Inferior Vena Caval Stenting

Inferior vena caval stenosis after liver transplantation is an uncommon complication that may present with lower extremity edema or ascites. Angioplasty and stenting offer a rapid, minimally invasive therapy for inferior vena caval stenosis. A variety of metallic stents have been used to successfully alleviate caval strictures including Wallstents (Boston Scientific, Natick, MA) and Gianturco-Rosch tracheobronchial Z-stents (Cook, Inc., Bloomington, IN).[1] [2] [3] The latter are attractive because they possess high radial strength, exhibit minimal foreshortening and have large interstices.

REFERENCES

• 1 Simo G, Echenagusia A, Camunez F et al.. Stenosis of the inferior vena cava after liver transplantation: treatment with Gianturco expandable metallic stents.  Cardiovasc Intervent Radiol. 1995;  18 212-216
• 2 Weeks S M, Gerber D A, Jaques P F et al.. Primary Gianturco stent placement for inferior vena cava abnormalities following liver transplantation.  J Vasc Interv Radiol. 2000;  11 177-187
• 3 Borsa J J, Daly C P, Fontaine A B et al.. Treatment of inferior vena cava anastomotic stenoses with the Wallstent endoprosthesis after orthotopic liver transplantation.  J Vasc Interv Radiol. 1999;  10 17-22
• 4 Wittich G R, Goodacre B W, Kennedy P T, Mathew P. Anchoring a migrating inferior vena cava stent with use of a T-fastener.  J Vasc Interv Radiol. 2001;  12 994-996
• 5 Slonim S M, Dake M D, Razavi M K et al.. Management of misplaced or migrated endovascular stents.  J Vasc Interv Radiol. 1999;  10 851-859
• 6 Prahlow J A, O'Bryant T J, Barnard J J. Cardiac perforation due to Wallstent embolization: a fatal complication of the transjugular intrahepatic portosystemic shunt procedure.  Radiology. 1997;  205 170-172