Management of idiopathic obstruction of the hepatic and suprahepatic inferior vena cava with a self-expanding metallic stent

✍ Scribed by Kaul, Upendra ;Agarwal, Rajiv ;Jain, Pradeep ;Sharma, Sanjeev ;Sharma, Sanjiv ;Wasir, Harbans S.

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 577 KB
• Volume: 39
• Category: Article
• ISSN: 0098-6569
• DOI: 10.1002/(sici)1097-0304(199611)39:3<252::aid-ccd9>3.0.co;2-d

✦ Synopsis

Ten patients (median age 36 yr, 5 male) with idiopathic IVC obstruction underwent balloon angioplasty followed by placement of a self-expanding stent due to unfavourable lesion characteristics. Six had total occlusion, 5 had restenosis (including 2 with total occlusion), and 1 had a suboptimal result after initial dilatation. Median minimum IVC diameter increased from 0 to 14.5 mm, and the median gradient across the lesion decreased from 16.5 to 1 mmHg. Follow-up venography (median interval 69 d) in six patients revealed no restenosis with further enlargement at the lesion site (median 4.5 mm) and abolition of gradients. Follow-up ultrasound in nine patients revealed no restenosis In the IVC. One patient died 6 mo after the procedure with acute Budd-Chiari syndrome due to hepatic vein occlusion. Autopsy revealed a widely patent stent with hepatic vein thrombus.

Stent implantation is useful in the management of IVC obstruction with prior restenosis, total occlusion, or suboptimal result of balloon angioplasty.