Endovenous Intervention for Isolated Idiopathic Non-Malignant High-Grade Stenosis of the Suprahepatic Inferior Vena Cava for Chronic Venous Congestion

Abstract

A high-grade stenosis of the inferior vena cava (IVC) can cause swelling, discoloration of the lower extremities, and the development of venous ulcers. These patients may be unable to participate in physical activities as well. Although anticoagulation and compression therapy may help alleviate symptoms and prevent repeated thrombosis, few patients develop progressive symptoms. We present a case of an elderly female who had progressive venous claudication, edema, heaviness, and discoloration of both lower limbs. Despite endovascular laser therapy for varicose veins, the symptoms worsened, jeopardizing her quality of life. Endovenous intervention with a stent to treat high-grade stenosis at the junction of the suprahepatic IVC and right atrium (RA) could completely relieve her symptoms and improve her quality of life. Isolated severe stenosis of the IVC at the confluence with the RA is a rare cause of chronic venous congestion. Its leads to refractory venous congestion with secondary skin change with an adverse impact on quality of life. Endovenous intervention using an appropriate endovascular prosthesis is the treatment of choice.