Salaskar Abhijit, Ferra Michael, Narayanan Harish, Sood Rishi, Scher Daniel, Chun Albert, Venbrux Anthony, Sarin Shawn
Interventional Radiology Department, George Washington University Hospital, Washington, DC USA.
CVIR Endovasc. 2018;1(1):24. doi: 10.1186/s42155-018-0030-4. Epub 2018 Nov 22.
Radiofrequency (RF) wire recanalization of short segments of central venous obstruction has been considered safe; however its use for recanalization of long segments of inferior vena cava (IVC) has not been reported.
A 55-year-old female with recurrent massive hematemesis was found to have systemic venous upper esophageal varices on endoscopy and an extensive chronic IVC occlusion on CT. Using both a percutaneous transhepatic and transfemoral approach IVC recanalization was performed. A snare was advanced to the cavo-atrial junction via transhepatic venous access. From the groin utilizing RF wire steerable guide sheaths, endovascular reconstruction of the IVC was performed. Post recanalization venography demonstrated patent stented IVC and marked decrease in the intraabdominal-pelvic collaterals. No recurrence of hematemesis was noted. After 6 months, patient remained asymptomatic and had functioning right femoral arteriovenous hemodialysis graft.
Using appropriate techniques, Power wire recanalization of long occlusive segments of IVC can be safe and effective.
射频（RF）导线再通中心静脉短段阻塞已被认为是安全的；然而，其用于下腔静脉（IVC）长段再通的情况尚未见报道。
一名55岁复发性大量呕血的女性在内镜检查中发现有系统性静脉食管上段静脉曲张，CT显示有广泛的慢性IVC闭塞。采用经皮经肝和经股动脉途径进行IVC再通。通过经肝静脉通路将圈套器推进至腔房交界处。从腹股沟处利用射频导线可操纵导鞘进行IVC的血管腔内重建。再通后静脉造影显示IVC支架通畅，腹盆腔侧支明显减少。未再出现呕血。6个月后，患者无症状，右股动静脉血液透析移植物功能良好。
采用适当技术，IVC长段闭塞的动力导线再通可以安全有效。
