3:54 PM Abstract No. 88 Safety and efficacy of Gianturco tracheobronchial z-stent placement for recanalization in patients with inferior vena cava occlusion

Abstract

To evaluate the technical success and safety of Gianturco Z-stent placement in patients with occlusion of the inferior vena cava (IVC). Between January 2010 and July 2019, a retrospective review was performed including patients who underwent placement of Gianturco tracheobronchial Z-stents (Cook Medical, Bloomington, IN) in the IVC for treatment of IVC occlusion. Indication for placement, technical success, primary patency, and clinical success as measured by symptomatic improvement were recorded. Patients received clinical follow-up and computed tomographic (CT) imaging for patency evaluation initially at 1 to 4 months and yearly thereafter. Z-stent placement was performed in the IVC of 20 patients (median, age, 47 years; range, 21-88 years; percent female, 50%). Indications for IVC stent placement consisted of non-malignant occlusions in 13 patients and malignant occlusions in 7 patients. Technical success was achieved in all patients; no procedure-related major adverse events were observed. Data on clinical success was available in 11 of 13 patients treated for non-malignant IVC occlusions at initial follow-up (mean follow-up length, 1.4 months; range, 1-2 months) demonstrating symptomatic improvement in 100% (11/11) of patients. Patency of IVC stents was maintained in 92.3% (12/13) of patients treated for non-malignant occlusions (mean follow-up length, 1.5 months; range, 1-4 months). Longer-term follow-up was available in 5 patients with non-malignant occlusions and all (5/5) demonstrated maintained patency of IVC stents (mean follow-up length, 21.8 months; range, 12-45 months). Of the patients treated for malignant IVC occlusion for whom data was available, symptomatic improvement was achieved in 100% (4/4 patients; median follow-up length, 3.5 months; range, 2-17 months) and patency of the IVC stent was maintained in 100% (5/5 patients; median follow-up length, 5 months; range, 2 weeks-19 months). Through available follow-up, off-label placement of Gianturco tracheobronchial Z-stents in the IVC appears safe for patients with both non-malignant and malignant occlusions. Long-term follow-up will be necessary in evaluating the efficacy and durability of the intervention.