Early outcomes using dedicated venous stents in the upper limb of patients with venous thoracic outlet syndrome: A singe centre experience

Saissan Rajendran*, Tommy Y. Cai, Jacky Loa, Prakash Saha, Steven Dubenec

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Introduction: Surgical management of Venous Thoracic Outlet Syndrome (vTOS) is based upon resection of the first rib. The optimal method to treat any residual venous scarring however remains unclear. The purpose of this study was to evaluate a single quaternary centre’s early and mid-term outcomes following endovascular reconstruction of the axillo-subclavian vein using dedicated venous stents in patients with VTOS. Methodology: A retrospective analysis of patients at Royal Prince Alfred Hospital, who underwent upper limb deep venous stenting as an adjunct in the treatment of vTOS was performed. All patients between 2012 and 2017 were included. Stent patency was assessed with duplex ultrasonography. All re-interventions and their indications were recorded. Results: A total of 24 limbs in 21 patients (13 female, median age 44 yrs) were treated with dedicated venous stents between 2012 and 2017. All patients had resection of their first rib using a transaxillary approach. Nine patients initially presented with an acute DVT and underwent thrombolysis. In three of these patients a venous stent was placed before rib resection following completion of lysis. In the remainder, the median time for stent placement following surgery was 64 days. Median follow-up from stent insertion was 50 months. Primary, primary-assisted and secondary patency at 24 months was 55%, 95% and 100% respectively with one patient lost during follow-up. There were no major complications. A total of 14 re-interventions were performed on these patients. Three patients reported residual symptoms following stenting including heaviness (n = 1), bluish discolouration (n = 1) and prominent veins on the chest (n = 1) with the remainder asymptomatic. Conclusion: In this single centre study, endovascular reconstruction using dedicated venous stents appears to be an effective and safe method to reconstruct a damaged subclavian vein following rib resection in patients with vTOS.

Original languageEnglish
Article number22
JournalCVIR Endovascular
Volume2
Issue number1
DOIs
Publication statusPublished - 1 Dec 2019

Fingerprint

Dive into the research topics of 'Early outcomes using dedicated venous stents in the upper limb of patients with venous thoracic outlet syndrome: A singe centre experience'. Together they form a unique fingerprint.

Cite this