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Although the present confluence technique has been mentioned before, no clear description of the technique and interventional tools were given.
In our opinion, both the fenestration and apposition technique should be considered inferior to the confluence technique.
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First, the observational design of the study makes it difficult to draw strong conclusions toward the optimal confluence stent technique.
We report our experience with two different confluence stenting techniques to treat chronic bi-iliocaval obstructions.
In this article, we describe our experience with two confluence stenting techniques, one with merely self-expandable stents, the other with balloon-expandable stents bridging the common iliac vein confluence.
In order to minimize stent strut interactions at the confluence, an alternative technique was used where two balloon-expandable stents (AndraStent, Andramed®, Reutlingen, Germany) were placed in the vena cava stent toward the common iliac veins (BECS group; Fig. 2).
Specifically, for confluence stenting, only few techniques and stent configurations have been proposed, mainly due to limitations in stent design.
Preservation of bilateral symmetric inflow, protection of stent integrity, and avoidance of abundant stent material at the level of the confluence suggest that the BECS technique is superior to earlier described techniques.
Based upon our experience with stenting across the common iliac vein confluence, we suggest preferable stenting technique to treat bilateral iliocaval obstructions.
By 1957 he had coined the term third stream to describe the confluence of jazz and classical techniques.
The purpose of this special issue is to obtain a broader picture on the algorithmic techniques at the confluence between multi-objective optimization and reinforcement learning.
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