Presenter: Professor S Black

Hospital: Department of Vascular Surgery, St Thomas' Hospital, London

Abstract

Analysis of 515 venous stent cases reveals 2-week ultrasound surveillance predicts long-term patency (＞50% stenosis: 5-year HR=4.66) and demonstrates Venovo stent's evidence-based value in iliofemoral obstruction. Proposes lifelong management strategies.

Introduction

"Venous patients live long—believing one procedure solves all is naïve." (S Black)

Key findings:

-50% stent failures occur within 6 weeks

-66.1% reinterventions are surveillance-driven (asymptomatic)

-Early intimal hyperplasia (ISR) detection is critical

Research Insights: Three Pillars of Long-term Management

1.Etiology-Dependent Patency

-5-year secondary patency (GSTT data):

NIVL: 100%

PTS: 84%

IFDVT: 85%

-PTS patients require intensified surveillance

2.2-Week Ultrasound as Early Warning

-ISR severity predicts long-term failure:

-Mandatory 2-week ultrasound is justified

3.Reintervention Redefined

66.1% of reinterventions detected via surveillance (asymptomatic)

Median intervention time: 8 days (IQR 4-28)

Active surveillance is not failure—but essential for lifelong care

Technology Synergy: Venovo Stent's Evidence

1.Open-Cell Design for Venous Dynamics

Addresses warnings:

Migration resistance: 3mm flared ends (counteracts small-stent migration risk)

Radial strength: Optimized for iliac curvature (critical at inguinal ligament)

2.Validated Long-term Performance

VERNACULAR trial (n=170):

Aligns with GSTT 5-year PTS patency (84%)

3.Anatomic Versatility

20mm diameter/160mm length → Covers complex anatomy

Directly supports "lifelong vessel maintenance" principle

Conclusion

1.Stratified Surveillance: Annual for NIVL, intensified for PTS (focus: 2-week/6-week)

2.Early Intervention: Evaluate ＞30% stenosis at 2-week scan (don’t wait for symptoms)

3.Device Selection: Choose migration-resistant venous stents (e.g., Venovo)

4.Lifelong Management: Embed reinterventions into care continuum