Superior vena cava thrombosis treated by angioplasty and stenting in a cirrhotic patient with peritoneovenous shunt

We report a case of superior vena cava (SVC) thrombosis in a patient with liver cirrhosis and peritoneovenous surgical Denver shunt, successfully treated by angioplasty. In 2005, a 75-year-old man with a criptogenetic liver cirrhosis and peritoneovenous surgical Denver shunt was admitted to our hospital for chylous ascites. Venography showed a stenosis near the junction of the SVC with the right atrium. Magnetic resonance confirmed an endoluminal filling defect, suggestive of thrombosis, close to the jugular extremity of the peritoneovenous surgical denver shunt. A percutaneous transluminal angioplasty of the SVC thrombosis was successfully performed. Dicumarolic treatment was started. Two and 8 months after percutaneous transluminal angioplasty, a computed tomography scan showed the patency of the SVC. The patient died in June 2006 due to severe liver function impairment and hepato-renal syndrome. The present case shows that percutaneous transluminal angioplasty represents a good choice for primary intervention.