Endovascular stenting of ascending lumbar veins for refractory inferior vena cava occlusion.

Chronic inferior vena cava (IVC) occlusion is a debilitating disease process. Recently, endovascular techniques have been described using progressive balloon dilatation and stenting to treat IVC occlusion with reasonable success. We present two cases of endovascular dilatation and stenting of the ascending lumbar vein. This technique provided good early relief of symptoms with ulcer healing, decreased swelling, and decreased pain. To our knowledge this is the first report of endovascular therapy of IVC occlusion via stenting of the ascending lumbar vein. This technique may provide a feasible treatment option when the occluded IVC cannot be reopened.