Choosing the Right Patient: Understanding the Presenting and Postoperative Complexities of Iliac Vein Stenting in Diabetic Patients With Lower Extremity Ulcers

The incidence of lower extremity ulcers increases with venous disease and is strongly associated diabetes. However, the effects treating on preventing subsequent ulcer formation has not been widely explored. We undertook this study comparing patients without diabetes to examine differences in presentation outcomes iliac vein stenting (IVS) regarding their ulcers. A clinical registry 877 who underwent IVS for chronic proximal outflow obstruction (PVOO) from 2011 2021 at a single institution was retrospectively analyzed. Patients were stratified into groups based presence or absence followed an average 743 days after IVS. Symptoms quantified using severity (VCSS) Clinical-Etiological-Anatomical-Pathophysiological (CEAP) scores. Postoperative symptom resolution assessed Clinical Assessment Score (CAS), which grades symptoms resolved, significant improvement, mild no change, worsened. Major reoperations defined as interventions requiring venogram, whereas minor endovenous thermal ablation superficial vein. Of patients, 189 (21.5%) had diabetes, 688 (78.5%) did not. Diabetes statistically greater hypertension (82.8% vs 42.9%; P < .001), coronary artery (27.1% 7.4%; smoking history (27.6% 19.2%; = .015), malignancy (17.4% 9.0%; .002). CEAP 6 (11.6% 6.9%; .041) also seen diabetic cohort intraoperative findings suggestive remote DVT (38.5% 23.3%; .001). At 1 year postoperatively, reported significantly less “complete resolution” “worsening” (2.9% 12.2% 3.5% 2.3%, respectively; .002) than those Diabetic PVOO more likely present cardiovascular comorbidities well active Intraoperatively, these have DVT. Postoperatively, report experience worsening symptoms. placement remains safe durable should be considered including ulcers; however, counseled worsened prognosis resolution.