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Transjugular approach for successful recanalization and stenting for inferior vena cava stenosis

Budanur Chikkaswamy Srinivas1, Ajit Pal Singh, C M Nagesh

  • 1Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, 560069, India.

Cardiovascular Intervention and Therapeutics
|February 26, 2013
PubMed

Insights

Budd-Chiari syndrome, a rare hepatic outflow obstruction, was treated with a novel recanalization technique. This minimally invasive approach successfully dilated and stented a chronic total occlusion of the inferior vena cava (IVC).

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Hepatology

Background:

  • Budd-Chiari syndrome involves hepatic vein or inferior vena cava (IVC) obstruction.
  • Percutaneous transluminal angioplasty and stenting are first-line treatments for central venous disease.
  • Surgical IVC reconstruction has high morbidity and poor patency rates.

Observation:

  • A case of long-segment, thrombotic, chronic total occlusion of the IVC was presented.
  • A jugular venous approach was utilized for intervention.
  • Specialized tools including a Brokenborough septal puncture needle, Mullin dilator, and Accura balloon were employed.

Findings:

  • The chronic total occlusion of the IVC was successfully recanalized.
  • The IVC was dilated and stented using the described technique.
  • The procedure demonstrated the feasibility of this minimally invasive approach for complex IVC occlusions.

Implications:

  • This recanalization technique offers a minimally invasive alternative for complex IVC occlusions in Budd-Chiari syndrome.
  • Successful stenting may improve hepatic venous outflow and patient outcomes.
  • Further studies are warranted to evaluate long-term patency and efficacy.

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