P02] Inferior Vena Cava Reconstruction: A Single Centre Experience

Abstract

<h3>Objective</h3> Inferior vena cava (IVC) stenting is carried out for symptomatic chronic IVC stenosis or occlusion, and for the treatment of malignant IVC obstruction. The patency of IVC stents placed for both acute on chronic and chronic venous occlusion was determined. <h3>Methods</h3> Retrospective analysis of prospectively collected data was completed on all patients who underwent technically successful IVC stenting for treatment of symptomatic venous outflow obstruction or stenosis between February 2015 and November 2021. All patients had standard pre-operative work up, including venography ± intravascular ultrasound for chronic cases, and followed standard anticoagulation and surveillance programmes post-procedure, unless there was malignant disease. <h3>Results</h3> Sixteen patients underwent IVC stenting. Seven cases (43%) presented acutely with deep vein thrombosis and chronic underlying IVC stenosis or occlusion. Five cases (31%) were for symptomatic malignant external IVC compression. In four cases (25%), kissing iliac stents were placed into the IVC to treat infrarenal IVC disease. The remainder required single stents in the IVC, or were combined with double barrelled iliac stents. Re-intervention occurred in four cases (25%) for in stent thrombosis. Primary patency was 75%, and primary assisted patency was 88%. Stenting the IVC in all cases for malignant obstruction gave symptomatic relief. <h3>Conclusion</h3> Stenting of the occluded/atretic IVC may require additional access from the right internal jugular vein. Stenting above and across the renal veins did not cause any additional complications in this series. Stenting of the IVC is safe, and can give significant improvement in symptoms in patients with limited alternative options for treatment.