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In Patients with Chronic Venous Stenosis, Does Placement of a Stent Improve Patency Compared to Recurrent Angioplasty?

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Difficult Decisions in Vascular Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

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Abstract

The endovascular treatment of chronic venous stenosis or occlusion in both the upper and lower extremities are increasing in frequency. Chronic venous stenoses in the upper extremity are primarily related to dialysis access, indwelling catheters, and pacemakers. In the lower extremity, they are primarily related to chronic deep vein thrombosis, surgical complications, and iliac vein compression syndrome. Many resources are expended to maintain appropriate dialysis access in the end-stage renal failure population. Treating patients with post thrombotic syndrome secondary to venous stenoses in the femoroiliocaval segments can alleviate debilitating symptoms, improve quality of life, and help heal ulcerations. In treating the upper central veins in a patient with end-stage renal disease on dialysis it seems that stenting does not convey an advantage in patency or longevity of the dialysis access over multiple angioplasties. In treating the lower central veins angioplasty followed by primary stenting seems to be the overwhelming modality of choice, combining the benefits of a low complication rate and high long-term patency rates.

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Author information

Authors and Affiliations

  1. Horizon Vascular Specialists, Germantown, MD, USA

    Jeffrey Y. Wang MD

  2. The Cardiac and Vascular Institute, Gainesville, FL, USA

    Arthur C. Lee MD

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  1. Jeffrey Y. Wang MD
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  2. Arthur C. Lee MD
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Correspondence to Jeffrey Y. Wang MD .

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Editors and Affiliations

  1. The University of Chicago Medical Center and Biological Science Division, Chicago, Illinois, USA

    Christopher L. Skelly

  2. The University of Chicago Medical Center and Biological Science Division, Chicago, Illinois, USA

    Ross Milner

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Wang, J.Y., Lee, A.C. (2017). In Patients with Chronic Venous Stenosis, Does Placement of a Stent Improve Patency Compared to Recurrent Angioplasty?. In: Skelly, C., Milner, R. (eds) Difficult Decisions in Vascular Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-319-33293-2_36

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  • DOI: https://doi.org/10.1007/978-3-319-33293-2_36

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