Physiologic Effect of Stent Therapy for Inferior Vena Cava Obstruction Due to Malignant Liver Tumor

Kishi, Kazushi; Sonomura, Tetsuo; Hisashi, Fujimoto; Kimura, Masashi; Yamada, Katsuya; Sato, Morio; Juri, Masanobu

doi:10.1007/s00270-004-0324-x

Cited by 9 publications

(5 citation statements)

References 44 publications

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“…8 As expected, the immediate effect of IVC stent was recovery of caval flow. Secondary effects included increased atrial filling potentially leading to pulmonary edema and tachyarrhythmias, prominent diuresis secondary to increased renal blood flow and decrease in edema and ascites caused by migration of extravascular fluid into the intravascular space.…”

Section: Discussionmentioning

confidence: 61%

“…The boxed "RA" represents the right atrium. Various reports of metallic stent placement for treatment of other causes of venous outflow obstruction abound the literature including patients with intractable ascites due to polycystic liver disease, 7 patients with malignant liver tumors, 8 and post-right lateral sector living-donor liver transplantation. 9 Patients should be maintained on anticoagulation for at least 6 months following placement of the stent.…”

Section: Discussionmentioning

confidence: 99%

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Remnant Torsion Causing Budd-Chiari Syndrome After Right Hepatectomy

Wang

Truty

Donohue

2010

Journal of Gastrointestinal Surgery

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Remnant Torsion Causing Budd-Chiari Syndrome After Right Hepatectomy

Wang

Truty

Donohue

2010

Journal of Gastrointestinal Surgery

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“…In our study collective, the average procedure time amounted to 26 min which is considerably shorter than in previously published studies. This is supposed to be a result of the operator’s experience [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…edema, anasarca and ascites before and after the procedure. To this end, we modified previously published grading systems [ 6 , 10 , 11 ].…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2022

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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.

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“…Radiation and chemotherapy are only modestly effective for vein obstruction secondary to malignant tumors, thus stent placement represents a less invasive but effective therapy for relieving vein obstruction and increasing the quality of life of these patients (2,8,10,(16)(17)(18)(19)(20)(21)(22)(23). Due to risk factors, SVC occlusion is usually more serious than that of IVC and iliac veins for similar venous obstructive symptoms.…”

Section: Discussionmentioning

confidence: 99%

Endoluminal treatment for venous vascular complications of malignant tumors

Xiao

Tong

Shen

2012

Experimental and Therapeutic Medicine

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Abstract. The aim of this study was to explore the efficacy and safety of interventional treatment for venous vascular complications of malignant tumors. Sixty-one patients with venous vascular complications of malignant tumors were treated from May 2002 to May 2009; 37 men and 24 women with mean age 57.8 years (33-82 years). Lesions included acute deep vein thrombosis (n=18); venous stenosis or occlusion (n=32); tumor embolus in vein (n=11). The interventional therapeutic operations included vena cava filter implantation, transcatheter thrombolytic therapy, recanalization, percutaneous transluminal angioplasty (PTA) and stenting. The success rate of thrombolysis and stent implantation, the clinical success rate, complications, recurrence rate of the treated region and survival duration were recorded. Eighteen patients accepted filter and thrombolytic therapy with a success rate of 100%; total urokinase dosage was 7.42±1.49 (4.5-10) million units. Symptoms disappeared (n=15), were palliated (n=3) and thrombi were completely dissolved (n=2), almost completely dissolved (n=8, >90%), partially dissolved (n=6, 50-90%) and not dissolved (n=2, <50%). No pulmonary embolism emerged after the operation. Forty-three patients accepted recanalization, PTA and stent therapy with a success rate of 95.3% (41/43). Symptoms disappeared (n=25), were palliated (n=16) and did not change (n=2) 3 days following the operation. There were no severe complications during the procedure. During followup, 12 patients again suffered symptoms of venous occlusion and 47 patients died of tumor aggravation without symptom recurrence. As a result, interventional therapy has advantages including smaller injuries, well tolerance, high success rate, quick palliation of symptoms and superior clinical efficacy in the treatment of venous vascular complications for malignant tumors.

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Physiologic Effect of Stent Therapy for Inferior Vena Cava Obstruction Due to Malignant Liver Tumor

Cited by 9 publications

References 44 publications

Remnant Torsion Causing Budd-Chiari Syndrome After Right Hepatectomy

Remnant Torsion Causing Budd-Chiari Syndrome After Right Hepatectomy

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

Endoluminal treatment for venous vascular complications of malignant tumors

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