STENOSIS OF THE INFERIOR VENA-CAVA AFTER LIVER-TRANSPLANTATION - TREATMENT WITH GIANTURCO EXPANDABLE METALLIC STENTS

Purpose: Evaluate the efficacy of double Gianturco expandable metallic stents for stenosis of the inferior vena cava (IVC) after orthotopic liver transplantation (OLT). Methods: Three patients developed severe Budd-Chiari syndrome secondary to suprahepatic caval stenosis after OL T. Percutaneous angioplasty (PTA) of the stenoses was unsuccessful. Th erefore double Gianturco expandable metallic stents, connected in tand em, were deployed at the site of the stenoses. Results. One double ste nt was successfully and definitively deployed in patient 1. Partial di slocation of the upper and lower stents comprising the double stent oc curred in patient 2. The double stent initially implanted across the s tenosis became displaced in patient 3. The Budd-Chiari syndrome resolv ed in all three patients who remained asymptomatic during follow-up fr om 3 to 32 months. Conclusions: Double Gianturco stent deployment is a viable option in patients with anastomotic stenosis of the IVC second ary to OLT when initial treatment with PTA fails. Certain modification s of the stents employed are suggested for the purpose of avoiding tec hnical complications.