{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T21:24:03Z","timestamp":1790025843842,"version":"4.0.1"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["CVIR Endovasc"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Endovascular stenting is widely accepted as the standard treatment for central venous obstruction syndromes such as superior vena cava (SVC) syndrome due to its demonstrated clinical efficacy and improved patient outcomes. However, its application in axillosubclavian vein thrombosis (ASVT) has been limited due to concerns about stent compression within the thoracic outlet. This report aims to evaluate the feasibility and safety of the off-label use of dedicated venous stents\u2014engineered with enhanced mechanical features\u2014as an alternative endovascular approach for the treatment of ASVT.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Thirty-eight patients (43 affected limbs) with symptomatic ASVT and no prior treatment or surgical decompression underwent endovascular placement of dedicated venous stents across the thoracic outlet with Abre Venous Stents (Medtronic, Dublin, Ireland), Venovo Venous Stents (BD, Franklin Lakes, NJ, USA), or Vici Venous Stents (Boston Scientific, Marlborough, MA, USA). Stents were extended peripherally to the subclavian or axillary veins and centrally to the brachiocephalic vein or SVC. Technical success was defined as successful stent deployment across the costoclavicular space, and clinical success as symptomatic improvement.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Stent placement was technically successful in all 43 limbs (100%), with clinical improvement observed in 97.4% of patients. The one patient without clinical improvement experienced early thrombosis of the stent, requiring mechanical thrombectomy and additional stenting. Follow-up CT venography at a mean of 301.3\u00a0days demonstrated high primary stent patency rates (81.4%), with stent crushing observed in only 7.0% of limbs and no instances of stent fracture. Adverse events were limited, including two access site hematomas and one hypotensive episode, all of which resolved without evidence of long-term complications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Our findings suggest that stenting across the thoracic outlet for the treatment of ASVT may be a viable option with the use of novel dedicated venous stents, potentially expanding treatment strategies for TCVO.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s42155-025-00577-4","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T05:25:27Z","timestamp":1754371527000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Dedicated venous stent placement across the thoracic outlet: will novel venous stents transform axillosubclavian vein thrombosis treatment paradigm?"],"prefix":"10.1186","volume":"8","author":[{"given":"Gabriel E.","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2131-8803","authenticated-orcid":false,"given":"Mayura P.","family":"Umapathy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Abad-Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J.","family":"Monroe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey Forris Beecham","family":"Chick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mina S.","family":"Makary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,5]]},"reference":[{"issue":"9","key":"577_CR1","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1007\/s00270-024-03820-y","volume":"47","author":"G Maleux","year":"2024","unstructured":"Maleux G, Claus E, Laenen A, Buyck PJ, Claes K, Bonne L, Nackaerts K, Dooms C. Newly designed, self-expanding large-bore nitinol stents for symptomatic central venous stenosis: technical and long-term clinical outcome. Cardiovasc Intervent Radiol. 2024;47(9):1200\u20139. https:\/\/doi.org\/10.1007\/s00270-024-03820-y. (Epub 2024 Aug 12 PMID: 39134807).","journal-title":"Cardiovasc Intervent Radiol"},{"issue":"2","key":"577_CR2","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1067\/mva.2000.106945","volume":"32","author":"F Hammer","year":"2000","unstructured":"Hammer F, Becker D, Goffette P, Mathurin P. Crushed stents in benign left brachiocephalic vein stenoses. J Vasc Surg. 2000;32(2):392\u20136. https:\/\/doi.org\/10.1067\/mva.2000.106945. (PMID: 10918001).","journal-title":"J Vasc Surg"},{"issue":"1","key":"577_CR3","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/s42155-019-0066-0.PMID:32026125;PMCID:PMC6966406","volume":"2","author":"S Rajendran","year":"2019","unstructured":"Rajendran S, Cai TY, Loa J, Saha P, Dubenec S. Early outcomes using dedicated venous stents in the upper limb of patients with venous thoracic outlet syndrome: a single centre experience. CVIR Endovasc. 2019;2(1):22. https:\/\/doi.org\/10.1186\/s42155-019-0066-0.PMID:32026125;PMCID:PMC6966406.","journal-title":"CVIR Endovasc"},{"key":"577_CR4","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.clinimag.2022.11.011","volume":"95","author":"C Greenberg","year":"2023","unstructured":"Greenberg C, Shin DS, Abad-Santos M, Monroe EJ, Ingraham CR, Vaidya SS, Chick JFB. Reconstruction of upper extremity and thoracic central veins using dedicated venous stents: Implantation of 75 stents in 46 patients. Clin Imaging. 2023;95:24\u20137. https:\/\/doi.org\/10.1016\/j.clinimag.2022.11.011. (Epub 2022 Nov 24 PMID: 36603415).","journal-title":"Clin Imaging"},{"issue":"10","key":"577_CR5","doi-asserted-by":"publisher","first-page":"1432","DOI":"10.1016\/j.jvir.2017.06.019","volume":"28","author":"O Khalilzadeh","year":"2017","unstructured":"Khalilzadeh O, Baerlocher MO, Shyn PB, Connolly BL, Devane AM, Morris CS, Cohen AM, Midia M, Thornton RH, Gross K, Caplin DM, Aeron G, Misra S, Patel NH, Walker TG, Martinez-Salazar G, Silberzweig JE, Nikolic B. Proposal of a new adverse event classification by the society of interventional radiology standards of practice committee. J Vasc Interv Radiol. 2017;28(10):1432-1437.e3. https:\/\/doi.org\/10.1016\/j.jvir.2017.06.019. (Epub 2017 Jul 27. Erratum in: J Vasc Interv Radiol. 2018 Jan;29(1):146. 10.1016\/j.jvir.2017.10.012. PMID: 28757285).","journal-title":"J Vasc Interv Radiol"},{"issue":"9","key":"577_CR6","doi-asserted-by":"publisher","first-page":"1182","DOI":"10.1007\/s00270-023-03461-7","volume":"46","author":"P Kitrou","year":"2023","unstructured":"Kitrou P, Katsanos K, Karnabatidis D. Management of central venous stenoses and occlusions. Cardiovasc Intervent Radiol. 2023;46(9):1182\u201391. https:\/\/doi.org\/10.1007\/s00270-023-03461-7. (Epub 2023 Jul 17. PMID: 37460644; PMCID: PMC10471665).","journal-title":"Cardiovasc Intervent Radiol"},{"issue":"1","key":"577_CR7","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.jvs.2010.01.091","volume":"52","author":"DH Stone","year":"2010","unstructured":"Stone DH, Scali ST, Bjerk AA, Rzucidlo E, Chang CK, Goodney PP, Nolan BW, Walsh DB. Aggressive treatment of idiopathic axillo-subclavian vein thrombosis provides excellent long-term function. J Vasc Surg. 2010;52(1):127\u201331. https:\/\/doi.org\/10.1016\/j.jvs.2010.01.091. (Epub 2010 Apr 10. PMID: 20385467; PMCID: PMC5240840).","journal-title":"J Vasc Surg"},{"issue":"6","key":"577_CR8","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1016\/j.ejvs.2022.08.019","volume":"64","author":"M de Boer","year":"2022","unstructured":"de Boer M, Shiraev T, Saha P, Dubenec S. Medium term outcomes of deep venous stenting in the management of venous thoracic outlet syndrome. Eur J Vasc Endovasc Surg. 2022;64(6):712\u20138. https:\/\/doi.org\/10.1016\/j.ejvs.2022.08.019. (Epub 2022 Aug 24 PMID: 36028006).","journal-title":"Eur J Vasc Endovasc Surg"}],"container-title":["CVIR Endovascular"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42155-025-00577-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s42155-025-00577-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42155-025-00577-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T18:05:38Z","timestamp":1754417138000},"score":1,"resource":{"primary":{"URL":"https:\/\/CVIRendovasc.springeropen.com\/articles\/10.1186\/s42155-025-00577-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,5]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["577"],"URL":"https:\/\/doi.org\/10.1186\/s42155-025-00577-4","relation":{},"ISSN":["2520-8934"],"issn-type":[{"value":"2520-8934","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,5]]},"assertion":[{"value":"6 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Institutional review board approval was obtained for preparation of this report, and the need for informed consent was waived.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"DSS is a consultant for Inari Medical. EJM is a consultant for Biogen, Guerbet, Inari Medical, and Vector Surgical. JFBC is a consultant for Inari Medical, Guerbet, C. R. Bard, Argon Medical Devices, Boston Scientific, NXT Biomedical, and Aidoc.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"62"}}