Percutaneous Transluminal Angioplasty for Complete Membranous Obstruction of Suprahepatic Inferior Vena Cava: Long-Term Results.

Abstract

To determine the long-term results of percutaneous transluminal angioplasty (PTA) for a complete membranous obstruction of the suprahepatic inferior vena cava. Patients (n=65) who were referred to the interventional unit for PTA for a complete membranous obstruction of the suprahepatic inferior vena cava between January 2006 and October 2014 were included in the study. Thirty-two patients (18 males, 14 females, mean age 35±10.7, range 20-42years) were treated. The patients presented with symptoms of ascites (88%), pleural effusion (53%), varicose veins (94%), hepatomegaly (97%), abdominal pain (84%), and splenomegaly (40%). Transjugular liver access set and re-entry catheter were used to puncture and traverse the obstruction from the jugular side. PTA balloon dilations were performed. The mean follow-up period was 65.6±24.5months. The objective was to evaluate technical success, complications, primary patency, and clinical improvement in the symptoms of the patients. The technical success rate was 94%. In two patients, obstruction could not be traversed. These patients underwent cavoatrial graft bypass surgery. There were no procedure-related complications. Clinical improvements were achieved in all patients within 3months. The primary patency rate at 4years was 90%. There was no primary assisted patency. There was no need for metallic stent deployment in the cohort. The secondary patency rate at 4years was 100%. Percutaneous transluminal angioplasty for a complete membranous obstruction of the suprahepatic inferior vena cava is safe and effective, and the long-term results are excellent.