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(Radiology. 2000;214:133-138.)
© RSNA, 2000

Vascular and Interventional Radiology

Chronically Occluded Inferior Venae Cavae: Endovascular Treatment1

Mahmood K. Razavi, MD, Ernst C. Hansch, MD, Stephen T. Kee, MD, Daniel Y. Sze, MD, Charles P. Semba, MD and Michael D. Dake, MD

1 From the Department of Radiology, Division of Cardiovascular-Interventional Radiology, Stanford University Hospital, Ste H-3651, 300 Pasteur Dr, Stanford, CA 94305-1056. Received November 19, 1998; revision requested December 22; revision received April 1, 1999; accepted May 25. Address reprint requests to M.K.R. (e-mail: mrazavi@stanford.edu).

PURPOSE: To report the results of endoluminal recanalization and stent placement in patients with chronic occlusions of the inferior vena cava (IVC).

MATERIALS AND METHODS: Seventeen consecutive patients (12 male, five female patients; mean age, 40.6 years; age range, 15–77 years) with chronic IVC occlusions were treated during a 6-year period. The mean duration of symptoms was 32 months. Underlying active malignancy was the cause of occlusion in four patients. Five patients with superimposed acute thrombus underwent catheter-directed thrombolysis prior to IVC recanalization. Clinical patency was defined as absence or improvement of symptoms. Clinical follow-up was supplemented with ultrasonography, vena cavography, or both in 10 patients.

RESULTS: Technical success was achieved in 15 (88%) patients. Additional thrombolytic therapy and stent placement was needed in two patients to maintain patency at 4 and 6 months after the procedure. Twelve patients had IVCs that remained patent after a mean follow-up of 19 months for a primary patency rate of 80%. The primary assisted patency rate was 87% (13 of 15). There were four deaths owing to underlying disease 6–21 months after the procedures. There were no procedure-related complications.

CONCLUSION: Endoluminal recanalization and stent placement in chronically occluded IVCs has a good intermediate-term outcome and should be considered in patients who have symptoms and who often do not have adequate alternative therapy.

Index terms: Venae cavae, grafts and prostheses, 569.126, 949.1268 • Venae cavae, interventional procedures, 569.126, 949.1268 • Venae cavae, stenosis or obstruction, 569.30, 569.40, 949.30, 949.40, 949.72 • Venae cavae, thrombosis, 569.1265, 949.1265, 949.751




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