We evaluated the clinical outcome of malignant inferior vena cava (IVC) syndrome after intrahepatic IVC
stent placement by retrospective analysis of 50 consecutive patients (25 men, 25 women, age 32-83 years) with malignant IVC syndrome who were treated with intrahepatic
stent placement. Gianturco-Rosch-Z (GRZ)
stents (n = 45), and Wallstents (n = 5) were inserted. Clinical outcome was assessed from patients' records using a score based on leg swelling, scrotal/vulvar
edema,
ascites and
anasarca before and after
stent placement, as well as at last follow-up visit before death. Clinical follow-up was supplemented by duplex sonography in 36 patients. Inferior venocavography was performed in 5 patients prior to re- intervention. Follow-up time ranged from 1 to 932 days (mean 62 days). Mean pressure gradient in the IVC was reduced from 14 +/- 4.1 mmHg before to 2.9 +/- 3.2 mmHg after
stent placement (p < 0.001). Four patients had
stent occlusion, 2 of whom were successfully re-stented. Primary and secondary patency was 59% and 100%, respectively at 540 days. Immediate clinical data were available in 44 patients: 38 improved; 6 did not respond. Last follow-up visit data were available in 36 patients: 24 showed persistent symptom relief till death. All symptom scores were significantly improved after
stent placement (p < 0.001) and with the exception of
ascites, remained significantly improved (p < 0.05) until the last follow-up. Increased serum
bilirubin was a common characteristic of clinical failures and recurrences. Intrahepatic IVC
stent placement resulted in significant symptomatic relief in patients with malignant IVC syndrome. Palliation was effective even in patients with a very short life expectancy.