Stent Placement for Idiopathic Obstruction of the Inferior Vena Cava

Ten patients (mean age 36.6 ± 8 years; 5 male) with idiopathic inferior vena cava obstruction underwent balloon angioplasty, followed by placement of a self-expanding stent. Six had total occlusion, 5 had restenosis (including 2 with total occlusion), and I had a suboptimal result after initial dilatation. The mean diameter of the inferior vena cava increased from 1.5 ± 2.1 mm to 14.4 ± 2.7 mm, and the pressure gradient between the vena cava and the right atrium decreased from 15.2 ± 5.0 mm Hg to 1.1 ± 1.5 mm Hg. Follow-up venography after 74 ± 35 days in 6 patients, revealed ho restenosis, with further enlargement of the mean diameter by 5.2 ± 3.1 mm (44 ± 35%) and abolition of pressure gradients. One patient died 6 months after the procedure from acute Budd-Chiari syndrome. Autopsy revealed a widely patent stent with hepatic vein thrombus. Stent implantation is useful in the management of inferior vena cava obstruction with prior restenosis, total occlusion, or suboptimal results of balloon angioplasty.

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Endovascular treatment of an obstructive membrane between inferior vena cava and right atrium in an unrecognized Budd-Chiari syndrome

CVIR Endovascular ◽

10.1186/s42155-020-00168-5 ◽

2020 ◽

Vol 3 (1) ◽

Author(s):

Maja Strozzi ◽

Kristina Maric Besic ◽

Knezevic Stromar Ivana ◽

Anić Darko

Keyword(s):

Inferior Vena Cava ◽

Balloon Angioplasty ◽

Inferior Vena ◽

Vena Cava ◽

Percutaneous Treatment ◽

Right Atrial ◽

Budd Chiari Syndrome ◽

Inferior Vena Cava Obstruction ◽

Chiari Syndrome ◽

Atrial Tumor

Abstract Background Budd-Chiari syndrome is defined as a hepatic venous outflow track obstruction of various etiology, which appears at different levels. The inferior vena cava outflow membrane is an unusual, but a potentially treatable cause. The percutaneous treatment has emerged as a very promising management mode for such patients. Follow-up results are favorable for balloon angioplasty and/or stenting, with minimal re-stenosis rates. Case presentation We report a case of a young woman, earlier operated on congenital heart defect and with previous pulmonary embolic incident after childbirth, with no evidence of thrombophilia. She was admitted to our institution for a suspected right atrial tumor. After the diagnosis of Budd-Chiari syndrome caused by membranous inferior vena cava obstruction, a percutaneous treatment of a thick membrane was successfully performed, using an unusual technique. Conclusion Balloon angioplasty should be considered in cases of membranous obstruction of vena cava, where a focal obstruction is causing the symptoms. In our patient, the anatomy was not suitable for stenting, and balloon dilatation was successful just after the membrane was pulled apart with a big balloon in a “Rashkind-like” procedure.

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Recanalization and Reconstruction of a Chronically Occluded Inferior Vena Cava Through an Existing Transjugular Intrahepatic Portosystemic Shunt in the Setting of Budd-Chiari Syndrome

Vascular and Endovascular Surgery ◽

10.1177/15385744211002026 ◽

2021 ◽

pp. 153857442110020

Author(s):

Reza Talaie ◽

Hamed Jalaeian ◽

Nassir Rostambeigi ◽

Anthony Spano ◽

Jafar Golzarian

Keyword(s):

Inferior Vena Cava ◽

Transjugular Intrahepatic Portosystemic Shunt ◽

Inferior Vena ◽

Vena Cava ◽

Portosystemic Shunt ◽

Hepatic Veins ◽

Budd Chiari Syndrome ◽

Chiari Syndrome ◽

Intrahepatic Portosystemic Shunt ◽

The Right

Budd-Chiari syndrome (BCS) results from the occlusion or flow reduction in the hepatic veins or inferior vena cava and can be treated with transjugular intrahepatic portosystemic shunt when hepatic vein recanalization fails.1-3 Hypercoagulable patients with primary BCS are predisposed to development of new areas of thrombosis within the TIPS shunt or IVC. This case details a patient with BCS, pre-existing TIPS extending to the right atrium, and chronic retrohepatic IVC thrombosis who underwent sharp recanalization of the IVC with stenting into the TIPS stent bridging the patient until his subsequent hepatic transplantation.

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Large inferior vena cava tumor with cardiac extension revealed by venous thrombembolism in a patient with complete situs inversus: what are the odds?

Romanian Journal of Cardiology ◽

10.47803/rjc.2021.31.1.85 ◽

2021 ◽

Vol 31 (1) ◽

pp. 85-89

Author(s):

Diana-Andreea Roscaneanu ◽

Ovidiu Mitu ◽

Daniela Crisu ◽

Radu-Stefan Miftode ◽

Mihai Stefan Cristian Haba ◽

...

Keyword(s):

Inferior Vena Cava ◽

Situs Inversus ◽

Inferior Vena ◽

Vena Cava ◽

Diffi Cult ◽

Occult Malignancy ◽

Chiari Syndrome ◽

Liver And Kidney ◽

The Right ◽

Complete Situs Inversus

Venous thromboembolism (VTE) can be the fi rst symptom of an occult malignancy in apparently healthy individual. Inferior vena cava (IVC) tumors are rare conditions but with negative prognosis. We present the case of a 57 year-old male patient, with complete situs inversus, diagnosed with hepatic cirrhotic disease and frequent decompensations, that was hospitalized for deep venous thrombosis (DVT) and ascites. Further imagistic investigations revealed a 22 cm tumor inside the IVC with consequent Budd-Chiari syndrome that was actually causing the liver and kidney disease, extending from the infrarenal level to the right atrium. After compensation, the patient was referred to a multidisciplinary surgical team. However, the management of such patients is very diffi cult, and the prognosis is altered. Possible IVC leiomyosarcoma are very rare and such vascular extension has been rarely reported.

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Intrahepatic Cholangiocarcinoma Presenting as the Budd-Chiari Syndrome: A Case Report and Literature Review

Canadian Journal of Gastroenterology ◽

10.1155/2005/943269 ◽

2005 ◽

Vol 19 (12) ◽

pp. 723-728 ◽

Cited By ~ 10

Author(s):

Joanna K Law ◽

Jenny Davis ◽

Anne Buckley ◽

Baljinder Salh

Keyword(s):

Inferior Vena Cava ◽

Intrahepatic Cholangiocarcinoma ◽

Inferior Vena ◽

Primary Tumour ◽

Vena Cava ◽

Biliary Tree ◽

Budd Chiari Syndrome ◽

Radiological Findings ◽

Chiari Syndrome ◽

The Right

Intrahepatic cholangiocarcinoma, an increasingly recognized primary tumour of the liver, is associated with a very poor prognosis. A patient with this tumour who presented with Budd-Chiari syndrome (the first to the authors' knowledge in Western literature and only the third patient overall) secondary to extensive thrombosis in his inferior vena cava extending from the right atrium down to his iliac vessels is described. Neither curative nor palliative intervention was deemed to be an option in this patient, who deteriorated rapidly while on anti-coagulants. Postmortem examination confirmed the radiological findings, and histological analysis revealed characteristic appearances of this tumour within the biliary tree and invasion into the inferior vena cava. Furthermore, biliary dysplasia, which can be a precursor to this cancer, was also noted within some of the bile ducts.

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Percutaneous balloon angioplasty of inferior vena cava in Budd–Chiari syndrome-R1

International Journal of Cardiology ◽

10.1016/s0167-5273(02)00037-2 ◽

2002 ◽

Vol 83 (2) ◽

pp. 175-178 ◽

Cited By ~ 47

Author(s):

Tongguo Wu ◽

Lexin Wang ◽

Qiang Xiao ◽

Bosong Wang ◽

Shanying Li ◽

...

Keyword(s):

Inferior Vena Cava ◽

Balloon Angioplasty ◽

Inferior Vena ◽

Vena Cava ◽

Budd Chiari Syndrome ◽

Percutaneous Balloon ◽

Chiari Syndrome ◽

Percutaneous Balloon Angioplasty

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A Rare Case of Budd-Chiari Syndrome with Inferior Vena Cava Obstruction in a Patient with Sickle Cell Trait

The American Journal of Gastroenterology ◽

10.14309/00000434-200809001-00545 ◽

2008 ◽

Vol 103 ◽

pp. S210-S211

Author(s):

Matthew Tsushima ◽

Deborah Anghesom ◽

Bruce Runyon

Keyword(s):

Inferior Vena Cava ◽

Sickle Cell ◽

Rare Case ◽

Inferior Vena ◽

Sickle Cell Trait ◽

Vena Cava ◽

Budd Chiari Syndrome ◽

Inferior Vena Cava Obstruction ◽

Chiari Syndrome

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Accuracy of Central Venous Pressure Measuremet From the Abdominal Inferior Vena Cava

PEDIATRICS ◽

10.1542/peds.89.3.506 ◽

1992 ◽

Vol 89 (3) ◽

pp. 506-508

Author(s):

THOMAS R. LLOYD ◽

RICHARD L. DONNERSTEIN ◽

ROBERT A. BERG

Keyword(s):

Inferior Vena Cava ◽

Central Venous Pressure ◽

Right Atrium ◽

Inferior Vena ◽

Venous Pressure ◽

Vena Cava ◽

Pressure Measurements ◽

Central Venous ◽

The Mean ◽

The Right

Central venous pressure measurements in the abdominal inferior vena cava were compared with measurements in the right atrium in 10 infants and 10 children during cardiac catheterization. At end expiration, the mean pressures at these two sites were within 1 mm Hg of each other in all 20 patients, with a mean difference of 0.0 ± 0.36 mm Hg. The abdominal inferior vena cava is a safe and convenient site for measurement of central venous pressure, and our study confirms that such measurements are accurate.

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