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Techniques and Outcomes of Recanalization and Reconstruction for Treatment of Symptomatic Venous Ligation

Year: 2026

Type: article

Abstract: BACKGROUND: To report techniques, adverse events, and outcomes of endovascular recanalization and stent reconstruction for symptomatic venous ligation. METHODS: In this single-center retrospective study, 9 patients (mean age, 52.9), underwent endovenous recanalization and stent reconstruction for symptomatic venous ligation between January 2014 and January 2024. Patients presented with clinical-etiology-anatomy-pathophysiology 3 (55.6%), 4 (11.1%), and 5 (33.3%) disease. Ligation sites commonly involved the external iliac (66.7%) or femoral veins (44.4%); 5 patients had multisegment ligation. Etiologies included surgical injury (44.4%), trauma (22.2%), chronic venous thrombosis (22.2%), and malignant resection (11.1%). Procedural techniques, recanalization methods, stent selection, adverse events, patency, and clinical outcomes were recorded. RESULTS: Primary single-session recanalization was achieved in 9 patients (100%). Ten procedures were performed, as 1 patient required reintervention for early thrombosis. Sharp extravascular techniques were required in 6 procedures (60%). Twenty-six stents were deployed (Wallstents, cTAG devices, SMART stents), with a mean of 2.9 ± 2.5 stents per patient and mean stent diameter of 15.5 ± 3.2 mm. One patient (11.1%) developed early stent occlusion and was unable to be recanalized. All other reconstructions remained patent (primary/secondary patency 88.9%). Mean imaging follow-up was 466.4 ± 500.3 days, and mean clinical follow-up was 1,086.2 ± 717.5 days. Adverse events included 1 major (10.0%; Society of Interventional Radiology (SIR) class D) and 1 minor (10.0%; SIR class A). Clinical improvement occurred in 8 patients (88.9%), including complete symptom resolution in 6 (66.7%). No mortality occurred. CONCLUSION: Endovenous recanalization and reconstruction is a safe and effective treatment for symptomatic venous ligation.

Source: Annals of Vascular Surgery

DOI: 10.1016/j.avsg.2026.01.029

Authors: Andrew Woerner, Mayura P. Umapathy, Jeffrey Forris Beecham Chick, David S. Shin, Mark H. Meissner, Mina S. Makary

Institutions: University of Washington, The Ohio State University Wexner Medical Center, The Ohio State University, University of Southern California

Language: English

Topic: Vascular anomalies and interventions

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,560