Treatment of nonthrombotic iliac vein lesions in octogenarians and nonagenarians in an office setting is safe and effective, researchers reported in Vascular.
“Contrary to previous beliefs that venoplasties are optimally performed in a hospital setting where ancillary staff are available should issues arise, our experience with office-based venoplasties has been otherwise,” Pavel Kibrik, DO, vascular surgery researcher from the Vascular Institute of New York, Brooklyn, and colleagues wrote. “Due to the perceived increased risk, some have questioned the safety and efficacy of iliac vein stenting in the elderly.”
Kibrik and colleagues assessed the safety and efficacy of evaluating nonthrombotic iliac vein lesions in an office-based setting in octogenarians and nonagenarians.
A total of 192 patients aged 80 years or older with venous insufficiency in 300 limbs were enrolled between January 2012 and December 2013 and evaluated for nonthrombotic iliac vein lesion.
Researchers diagnosed and treated patients using venography, IVUS and stent placement for significant lesions demonstrated by greater than 50% diameter or cross-sectional area reduction.
The study was comprised of two patient groups: octogenarians (n = 168; mean age, 84 years; female-to-male ratio, 1.75:1) and nonagenarians (n = 24; mean age, 93 years; female-to-male ratio, 3:1).
Among octogenarians, 86% had stents placed, vs. 90% for nonagenarians. In both groups, 11% of patients had two stents placed.
According to the researchers, 59% of octogenarians and 65% of nonagenarians reported improvement in pain, edema, and ulcers.
There were no surgical site infections, pseudo-aneurysms, arteriovenous fistulas, or femoral artery injuries in either group.
In addition, no one in either group required a transfusion within 3 days after the procedure, and there were no cases of 30-day mortality.
“In conclusion, we believe that the treatment of [nonthrombotic iliac vein lesions] in an office-based setting is safe and efficacious in both octogenarians and nonagenarians and is an attractive alternative to hospital-based intervention,” the researchers wrote. – by Dave Quaile
Disclosure: The authors report no relevant financial disclosures.