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Inferior vena cava obstruction: long-term results of endovascular management

B C Srinivas1, P V Dattatreya, K H Srinivasa

  • 1Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, India. lotusheart7@gmail.com

Indian Heart Journal
|May 11, 2012
PubMed

Insights

Endovascular management of chronic inferior vena cava (IVC) obstruction is a safe and effective treatment. This minimally invasive approach offers good long-term patency rates for hepatic venous outflow obstruction (HVOO).

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Hepatology

Background:

  • Hepatic venous outflow obstruction (HVOO) presents acutely or chronically.
  • Chronic inferior vena cava (IVC) obstruction can be managed with endovascular techniques, offering a safer alternative to surgery.
  • Surgical intervention for IVC obstruction carries high risks of mortality and morbidity.

Purpose of the Study:

  • To evaluate the feasibility of endovascular management for chronic IVC obstruction.
  • To assess the long-term follow-up outcomes of endovascular treatment for HVOO.

Main Methods:

  • Twelve patients with HVOO underwent endovascular procedures, including balloon angioplasty and stenting.
  • Diagnosis involved clinical examination, venous Doppler, venography, and CT angiography.
  • Causes of obstruction included membranous obstruction, segmental stenosis, and tumor compression.

Main Results:

  • All 12 cases achieved procedural success.
  • Endovascular treatment resulted in an 84% gradient reduction and collateral disappearance.
  • Follow-up over 13 years showed good long-term patency, with one case of restenosis successfully managed by stenting.

Conclusions:

  • Endovascular management is a safe and effective treatment for chronic IVC obstruction.
  • The procedure demonstrates favorable long-term patency rates.
  • This approach provides a viable alternative to surgery for HVOO.
Abstract

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