[Interventional radiology in central venous obstructions. Dilatation--stent implantation--thrombolysis].

PURPOSE: Venous congestion of the superior or inferior caval system has to be considered as a medical emergency. The results of various recanalization procedures and their utility are analyzed. PATIENTS AND METHODS: 176 patients with superior and 28 with inferior caval obstruction were treated with Gianturco-Z (n = 39) and Wall Stents (n = 207) respectively. Balloon venoplasty was performed prior to stent implanation. In 27 cases, local thrombolysis with urokinase was employed. RESULTS: Interventional procedures were successful in 198 and without success in 6 patients. In most patients, symptoms were relieved during or early after recanalization. No major complications were found. DISCUSSION: Balloon angioplasty with stent placement and local thrombolysis are successful in the treatment of superior and inferior caval obstruction. Self-expanding Wallstents are superior to Gianturco-Z-stents. Oncologists should be made familiar with this type of treatment.