Case Competition Highlights: Rare and Complex Venous Cases
Case Competition: Rare and Complex Venous Presentations
Trainees presented eight cases at this case competition, covering unusual complications and inventive rescues across venous and lymphatic disease.
A Cautionary Tale
One presenter described a catastrophic complication: during iliocaval thrombolysis for suspected IVC atresia, catheters were unknowingly advanced into the spinal canal, leading to an epidural hematoma and permanent paraplegia. Preoperative axial imaging was identified as essential before intervening on chronic IVC occlusion.
Device and Technique Cases
- A fractured IVC filter strut embolized to the pulmonary artery was retrieved with a telescoping large bore catheter system.
- A Palma crossover bypass, supported by staged inflow optimization, restored outflow in post-thrombotic central venous obstruction.
- Double barreled venous stents rescued a patient with recurrent superior vena cava syndrome.
Diagnostic and Complication Cases
Other cases covered a delayed glue granuloma after cyanoacrylate ablation, thoracic outlet syndrome masquerading as lymphedema, and a thrombosed IVC filter cleared with retrograde sheathing. The top scoring case described renal autotransplantation for two siblings with retroaortic Nutcracker syndrome after renal vein transposition failed.
