🎯 Principle
Venous recanalisation is indicated for obstructive post-thrombotic syndrome (PTS): chronic swelling, pain, itching, skin discolouration, difficulty on exertion. It is offered after discussion at a multidisciplinary meeting (vascular physicians, internists, radiologists).
The procedure consists of reopening the obstructed vein with a balloon (angioplasty), then placing one or more venous stents (Nitinol springs) that keep the vein permanently open, restoring venous drainage.
📋 Indications
- Obstructive post-thrombotic syndrome (swelling, pain, venous ulcer)
- Iliac, femoral or inferior vena cava obstruction
- May-Thurner syndrome (compression of the left iliac vein by the right iliac artery)
- Sufficiently significant clinical impact, assessed with the Villalta score and the CIVIQ questionnaire
The location of the obstruction must be confirmed by CT venography, venous duplex ultrasound and/or MR venography before any treatment decision.
🔧 Procedure
Pre-operative work-up: CT venography, targeted duplex ultrasound, IR consultation, anaesthetic consultation (mandatory, at least 48 hours beforehand).
Short hospital stay: admission the day before or the same morning. Fasting for 6 hours. General anaesthesia or sedation.
Venous access: a catheter is inserted by puncture (femoral or popliteal vein) up to the obstructed vein, with monitoring by injection of iodinated contrast.
Recanalisation: a guidewire is passed through the obstruction, balloon dilation, then placement of one or more Nitinol venous stents.
End of procedure: a check venogram confirms patency, then compression of the puncture site. Total duration: 1 to 2 hours.
🏥 Recovery and follow-up
- Pneumatic venous compression on the legs from waking
- Walking resumed as early as possible — an essential part of treatment
- Anticoagulant treatment started immediately, continued for at least 6 months
- Antiplatelet medication added for the first month
- Check duplex ultrasound the next morning before discharge
- Follow-up duplex at 1, 3 and 6 months · CT scan at 1 year
- IR consultation at 6 months and 1 year
⚠️ Never stop the anticoagulant treatment without medical advice, even for a few days. If your doctor is unavailable, contact our team for a bridging prescription.
❓ Frequently asked questions
What is a venous stent?
A venous stent is a small Nitinol spring (a shape-memory alloy) left permanently in the vein to keep it open. It is MRI-compatible. Its presence does not affect daily life.
Do I need to stay on anticoagulants for life?
Anticoagulant treatment is continued for at least 6 months. The total duration is discussed with the team depending on your situation (cause of the initial thrombosis, risk factors, follow-up results).
When should I alert the team after the procedure?
Report any change in your venous symptoms (swelling, pain) immediately, even if a duplex scan is already scheduled. An early procedure on a re-thrombosing stent is often possible if performed before complete obstruction.
📄 Patient information sheet
Patient information sheet — Venous recanalisation
A complete document on the procedure, recovery and monitoring. Read before your procedure.
✅ Covered by French National Health Insurance · No additional fees · Cochin University Hospital AP-HP