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Ann Vasc Surg ; 49: 64-74, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29486230

RESUMEN

BACKGROUND: Limited guidelines for the treatment and management of acute and chronic iliocaval thrombosis are published in the literature. The purpose of this report is to present global iliocaval stent reconstruction practices by interventionalists. METHODS: A 45-question survey focusing on iliocaval stent reconstruction evaluation was distributed through the Open Forum and Venous Disease Service Line of the Society of Interventional Radiology Connect website from June 20, 2017 until September 7, 2017 and the Cardiovascular and Interventional Radiological Society of Europe electronic newsletter on August 11, 2017. RESULTS: One hundred seven complete responses were received from interventional radiologists in the United States, 2 from South America, and 2 from Central America. 92.5% performed iliocaval reconstruction, and 79.8% performed the procedure for both acute and chronic iliocaval thrombosis. 82.8% completed a standardized physician assessment tool, and 91.9% obtained computed tomography (CT) venography before the procedure. 64.6% used intravascular ultrasound to guide reconstruction. 41.4% found blunt recanalization successful for >75% of patients. 63.6% used sharp recanalization for <25% of patients. 97.0% and 90.9% used uncovered and self-expanding stents, respectively. Wallstents were used most commonly. Most common stent diameters were 24-mm in the inferior vena cava, 14-mm in the common iliac vein, and 12-mm in the external iliac vein. 48.5% and 21.2% prescribed 2 and 3 anticoagulants after stent placement, respectively. 62.6% found iliocaval reconstruction provided symptomatic clinical improvement for iliocaval thrombosis in >75% of patients. 72.7% estimated their 1-year primary stent patency to be >75%. CONCLUSIONS: Iliocaval reconstruction is performed by many interventionalists; however, there are global inconsistencies in practices, suggesting a need for further research and guideline development.


Asunto(s)
Procedimientos Endovasculares/tendencias , Vena Ilíaca , Pautas de la Práctica en Medicina/tendencias , Stents/tendencias , Vena Cava Inferior , Trombosis de la Vena/terapia , Anticoagulantes/uso terapéutico , América Central , Angiografía por Tomografía Computarizada/tendencias , Procedimientos Endovasculares/efectos adversos , Procedimientos Endovasculares/instrumentación , Encuestas de Atención de la Salud , Disparidades en Atención de Salud/tendencias , Humanos , Vena Ilíaca/diagnóstico por imagen , Vena Ilíaca/fisiopatología , Flebografía/tendencias , Punciones/tendencias , América del Sur , Factores de Tiempo , Resultado del Tratamiento , Ultrasonografía Intervencional/tendencias , Estados Unidos , Grado de Desobstrucción Vascular , Filtros de Vena Cava/tendencias , Vena Cava Inferior/diagnóstico por imagen , Vena Cava Inferior/fisiopatología , Trombosis de la Vena/diagnóstico por imagen , Trombosis de la Vena/fisiopatología
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