🇫🇷 FR 🇬🇧 EN
Cochin University Hospital – AP-HP · Paris Cité University
← Interventional Radiology
Cochin University Hospital – AP-HP · Paris Cité University
← Imaging PortalInterventional Radiology
RI Cochin

Venous recanalisation

Interventional Radiology · Cochin University Hospital AP-HP

🩸 Syndrome post-thrombotic

Venous recanalisation — angioplasty and venous stenting

Treatment du syndrome post-thrombotic obstructif · Taux de réussite > 90% · Concertation pluridisciplinaire

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.

>90%
technical success
99%
clinical improvement
>70%
asymptomatic patients

Venous recanalisation at a glance — At a glance

Venous recanalisation reopens a blocked or narrowed deep vein using balloons and stents, restoring normal venous drainage from the leg or pelvis.

Criterion Data
IndicationsPost-thrombotic syndrome, iliac vein compression (May-Thurner syndrome)
Expected benefitReduced swelling and heaviness, improved walking distance
Follow-up treatmentAnticoagulation generally required after stenting
CostCovered by French national health insurance at Cochin AP-HP — no out-of-pocket fees

Data validated by the team of Prof. Anthony Dohan, Department of Interventional Radiology, Cochin Hospital AP-HP, Université Paris Cité.

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

1

Pre-operative work-up: CT venography, targeted duplex ultrasound, IR consultation, anaesthetic consultation (mandatory, at least 48 hours beforehand).

2

Short hospital stay: admission the day before or the same morning. Fasting for 6 hours. General anaesthesia or sedation.

3

Venous access: a catheter is inserted by puncture (femoral or popliteal vein) up to the obstructed vein, with monitoring by injection of iodinated contrast.

4

Recanalisation: a guidewire is passed through the obstruction, balloon dilation, then placement of one or more Nitinol venous stents.

5

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.
What is venous recanalisation?
It is the reopening of a blocked or narrowed deep vein (typically iliac or vena caval) using balloons and stents, delivered through a small puncture, to restore normal venous drainage from the leg or pelvis.
Who is it for?
Patients with post-thrombotic syndrome (persistent swelling, heaviness, pain or venous ulcers after a deep vein thrombosis) and patients with iliac vein compression (May-Thurner syndrome).
What improvement can I expect?
Most patients experience reduced swelling, less heaviness and improved walking distance. Venous ulcers heal more readily once drainage is restored.
Will I need blood thinners afterwards?
Yes, anticoagulation is generally required after stenting, with the duration decided individually depending on your history and risk factors.
Is it covered by insurance?
Yes. At Cochin AP-HP (a French public hospital), this procedure is covered by national health insurance with no out-of-pocket fees. Contact ri.cch@aphp.fr or +33 1 58 41 46 12.

Patient information sheet

📄

Patient information sheet — Venous recanalisation

A complete document on the procedure, recovery and monitoring. Read before your procedure.

📥 Download (PDF)

✅ Covered by French National Health Insurance · No additional fees · Cochin University Hospital AP-HP

Related pages

Why this page is trustworthy

Written by the Interventional Radiology team at Cochin Hospital AP-HP, Université Paris Cité. Medically reviewed by an interventional radiologist of the department. Last updated: August 2026.

🏥 Le service 📰 Actualités 🔬 Recherche & essais cliniques