CiDA Presentation: Stenting of Central Vein Stenosis is so B

daniel · Post by **daniel** » Fri Sep 17, 2010 12:51 pm

"CiDA Presentation: Stenting of Central Vein Stenosis is so Bad it Should Rarely be Done"

I'm attaching the PDF from http://www.endovascular.org/conference/main.cfm

Here's a link to the full pdf (link)

It's pretty short but states:

Vascular patency after stent depends on location
Typical 12-month patency
• Coronary artery 75%
• LE artery 68%
• VA of grafts 36%
• Central veins 14-25%

So it looks like other veins have trouble staying patent.. lets hope our jugulars have a better chance

- dan

frodo · Post by **frodo** » Fri Sep 17, 2010 2:21 pm

I don't understand. If they claim that to have a stenosis in the CNS veins does not matter and is irrelevant, how can they claim that to poke around those same veins is "extremely dangerous"?

daniel · Post by **daniel** » Fri Sep 17, 2010 2:42 pm

I don't think they said anywhere that it doesn't matter and is irrelevant...?

marcstck · Post by **marcstck** » Fri Sep 17, 2010 4:15 pm

Here's a paper that comprehensively goes over the use of stents in the veins of hemodialysis patients. Most have a patency rate of under 50% after 12 months.

Of course, the stresses put on the stents during dialysis differ greatly from the stresses placed on them when used to treat CCSVI. Still, one must always keep in mind that the stents in current use were not designed to withstand the twisting, bending, and torque that they experience when placed in the jugular veins above the clavicle.

http://cjasn.asnjournals.org/cgi/content/full/4/5/996

I posted this info before, but nobody seemed very interested…

Cece · Post by **Cece** » Fri Sep 17, 2010 4:47 pm

Conclusions
• Central vein stenosis has a poor primary
patency after stent placement.
• Time to recurrent stenosis is similar after
stent or PTA alone.
• Stents are very expensive and don’t prolong
primary patency after PTA of CV stenosis.
• Thus, stents should only be used in CV
stenosis if there is immediate elastic recoil.

The author of the article does still advise stent use if there is immediate elastic recoil. Isn't this how they're being used in CCSVI? If angio alone opens up the vein, the docs don't then add a stent anyways.

jamit · Post by **jamit** » Fri Sep 17, 2010 4:56 pm

This paper shows good stent [patency for the illiac vein in May-thurner

http://www.ajronline.org/cgi/content/abstract/195/3/751