Invited Speakers
Minyi Yin
Nationality
China
Current Position
Chief Physician
Organization
Department of Vascular Surgery, the Ninth People’s Hospital, affiliated to Shanghai Jiao Tong University School of Medicine
Venous SessionFriday, Oct. 21, 2022 08:30-10:00 @Junior Ballroom

Topic: Endovascular debulking in the chronically venous ISR

Abstract

Objective: The study aimed to evaluate the feasibility, safety, and outcome of endovascular debulking of chronically venous in-stent re-obstruction patients (VISR) with moderate to severe symptoms.
Methods: A retrospective review of symptomatic patients with chronic VISR that underwent endovascular debulking of obstructive stent was conducted in our institutions from January 2015 through December 2020. Eighty-seven patients with moderate to severe symptoms were included in the study. Demographics, previous endotreatment, procedural data, technical success, complications, vessel patency and symptom improvement were analyzed.
Results: The reasons for previous venous stent mainly included post-thrombotic syndrome (PTS) (n=61, 70.1%) and Cockett syndrome combined with thrombosis (n=25, 28.7%). The median symptom recurrence period was 16.7 months (range, 3-43months). All patients had moderate (n=62, 71.3%) or severe (n=25, 28.7%) chronic symptoms according to the Villalta score. Technical success of reconsturction was achieved in 71 (81.6%) of 87 limbs. All patients received re interventional therapy based on debulking technology (Rotarex in 33, Turbo elite in 28 and Turbo hawk in 10). Intraoperative complications included 5 vessel perforations (5.7%), 2 access hematomas (2.3%) and 1 acute thrombosis (1.1%). The mean follow-up period was 23.6 months. The primary and secondary patency rates were 73.1% (±0.05 standard error [SE]) and 88.7% (±0.04 SE) at 12 months, 67.0% (±0.06 SE) and 74.2% (±0.05 SE) at 24 months follow up. The Villalta score was significantly improved during follow up (13.82±2.94 vs. 8.75±3.18, p <0.01). seven (9.9%) and 47 (66.2%) patients reached two and one grades relief of Villalta score respectively.
Conclusions: Endovascular debulking of chronic VISR is a safe and feasible procedure, with reasonable technical success, vessel patency and symptom improvement rates. Although technically challenging, this therapeutic option could be highly recommended in chronic VISR patients with moderate to severe symptoms.

Session

Topic:

Abstract

Education

・2007 Master’s degree Shanghai Jiao Tong University
・1/2010 to 6/2010 Vascular Surgery Visiting Scholar, Department of Vascular Surgery, Cleveland Clinic
・2012 PhD Shanghai Jiao Tong University
・7/2014 to 6/2015 Vascular Surgery Visiting Scholar, Department of Vascular Surgery, Stanford University

Research Experience

・The role and mechanism of tPA in venous wall fibrosis remodeling after DVT
・Funded by National Nature Science Foundation of China

Honors/Awards

-

Selected Publications
  • Three-dimensional computed tomography venography reconstruction facilitates identification of atypical radiologic features of May-Thurner syndrome. J Vasc Surg Venous Lymphat Disord. 2021;9(4):946-953
  • Near-infrared -triggered release of tirofiban from nanocarriers for the inhibition of platelet integrin αIIbβ3 to decrease early-stage neointima formation. Nanoscale. 2020 ;12(7):4676-4685.
  • Staged endovascular repair of critical limb ischemia in high risk patients: the procedural and clinical outcomes. Int Angiol. 2018 ;37(1):52-58.
  • In Situ Laser Fenestration Is a Feasible Method for Revascularization of Aortic Arch During Thoracic Endovascular Aortic Repair. J Am Heart Assoc. 2017 ;6(4). pii: e004542. doi: 10.1161/JAHA.116.004542.
  • Endovascular treatment of atherosclerotic popliteal artery disease based on dynamic angiography findings. J Vasc Surg. 2017 Jan;65(1):82-90.
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