Publications by authors named "Neglen P"

Background: To evaluate the performance of a closed-cell designed venous stent for the treatment of chronic ilio-femoral venous outflow obstruction (VOO) in the shortterm.

Patients And Methods: Safety, stent patency and clinical outcome after placement of the Vici Venous Stent® in patients with chronic ilio-femoral venous obstruction were assessed retrospectively. Stent patency was evaluated by duplex ultrasound scanning, and clinical outcome was determined using the revised Venous Clinical Severity score (rVCSS).

View Article and Find Full Text PDF
Invited commentary.

J Vasc Surg Venous Lymphat Disord

March 2018

View Article and Find Full Text PDF

Objective: The objective of this study was to assess the safety and efficacy of a dedicated venous stent (the VICI VENOUS STENT; VENITI, Fremont, Calif) for treatment of symptomatic iliofemoral venous outflow obstruction.

Methods: Thirty patients (24 female; median age, 43 years) were enrolled in the feasibility phase of an international, multicenter investigational device exemption trial from June 2014 to February 2015. All patients exhibited unilateral venous disease with ≥50% stenosis in the iliofemoral veins.

View Article and Find Full Text PDF

Objective/background: For decades acute lower limb deep venous thrombosis (DVT) has been subdivided into distal DVT (isolated to the calf veins) and proximal DVT (extending above calf vein level). The aim of this study was to analyse the anatomical site and extent of thrombus in a large cohort of patients with acute DVT.

Methods: A retrospective analysis of all patients aged >18 years, presenting with unilateral DVT according to duplex ultrasound investigation was performed at the University Hospital of Antwerp, Belgium (1994-2012).

View Article and Find Full Text PDF

Objective: This prospective multicenter investigation was conducted to define the repeatability of duplex-based identification of venous reflux and the relative effect of key parameters on the reproducibility of the test.

Methods: Repeatability was studied by having the same technologist perform duplicate tests, at the same time of the day, using the same reflux-provoking maneuver and with the patient in the same position. Reproducibility was examined by having two different technologists perform the test at the same time of the day, using the same reflux-provoking maneuver and with the patient in the same position.

View Article and Find Full Text PDF

Background: Chronic venous disease (CVD) is a common cause of secondary lymphedema. Venous lymphedema is sometimes misdiagnosed as primary lymphedema and does not receive optimal treatment. We have routinely used intravascular ultrasound (IVUS) imaging in all cases of limb swelling.

View Article and Find Full Text PDF

Objectives: A protective inferior vena cava (IVC) filter may later be incorporated into a chronic postthrombotic ilio-caval obstruction (occlusive, requiring recanalization, or nonocclusive). This study aims to assess the safety and stent-related outcome following stenting across an obstructed filter.

Methods: From 1997 to 2009, 708 limbs had stenting for postthrombotic ilio-caval outflow obstruction (occlusion in 121 limbs).

View Article and Find Full Text PDF

Background: Leg swelling in menopausal women is well known. Prevailing concept in primary care is that it is polycentric and a treatable cause may not be found. Patients are placed on empiric diuretics often without benefit.

View Article and Find Full Text PDF

Deep venous disease includes primary and/or secondary pathological changes in the deep venous system. These may consist of valve insufficiency, complete or incomplete vein obliteration and/or functional impairment.

View Article and Find Full Text PDF

Objective: This study describes three techniques of stent placement at the iliocaval confluence for chronic nonmalignant obstruction and its stent-related outcome.

Methods: From 1997 to 2008, 115 patients (230 limbs) underwent bilateral stenting for iliocaval obstruction. All limbs were CEAP classified using clinical examination and duplex ultrasound study.

View Article and Find Full Text PDF

Background: Treatment of chronic venous insufficiency (CVI) has largely focused on reflux. Minimally-invasive techniques to address superficial and perforator reflux have evolved, but correction of deep reflux continues to be challenging. The advent of intravascular ultrasound (IVUS) scan and minimally invasive venous stent technology have renewed interest in the obstructive component in CVI pathophysiology.

View Article and Find Full Text PDF

Background: Chronic venous insufficiency (CVI) in the obese, often with severe clinical manifestations, is increasingly encountered in clinical practice. The association has drawn special interest as the pathophysiology may be different from that seen in the non-obese. The disease poses special management problems in the obese as traditional conservative measures are seldom effective.

View Article and Find Full Text PDF

Background: Venovenous bypass has been the standard in relieving chronic total occlusions of iliac veins. The technical feasibility of percutaneous recanalization was previously reported. Routine applicability of this technique in a wide spectrum of lesions and patients, stent patency, and clinical outcome forms the basis of this presentation.

View Article and Find Full Text PDF

Venous stenting has introduced a minimally invasive and safe technique that can be performed on an outpatient basis with little downtime for the patient. It is applicable in a wide spectrum of patients with chronic venous disease with disabling symptoms. Long-term patency and clinical outcome are excellent even when associated reflux is present and left untreated.

View Article and Find Full Text PDF

Background: Percutaneous iliofemoral venous stenting has been shown to be effective, safe, and durable in both nonthrombotic iliac vein lesion (NIVL) and postthrombotic disease. A small fraction of stented limbs require reintervention to correct stent malfunction. This manuscript examines the reasons for reintervention, types of procedures performed, and outcome.

View Article and Find Full Text PDF

Background: Arterial stenting across joints is not recommended because of increased risk of in-stent focal neointimal hyperplasia and compression or fracture of the stent by joint motion with decreased long-term patency. The aim of this study was to assess the risk of placing stents in the venous system across the inguinal ligament.

Materials And Methods: From 1997 to 2006, 177 limbs with chronic non-malignant obstructive lesions had stents placed in the iliofemoral venous outflow across the inguinal ligament into the common femoral vein.

View Article and Find Full Text PDF