Rheolytic mechanical thrombectomy in an oncological emergency
Introduction: suprahepatic veins and inferior vena cava thrombosis can occur in up to 10 % of patients with intrahepatic tumours. The phenomenon of malignant compression venous thromboembolism with or without added superinfection has a short-term poor prognosis. although there is no gold standard in...
| Autores: | , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2022 |
| País: | España |
| Institución: | Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) |
| Repositorio: | r-FISABIO. Repositorio Institucional de Producción Científica |
| OAI Identifier: | oai:fisabio.fundanetsuite.com:p14179 |
| Acceso en línea: | https://fisabio.portalinvestigacion.com/publicaciones/14179 |
| Access Level: | acceso abierto |
| Palabra clave: | Inferior vena cava syndrome Rheolytic mechanical thrombectomy Endovascular surgery |
| Sumario: | Introduction: suprahepatic veins and inferior vena cava thrombosis can occur in up to 10 % of patients with intrahepatic tumours. The phenomenon of malignant compression venous thromboembolism with or without added superinfection has a short-term poor prognosis. although there is no gold standard in its management, it has been suggested that thrombectomy can prevent death and major complications. Case report: 66-year-old patient with a history of cholangiocarcinoma, treated by resection and a new surgical rescue with chemotherapy and neoadjuvant radiotherapy due to liver tumour relapse. a postoperative complication was registered, due to Budd-Chiari syndrome and a biliary fistula that were managed conservatively. Weeks later, a septic shock was diagnosed which required admission into Intensive Care Unit. a computed tomography angiography was performed, which showed an almost complete filling defect of the infra and supradiaphragmatic inferior vena cava. a rheolytic mechanical thrombectomy with an angioJet (TM) device was performed. Complete resolution of the thrombosis without complications derived from the intervention and with tumour remission at six months of subsequent follow-up. Discussion: rheolytic thrombectomy of the inferior vena cava can be a safe and low-invasive alternative in patients with stage IIIa thrombosis. |
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