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Novel Endovascular Approach to IVC Reconstruction

Case and Plan: HPI: 62-year-old previously active male w/ CVI related to complete IVC occlusion/compression presents for venous intervention. Initial Approach Access b/l CFV with 5 Fr sheath Diagnostic venogram Cross into the distal IVC from both sides Upsize femoral sheaths to 10Fre and utilities IVUS Select stenting strategy CEAP 4-5 PMHx: Gastric cancer Social Hx: No toxic habits Medications: Xarelto 20mg daily, bumetanide 1mg PO BID Normal ABI Non obstructive arterial duplex US TTE wnl, no evidence of thrombus in the right atrium No respirophacifcisity of common femoral vein in compression Deep vein reflux signifnant with ivc comporession.