113-16.
DOI: https://doi.org/10.1053/j.tvir.2018.03.007
Li N, Mendoza F, Rugonyi S, et al. Venous biomechanics of angioplasty and stent placement: implications of the poisson effect. J Vasc Interv Radiol 2020;31:1348-56.
DOI: https://doi.org/10.1016/j.jvir.2020.02.033
Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation 2014;130:333-46.
DOI: https://doi.org/10.1161/CIRCULATIONAHA.113.006898
Fu J, Tang B, Wang H, et al. Stent characteristics of 32 patients with early (<14 days) iliofemoral stent occlusion. J Vasc Surg Venous Lymphat Disord 2020;S2213-333X(20)30556-4
DOI: https://doi.org/10.1016/j.jvsv.2020.10.011
Villalba L. Chronic venous insufficiency: the role of venous obstruction and treatment options. Medicine Today 2017;18:33-8.
Veroux P, Giaquinta A, Virgilio C, et al. Novel compliant scaffold with specific design for venous system: results of a porcine model study. Biomed Res Int 2018;2018:7312315.
DOI: https://doi.org/10.1155/2018/7312315
Titus JM, Moise MA, Bena J, et al. Iliofemoral stenting for venous occlusive disease. J Vasc Surg 2011;53:706-12.
DOI: https://doi.org/10.1016/j.jvs.2010.09.011
Raju S. Treatment of iliac-caval outflow obstruction. Semin Vasc Surg 2015;28:47-53.
DOI: https://doi.org/10.1053/j.semvascsurg.2015.07.001
Kölbel T, Lindh M, Akesson M, et al. Chronic iliac vein occlusion: midterm results of endovascular recanalization. J Endovasc Ther 2009;16:483-91.
DOI: https://doi.org/10.1583/09-2719.1
Qiu P, Zha B, Xu A, et al. Systematic review and meta-analysis of iliofemoral stenting for post-thrombotic syndrome. Eur J Vasc Endovasc Surg 2019;57:407-16.
DOI: https://doi.org/10.1016/j.ejvs.2018.09.022
Fatima J, AlGaby A, Bena J, et al. Technical considerations, outcomes, and durability of inferior vena cava stenting. J Vasc Surg Venous Lymphat Disord 2015;3:380-8.
DOI: https://doi.org/10.1016/j.jvsv.2015.04.001
Kurklinsky AK, Bjarnason H, Friese JL, et al. Outcomes of venoplasty with stent placement for chronic thrombosis of the iliac and femoral veins: single-center experience. J Vasc Interv Radiol 2012;23:1009-15.
DOI: https://doi.org/10.1016/j.jvir.2012.04.019
Neglén P, Hollis KC, Olivier J, Raju S. Stenting of the venous outflow in chronic venous disease: long-term stent-related outcome, clinical, and hemodynamic result. J Vasc Surg 2007;46:979-90.
DOI: https://doi.org/10.1016/j.jvs.2007.06.046
Garg N, Gloviczki P, Karimi KM, et al. Factors affecting outcome of open and hybrid reconstructions for nonmalignant obstruction of iliofemoral veins and inferior vena cava. J Vasc Surg 2011;53:383-93.
DOI: https://doi.org/10.1016/j.jvs.2010.08.086
Jayaraj A, Raju S. Stenting for obstructive iliac vein lesions. Veins and Lymphatics 2017;6:6855.
DOI: https://doi.org/10.4081/vl.2017.6855
Petrov I, Grozdinski L, Kaninski G, et al. Safety profile of endovascular treatment for chronic cerebrospinal venous insufficiency in patients with multiple sclerosis. J Endovasc Ther 2011;18:314-23.
DOI: https://doi.org/10.1583/11-3440.1
Mandato KD, Hegener PF, Siskin GP, et al. Safety of endovascular treatment of chronic cerebrospinal venous insufficiency: a report of 240 patients with multiple sclerosis. J Vasc Interv Radiol 2012;23:55-9.
DOI: https://doi.org/10.1016/j.jvir.2011.09.019
Raju S, Hollis K, Neglen P. Obstructive lesions of the inferior vena cava: clinical features and endovenous treatment. J Vasc Surg 2006;44:820-7.
DOI: https://doi.org/10.1016/j.jvs.2006.05.054
Gasparis AP, Labropoulos N. Venous outflow obstruction managing intervention after iliofemoral thrombolysis. Endovascular Today 2011;3:51-6.
Razavi MK, Jaff MR, Miller LE. Safety and effectiveness of stent placement for iliofemoral venous outflow obstruction: systematic review and meta-analysis. Circ Cardiovasc Interv 2015;8:e002772.
DOI: https://doi.org/10.1161/CIRCINTERVENTIONS.115.002772
Dabir D, Feisst A, Thomas D, et al. Physical properties of venous stents: an experimental comparison. Cardiovasc Intervent Radiol 2018;41:942-50.
DOI: https://doi.org/10.1007/s00270-018-1916-1
Razavi M, Black S, Gagne P, et al. Pivotal study of endovenous stent placement for symptomatic iliofemoral venous obstruction. Circ Cardiovasc Interv 2019;12:e008268.
DOI: https://doi.org/10.1161/CIRCINTERVENTIONS.119.008268
George R, Verma H, Ram B, Tripathi R. The effect of deep venous stenting on healing of lower limb venous ulcers. Eur J Vasc Endovasc Surg 2014;48:330-6.
DOI: https://doi.org/10.1016/j.ejvs.2014.04.031
O’Sullivan GJ, Sheehan J, Lohan D, McCann-Brown JA. Iliofemoral venous stenting extending into the femoral region: initial clinical experience with the purpose-designed Zilver Vena stent. J Cardiovasc Surg 2013;54:255-61.
Wen-da W, Yu Z, Yue-xin C. Stenting for chronic obstructive venous disease: A current comprehensive meta-analysis and systematic review. Phlebology 2016;31:376-89.
DOI: https://doi.org/10.1177/0268355515596474
Aurshina A, Ganelin A, Hingorani A, et al. Clinical correlation of the area of inferior vena cava, iliac and femoral veins for stent use. Vascular 2018;26:126-31.
DOI: https://doi.org/10.1177/1708538117715343
Jayaraj A, Crim W, Knight A, Raju S. Characteristics and outcomes of stent occlusion after iliocaval stenting. J Vasc Surg Venous Lymphat Disord 2019;56-64.
DOI: https://doi.org/10.1016/j.jvsv.2018.07.013
Daugherty SF and Gillespie DL. Venous angioplasty and stenting improve pelvic congestion syndrome caused by venous out ow obstruction. J Vasc Surg Venous Lymphat Disord 2015;3:283-9.
DOI: https://doi.org/10.1016/j.jvsv.2015.01.003
Scerrati A, Menegatti E, Zamboni M, et al. Internal jugular vein thrombosis: etiology, symptomatology, diagnosis and current treatment. Diagnostics (Basel) 2021;11:378.
DOI: https://doi.org/10.3390/diagnostics11020378
Andersen PE, Midtgaard A, Brenøe AS, et al. A new nitinol stent for use in superior vena cava syndrome. Initial clinical experience. J Cardiovasc Surg 2015;56:877-8.
Razavi M, Marston W, Black S, et al. The initial report on 1-year outcomes of the feasibility study of the VENITI VICI VENOUS STENT in symptomatic iliofemoral venous obstruction. J Vasc Surg Venous Lymphat Disord 2018;6:192-200.
DOI: https://doi.org/10.1016/j.jvsv.2017.10.014
De Wolf MA, de Graaf R, Kurstjens RL, et al. Short-term clinical experience with a dedicated venous nitinol stent: initial results with the sinus-venous stent. Eur J Vasc Endovasc Surg 2015;50:518-26.
DOI: https://doi.org/10.1016/j.ejvs.2015.05.011
Stuck AK, Kunz S, Baumgartner I, Kucher N. Patency and clinical outcomes of a dedicated, self-expanding, hybrid oblique stent used in the treatment of common iliac vein compression. J Endovasc Ther 2017;24:159-66.
DOI: https://doi.org/10.1177/1526602816676803
Raju S, Davis M. Anomalous features of iliac vein stenosis that affect diagnosis and treatment. J Vasc Surg Venous Lymphat Disord 2014;2:260-7.
DOI: https://doi.org/10.1016/j.jvsv.2013.12.004
Neglén P, Tackett TP Jr, Raju S. Venous stenting across the inguinal ligament. J Vasc Surg 2008;48:1255-61.
DOI: https://doi.org/10.1016/j.jvs.2008.06.035
Hartung O, Grisoli D, Boufi M, et al. Endovascular stenting in the treatment of pelvic vein congestion caused by nutcracker syndrome: lessons learned from the first five cases. J Vasc Surg 2005;42:275-80.
DOI: https://doi.org/10.1016/j.jvs.2005.03.052
Zamboni P, Giaquinta A, Rimondi E, et al. A novel endovenous scaffold for the treatment of chronic venous obstruction in a porcine model: histological and ultrastructural assessment. Phlebology 2019;34:336-46.
DOI: https://doi.org/10.1177/0268355518805686
Jayaraj ACW, Murphy EH, Raju S. Occlusion following iliocaval stenting characteristics and outcomes. J Vasc Surg 2016;63:53S-54S.
DOI: https://doi.org/10.1016/j.jvs.2016.03.028
Grøtta O, Enden T, Sandbæk G, et al. Infrainguinal inflow assessment and endovenous stent placement in iliofemoral post-thrombotic obstructions. CVIR Endovasc 2018;1:29.
DOI: https://doi.org/10.1186/s42155-018-0038-9
Zamboni P, Galeotti R, Menegatti E, et al. Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis. J Neurol Neurosurg Psychiatry 2009;80:392-99.
DOI: https://doi.org/10.1136/jnnp.2008.157164
Sisini F, Tessari M, Gadda G, et al. An ultrasonographic technique to assess the jugular venous pulse: a proof of concept. Ultrasound Med Biol 2015;41:1334-41.
DOI: https://doi.org/10.1016/j.ultrasmedbio.2014.12.666
Zamboni P, Malagoni AM, Menegatti E, et al. Central venous pressure estimation from ultrasound assessment of the jugular venous pulse. PLoS One 2020;15:e0240057.
DOI: https://doi.org/10.1371/journal.pone.0240057
Seager MJ, Busuttil A, Dharmarajah B, Davies AH. A systematic review of endovenous stenting in chronic venous disease secondary to iliac vein obstruction. Eur J Vasc Endovasc Surg 2016;51:100-20.
DOI: https://doi.org/10.1016/j.ejvs.2015.09.002
Jayaraj A, Raju S. The venous stent: is it primetime yet? Curr Manage Venous Dis 2017;489-96.
DOI: https://doi.org/10.1007/978-3-319-65226-9_37
Zamboni P, Scerrati A, Menegatti E, et al. The eagle jugular syndrome. BMC Neurol 2019;19:333.
DOI: https://doi.org/10.1186/s12883-019-1572-3
De Bonis P, Menegatti E, Cavallo MA, et al. JEDI (jugular entrapment, dilated ventricles, intracranial hypertension) syndrome: a new clinical entity? A case report. Acta Neurochir (Wien) 2019;161:1367-70.
DOI: https://doi.org/10.1007/s00701-019-03908-2
Giaquinta A, Beggs CB, Veroux M, et al. Factors influencing the hemodynamic response to balloon angioplasty in the treatment of outflow anomalies of internal jugular veins. J Vasc Surg Venous Lymphat Disord 2017;5:777-88.
DOI: https://doi.org/10.1016/j.jvsv.2017.06.015
Zamboni P, Galeotti R, Salvi F, et al. Effects of venous angioplasty on cerebral lesions in multiple sclerosis: expanded analysis of the brave dreams double-blind, sham-controlled randomized trial. J Endovasc Ther 2020;27:1526602819890110.
DOI: https://doi.org/10.1177/1526602819890110
How to Cite
Massi, I., & Zamboni, P. (2021). What are the ideal characteristics of a venous stent?. Veins and Lymphatics, 10(1). https://doi.org/10.4081/vl.2021.9739
Copyright (c) 2021 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
