Endovascular Venous Stenting for Chronic Iliofemoral Venous Obstruction in Post-Thrombotic Syndrome and Non-Thrombotic Iliac Vein Lesion: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Prospective Single-Arm Clinical Trials.

Authors

Aarushi Batra, Bhumesh Tyagi, Ashok Kumar, Archana Sood

Published in

Journal of vascular and interventional radiology : JVIR. Pages 109128. Oct 08, 2026. Epub Oct 08, 2026.

Abstract

To evaluate pooled patency, symptomatic, and safety outcomes following dedicated nitinol venous stent placement for symptomatic chronic iliofemoral venous obstruction (CIVO), and to compare outcomes between post-thrombotic syndrome (PTS) and non-thrombotic iliac vein lesion (NIVL) etiologies.
PubMed, Scopus, CENTRAL, and ClinicalTrials.gov were searched from inception to May 2026 for randomized controlled trials and prospective registered single-arm studies evaluating venous stents in symptomatic CIVO. Proportional meta-analysis was conducted using Stata(v19.5). Risk of bias was judged with RoB-2 and ROBINS-I. Certainty of evidence was evaluated with GRADE.
13 studies (21 arms; n=1450) were included. Pooled 12-month primary patency was 93% (95% CI 90-97; I²=83.17%), declining to 90% and 89% at 24 and 36-months, respectively. Primary patency at 12-months was significantly greater in NIVL (98%; 95% CI 96-99%; I²=59.05%) than PTS (84%; 95% CI 81-87%; I²=0.0%). A mean reduction of 4.76 points in Venous Clinical Severity Score (VCSS) (0-30 scale; higher score indicates greater severity) and 6.40 points in Villalta score (0-33 scale; ≥5 indicates PTS) was observed. Stent thrombosis occurred more frequently in PTS than NIVL. Exploratory analysis of three RCTs demonstrated reduction in VCSS for stent placement versus standard of care (2.24; 95% CI -3.34 to -1.14; I²=0%).
Prospective evidence suggests favorable patency and symptom improvement following venous stent placement for symptomatic CIVO, although substantial heterogeneity and low-to-very-low certainty of evidence warrant cautious interpretation. Outcomes differ significantly between PTS and NIVL, reflecting an association between etiology and long-term stent performance.

PMID:
42849871
Bibliographic data and abstract were imported from PubMed on 09 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.