Clinical evaluation of stenting for different types of malignant inferior vena cava obstruction

Objective: To evaluate the clinical outcome of stenting for different types of malignant inferior vena cava (IVC)obstruction. Methods: Eighty-four liver cancer patients complicated with IVC obstruction were divided into external compression type and embolic type by magnetic resonance angiography (MRA)and/or digital subtraction angiography (DSA). Of the 47 cases with external compression type, 26 patients were undergone interventional stent placement (group A)and the other 21 patients were served as control group(group B). Of the 37 cases with embolis type, 20 patients were stented (group C)and remaining 17 patients were in control group (group D). Transarterial chemo-embolization (TACE)were performed for those patients without contraindications. Results: Within one week remission rates of clinical symptoms were 96.2% and 90.0% in group A and group C (P>0.05), after six weeks remission rates were 84.6% and 30.0%, respectively (P<0.05). Re-obstruction rates in these two groups were 30.8% and 75.0%, respectively (P< 0.05). The median survival term was 300 days in group A and 120 days in group B (P<0.05), and those in group C and group D were 67 days and 55 days, respectively (P>0.05). Conclusions: Interventional stent placement is recommended for patients with external compression IVC obstruction, with significant relief of the clinical symptoms and prolongation of the survival term. For embolic type of IVC obstruction patients, stenting is only a short-term palliative modality because of higher re-obstruction rate and shorter survival term. (authors)