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Inferior vena caval obstruction: transvenous instrumental membranotomy

Y Yamazaki1, S Eguchi, M Terashima

  • 1Second Department of Surgery, University of Niigata School of Medicine, Japan.

Cardiovascular and Interventional Radiology
|January 1, 1988
PubMed

Insights

Transvenous membranotomy effectively treated hepatic inferior vena cava obstruction in four patients. This minimally invasive procedure relieved stenosis, though one patient required a repeat intervention years later.

Area of Science:

  • Interventional Cardiology
  • Vascular Surgery
  • Hepatology

Background:

  • Hepatic segment of the inferior vena cava (IVC) obstruction is a rare but serious condition.
  • Membranous obstruction of the IVC can lead to significant venous hypertension and liver dysfunction.

Purpose of the Study:

  • To evaluate the efficacy and safety of transvenous instrumental membranotomy for treating membranous obstruction of the hepatic IVC segment.
  • To assess the long-term outcomes of this minimally invasive approach.

Main Methods:

  • Five transvenous instrumental membranotomies were performed in four patients using a specialized dilator-like instrument.
  • Access was gained via femoral or right internal jugular veins.
  • Angiography and ultrasonography confirmed successful stenosis release and monitored for recurrence.

Main Results:

  • Successful pressure gradient abolition across the obstructing membrane was achieved in all initial procedures.
  • Angiography and ultrasonography confirmed the release of hepatic IVC stenosis.
  • One patient experienced recurrent stenosis 7 years post-procedure, necessitating a second membranotomy.

Conclusions:

  • Transvenous instrumental membranotomy is an effective treatment for membranous obstruction of the hepatic IVC segment.
  • The procedure offers a minimally invasive solution with generally good short-term outcomes.
  • Long-term surveillance is important due to the potential for recurrent stenosis.

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