PMC6193798_01
Venogram before and after stent placement. (
A
) New thrombi in the common femoral and external iliac veins. (
B
) Thrombolysis resolved new thrombi, while external iliac and common iliac veins were still occluded. (
C
) A 14 x 120 mm Luminexx stent was implanted, but thrombosis occurred in this stent 50 days later. (
D
) Thrombolysis partially resolved the thrombi. (
E
) A second 14 x 120 mm Luminexx stent was implanted to restore the patent of the first stent and a 12 x 90 mm WALLSTENT to restore the patency of the common femoral vein. (
F
) Left lateral venogram showing the long-curve stents.
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New thrombi were founded in the common femoral and external iliac veins ( Fig. 1A ). After thrombolysis with urokinase (Tianjin Biochemical Pharmaceutical, China) at a rate of 200,000 IU/8 h for 36 hours, the new thrombi were resolved, and large lateral branches joining the contralateral common iliac vein were observed, while the external iliac and common iliac veins were still occluded ( Fig. 1B ). Swelling in the left lower extremity reoccurred 50 days later, and venography showed full thrombosis in stent and common femoral vein ( Fig. 1C ). Thrombolysis with urokinase at a rate of 200,000 IU/8 h for 42 hours, the thrombi in stent were partially resolved, and the stent partially recanalized ( Fig. 1D ). Luminexx stent was implanted again to restore the patent of stent, and a self-expanding 12 x 90 mm Wallstent (Boston Scientific, United States) was used to restore the patent of common femoral vein ( Fig. 1E ). Left lateral venogram showed that the implanted long stents in left iliofemoral vein were S-shaped curve ( Fig. 1F ). 
The left iliac vein stent induced inferior vena cava thrombosis. (
A
) The third stent implantation 60 days later, thrombosis occurred in the inferior vena cava, and the left iliac vein stents. (
B
) The proximal end of the stents extended far into the inferior vena cava and covered the outlet of the right common iliac vein. (
C
) The proximal end of the stent depressed the balloon at the outlet of the right common iliac vein. (
D
) Thrombolysis resolved the thrombi in the stents. (
E
) Thrombolysis resolved the thrombi in the inferior vena cava.
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 Despite continual anticoagulation with warfarin, swelling in the left lower extremity reoccurred 60 days later, and full thrombosis occurred in the distal inferior vena cava and stents ( Fig. 2A ). The proximal end of the stent was extended far into the inferior vena cava and covered the outlet of the right common iliac vein ( Fig. 2B and C ). Thrombolysis with urokinase resolved the thrombi in stents for 3 days ( Fig. 2D ) and in inferior vena cava for 5 days ( Fig. 2E ).