{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"Wysdom Radio™","title":"Venous Stents: How Much Inflow is Enough?","html":"","width":"100%","height":180,"duration":1220,"description":"This episode breaks down two recent retrospective studies in deep venous work: a stent that looks well deployed on the table can still thrombose within weeks, because the low-flow venous system punishes any stasis. Following, there is a great commentary by Dr. Rusty Hofmann from Stanford University.Clinical Question: Can venous stent outcomes, long treated as operator-dependent and hard to forecast, be predicted before intervention from anatomy and inflow quality alone?Anatomical Classification: A multicenter EJVES study of 1,033 patients proposed a five-type system graded by how far chronic venous obstruction extends, from a non-thrombotic iliac lesion (type 1) to obstruction of both main inflow veins (type 5). Twelve-month primary patency dropped step by step with extent: 94.9%, 90.3%, 80.8%, 60.6%, and 39.4% for types 1 through 5.Inflow Quality: A single-center JVIR study of 80 post-thrombotic limbs isolated inflow as the mechanism. One-year primary patency was 89.2% with no inflow disease, 57.7% with single-vessel disease, and 47.1% with double-vessel disease. Femoral vein inflow disease was the only independent predictor of failure, with an odds ratio of 10.99.Timing and Salvage: In the JVIR cohort every primary patency loss occurred within the first 30 weeks, yet secondary patency stayed high in both studies. Stenting complex disease is best framed to patients as a re-intervention pathway, not a single definitive fix.Limitations: Both studies are retrospective, without a core lab, and grade inflow visually rather than by any flow-volume metric, so the reported later patency numbers likely run optimistic. Tune in to learn how anatomical extent and inflow quality can turn one of the least predictable procedures in the venous space into a risk-stratified workflow with honest expectations set up front.This podcast is generated using an AI model that has been trained in the context of endovascular surgery and interventional radiology in addition context of the...","thumbnail_url":"https://img.transistorcdn.com/MTWsVlQNVWnqK7R-Z-jI7G_aa5KttFr_japy-P3mayc/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS81ODli/OTVlYjRiZjJlZGZi/ZDQxYmE2NDU2YmUx/Y2ZhMy5qcGc.webp","thumbnail_width":300,"thumbnail_height":300}