Factors associated with patency loss after iliocaval and iliofemoral venous stenting.
Can Chen, Yutong Shi, Mingzhe Cui et al.
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In 30 seconds
This systematic review and meta-analysis examined factors associated with patency loss after iliocaval and iliofemoral venous stenting. It included 49 studies, predominantly retrospective cohorts, and pooled adjusted estimates when comparable data were available. Post-thrombotic disease, stent extension across or below the inguinal ligament, and hyperlipidemia were associated with increased patency loss; increasing age had a modest inverse association. Greater anatomical disease extent was also linked to poorer patency in narrative analyses, while findings on impaired venous inflow were heterogeneous. The retrospective evidence does not establish causality.
Key findings
- Post-thrombotic disease, stent extension across or below the inguinal ligament, and hyperlipidemia were associated with increased risk of patency loss.
- Increasing age showed a modest inverse association with patency loss.
- Greater anatomical disease extent was associated with poorer patency; evidence on impaired venous inflow was heterogeneous.
- Pooled analyses found no statistically significant association for sex, stent length, or number of stents; evidence on antithrombotic strategies was insufficient and inconsistent.
Why it matters
Patency loss may reflect both the underlying disease phenotype and the anatomical burden and landing strategy of the stent. These findings help frame risk assessment after venous stenting, while the variable evidence—particularly for inflow and antithrombotic management—underscores the need for standardized definitions and better-adjusted prospective studies.
What to keep in mind
The evidence was predominantly retrospective, precluding causal inference. Findings on venous inflow were heterogeneous, and evidence regarding anticoagulation discontinuation and adjunctive antiplatelet therapy was insufficient and inconsistent.