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Introduction: Little is known about gender's role in chronic venous insufficiency (CVI). The aim of this study was to evaluate the impact of gender on outcomes of iliac vein stenting(IVS) for CVI. Methods: 866 patients who underwent vein stenting for CVI at one institution from August 2011 to June 2021 were analyzed via retrospective review. Patients were followed up to 5 years after initial stent placement. Presenting symptoms were quantified using Venous Clinical Severity Score(VCSS), Clinical Assessment Score(CAS), and Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) class. Reoperations after initial IVS were recorded. Major reoperations were defined as iliac interventions using venography. Minor reoperations were defined as thermal ablation. Multivariate logistic regression models were used determine odds of any and major reintervention. Results: Compared to females, males pre-operatively presented with a higher mean CEAP class (3.6 vs.3.3; P <.001), VCSS composite (11.3 vs.9.9; P <.001), and smoking history (134 vs.49; P <.001). The 2 groups were similar in age (P =.125), BMI(P =.898), previous DVT (P =.085), diabetes (P =.386), hypertension (P = 1.0), and CAD (P =.499). Multivariate analyses revealed no association between gender and any reintervention (OR, 1.02; 95%CI,.71-1.46; P =.935) or gender and major reintervention (OR, 1.39; 95% CI,.86-2.23 P =.177). There were no differences in number of stents placed (P =.736) or symptomatic improvement at 1 month (P =.951), 3 months (P =.233), 6 months(P =.068), and greater than 1 year (P =.287). At the 1 year follow-up, the male cohort had higher CAS values than females P =.034). Males had larger reduction in composite VCSS than women at 1 year (5.1 vs. 3.8; P =.003) and 3 years (5.3 vs.3.7; P =.031) of follow-up and similar levels of improvement in post-op (4.0 vs.3.5; P =.059), 2 years (4.3 vs.3.8; P =.295), 4-years (5.1 vs.4.6; P =.529), 5 years (5.6 vs.4.2; P =.174), and 6 years (5.93vs.3.3 P =.089). Conclusions: In a single site study of IVS in patients with CVI, males tended to present worse symptoms than females. After surgery, however, both cohorts showed improvement, and both seemed to improve to the same degree of residual symptoms. [ABSTRACT FROM AUTHOR]

May-Thurner syndrome (MTS) is a known structural risk factor for deep vein thrombosis (DVT) and embolism. In patients with a patent foramen ovale (PFO), emboli originating from the deep veins are able to paradoxically reach the systemic circulation via the PFO, consequently resulting in transient ischemic attacks (TIA) or stroke. We report the case of a 31-year-old pregnant woman, with a recent history of TIA, who presented with chronic bilateral numbness, pain, and swelling in the lower extremities. On imaging, she was found to have a PFO and MTS. Her pregnancy was subsequently terminated. This decision was made independently by the patient. Her care team did not advise her to terminate her pregnancy as there was no specific medical reason to do so. However, the patient was in significant physical pain and distress and ultimately was not comfortable continuing with the pregnancy. This highlights the complex, multifactorial decision-making process that pregnant patients with comorbid health conditions undertake. The patient then underwent transcatheter PFO closure and stents were placed bilaterally in the left and right common iliac veins. Following the stent procedure, lower extremity symptoms swiftly resolved, allowing the patient to significantly improve her ability to ambulate. There have been no signs of TIA since her procedures, and her venous symptoms have been stable. In patients with TIA or stroke from a paradoxical embolism, MTS should be considered as a potential etiology. Endovascular intervention to treat the underlying MTS should also be considered to decrease the risk of recurrent DVT and embolism. [ABSTRACT FROM AUTHOR]