Endovascular strategies for inferior vena cava obstruction

Inferior vena cava (IVC) syndrome is a relatively uncommon yet debilitating disorder. Traditional medical and surgical therapy has been suboptimal in dealing with this entity. Endovascular therapy depends on the nature and chronicity of the lesion, requiring correlation with presenting symptoms, noninvasive imaging findings, and angiographic findings. We present a brief review of the literature on the treatment of vena cava obstruction, as well as our experience in IVC recanalization in 17 patients with chronic obstructions. Of the 17 patients, 15 had initial technical success, with 14 of these undergoing stent deployment. At a follow-up time of up to 19 months, a primary patency rate of 80% and secondary patency rate of 87% was observed. Endovascular therapy of IVC syndrome is a promising and successful approach to the treatment of IVC syndrome, both in cases of acute obstruction due to malignant cause, as well as chronic obstruction of benign cause.