Jan Sloves: When Stent Placement Misses the Mark – A Lesson in Precision and Follow-Up
Jan Sloves, President and Consultant at Vascular Imaging Professionals LLC, shared on LinkedIn:
”When Stent Placement Misses the Mark: A Lesson in Precision and Follow-Up
This is a great real-world example of why precise access and follow-up imaging matter.
Here, we’re looking at a 64-year-old female with right-sided post-thrombotic changes (C5) and a healed venous ulcer.
She previously underwent stent placement for significant outflow obstruction — but the access site was positioned too high.
As a result, the true lesion was missed, leaving behind venous fibrosis and aliasing consistent with a high-grade venous stenosis (~200 cm/s).
Despite intervention, the patient remained symptomatic and ultimately required revision in the cath lab.
In this case, I’m demonstrating how to assess the diameter and velocity ratio — greater than 5 — which meets diagnostic criteria for left renal vein compression.
Technical pearls:
Optimize grayscale to clearly delineate anatomy.
Use calipers to measure both the maximally obstructed and dilated segments.
Advance your Doppler sample through the narrowest point to capture the peak velocity for an accurate ratio.
It’s straightforward — but small details like these define accuracy, guide treatment, and ultimately improve patient outcomes.
Want to see more practical vascular cases and scanning strategies like this?
Join our growing education hub at Ultrasound Unlocked.
— where physicians and sonographers share real cases, refine technique, and grow together.”
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