Vidéos commentées
Video : State-of-the-Art Endovascular Management of Venous Diseases
Video : State-of-the-Art Endovascular Management of Venous Diseases
Comments : Video : State-of-the-Art Endovascular Management of Venous Diseases
Video : Interventional treatment of venous thrombosis
Video : Interventional treatment of venous thrombosis
Comments : Video : Interventional treatment of venous thrombosis
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Sharif Khashaba K. kindly improve the voice
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Vanessa R. How do you treat venous non thrombotic in stent restenosis
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Gustavo R. In chronic oclusion how often did you see instent stenosis in Iliocaval Wallstent
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Olivier H. in our experience on 162 patients with a median follow-up of 44 months, primary patency is 70% at 60 months and assisted primary patency 85%
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Peter N. Using the Wallstent, the cumulative in-stent stenosis rate at 6 years is in non-thrombotic obstructions (NIVL) 1% and in postthrombotic obstructions approximately 10%. In-stent stenosis is then defined as being >50% lumen reduction. It is common to see some in-stent layering of
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Jacobo N. What do you think is the best aproach to the lesion, popliteal or contralateral? Thanks
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Olivier H. for chronic lesion, i prefer anterograde approach through the femoral or popliteal. Some teams favor internal jugular approach (must always be ready in case of IVC lesions)
for acute lesions, it depends on the patency of the popliteal vein. If occluded, jugular or controlateral acess
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Maria Fabrizia G. do you use the same strategy in presence of PE?
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Olivier H. PE does not change the strategy but can make discuss the use of an IVC filter
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bander A. what is he indications in case of non thrombotic iliac vein lesion ?
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Olivier H. symptomatic and disabled patients C2-6, pelvic congestion syndrome
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Peter N. I agree with Olivier, but wants to qualify it slightly. As we pointed out in the discussion, compression of the iliac veins are common in the asymptomatic population and possibly up to 30% have >50% stenosis with no symptoms! So there is a potential risk of overtreatment. In chronic venous disease of the lower limb, treatment of the outflow obstruction is indicated in patients with the C-class in CEAP being marked swelling (C3) and those with skin changes/ulcers (C4-C6). In addition, you have those patients with venous pain without skin changes or varicose veins, which can not be solely explained by the presence of reflux, if any. We use visual analogue scale (VAS) to evaluate that, considering VAS >5 being significant. As Olivier pointed out the symptoms have to affect the patients' quality of life.
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Sandeep S. When using three stents, why is the middle stent placed last in iliofemoral venous intervention?
Is there any algorithim to decide on when and not to stent across deep femoral vein?
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Video : Deep venous thrombosis (DVT)
http://www.incathlab.com/en/videos/2-peripheral/49-venous/1491-deep-venous-thrombosis-dvt
Video : Deep venous thrombosis (DVT)
Comments : Video : Deep venous thrombosis (DVT)
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ibrahim A. thanks for this nice symposium
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marie C. thank you for this nice and difficult case
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Ali F. Hello everyone
If we have a patient with congestive pelvic syndrome (Symptomatic,lower abdominal heaviness at afternoon, dysparonia,...)
MRV shows nutcracker radiologic finding (asymptomatic, no flank pain no hematuria)
And shows also significant reflux in the left ovarian vein with hudge intrapelvic varicosiries
How do you manage this patient
Do u treat nutcracker or not,first?
Do u treat left ovarian vein only?
Mehmet M. I eill prefer to treat only left ovarian vein by coil embolization.
Nutcracker treatment is more complicated and usually not necessary
Houman J. I agree fully with Mehmet
Guillermo M. Totally agree with Mehmet
Guillermo M. Patient with symptomatic Nutcracker. Severe stenosis of left renal vein. Reflux on left gonadal vein wich is enlarged (9 mm). After embolization of LGV the patient suffers a worsening of her symptoms. What would you make, open surgery or stenting
maria R. Hola, los síntomas empeoran en muchos casos tras la embolizacion por la trombosis del plexo, mejoran en semanas con antiinflamatorios
Mangesh T. Dear Dr.Houmann Sir, Again great presentation on Embolisation in PCS And Deep Venous Stenting; But do you follow the newer “SVP Classification” for Pelvic Venous disorders and plan your Endovascular IR treatment accordingly??
Which will you address first “Venous Reflux or Obstruction” to normalise increased Pelvic Venous Pressure and how much is your overall Technical Success rates??
Houman J. Dear Mangesh,
I would normally go first for the obstruction and then treat the reflux.
Best
Houman