VENOUS STENTING VALUE AND LIMITATIONS

Abstract

Venous stenting is an effective treatment of obstructions of large veins, particularly of the superior vena cava, inferior vena cava and their major branches. A wide variety of pathologic conditions can result in large vein obstructions. Neoplastic masses, inflammatory or trumatic lesions and radiation result in large veins obstruction. Central venous stenoses or occlusions in hemodialysis patients are most common. Venous stenting is a simple, percutaneous, low risk procedure that immediately relieves obstruction and results in rapid resolution of patients congestive syndromes. In patients with malignancies, stent placement is an excellent palliative treatment and gives long-term relief in the majority of patients. In patients with benign lesions, stent placement, according to the present experience, promises to be the definitive of large vein obstructions. Patients with obstruction related to their arteriovenous dialysis shunt can benefit from stent placement because it can significantly prolong the life ofthe shunt. Local fibrinolytic therapy is an

essential adjunct treatment prior to patients with venous obstruction superimposed thrombosis.