Mustafa Biomy and Eslam M. Ibrahim
Tamer Alsaied Alnaimy , Tamer Rushdy Elalfy and Mohammed A.Elkilany
Ahmed Mahmoud Hussein1 M.D.; Ahmed Abd Alaziz Mohammad1 M.D.; Ahmed Mohammed Ahmed Nasser2 M.Sc.
Sherif Essam Eldin Tawfik, MD; Abdelrahman Mohamed Salem, MD
Abdelrahman Mohammed, MD, Ahmed Kamal Gabr, MD, Sherif Essam Eldin Tawfik, MD
Ashraf Elsebaie MD, Ahmed Abdelsalam Hafiz MD, Ahmed Maher MD, Rasha Abdelkader MD
Ahmed M.S.M Marzouk, Haitham S. Omar
Hany F. Habashy
Maged Rihan, MD, MRCS
Karim Sabry (MD, MRCS) , Wael A Jumuah (MD) ,Yasser El Ghamrini (MD)
Ahmed Shoka, MD, MRCS, Fady Makram, MD, FACS, Mohamed Matar, MD, FACS.
Mohammed Matar,1 MD, FACS, Ahmed Shoka,1 MD, MRCS, Heba Nader,2 MD
Mokhtar Abd Elrahman Bahbah, MD; Ehab M Oraby, MD.
Youssif Khachaba, Waleed Reda, Ahmed Abd El Salam, Ahmed Samy Saad Hussein, Nadeen Mohamed El Essawy, Ashraf El Sebaie
Naguib Abdelkreem ElAskary MD, Ahmed Osmane MD
Mahmoud Hamda MS, Naguib Abdelkreem ElAskary MD, Ahmed Osmane MD
Ahmed M.S.M. Marzouk
1Waleed AlBadry, MSc, MRCS;1Raafat Gohar, MD; 1Ashraf El-Sebaie; 2Mohamed Salah, MD;1Mohamed Ashraf El Meleigy, MD
Iliofemoral Venous Stenting for Patients with Chronic Post-thrombotic Venous Occlusive Disease
Introduction: Post-thrombotic syndrome resulting from iliofemoral venous occlusive disease constitutes a
magnificent burden to the patient, affecting his functionality. For decades the traditional treatment for
chronic iliofemoral venous occlusive disease has been mainly conservative lines of treatment.
Unfortunately this conservative treatment did not improve the functional outcome in the vast majority of
patients. In our study we aimed at studying the effect of interventional lines of treatment in the form of
endovascular iliofemoral venous stenting in patients with chronic post thrombotic syndrome with special
emphasis on clinical and functional outcomes after such relatively new line of treatment. Methods:
Between March 2013 and January 2015, we enrolled 23 patients with chronic post-thrombotic iliofemoral
venous occlusive disease in our prospective interventional clinical study. Our patients were treated by
endovascular balloon dilatation and stenting for the affected iliofemoral venous segment through femoral
or popliteal vein access. our primary end points were primary and assisted primary patency at 24 months
follow up, while secondary end points were clinical and functional outcomes as measured by the Villalta
scale and venous disability score (VDS). Results: Data was obtained for 23 patients. All of them presented
with unilateral lower limb Post-thrombotic manifestations. The mean duration of post thrombotic symptoms
was 17.5 months. The baseline CEAP classification of the 23 patients was, C4 (21.7%), C5 (43.5%), and
C6 (34.8%). Immediate technical success was achieved in 19(82.6%) patients. Stenting was attempted in all
19 patients. Analysis of the clinical outcome at 24 months according to the Villalta scale showed a mean
Villalta score difference of 15.04, t =7.87, p<0.00001 (highly significant). Analysis of the functional
outcome at 24 months according to the venous disability score (VDS) using the Wilcoxon signed rank test
showed a mean score difference of 0.84, z= 3.823, p= 0.00014 (highly significant). Primary, and assisted
primary patency rates were calculated using survival analysis with the Kaplan-Meier method. Our primary
patency rate was 89.4% at 24 months, while our assisted primary patency rate was 100% at 24 months.
Conclusion: This study successfully demonstrates a durable 2-years primary, and assisted primary
patencies as well as sustained symptomatic relief and significant improvement in functional outcome with
the majority of patients able to resume their activities of daily living. Therefore, aggressive endovascular
therapy provides durable patency as well as significant clinical and functional improvement in patients
with chronic post-thrombotic iliofemoral venous occlusive disease.
Keywords: iliofemoral; post thrombotic; venous stenting.