VS perspective on deep venous stents, by David Greenstein

David Greenstein

Northwick Park

Pros and cons of deep venous stenting

stents in veins need to be big and need to be long

bad place to end a venous stent is at the U bend (picture of cistern to explain)

slide highlighting radial force versus crush resistance

Veneti stent with strong radial force has been taken off the market due to migration to heart

veneti was closed cell - is off market

Open cell is more oblong and compression resistant - the open cell had more radial force

high variation in vein size with filling.

The degree of venous stenosis that is ‘significant’ on duplex is not clear. With IVUS the figure is deemed 50% - but IVUS is dependent on whether patient is supine or prone.

Ambulatory venous pressure predicts risk of venous ulceration

If 90 mmHg then 100% risk ulceration

If 31 - 40 mmHg then 14% risk