Inferior vena cava (IVC) stenting is carried out for symptomatic chronic IVC stenosis or occlusion, and for the treatment of malignant IVC obstruction to alleviate symptoms. We aim to determine the patency of IVC stents placed for both acute-on-chronic and chronic venous occlusion in our tertiary vascular centre.

We completed a retrospective analysis of prospectively collected data on all patients that underwent technically successful IVC stenting. This was undertaken for the treatment of symptomatic venous outflow obstruction or stenosis. We identified cases that took place between February 2015 to November 2021. All patients had standard preoperative work up, including venography with or without intravascular ultrasound for chronic cases. All patients followed standard anticoagulation and surveillance programmes post-procedure, unless there was malignant disease.

A total of 16 patients underwent IVC stenting. 7 of these cases (44%) presented acutely with deep vein thrombosis and chronic underlying IVC stenosis or occlusion. 5 cases (31%) were for symptomatic malignant external IVC compression. In 4 cases (25%), kissing iliac stents were placed into the IVC to treat infrarenal IVC disease. The remainder required single stents in the IVC, or were combined with double-barrelled iliac stents. Re-intervention occurred in 4 cases (25%). This was for in-stent thrombosis. Primary patency was achieved in 75% of cases, while primary-assisted patency was 88%. Stenting the IVC in all cases for malignant obstruction gave symptomatic relief.

In our series, we have been able to demonstrate acceptable patency rates of inferior vena cava stents. Stenting of the occluded / atretic IVC may require additional access from the right internal jugular vein. Stenting above and across the renal veins did not cause any additional complications in our series. Stenting of the IVC is a safe and viable choice, and can give significant improvement in symptoms in patients with limited alternative options for treatment.