Stenting to treat obstructions in patients with chronic venous insufficiency (CVI) dramatically reduces the symptoms of deep reflux disease, even though the reflux itself remains untreated, according to research published December 14, 2009, ahead of print in the Journal of Vascular Surgery.
New Treatment Paradigm
“Our treatment paradigm has changed,” said Dr. Raju. "Putting in a stent is simpler and easier than open surgery. So, it’s what we do. Reflux open surgery has pretty much gone out as a treatment option in our center because the results of stenting are so good."
William A. Gray, MD, of Columbia University Medical Center (New York, NY) told TCTMD in an e-mail communication that this study is important because previously, "it was not clear that there was this degree of iliac vein disease contributing to deep venous reflux, and that it could be addressed so effectively with endovascular therapy." He agreed that stenting should become the primary treatment for deep reflux disease, "assuming that these results can be replicated in a broader experience (i.e., in multiple centers with multiple operators). For patients with deep venous reflux identified in the lower extremities, a determination of iliac venous issues should be undertaken, since there appears to be a probable effective treatment."