[Interventional treatment of idiopathic long-segment occlusion of infrahepatic inferior vena cava complicated with thrombosis].

Objective: To evaluate the efficacy of interventional treatment of idiopathic long-segment occlusion of infrahepatic inferior vena cava (IVC) complicated with thrombosis.

Methods: Fourteen patients with idiopathic long-segment occlusion of infrahepatic IVC complicated with thrombosis underwent endovascular recanalization. All procedures were performed under local anesthesia via internal jugular vein in combination with a unilateral femoral approach. First catheter-directed urokinase thrombolysis was performed. Then the occlusion of IVC was treated with balloon angioplasty and/or stent placement.

Results: Iliocavogram demonstrated an occlusion of IVC from intrahepatic segment to infrarenal segment in 3 patients and an occlusion of infrahepatic IVC above renal veins in 11 patients. Thrombosis was located in IVC (n = 14) and extended to iliofemoarl veins (n = 12). Technical success was achieved in 12 patients. IVCs were recanalized successfully. Complete or partial thrombus removal was accomplished in 8 and 4 cases, respectively. Recanalization failure occurred in 2 patients. No rethrombosis occurred over a mean follow-up of 12 +/- 6 months (range: 1 - 36). And an asymptomatic restenosis of IVC was diagnosed by duplex scanning.

Conclusion: Interventional treatment of idiopathic long-segment occlusion of infrahepatic IVC complicated with thrombosis is a safe and effective method.