What Are Venous Stents?
Many people are familiar with coronary stents placed in the heart's arteries to improve blood flow. Venous stents function in the same way.
Venous stents are metal mesh tubes that expand against blocked or narrowed vein walls. They act as a scaffold to keep veins open. In most cases, surgeons place venous stents in larger, central veins, such as those found in the:
Conditions we treat with venous stents
At UPMC, we use venous stents to treat conditions such as:
- Chronic deep vein thrombosis (DVT) — DVT is a blood clot in one of the large, deep veins that returns blood from the leg — or less commonly, from the arm — to the heart and lungs.
- Hemodialysis/arteriovenous fistulae — People who receive hemodialysis and whose grafts or fistulas experience decreased blood flow can sometimes benefit from venous stents. Stenting also opens the central veins in the chest, which helps drain for dialysis access.
- May-Thurner syndrome — In this condition, the artery that runs from your abdomen to your right leg — called the right iliac artery — presses against the left iliac vein, causing it to narrow and scar. This may cause symptoms including chronic left leg swelling, pain, and sometimes fatigue.
- Nutcracker syndrome — In this condition, the arteries near your kidney compress your left renal (kidney) vein, making blood flow backward and causing symptoms like flank pain and blood in urine.
- Post-thrombotic syndrome — DVT can damage veins, which can lead to symptoms such as chronic swelling and pain. People may not have symptoms of post-thrombotic syndrome until years after DVT.
Why Would I Need Venous Stents?
You may need a venous stent if you have chronic blood clots or other conditions that compress or narrow the veins, limiting blood flow.
Who’s a candidate for venous stents?
You may be a candidate for venous stents if you have decreased blood flow symptoms.
What Are the Risks and Complications of Venous Stents?
Venous stenting is a minimally invasive procedure. However, like all medical procedures, there are some risks, including:
- Allergic reactions.
- Bleeding and blood clots.
- Infection.
- Stent failure or movement.
What Should I Expect From Venous Stenting?
Before: How to prepare for venous stenting
In addition to taking your medical history and performing a physical exam, your vascular surgeon may order imaging or other tests, including:
- Duplex ultrasound — Duplex ultrasound uses high-frequency sound waves to create images of your blood vessels and measures the direction and speed of blood flowing through your veins. Ultrasound gives your doctor a clear picture of the structure of your blood vessels and helps to pinpoint the exact location of any narrowing or blockage.
- Venogram — If an ultrasound is ineffective because of the vein's location, your vascular surgeon may suggest a venogram. This is an x-ray that allows your doctor to see the anatomy of your veins. After inserting a thin, flexible tube called a catheter into your vein — most often in the leg — your doctor injects a contrast dye into the catheter, which allows your veins to be seen on the x-ray. Your vascular surgeon can use the venogram to diagnose and treat your condition by performing venous angioplasty and stent placement simultaneously if necessary.
Your doctor will explain the venous stenting procedure and answer your questions. To prepare for venous stenting, you should:
- Tell your doctor if you are sensitive or allergic to any medications, iodine, latex, tape, or anesthetic agents (local and general).
- Tell your doctor about all medications (prescription and over-the-counter) and herbal or other supplements you are taking.
- Tell your doctor if you have heart valve disease. You may need to receive an antibiotic before the procedure.
- Tell your doctor if you have a history of bleeding disorders or if you are taking any blood-thinning medications, aspirin, or other medications that affect blood clotting. You may need to stop some of the medications before the procedure.
- Fast for a certain time before the procedure. Your doctor will tell you how long to fast (usually overnight).
- Have any tests that your doctor recommends. For example, your doctor may request a blood test before the procedure to determine how long it takes your blood to clot.
On the day of your procedure, be sure to bring your photo ID and health insurance card(s). Leave valuables such as cash and jewelry at home.
After your procedure, you can go home the same day. You should also arrange for someone to drive you home from the hospital after you are discharged.
How long does venous stenting take?
Venous stenting usually takes an hour or less, depending on your condition.
During your venous stenting procedure
Your UPMC vascular surgeon can place most venous stents on an outpatient basis under moderate sedation. You will feel relaxed and sleepy during your procedure, so you shouldn’t feel discomfort.
If a clot or other obstruction is blocking the vein, your surgeon may perform angioplasty before placing the stent. During venous angioplasty, your vascular surgeon will:
- Insert a needle into a vein in your groin or behind your knee, depending on which vein needs stenting.
- Insert a guide wire and pass a catheter sheath over it, followed by a guide catheter through the sheath.
- Use x-ray guidance (fluoroscopy) to steer the catheter to the site of the narrowing.
- Advance a balloon-tipped catheter to the site of the narrowing.
- Inflate and deflate the balloon several times to widen the narrow vein.
To place a venous stent, your surgeon will:
- Remove the angioplasty balloon and insert a catheter with a closed stent on it.
- Place the stent in the vein. The stent pushes against the walls of the vein, serving as a support to keep it open.
- Remove the catheters and apply pressure to the insertion point to close the wound.
Can you feel a venous stent?
You may feel discomfort after placing your venous stent, but it should go away quickly. If you feel any discomfort, be sure to let your doctor know.
Recovery after venous stenting
Usually, people go home the same day after their venous stenting procedure.
Most people can return to normal activities immediately after the procedure, but you should avoid strenuous activity for a few days. Your doctor will provide you with instructions for your recovery.
Most people must take a blood-thinning medication for a few months to prevent blood clots from developing.
When to call your doctor about venous stenting complications
You should call your doctor if you are experiencing any unusual symptoms, including:
- A fever of more than 100.0°F or chills.
- Fainting, dizziness, or weakness.
- Chest pain or shortness of breath.
- Pain, redness, bleeding, drainage, or increased swelling at the insertion site.
- Severe pain, coldness, numbness, swelling, or discoloration in the limb where the catheter was inserted.
If any of these symptoms are severe, you should dial 911 immediately.
What’s the prognosis after venous stenting?
Venous stenting is an effective procedure for restoring blood flow, reducing symptoms, and improving quality of life. However, you will need routine follow-up care to monitor your condition.
How long do venous stents last?
Venous stents are intended to remain in your body permanently.
What’s the success rate of venous stenting?
The success rate for venous stenting depends on the condition you have. Generally, success rates for venous stenting are higher than 95 percent.
Why Choose UPMC for Venous Stenting?
At UPMC, we are experts in venous stenting. Many of our surgeons are regional leaders in the diagnosis and treatment of conditions requiring the use of a venous stent.
If venous stenting isn’t the best option for you, we will recommend other more appropriate treatments for your condition.
We are also at the forefront of vascular research. Research programs at UPMC have helped establish some of the practice guidelines doctors use to place venous stents.
By UPMC Editorial Staff. Last reviewed on 2024-10-01.
