Journal: Frontiers in Pharmacology
Article Title: Endovascular management of primary long-segment inferior vena cava occlusion: treatment strategies and clinical outcomes
doi: 10.3389/fphar.2025.1512157
Figure Lengend Snippet: Innovative treatment and 1-year follow-up outcomes of IVC stenosis. Note: (A) A CT scan revealed a complete occlusion of the IVC, extending from the bilateral iliac veins to the entrance of the right atrium. The white arrow indicates the compensatory dilatation of the left lumbar vein, while the black arrow points out the calcified region of the iliac vein. (B) After unsuccessful attempts to access the occlusion via the femoral vein, a stiff wire and a guiding catheter were successfully inserted into the obstructed IVC through the right internal jugular vein. Subsequently, the wire was removed from the groin. (C) Femoral venography revealed the presence of abundant collateral circulation, which raised doubts about the correct placement of the wire in the IVC. (D) A thrombolysis catheter was successfully placed in the IVC, and the position of the catheter in the true lumen was confirmed through venography. The distance between the two arrows indicates the effective length of the thrombolysis catheter. (E) Gradual dilation of the IVC was performed using a balloon. Despite the dilation, the imaging results showed that the stenosis of the IVC still exceeded 50%. Therefore, four Wallstents and two Luminex stents were placed between the hepatic and right external iliac veins. After the stents were placed, subsequent imaging results demonstrated the restoration of patency in the IVC. (F) The one-year follow-up CT scan confirmed the IVC and right iliac vein patency with no residual stenosis. The black arrow in the image points to the hepatic vein, while the white arrow indicates the calcified region of the iliac vein.
Article Snippet: Stent models and manufacturers included Wallstents (Boston Scientific, United States), Z-stents (Shenyang Yongtong Technology Co., Ltd., China), Zilver stents (Cook Medical, Ireland), and lumbar stents (Bard, Germany).
Techniques: Computed Tomography, Imaging, Luminex
