Abstract
Objective:
Establish a predictive tool for assessing post-iliac vein stent placement (IVSP) patency loss within 1 year.
Background:
Post-IVSP stent surveillance is vital for detecting stent malfunction and guiding interventions. Despite extensive research on vascular patency after IVSP, individual risks for patency loss remain understudied.
Materials and Methods:
We developed a predictive model for assessing patency loss risk within 1 year after IVSP using data from 162 patients. Cox regression and the Boruta method identified risk factors, leading to the construction of a random forest (RF) model. We validated the model’s performance using testing data and developed a user-friendly risk tool, the Etiology-Stenosis-Age-Length (ESAL) Classification.
Results:
The RF model demonstrated excellent performance, with high sensitivity, specificity, and negative predictive value. Risk factors identified included younger age, post-thrombotic lesions, short-segment occlusions, and preoperative target lesion occlusion. Shapley Additive exPlanations analysis and Cox regression enhanced model interpretability.
Conclusions:
We present a novel, intuitive model for assessing patency loss risk after IVSP. The ESAL classification provides clinicians with a practical tool to identify high-risk patients. Future research should focus on larger, more representative cohorts to validate and refine the model.
Clinical Impact
How will this change clinical practice?
The risk of iliac vein stent patency loss within one year post-placement can be predicted in advance.
What does it mean for the clinicians?
The newly introduced Etiology-Stenosis-Age-Length (ESAL) Classification offers clinicians a practical and user-friendly tool for identifying high-risk patients who may experience patency loss after iliac vein stent placement.
What is the innovation behind the study?
Researchers have successfully developed a predictive model for assessing the risk of iliac vein stent patency loss within one year post-placement.
Keywords
Get full access to this article
View all access options for this article.
References
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
