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
