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Venous stenting can have myriad benefits for carefully selected patients with deep and pelvic venous disease. However, as venous stenting has quickly gained popularity, concerns have arisen about the appropriateness of its use and the potential complications that may occur. Rick de Graaf (Friedrichshafen, Germany) talks to Venous News about the serious issue of venous stent migration, highlighting that this can cause life-threatening complications. De Graaf calls for a clear distinction to be made between post-thrombotic (PTS) patients and non-iliac vein compression lesion (NIVL) patients when stents are being considered. He also calls out the “larger risk” of stent migration and other complications that may perhaps be attributed in part to “little” operator experience that can lead to either “misdiagnosing or undersizing the stent”. The use of intravascular ultrasound (IVUS), says de Graaf, is “one of the most important tools to help” prevent complications.