Percutaneous Transluminal Angioplasty for Complete Membranous Obstruction of Suprahepatic Inferior Vena Cava: Long-Term Results.
OBJECTIVE
To determine the long-term results of percutaneous transluminal angioplasty (PTA) for a complete membranous obstruction of the suprahepatic inferior vena cava.


METHODS
Patients (n = 65) who were referred to the interventional unit for PTA for a complete membranous obstruction of the suprahepatic inferior vena cava between January 2006 and October 2014 were included in the study. Thirty-two patients (18 males, 14 females, mean age 35 ± 10.7, range 20-42 years) were treated. The patients presented with symptoms of ascites (88 %), pleural effusion (53 %), varicose veins (94 %), hepatomegaly (97 %), abdominal pain (84 %), and splenomegaly (40 %). Transjugular liver access set and re-entry catheter were used to puncture and traverse the obstruction from the jugular side. PTA balloon dilations were performed. The mean follow-up period was 65.6 ± 24.5 months. The objective was to evaluate technical success, complications, primary patency, and clinical improvement in the symptoms of the patients.


RESULTS
The technical success rate was 94 %. In two patients, obstruction could not be traversed. These patients underwent cavoatrial graft bypass surgery. There were no procedure-related complications. Clinical improvements were achieved in all patients within 3 months. The primary patency rate at 4 years was 90 %. There was no primary assisted patency. There was no need for metallic stent deployment in the cohort. The secondary patency rate at 4 years was 100 %.


CONCLUSIONS
Percutaneous transluminal angioplasty for a complete membranous obstruction of the suprahepatic inferior vena cava is safe and effective, and the long-term results are excellent.
Department of Interventional Radiology, Turkiye Yuksek Ihtisas Hospital, Sihhiye, 06100, Ankara, Turkey. fkucukay@hotmail.com.
Fahrettin
F
Kucukay
Department of Gastroenterology, Turkiye Yuksek Ihtisas Hospital, Sihhiye, 06100, Ankara, Turkey.
Meral
M
Akdogan
Department of Gastrointestinal Surgery, Turkiye Yuksek Ihtisas Hospital, Sıhhiye, 06100, Ankara, Turkey.
Erdal Birol
EB
Bostanci
Department of Cardiovascular Surgery, Hacettepe University, Sıhhiye, 06100, Ankara, Turkey.|Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Hospital, Sihhiye, 06100, Ankara, Turkey.
Ahmet Tulga
AT
Ulus
Department of Internal Medicine, Lokman Hekim Hospital, Sincan, 06350, Ankara, Turkey.
Murat Bulent
MB
Kucukay
D000328:Adult; D017130:Angioplasty / Q000379:methods*; D006502:Budd-Chiari Syndrome / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006529:Hepatomegaly / Q000150:complications; D006801:Humans; D008297:Male; D014648:Varicose Veins / Q000150:complications; D014682:Vena Cava, Inferior / Q000503:physiopathology*; D055815:Young Adult
Angioplasty; Budd–Chiari; Membranous obstruction; Vena cava