Ultrasonically guided inferior vena cava stent placement: experience in 83 cases.
OBJECTIVE
Traditionally, inferior vena cava (IVC) stent placement is performed with fluoroscopic guidance. The object of this study was to evaluate use of ultrasound (US) as guidance for IVC stent placement for the management of Budd-Chiari syndrome.


METHODS
Eighty-three patients with IVC membranous stenosis (n = 30), membranous occlusion (n = 19), segmental stenosis (n = 21), or segmental occlusion (n = 13) underwent IVC recanalization, balloon dilation, and stent placement under US guidance. Among the 83 patients, 67 had at least one patent hepatic vein, while 16 patients had three occluded hepatic veins.


RESULTS
IVC stents were successfully placed in 79 of 83 patients, with a success rate of 95%. After the procedure, the symptoms and signs of IVC obstruction disappeared or markedly improved in all patients, and the blockage of hepatic outflow was alleviated in 67 patients. Pericardial effusion, complete atrial ventricular block, and stent migration into the right atrium occurred, respectively, in one patient. During 1-46-month follow-up, stent restenosis occurred in one patient; the other stents remained open and functioned effectively.


CONCLUSIONS
Because of the absence of nonionizing radiation and iodinated contrast material, and its low cost, US is well suited and often preferred for guidance of IVC stent placement.
Zhang
C
C
Department of Gastroenterology, Shandong Provincial Hospital, Jinan, China.
Fu
L
L
Zhang
G
G
Xu
L
L
Shun
H
H
Wang
Z
Z
Zhu
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D006502:Budd-Chiari Syndrome / Q000628:therapy*; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation; D003251:Constriction, Pathologic / Q000628:therapy; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000209:etiology; D006327:Heart Block / Q000209:etiology; D006503:Hepatic Veins / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000209:etiology; D012008:Recurrence; D012039:Regional Blood Flow / Q000502:physiology; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D018084:Ultrasonography, Interventional; D014654:Vascular Patency; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging*