WHAT IS VENOUS STENTING?

 

Venous stenting is a minimally invasive procedure used to improve blood flow when a vein is narrowed or compressed. This helps restore healthy blood flow. The stent is a wire mesh tube that is permanently placed in a vein and acts as a scaffolding to keep veins open.

WHY MIGHT I NEED VENOUS STENTING? Venous stents can help people with chronic blood clots or other conditions that compress or narrow the veins, limiting blood flow. These conditions include: • May-Thurner Syndrome: the artery that runs from your abdomen to your right leg, the right iliac artery, presses against the left iliac vein. This causes it to narrow and scar, leading to chronic left leg swelling, pain, and sometimes fatigue. • Chronic deep vein thrombosis (DVT): DVT is a blood clot in one of the large, deep veins that returns blood from the leg, or sometimes from the arm, to the heart and lungs. • Post-thrombotic syndrome: DVT can damage veins, which can lead to symptoms such as chronic swelling and pain. People may not suffer the symptoms of post-thrombotic syndrome until years after DVT. • Nutcracker syndrome: the arteries near the kidney compress the left renal vein, making blood flow backward and causing symptoms like flank pain and blood in the urine.

WHAT ARE THE RISKS OF VENOUS STENTING?

 

• Bleeding, swelling caused by a collection of blood (hematoma), injury to nerves or infection.

 

• Damage to an artery or an artery wall. This can cause blood clots, abnormal ballooning of the artery, or abnormal link between the artery and nearby vein.

 

• Temporary kidney failure. Please notify your provider if you have had recent imaging testing that included contrast, as this would increase your risk for kidney issues.

 

 

TELL YOUR HEALTHCARE PROVIDER IF YOU:

 

• Are pregnant or think you may be pregnant. Radiation exposure during pregnancy may lead to birth defects.

 

• Are allergic to or sensitive to any medications, contrast, latex, tape, or anesthetic medicines (local or general). *Have kidney failure or other kidney problems. In some cases, the contrast can cause kidney failure. You are at higher risk for this if you take certain diabetes medicines. You may need to hold certain medications prior to the procedure.

 

• Are taking any medication that include prescriptions, over-the-counter, and herbal supplements.

 

• Have a bleeding disorder or take blood thinners, aspirin, or medications or supplements that affect blood clotting. These may have to be stopped prior to the procedure.

HOW DO I GET READY FOR A VENOUS STENTING?

 

• You will need to have blood work prior to your procedure. You should receive an order from your physician.

 

• You will be asked not to eat after midnight prior to the procedure. You may have clear liquids 2 hours before your arrival time.

 

• Bring your insurance card and picture ID with you to the appointment. You may bring an adult guest with you.

 

• You will need a driver to your appointment. If you need transportation, please let the office know so that we can arrange it for you.

WHAT HAPPENS PRIOR TO VENOUS STENTING?

 

• You will read and sign your consent that gives your permission for the procedure to be performed. You will have the opportunity to ask your provider questions and have anything explained that you do not understand .

 

• You will be asked to remove any clothing or jewelry that may get in the way of the test. You will be given a gown to wear. You will be asked to empty your bladder prior to the test.

 

• An intravenous (IV) line will be started in your hand or arm. You will be connected to a monitor that records your heart rate, blood pressure, and breathing.

 

• You may get medication to help you relax before the procedure.

WHAT HAPPENS DURING VENOUS STENTING?

 

Your skin will be cleansed near your groin, on the top part of both of your thighs. The skin will be injected with a local pain medication to numb the area. A catheter will be placed in the larger vein in each thigh. The catheter will be advanced for imaging of each leg. Intravascular ultrasound may be used, as well as contrast. Fluoroscopy is used to see the catheter. When contrast is injected, you may feel a warm, flushing sensation, salty or metallic taste, a brief headache, or nausea. These effects usually last for a few moments.

 

• A Certified Sedation nurse monitors you 1-on-1 during your procedure.  You will receive anesthesia that allows for conscious sedation. The medication will make you feel very relaxed and alleviate any pain. you may drift to sleep. You will not be intubated and can breathe comfortably and unassisted. Supplemental oxygen is used during anesthesia.

 

• Tell the physician or nurse if you experience any trouble breathing, sweating, numbness, or heart palpitations.

 

• If it is determined that an intervention is needed and can be done at that time, (percutaneous balloon or stenting) it can be done during the procedure. These procedures are included in the consent form as treatment possibilities.

 

• Once the procedure is completed, the physician will remove the catheters. Pressure will be applied to the site to keep it from bleeding. Manual pressure will be used to close the puncture site. After the bleeding stops, a dressing will be applied on the sites.

WHAT HAPPENS AFTER VENOUS STENTING?

 

• You will be taken to the recovery room. A nurse will watch your vital signs and the access

site(s). They will check the circulation and sensation in your extremities.

 

• Depending on the closure device used, you will be discharged after a period of rest and no signs of bleeding.

 

• You will be encouraged to drink water and fluids to help flush the contrast from your body.

 

• You will receive written discharge instructions about returning to your daily activities and how to care for your bandage and incision site.

AT HOME • Once home, you should watch the injection site for bleeding. A small bruise is normal. So is an occasional drop of blood at the site. • You should watch your arm or leg for changes in temperature, color, pain, numbness, tingling, or loss of movement. • Drink plenty of fluids to help the contrast leave your body. You may not be able to do any strenuous activities or take a bath or shower for a period of time after the procedure.

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