IVC kinking and stenosis

Tagged: IVC stenosis

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- 23 July 2018 at 0h12 #2095
  
  Markus Peck-Radosavljevic
  Participant
  
  I am not sure about the ”twisting“ but we had similar cases of IVC-stenosis and were able to treat them successfully with stenting.
  So, I personally would stent this patient.
  
  Kind regards,
  
  Markus Peck
  
  Prof. Dr. Markus Peck-Radosavljevic, M.D.
  
  Chair, Dept. Internal Medicine & Gastroenterology (IMuG)
  Hepatology, Endocrinology, Rheumatology and Nephrology
  with Centralized Emergency Department (ZAE)
  
  Klinikum Klagenfurt am Wörthersee
  Feschnigstrasse 11
  9020 Klagenfurt
  Austria
  
  Ph: +43 463 538 31103 (Ms. Werkl)
  Fax: +43 463 538 31109
  
  On Twitter: @MarkusPeck1
- 23 July 2018 at 7h31 #2096
  
  Juan Carlos Garcia-Pagan
  Participant
  
  I completely agree about stenting,
  best
- 23 July 2018 at 10h26 #2097
  
  David Patch
  Participant
  
  the stenosis is between the tips and the right atrium-it is a maximum of 2cm. Any stent will then end up with the free end in the atrium, plus could also impinge on the TIPS stent. I have an inherent worry about metal stents in benign disease anyway tho there are short large diameter stents available. PLus, she is relatively young, and I am also concerned about complicating the transplant issue with an embedded IVC stent in say 5 years time….
  Its not easy!(not sure if there is a way we can share some of the images-the NHS firewall is relatively robust, unlike our politicians!
- 23 July 2018 at 11h12 #2098
  
  Fabio Piscaglia
  Participant
  
  I share David’s concerns about future transplant possibilities and I wonder whether it could already be the time to consider candidacy if there is not effective alternative. It is also strange how often the TIPS needed to be revised, is there any possible explanation?
- 23 July 2018 at 11h27 #2099
  
  David Patch
  Participant
  
  the problem with transplant is that she “only” has abdominal distension and probable gut oedema. She has no ascites etc-and well preserved liver function.
  re frequent recurrence-I can only imagine that when we dilate, the IVC “un-twists” a bit, and after dilatation it gradually returns back to predilatation state.
- 23 July 2018 at 15h29 #2100
  
  Juan G Abraldes
  Participant
  
  Agree I would not place an stent that has to enter the atrium. Agree with Fabio that the best long term solution would be a transplant, even if the only hard indication is the inability to keep the IVC open
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