Document Detail


Stenting of stenotic or occluded iliofemoral veins, superior and inferior vena cavae in children with congenital heart disease: acute results and intermediate follow up.
MedLine Citation:
PMID:  19156885     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine the short and intermediate term outcome following systemic venous stent placement in children with congenital heart disease. BACKGROUND: Patients with congenital heart disease are at risk of stenosis or occlusion of systemic veins following indwelling lines or catheterizations. Stent dilation may ameliorate symptoms and open the vessel for use during future procedures. We report our acute and intermediate results. METHODS: All patients with systemic venous stent placement in the iliofemoral veins, inferior or superior vena cava at our institution between 1998 and 2006 were included. Initial and the follow-up catheterization data were reviewed retrospectively. RESULTS: 70 stents were placed in 33 patients (36 vessels). Median age was 2.6 years (0.2-14.2) and weight 11.5 kg (3.8-78.7). 17/36 vessels (47%) were occluded requiring recanalization. Following stent delivery, the mean minimum vessel diameter increased from 3.1 +/- 3.2 to 7.2 +/- 3.0 mm (P < 0.001). There were no major complications. Seventeen patients and vessels had a total of 62 follow-up catheterizations, with median length of follow-up 4.1 years (0.7-9.3). During intermediate follow up, 7/17 vessels (41%) required additional intervention. Six patients had additional balloon dilation of existing stents, and one additional stent was placed. Vessels were further dilated to 8.4 +/- 3.5 mm at the last catheterization. CONCLUSION: Systemic venous stents are safe and effective in recanalizing stenosed or occluded vessels. At follow-up, reocclusion can occur, however, previously placed stents can be safely recanalized if necessary. Future studies will determine if stenting is indicated in a broader population.
Authors:
Jeffrey R Frazer; Frank F Ing
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  73     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-01-28     Completed Date:  2009-03-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  181-8     Citation Subset:  IM    
Copyright Information:
(c) 2009 Wiley-Liss, Inc.
Affiliation:
Rady Children's Hospital, San Diego, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Balloon Dilatation / instrumentation*
Catheterization, Peripheral / adverse effects
Catheters, Indwelling / adverse effects
Child
Child, Preschool
Constriction, Pathologic
Female
Femoral Vein* / physiopathology,  radiography
Heart Catheterization / adverse effects
Heart Defects, Congenital / therapy*
Humans
Iliac Vein* / physiopathology,  radiography
Infant
Male
Peripheral Vascular Diseases / etiology,  radiography,  therapy*
Phlebography
Recurrence
Retrospective Studies
Stents*
Superior Vena Cava Syndrome / etiology,  therapy
Time Factors
Treatment Outcome
Vascular Patency
Vena Cava, Inferior* / physiopathology,  radiography
Vena Cava, Superior* / physiopathology,  radiography
Venous Insufficiency / etiology,  therapy
Venous Thrombosis / etiology,  therapy
Comments/Corrections
Comment In:
Catheter Cardiovasc Interv. 2009 Feb 1;73(2):189   [PMID:  19156886 ]

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