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      Thank you for the comments and questions from Bademci et al
      • Bademci M.S.
      • Kocaaslan C.
      • Bayraktar F.A.
      • Oztekin A.
      • Uslu O.A.
      • Aydin E.
      Efficacy of iliac venous stenting for proximal venous occlusive disease.
      for the article “Clinical outcomes of venous self-expanding stent placement for ilio-femoral venous outflow obstruction.” It is our pleasure to address the questions as follows.
      First, the reasons that we did not routinely choose the small saphenous vein for venous access include the high chances of phlebitis, saphenous nerve injury, and bleeding related to the small saphenous access,
      • Duan P.F.
      • Ni C.F.
      Randomized study of different approaches for catheter-directed thrombolysis for lower-extremity acute deep venous thrombosis.
      but the key issue is that until now we could not find any piece of solid evidence to support that the small saphenous vein as the access for venous intervention would not potentiate venous thrombus formation.
      Secondly, although routine use of retrievable inferior vena cava filters has been found to have some disadvantages, according to our current guideline,
      Vascular Surgery Group of Surgery of Chinese Medical Association
      Guidelines for the diagnosis and treatment of deep venous thrombosis (3nd edition).
      the placement of filters was justified on the basis of preventing the patients from pulmonary embolism when they underwent pharmacomechanical thrombolysis or catheter-directed thrombolysis.
      Thirdly, there is no definitive guideline or solid evidence to either support or undermine the stent use in patients with malignancy. However, it is important to balance between life expectancy and stent patency when stenting patients with cancer. In our practice, we usually recommend that stent implantation be considered for patients with more than 1 year of survival.

      References

        • Bademci M.S.
        • Kocaaslan C.
        • Bayraktar F.A.
        • Oztekin A.
        • Uslu O.A.
        • Aydin E.
        Efficacy of iliac venous stenting for proximal venous occlusive disease.
        J Vasc Surg Venous Lymphat Disord. 2021; 9: 1596
        • Duan P.F.
        • Ni C.F.
        Randomized study of different approaches for catheter-directed thrombolysis for lower-extremity acute deep venous thrombosis.
        J Formos Med Assoc. 2016; 115: 652-657
        • Vascular Surgery Group of Surgery of Chinese Medical Association
        Guidelines for the diagnosis and treatment of deep venous thrombosis (3nd edition).
        Chin J Vasc Surg. 2017; 2: 201-208

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