Venous stenting for iliac vein outflow obstruction is associated with excellent long-term stent patency and symptom resolution. However, the safety of iliac vein stenting performed in an office-based laboratory (OBL) setting is not well-defined. The purpose of this investigation was to determine the safety profile of iliac vein stenting in an OBL setting.
Data was prospectively collected in the Center for Vascular Medicine (CVM) electronic medical record system (NextGen Healthcare Information System, Irvine, CA) and retrospectively analyzed. Standardized patient safety and sedation protocols were utilized as per the accreditation standards of the Joint Commission for Accreditation of Hospital Organizations (JCAHO) for Office Based Surgery Centers. Patient consultations, interventions, and follow-ups at 1-6 weeks were included in this analysis. All patients received moderate sedation during their procedures. Complications requiring hospitalization were classified as major complications. Minor complications consisted of bleeding, hematoma, vasovagal response, in-stent thrombosis resulting in complete occlusion of the iliac vein stent, allergic reaction, hematemesis, hypotension, pelvic discomfort and pseudoaneurysm.
Between January 2015 and January 2019, 1,223 iliac vein stents were placed in 1,104 patients (23.7% male, 76.3% female). A total of 90 minor complications (7.36%) and 5 major complications (0.41%) were observed. Major complications included the following: one allergic reaction, one episode of atrial fibrillation, one episode of supraventricular tachycardia, one episode of chest pain and one acute stent occlusion. Minor complications were primarily related to insertion site hematomas. No complications were related to sedation or acute renal failure. There were no mortalities.
Major complications were rare after iliac vein stenting in an OBL setting. Minor complications were primarily related to insertion site hematomas which did not require inpatient hospitalization. Based on our analysis, iliac vein stenting in an OBL setting is a safe and well-tolerated procedure.