Inferior vena cava-syndrome

Klein-Weigel, Peter; Elitok, Saban; Ruttloff, Andreas; Reinhold, Sabine; Nielitz, Jessica; Steindl, Julia; Lutfi, Philippe; Rehmenklau-Bremer, Lars; Hillner, Birgit; Fuchs, Heiko; Wrase, Christian; Herold, Thomas; Beyer, Lukas Philipp

doi:10.1024/0301-1526/a000919

Cited by 12 publications

(9 citation statements)

References 118 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The dose described can be either 37.5 Gy in 15 fractions or 40 Gy in 20 fractions, depending on the patients' general condition. Side effects include nausea, vomiting, anorexia, diarrhoea, and myelosuppression (69,70).…”

Section: Inferior Vena Cava Obstruction (Ivcs)mentioning

confidence: 99%

Radiotherapy in Metastatic Urothelial Carcinoma: Rationale and Clinical Applications

et al. 2022

View full text Add to dashboard Cite

Urothelial carcinoma is the most common type of bladder cancer including upper urinary tract urothelial cell carcinoma (renal pelvis and ureters) and urethral carcinoma. It exhibits high mortality and morbidity rates and is usually diagnosed at a late, incurable stage, carrying a poor prognosis. Local symptoms in patients with metastatic urothelial carcinoma (mUC) have an adverse impact on quality of life (QoL) and are associated with frequent hospitalizations. Herein, we review the role of palliative radiotherapy in mUC as the means to ameliorate a wide range of symptoms, seeking optimum patient stratification, even though the latter should be balanced against any acute or late toxicity that may arise. For this, links to the molecular biology of mUC are explored and QoL assessments are presented. To maximize patient benefit from radiotherapy, we conclude that multi-modal datasets need to be re-visited to better inform multi-center studies where policy makers, health professionals, researchers, and patient groups meet. Radiotherapy either as a monotherapy or alongside systemic therapy may serve as an added value.Urothelial carcinoma (UC) is considered as the most common tumor type that arises from the urinary tract and may present either as bladder carcinoma (BC), upper urinary tract urothelial cell carcinoma (UTUC), or urethral carcinoma (1). BC has been reported as the 10th most common cancer worldwide in 2020 and the 6th most common tumor type in the USA, occurring mainly in older people, with a median age at diagnosis of 73 years (2-4). In developed countries, UTUC shows a lower incidence than that of BC and the ratio of the UC incidence in the renal pelvis, ureter, and bladder is approximately 3: 1: 51 (5, 6). About 25% of patients with UC present with metastatic disease. The 5-year survival for this group of patients is only 7.7% (SEER statistics; 2, 3, 7, 8).Systemic therapy remains the cornerstone in the management of patients with mUC. Prior to the development of effective chemotherapy, median survival for mUC patients rarely exceeded 3 to 6 months (9). In the last few years, a revolution was witnessed in this field, with platinum-based chemotherapy, therapy with checkpoint inhibitors, and more recently immunotherapy, all giving promising results (10). Although the role of radiotherapy is limited in the management of mUC patients in the context of improving survival, its addition to our therapeutic toolbox offers considerable symptomatic relief especially in patients with hematuria and bone metastases (11, 12).Our aim was to feature the role of radiotherapy (RT) in mUC, emphasizing the new RT techniques available and offer guidelines on how to apply this treatment modality in different clinical scenarios. To this end, the underlying molecular enigmas and quality of life (QoL) endpoints cannot be overlooked. To maximize patient benefit from RT, either as a monotherapy or alongside systemic therapy, we conclude that multi modal datasets need to be re-visited to better inform multicenter studies where polic...

show abstract

Section: Inferior Vena Cava Obstruction (Ivcs)mentioning

confidence: 99%

Radiotherapy in Metastatic Urothelial Carcinoma: Rationale and Clinical Applications

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The former includes puncture site complications, improper positioning, delivery system complications, tilting, and incomplete deployment; the latter includes IVC-related thrombosis, filter fracture, vascular perforation, and vascular-enteric fistula [ 7 , 8 ]. Research has found that IVCT is the most common complication of filter implantation [ 9 ], and the presence of the filter increases the risk of lower extremity DVT, particularly when anticoagulation therapy is not administered [ 10 ]. A meta-analysis conducted by Angel et al [ 11 ] revealed an occurrence rate of 4.1% for IVC thrombosis or occlusion after IVCF insertion, with symptomatic cases accounting for 0.8% [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Acute caval thrombosis leading to obstructive shock in the early post insertion period of an inferior vena cava filter: a case report and literature review

Gao,

Chen,

Huang

et al. 2024

Thrombosis J

View full text Add to dashboard Cite

Background Obstructive shock is extremely rare in clinical practice and is caused by acute blood flow obstruction in the central vessels of either the systemic or pulmonary circulation. Utilizing inferior vena cava filters (IVCFs) to prevent pulmonary embolism (PE) is associated with some potential complications, such as inferior vena cava thrombosis (IVCT). Shock as a direct result of IVCT is rare. We present a case of obstructive shock secondary to extensive IVCT caused by inadequate anticoagulant therapy after the placement of an IVCF. Case presentation A 63-year-old male patient with a traffic accident injury presented orthopaedic trauma and lower limb deep vein thrombosis (DVT). He experienced sudden and severe abdominal pain with hypotension, tachycardia, tachypnea, oliguria and peripheral oedema 5 days after IVCF placement and 3 days after cessation of anticoagulant therapy. Considering that empirical anti-shock treatment lasted for a while and the curative effect was poor, we finally recognized the affected vessels and focused on the reason for obstructive shock through imaging findings—inferior vena cava thrombosis and occlusion. The shock state immediately resolved after thrombus aspiration. The same type of shock occurred again 6 days later during transfer from the ICU to general wards and the same treatment was administered. The patient recovered smoothly in the later stage, and the postoperative follow-up at 1, 3, and 12 months showed good results. Conclusion This case alerts clinicians that it is crucial to ensure adequate anticoagulation therapy after IVCF placement, and when a patient presents with symptoms such as hypotension, tachycardia, and lower limb and scrotal oedema postoperatively, immediate consideration should be given to the possibility of obstructive shock, and prompt intervention should be based on the underlying cause.

show abstract

“…Studies addressing IVC stenting in particular remain limited and are commonly reported in the context of heterogeneous patient cohorts including SVC obstructions as well [ 9 , 15 – 17 ]. One major reason for this fact is that malignant IVC obstruction is a rare condition [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Malignant obstruction of the inferior vena cava: clinical experience with the self-expanding Sinus-XL stent system

et al. 2022

View full text Add to dashboard Cite

Purpose To evaluate the technical and clinical outcome of Sinus-XL stent placement in patients with malignant obstruction syndrome of the inferior vena cava. Methods Between October 2010 and January 2021, 21 patients with different malignant primary disease causing inferior vena cava obstruction were treated with Sinus-XL stent implantation. Procedural data, technical and clinical outcome parameters were retrospectively analyzed. Results Technical success was 100%. Analysis of available manometry data revealed a significant reduction of the mean translesional pressure gradient following the procedure (p = 0.008). Reintervention rate was 4.8% (1/21). The available follow-up imaging studies showed primary and primary-assisted stent patency rates of 93% (13/14) and 100% (14/14), respectively. Major complications did not occur. The clinical success regarding lower extremity edema was 82.4% (14/17) for the first and 85.7% (18/21) for the last follow-up. Longer lengths of IVC obstruction were associated with reduced clinical improvement after the procedure (p = 0.025). Improvement of intraprocedural manometry results and lower extremity edema revealed only minor correlation. Ascites and anasarca were not significantly positively affected by the procedure. Conclusion Sinus-XL stent placement in patients with malignant inferior vena cava obstruction showed high technical success and low complication rates. Regarding the clinical outcome, significant symptom improvement could be achieved in lower extremity edema, whereas ascites and anasarca lacked satisfying symptom relief. Based on our results, this procedure should be considered as a suitable therapy in a palliative care setting for patients with advanced malignant disease.

show abstract

Inferior vena cava-syndrome

Cited by 12 publications

References 118 publications

Radiotherapy in Metastatic Urothelial Carcinoma: Rationale and Clinical Applications

Radiotherapy in Metastatic Urothelial Carcinoma: Rationale and Clinical Applications

Acute caval thrombosis leading to obstructive shock in the early post insertion period of an inferior vena cava filter: a case report and literature review

Malignant obstruction of the inferior vena cava: clinical experience with the self-expanding Sinus-XL stent system

Contact Info

Product

Resources

About