Management of pelvic venous stenosis with intravascular stainless steel stents

J. W. Carlson, G. K. Nazarian, E. Hartenbach, J. R. Carter, K. E. Dusenbery, J. M. Fowler, D. W. Hunter, L. L. Adcock, L. B. Twiggs, L. F. Carson

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Patients with gynecologic malignancies may develop stenosis of the large pelvic veins as a result of their disease or its treatment. The percutaneous insertion of a stainless steel vascular stent is a novel approach to the management of an extrinsically compressed vein. The objective of this study was to review the results of treating lower extremity edema secondary to a pelvic venous stenosis through the percutaneous insertion of a stainless steel vascular stent. A retrospective review was performed on gynecologic oncology patients who presented with an edematous lower extremity and underwent an evaluation to diagnose proximal venous stenosis. The evaluation included sonography, venography, and balloon angioplasty prior to the percutaneous insertion of a stainless steel vascular stent. If a venous thrombosis was documented, thrombolysis with urokinase was performed prior to evaluation for venous stenosis. Records were reviewed for the etiology of the venous stenosis, the location and type of stent inserted, and the ability of the stent to maintain patency and provide symptomatic relief. Patency was evaluated at 1-week and then at 1-, 3-, and 6-month intervals. The probability of vascular stent patency was calculated using life table analysis. Ten patients with cervical (n = 4), corpus (n = 3), ovarian (n = 1), vulvar (n = 1), and vaginal (n = 1) cancer had one or more vascular stents inserted for the treatment of a stenosed pelvic vein. The etiologies of venous stenosis were radiation fibrosis and surgery (n = 5), postoperative fibrosis (n = 3), and metastatic tumor (n = 2). The stented vessels were the left common (n = 5) or left external (n = 4) iliac veins, the right common (n = 1) or right external (n = 3) iliac veins, and the right common femoral vein (n = 1). The median follow-up was 21 months. All patients had subjective resolution of their edematous extremity while the stents were patent. The interval probability of patency of stented veins was greater than 85% at each evaluation interval. Patency was 100% for patients beyond 6 months of follow- up. There were no major complications. The percutaneous intravascular insertion of a stainless steel stent was safe and subjectively effective in the management of venous stenosis associated with a gynecologic cancer. A prospective trial with objective endpoints may be warranted.

Original languageEnglish
Pages (from-to)362-369
Number of pages8
JournalGynecologic Oncology
Volume56
Issue number3
DOIs
StatePublished - Apr 13 1995
Externally publishedYes

Fingerprint

Stainless Steel
Stents
Pathologic Constriction
Blood Vessels
Veins
Iliac Vein
Lower Extremity
Neoplasms
Vascular Patency
Radiation Pneumonitis
Life Tables
Balloon Angioplasty
Femoral Vein
Phlebography
Urokinase-Type Plasminogen Activator
Venous Thrombosis
Ultrasonography
Edema
Fibrosis
Extremities

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Carlson, J. W., Nazarian, G. K., Hartenbach, E., Carter, J. R., Dusenbery, K. E., Fowler, J. M., ... Carson, L. F. (1995). Management of pelvic venous stenosis with intravascular stainless steel stents. Gynecologic Oncology, 56(3), 362-369. https://doi.org/10.1006/gyno.1995.1064

Management of pelvic venous stenosis with intravascular stainless steel stents. / Carlson, J. W.; Nazarian, G. K.; Hartenbach, E.; Carter, J. R.; Dusenbery, K. E.; Fowler, J. M.; Hunter, D. W.; Adcock, L. L.; Twiggs, L. B.; Carson, L. F.

In: Gynecologic Oncology, Vol. 56, No. 3, 13.04.1995, p. 362-369.

Research output: Contribution to journalArticle

Carlson, JW, Nazarian, GK, Hartenbach, E, Carter, JR, Dusenbery, KE, Fowler, JM, Hunter, DW, Adcock, LL, Twiggs, LB & Carson, LF 1995, 'Management of pelvic venous stenosis with intravascular stainless steel stents', Gynecologic Oncology, vol. 56, no. 3, pp. 362-369. https://doi.org/10.1006/gyno.1995.1064
Carlson JW, Nazarian GK, Hartenbach E, Carter JR, Dusenbery KE, Fowler JM et al. Management of pelvic venous stenosis with intravascular stainless steel stents. Gynecologic Oncology. 1995 Apr 13;56(3):362-369. https://doi.org/10.1006/gyno.1995.1064
Carlson, J. W. ; Nazarian, G. K. ; Hartenbach, E. ; Carter, J. R. ; Dusenbery, K. E. ; Fowler, J. M. ; Hunter, D. W. ; Adcock, L. L. ; Twiggs, L. B. ; Carson, L. F. / Management of pelvic venous stenosis with intravascular stainless steel stents. In: Gynecologic Oncology. 1995 ; Vol. 56, No. 3. pp. 362-369.
@article{d72e9abeeb8a40fa8dcf9775647f508d,
title = "Management of pelvic venous stenosis with intravascular stainless steel stents",
abstract = "Patients with gynecologic malignancies may develop stenosis of the large pelvic veins as a result of their disease or its treatment. The percutaneous insertion of a stainless steel vascular stent is a novel approach to the management of an extrinsically compressed vein. The objective of this study was to review the results of treating lower extremity edema secondary to a pelvic venous stenosis through the percutaneous insertion of a stainless steel vascular stent. A retrospective review was performed on gynecologic oncology patients who presented with an edematous lower extremity and underwent an evaluation to diagnose proximal venous stenosis. The evaluation included sonography, venography, and balloon angioplasty prior to the percutaneous insertion of a stainless steel vascular stent. If a venous thrombosis was documented, thrombolysis with urokinase was performed prior to evaluation for venous stenosis. Records were reviewed for the etiology of the venous stenosis, the location and type of stent inserted, and the ability of the stent to maintain patency and provide symptomatic relief. Patency was evaluated at 1-week and then at 1-, 3-, and 6-month intervals. The probability of vascular stent patency was calculated using life table analysis. Ten patients with cervical (n = 4), corpus (n = 3), ovarian (n = 1), vulvar (n = 1), and vaginal (n = 1) cancer had one or more vascular stents inserted for the treatment of a stenosed pelvic vein. The etiologies of venous stenosis were radiation fibrosis and surgery (n = 5), postoperative fibrosis (n = 3), and metastatic tumor (n = 2). The stented vessels were the left common (n = 5) or left external (n = 4) iliac veins, the right common (n = 1) or right external (n = 3) iliac veins, and the right common femoral vein (n = 1). The median follow-up was 21 months. All patients had subjective resolution of their edematous extremity while the stents were patent. The interval probability of patency of stented veins was greater than 85{\%} at each evaluation interval. Patency was 100{\%} for patients beyond 6 months of follow- up. There were no major complications. The percutaneous intravascular insertion of a stainless steel stent was safe and subjectively effective in the management of venous stenosis associated with a gynecologic cancer. A prospective trial with objective endpoints may be warranted.",
author = "Carlson, {J. W.} and Nazarian, {G. K.} and E. Hartenbach and Carter, {J. R.} and Dusenbery, {K. E.} and Fowler, {J. M.} and Hunter, {D. W.} and Adcock, {L. L.} and Twiggs, {L. B.} and Carson, {L. F.}",
year = "1995",
month = "4",
day = "13",
doi = "10.1006/gyno.1995.1064",
language = "English",
volume = "56",
pages = "362--369",
journal = "Gynecologic Oncology",
issn = "0090-8258",
publisher = "Academic Press Inc.",
number = "3",

}

TY - JOUR

T1 - Management of pelvic venous stenosis with intravascular stainless steel stents

AU - Carlson, J. W.

AU - Nazarian, G. K.

AU - Hartenbach, E.

AU - Carter, J. R.

AU - Dusenbery, K. E.

AU - Fowler, J. M.

AU - Hunter, D. W.

AU - Adcock, L. L.

AU - Twiggs, L. B.

AU - Carson, L. F.

PY - 1995/4/13

Y1 - 1995/4/13

N2 - Patients with gynecologic malignancies may develop stenosis of the large pelvic veins as a result of their disease or its treatment. The percutaneous insertion of a stainless steel vascular stent is a novel approach to the management of an extrinsically compressed vein. The objective of this study was to review the results of treating lower extremity edema secondary to a pelvic venous stenosis through the percutaneous insertion of a stainless steel vascular stent. A retrospective review was performed on gynecologic oncology patients who presented with an edematous lower extremity and underwent an evaluation to diagnose proximal venous stenosis. The evaluation included sonography, venography, and balloon angioplasty prior to the percutaneous insertion of a stainless steel vascular stent. If a venous thrombosis was documented, thrombolysis with urokinase was performed prior to evaluation for venous stenosis. Records were reviewed for the etiology of the venous stenosis, the location and type of stent inserted, and the ability of the stent to maintain patency and provide symptomatic relief. Patency was evaluated at 1-week and then at 1-, 3-, and 6-month intervals. The probability of vascular stent patency was calculated using life table analysis. Ten patients with cervical (n = 4), corpus (n = 3), ovarian (n = 1), vulvar (n = 1), and vaginal (n = 1) cancer had one or more vascular stents inserted for the treatment of a stenosed pelvic vein. The etiologies of venous stenosis were radiation fibrosis and surgery (n = 5), postoperative fibrosis (n = 3), and metastatic tumor (n = 2). The stented vessels were the left common (n = 5) or left external (n = 4) iliac veins, the right common (n = 1) or right external (n = 3) iliac veins, and the right common femoral vein (n = 1). The median follow-up was 21 months. All patients had subjective resolution of their edematous extremity while the stents were patent. The interval probability of patency of stented veins was greater than 85% at each evaluation interval. Patency was 100% for patients beyond 6 months of follow- up. There were no major complications. The percutaneous intravascular insertion of a stainless steel stent was safe and subjectively effective in the management of venous stenosis associated with a gynecologic cancer. A prospective trial with objective endpoints may be warranted.

AB - Patients with gynecologic malignancies may develop stenosis of the large pelvic veins as a result of their disease or its treatment. The percutaneous insertion of a stainless steel vascular stent is a novel approach to the management of an extrinsically compressed vein. The objective of this study was to review the results of treating lower extremity edema secondary to a pelvic venous stenosis through the percutaneous insertion of a stainless steel vascular stent. A retrospective review was performed on gynecologic oncology patients who presented with an edematous lower extremity and underwent an evaluation to diagnose proximal venous stenosis. The evaluation included sonography, venography, and balloon angioplasty prior to the percutaneous insertion of a stainless steel vascular stent. If a venous thrombosis was documented, thrombolysis with urokinase was performed prior to evaluation for venous stenosis. Records were reviewed for the etiology of the venous stenosis, the location and type of stent inserted, and the ability of the stent to maintain patency and provide symptomatic relief. Patency was evaluated at 1-week and then at 1-, 3-, and 6-month intervals. The probability of vascular stent patency was calculated using life table analysis. Ten patients with cervical (n = 4), corpus (n = 3), ovarian (n = 1), vulvar (n = 1), and vaginal (n = 1) cancer had one or more vascular stents inserted for the treatment of a stenosed pelvic vein. The etiologies of venous stenosis were radiation fibrosis and surgery (n = 5), postoperative fibrosis (n = 3), and metastatic tumor (n = 2). The stented vessels were the left common (n = 5) or left external (n = 4) iliac veins, the right common (n = 1) or right external (n = 3) iliac veins, and the right common femoral vein (n = 1). The median follow-up was 21 months. All patients had subjective resolution of their edematous extremity while the stents were patent. The interval probability of patency of stented veins was greater than 85% at each evaluation interval. Patency was 100% for patients beyond 6 months of follow- up. There were no major complications. The percutaneous intravascular insertion of a stainless steel stent was safe and subjectively effective in the management of venous stenosis associated with a gynecologic cancer. A prospective trial with objective endpoints may be warranted.

UR - http://www.scopus.com/inward/record.url?scp=0028908101&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028908101&partnerID=8YFLogxK

U2 - 10.1006/gyno.1995.1064

DO - 10.1006/gyno.1995.1064

M3 - Article

VL - 56

SP - 362

EP - 369

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

IS - 3

ER -