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

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.