Long-term results of treatment of benign central venous obstructions unrelated to dialysis with expandable Z stents

PURPOSE: To evaluate long-term patency of self-expanding Z stents for treat ment of benign central venous obstructions unrelated to dialysis. MATERIALS AND METHODS: Z stents were placed in 19 patients, (ages 26-72 yea rs) with severe symptomatic obstructions of the superior or inferior venae cavae and their large branches and portal vein caused by surgical or cathet er injury (n = 8), fibrosis (n = 5), cirrhosis (n = 3), Budd-Chiari syndrom e (n = 2), and extrinsic compression (n = 1), Fourteen patients underwent s tent placement primarily, five after local urokinase infusion for superimpo sed thrombosis. Follow-up was performed with ultrasound and venography. RESULTS: Venous congestive symptoms quickly resolved in all patients after stent placement. The follow-up period was from 1 to 94 months. Twelve patie nts have died during follow-up from 1 to 37 months although all remained as ymptomatic until death. Six patients remain alive, asymptomatic, with paten t stents, and with follow-up from 24 to 94 months. Primary patency was 83%, and secondary patency was 100%. One patient with a patent stent at 12 mont hs was lost to follow-up. No stent migrations, perforations, infections, or significant complications occurred. CONCLUSION: Benign central venous obstructions are effectively treated by t he placement of self-expandable Z stents. Placed percutaneously into obstru ctive lesions with a minimum risk, these stents offer long-term durability and patency.