Extended Patient Survival after Inferior Vena Cava Stent Placement for Obstruction Caused by Metastatic Colon Cancer

Abstract

Venous obstruction by malignancy is a significant cause of morbidity. Stenting of superior or inferior vena cava obstruction can be very effective in improving symptoms. In some cases, patients who are considered palliative may become eligible for active cancer treatment as a result of the relief of their venous obstruction. In this report, we describe the case of a patient with advanced colon cancer with a large right hepatic lobe metastatic lesion severely compressing the suprarenal inferior vena cava (IVC) resulting in extensive venous collaterals, abdominal wall distension and edema of both lower extremities. Initial treatment with chemotherapy were unsuccessful. The patient was deemed not suitable for further treatment due to her poor performance status. A 24 mm x 70 mm Wallstent venous endoprosthesis was inserted under ultrasound guidance resulting in a rapid improvement in the patient's symptoms of abdominal pain and anasarca. The patient was restarted on chemotherapy one month after the stent insertion resulting in a significant decrease in the size of the dominant right hepatic lobe metastasis. The stent remains patent 7 months after insertion. The patient continues with active treatment of her cancer and maintains an excellent quality-of-life.