The Venovo Venous Stent in Pregnancy

Key words: cardiac imaging, computed tomography angiography, venography

Iliac vein compression  is prevalent in younger females with unilateral leg swelling and pain. The treatment of iliac vein compression is generally stenting of the compression site. Dedicated nitinol self-expanding venous stents were recently approved in the United States to treat iliac vein compression with excellent long-term outcome.

Younger females with a stent in their iliac vein may become pregnant. The impact of the gravid uterus on the nitinol venous stent integrity and patency is unknown at this time. We present the case of a young woman who became pregnant following placement of a Venovo venous stent (BD/Bard) in her left common iliac vein. 

The patient is a young female who presented with debilitating left leg pain. Computed tomography angiography of the abdomen and pelvis revealed a severe compression of the left common iliac vein by her right common iliac artery. The patient underwent venography and intravascular ultrasound to her left iliac veins. The left common iliac vein was severely compressed by the right common iliac artery with luminal area stenosis ranging from 80% to 90% when compared with the ipsilateral distal left common iliac vein reference. Stenting was carried out using an 18 x 60 mm Venovo venous stent. Repeat duplex ultrasound at 5 months into her pregnancy (Figure 1) showed no evidence of iliac vein compression and the stent was widely patent. At 33.5 weeks into her pregnancy, another duplex ultrasound was performed (Figure 2) and showed no evidence of stent compression by the gravid uterus and good flow. Computed tomography scan of the pelvis with venous filling was performed 2 years after her pregnancy.  The stent was widely patent with no restenosis, thrombosis, compression, or deformation and with optimal positioning (Figure 2). 

Our case illustrates the safety of the Venovo stent during pregnancy. This needs further validation with a larger registry.

From the Midwest Cardiovascular Research Foundation, Davenport, Iowa.

Disclosure: The authors have completed and returned the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr NW Shammas reports educational and research grant support from BD/Bard. The remaining authors report no conflicts of interest regarding the content herein.

The authors report that patient consent was provided for publication of the images used herein.

Manuscript accepted November 27, 2019.

Address for correspondence: Nicolas W. Shammas, MD, MS, FACC, FSCAI, Research Director, Midwest Cardiovascular Research Foundation, 1622 E. Lombard Street, Davenport, IA, 52803. Email: shammas@mchsi.com