Long-term results of treatment of benign central venous obstructions unrelated to dialysis with expandable Z stents.
OBJECTIVE
To evaluate long-term patency of self-expanding Z stents for treatment of benign central venous obstructions unrelated to dialysis.


METHODS
Z stents were placed in 19 patients, (ages 26-72 years) with severe symptomatic obstructions of the superior or inferior venae cavae and their large branches and portal vein caused by surgical or catheter injury (n = 8), fibrosis (n = 5), cirrhosis (n = 3), Budd-Chiari syndrome (n = 2), and extrinsic compression (n = 1). Fourteen patients underwent stent placement primarily, five after local urokinase infusion for superimposed thrombosis. Follow-up was performed with ultrasound and venography.


RESULTS
Venous congestive symptoms quickly resolved in all patients after stent placement. The follow-up period was from 1 to 94 months. Twelve patients have died during follow-up from 1 to 37 months although all remained asymptomatic until death. Six patients remain alive, asymptomatic, with patent stents, and with follow-up from 24 to 94 months. Primary patency was 83%, and secondary patency was 100%. One patient with a patent stent at 12 months was lost to follow-up. No stent migrations, perforations, infections, or significant complications occurred.


CONCLUSIONS
Benign central venous obstructions are effectively treated by the placement of self-expandable Z stents. Placed percutaneously into obstructive lesions with a minimum risk, these stents offer long-term durability and patency.
Dotter Interventional Institute, Portland, OR 97201-3098, USA.
B D
BD
Petersen
B T
BT
Uchida
D000328:Adult; D000368:Aged; D006502:Budd-Chiari Syndrome / Q000150:complications; D002405:Catheterization, Central Venous / Q000009:adverse effects; D003251:Constriction, Pathologic / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010960:Plasminogen Activators / Q000627:therapeutic use; D011169:Portal Vein / Q000293:injuries / Q000473:pathology* / Q000601:surgery; D011832:Radiation Injuries / Q000150:complications; D006435:Renal Dialysis; D015607:Stents; D015996:Survival Rate; D013927:Thrombosis / Q000150:complications / Q000188:drug therapy; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use; D014652:Vascular Diseases / Q000209:etiology / Q000628:therapy*; D014654:Vascular Patency; D014682:Vena Cava, Inferior / Q000293:injuries / Q000473:pathology* / Q000601:surgery; D014683:Vena Cava, Superior / Q000293:injuries / Q000473:pathology* / Q000601:surgery
D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator