# A duodenocaval fistula due to erosion of a covered vena cava stent after 10 years

## TL;DR

A man developed a rare intestinal-vein connection 10 years after a stent was placed, requiring surgery to remove the infected stent and repair the damage.

## Contribution

Reports a rare long-term complication of covered vena cava stents leading to a duodenocaval fistula.

## Key findings

- A covered vena cava stent eroded into the duodenum after 10 years, causing a fistula and infection.
- Surgical removal of the infected stent and repair of the duodenum were necessary due to extensive collateral circulation.
- The case highlights the potential for severe long-term complications in patients with complex venous histories.

## Abstract

A 58-year-old man developed a rare duodenocaval fistula a decade after cavo-bi-iliac stenting placed for chronic iliocaval occlusion after prior inferior vena cava (IVC) ligation. He presented with fever, polymicrobial bacteremia, and thrombus within the IVC stent. Imaging and endoscopy showed an infected covered stent eroding into the duodenum, creating a fistulous tract. A two-stage surgical approach repaired the damaged duodenum and removed the infected stent, followed by IVC closure using fascia lata. Extensive collateral circulation made reconstruction unsuitable. This case highlights the severe long-term risks of covered IVC stents, particularly in patients with complex venous histories.