Reconstruction of stenotic or occluded iliofemoral veins and inferior vena cava using intravascular stents: re-establishing access for future cardiac catheterization and cardiac surgery

Ing, Frank F.; Fagan, Thomas E.; Grifka, Ronald G.; Clapp, Sandra K.; Nihill, Michael R.; Cocalis, Mark W.; Perry, James S; Mathewson, James W.; Mullins, Charles E.

doi:10.1016/s0735-1097(00)01091-3

Cited by 53 publications

(30 citation statements)

References 29 publications

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“…However, it is problematic for future catheterizations and catheter interventions. In such cases stenting of the iliofemoral veins up to the inferior vena cava is possible and the procedure has been described by Ing and associates [170,171]. Immediate and follow-up results look satisfactory [172] as documented in one study; 70 systemic venous stents were placed in 33 patients and a significant increase in vessel diameter was observed.…”

Section: Systemic Veinsmentioning

confidence: 99%

Transcatheter Stent Therapy in Children: An Update

Sahu

Rao²

2012

Pediat Therapeut

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To address elastic recoil of vessel wall and intimal dissection that can follow balloon angioplasty, stents have been designed and these appear to produce more effective relief of obstruction. Of the two types of stents, namely, balloon expandable and self expandable, balloon expandable stents are most commonly used in children. The usefulness of stents in the management of vascular obstructive lesions not amenable to balloon angioplasty is well established and has been successfully used to treat branch pulmonary artery stenosis, coarctation of the aorta, stenotic right ventricular outflow tract conduits, obstructive lesions of the systemic and pulmonary veins and others. The techniques of implantation, indications, immediate and follow-up results and complications were reviewed. The stents have also been effectively used in keeping open naturally occurring or artificially created inter-circulatory connections and as adjuncts in hybrid procedures, but these have not been discussed in this review. Future directions include investigative work on biodegradable stents and growth stents to address issues related to increase in vessel size in infants and children, use of drug eluding stents to prevent neo-intimal proliferation to avoid pulmonary vein restenosis and refinement of stent technology in hybrid procedures such as neonatal palliation of hypoplastic left heart syndrome and transcatheter completion of Fontan procedure. The feasibility, safety and effectiveness stents in the pediatric population are demonstrated, although scrutiny of results of larger experience with longer follow-up is important.

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Section: Systemic Veinsmentioning

confidence: 99%

Transcatheter Stent Therapy in Children: An Update

Sahu

Rao²

2012

Pediat Therapeut

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“…Very rarely is this symptomatic, manifesting lower-extremity ectasia or prominent lower abdomen superficial veins. 613 The deep femoral veins remain patent, and venous collaterals will drain blood, bypassing the stenosis, often via the internal iliac vein and paravertebral venous system. Because femoral venous thrombosis is most often clinically silent, the true incidence is unknown.…”

Section: Incidence and Significance Of The Problemmentioning

confidence: 99%

“…Ing et al 613 have reported successful late transcatheter rehabilitation of femoral vein thrombosis identified at a followup cardiac catheterization with implantation of stents in 24 patients. Although guidewires were easily passed across the stenotic vessels, occluded vessels required puncture through the thrombosed sites with a stiff wire or transseptal needle.…”

Section: Post-cardiac Catheterization Venous Thrombosismentioning

confidence: 99%

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Giglia¹,

Massicotte²,

Tweddell³

et al. 2013

Circulation

283

245

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“…These techniques have been described in patients with congenital heart disease requiring access for catheterization by one of the authors (F.F.I.) 17,18 but not in children with other chronic illnesses. We illustrate with this case that these techniques can preserve life-sustaining access sites in chronically ill and prothrombotic, PN-dependent patients.…”

Section: Figurementioning

confidence: 99%

Recanalization of Occluded Central Veins in a Parenteral Nutrition–Dependent Child With No Access

Sullivan¹,

Merritt²,

Pelayo

et al. 2018

Pediatrics

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Central venous thromboses are common and pose challenges in the care of chronically ill pediatric patients. Among patients with intestinal failure (most commonly because of short bowel syndrome) who depend on parenteral nutrition, progressive loss of central venous access sites is a potentially fatal complication. We present the case of a 5-year-old girl with parenteral nutrition-dependent short bowel syndrome and no remaining standard central venous access sites despite medical anticoagulation, in whom angioplasty and stent implantations were used to reconstruct chronically occluded central veins. The patient presented with a bloodstream infection necessitating tunneled central venous line removal from the left internal jugular vein. All other standard access sites had known occlusions. The right iliofemoral vein (RIFV) and infrarenal inferior vena cava were recanalized and dilated with high-pressure balloons. The left internal jugular line was removed and a line was placed in the now-patent RIFV for antimicrobial therapy. After treatment, the RIFV line was removed and the vessels were stented open for future access. The occluded left innominate vein was recanalized and dilated to allow a new tunneled line to be placed. At 10 months, the line was functional and uninfected and the RIFV and inferior vena cava stents were patent without in-stent restenosis. We propose a new paradigm that uses these techniques to prevent access site exhaustion in patients who do not respond to anticoagulation therapy. This approach may reduce morbidity and mortality in patients with chronic access needs and the need for intestinal transplantation in patients with intestinal failure.

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Reconstruction of stenotic or occluded iliofemoral veins and inferior vena cava using intravascular stents: re-establishing access for future cardiac catheterization and cardiac surgery

Abstract: Stenotic/obstructed IFV and IVC may be reconstructed using stents to re-establish venous access to the heart for future cardiac catheterization and/or surgeries.

Cited by 53 publications

References 29 publications

Transcatheter Stent Therapy in Children: An Update

Transcatheter Stent Therapy in Children: An Update

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Recanalization of Occluded Central Veins in a Parenteral Nutrition–Dependent Child With No Access

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