Extraluminal Pelvic Vein Recanalization With Parallel Stents.

Purpose: A chronically-occluded stent during a pelvic vein recanalization attempt was crossed extraluminally to create a new channel to bypass the affected segment after conventional methods failed.

Case report: A 55-year-old male patient presented with recurrent acute deep vein thrombosis superimposed on a chronically-occluded older stent type 25 years after primary endovascular treatment. During the procedure, we used an unusual technique with extraluminal parallel stent insertion. Another recurrence 2.5 years later was treated with pharmacomechanical thrombectomy and stenting.

Conclusion: Recanalization of venous stent occlusions often requires advanced techniques. The presented technique could be considered as an alternative approach in difficult cases. However, the level of reproducibility is currently unknown due to the lack of further data.Clinical ImpactVenous obstruction can manifest with chronic symptoms that affect daily activities and might cause severe disability. Advanced endovascular recanalization techniques have potential to improve quality of life in cases where other methods failed.