Ep. 382 Iliofemoral Stenting: Decision-Making and Best Practices Explored with Dr. Kush Desai and Dr. Steven Abramowitz

In this episode, host Dr. Chris Beck interviews interventional radiologist Dr. Kush Desai (Northwestern University Feinberg School of Medicine) and vascular surgeon Dr. Steve Abramowitz (MedStar Washington Health Center) about iliofemoral venous stenting.

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SHOW NOTES

We start this episode by reviewing the evolution of knowledge and treatment of venous disease over recent years. Dr. Desai and Dr. Abramowitz identify referral patterns that connect patients with vascular and interventional physicians, and they emphasize how most patients are diagnosed in primary care pathways rather than in the emergency room. The doctors also underscore the importance of educating referring physicians and patients on the impact of early intervention and how vascular and interventional physicians are well-equipped to provide specialized care and management of venous disease.

Dr. Desai and Dr. Abramowitz explain their work-up of patients with deep venous disease. The doctors cover necessary imaging studies and conservative treatments for clinic visits. They also explain their procedural approach, access sites, patient positioning preferences, and more.

The doctors share guiding anatomical landmarks and recommendations on tools for crossing, along with their decision-making process in treating post-thrombotic patients. They also discuss best practices in venous stenting and post-operative follow up algorithms. We conclude this episode with important advice on how to avoid dangerous life-threatening outcomes.

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RESOURCES

Society of Interventional Radiology Position Statement on the Endovascular Management of Acute Iliofemoral Deep Vein Thrombosis (2023):

https://www.sciencedirect.com/science/article/pii/S1051044322013173

A review of the incidence, outcome, and management of venous stent migration:

https://www.sciencedirect.com/science/article/abs/pii/S2213333X2100411X