Chronically occluded inferior venae cavae: Endovascular treatment

PURPOSE: To report the results of endoluminal recanalization and stent plac ement 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 o cclusions were treated during a 6-year period. The mean duration of symptom s was 32 months. Underlying active malignancy was the cause of occlusion in four patients. Five patients with superimposed acute thrombus underwent ca theter-directed thrombolysis prior to IVC recanalization. Clinical patency was defined as absence or improvement of symptoms. Clinical follow-up was s upplemented with ultrasonography, vena cavography, or both in 10 patients. RESULTS: Technical success was achieved in 15 (88%) patients. Additional th rombolytic therapy and stent placement was needed in two patients to mainta in 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 pate ncy rate of 80%. The primary assisted patency rate was 87% (13 of 15). Ther e were four deaths owing to underlying disease 6-21 months after the proced ures. There were no procedure-related complications. CONCLUSION: Endoluminal recanalization and stent placement in chronically o ccluded IVCs has a good intermediate-term outcome and should be considered in patients who have symptoms and who often do not have adequate alternativ e therapy.