Introduction:
Lower extremity deep venous thrombosis (DVT) with severe iliac vein stenosis is common and can lead to significant morbidity and mortality. Treatment options are limited, and the safety and effectiveness of stent implantation are unclear. This study evaluated stent implantation for treating this condition.

Material and methods:
This observational clinical study analyzed data from DVT patients who underwent stent implantation at Changxing People’s Hospital, Zhejiang, China, between 2017 and 2022. Patients who received stent implantation comprised the experimental group, while those who did not formed the control group. All patients underwent thrombus aspiration and/or stent implantation, and outcomes were compared between the two groups during follow-up.

Results:
In this study, in 60 cases the procedures were completed with no significant changes in hemoglobin, hematoma formation, thrombolytic time, or bleeding complications (p > 0.05). The stent group demonstrated a higher thrombolytic rate and lower limb swelling (p < 0.05). During a mean follow-up of 15.2 ±5.8 months, 1 stent patient developed DVT and another had stenosis, while the control group had 3 DVT recurrences and 5 iliac vein occlusions. The stent group had a higher deep vein patency rate and lower iliac vein occlusion rate (p = 0.01), with similar DVT recurrence rates (p = 0.34). Additionally, the stent group had higher Chronic Venous Insufficiency Questionnaire (CIVIQ) (t = 2.54, p = 0.01) and lower CEAP scores (t = 3.72, p < 0.01).

Conclusions:
Our study suggests that stent implantation is an effective and safe treatment option for DVT with severe iliac vein stenosis.