State-of-the-Art Endovascular Management of Venous Diseases

v22e V. Interesting !

v22e V. visiteur2@altilab.com

Mangesh T. Highly impressed with Proper guidance, Good Selection of Hardware materials, devices used & IR Techniques applied for the Re-Vascularisation of Chronically Occluded (Thrombotic) Left ilio-femoral Venous tract. Cause offcourse May-Thurner’s Compression. Few Questions to Main operator Dr. Houman Jalaie Sir are as follows-

1) Why Atlas gold high pressure balloon used in Post Stenting Dilatation when more pressure is needed in Pre-dilatation and breaking of Chronic fibrotic synaechie in Venous lumen?

2) Mustang has 24 atm bursting pressure while Atlas Gold & Conquest PTA Ballons has 30-40 atm bursting pressure.

3) How Vessel preparation prior to Dedicated Venous Stenting matters more?

4) Can we use Popliteal Vein Access site instead of Mid thigh SFV Site? so that 10 Fr Introducer sheath can be easily fixed and Large bore Stent deployment possible with long working shaft.

5) How aggressively , How long Post Venous Stenting Anticoagulation Therapy followed? What about Surviellence & follow up check ups Schedule in this case?

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

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

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??