Management of hepatic caval stenosis and obstruction with modified Gianturco Z-stents

Eric Olsen; Kyle A Wilson; Jordan Ellis; Daniel L Kirkpatrick; William M Sherk

doi:10.1016/j.jvscit.2023.101287

Management of hepatic caval stenosis and obstruction with modified Gianturco Z-stents

J Vasc Surg Cases Innov Tech. 2023 Aug 7;9(3):101287. doi: 10.1016/j.jvscit.2023.101287. eCollection 2023 Sep.

Authors

Eric Olsen¹, Kyle A Wilson², Jordan Ellis², Daniel L Kirkpatrick², William M Sherk²

Affiliations

¹ University of Michigan Medical School, Ann Arbor, MI.
² Department of Radiology, University of Michigan, Ann Arbor, MI.

Abstract

Hepatic caval stenosis is managed with stenting; however, stent placement can be complicated by migration, which can be life-threatening. The risk of migration can be mitigated by increasing the length of the stent, which increases contact with the vessel wall. We describe the cases of three patients with hepatic caval stenosis treated with two Z-stents sutured together. Each had an uncomplicated postoperative course and demonstrated clinical improvement. The use of sutured Z-stents can increase the stability of the stent and, therefore, decrease the morbidity associated with stent placement for hepatic caval stenosis.

Keywords: Budd-Chiari syndrome; Inferior vena cava; Self-expandable metallic stents; Stents.