Usefulness of Cardiopulmonary Bypass in Reconstruction of Inferior Vena Cava Occupied by Renal Cell Carcinoma Tumor Thrombus

Yamashita, C; Azami, Takashi; Okada, Morihito; Toyoda, Yoshiya; Wakiyama, Hidetaka; Yoshida, Masato; Ataka, Kenichi; Okada, M

doi:10.1177/000331979905000106

Cited by 26 publications

(13 citation statements)

References 16 publications

(5 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Yong Yang and colleagues retrospectively reviewed data from a total of 10 patients that underwent temporary balloon occlusion of the IVC during resection of thrombus. 8 Access was gained through the right internal jugular vein. Under fluoroscopic guidance, the catheter was positioned just cranial to the thrombus.…”

Section: Discussionmentioning

confidence: 99%

Antegrade balloon occlusion of inferior vena cava during thrombectomy for renal cell carcinoma

Metcalfe

Chang-Kit

Dumitru

et al. 2013

CUAJ

View full text Add to dashboard Cite

Nephrectomy with inferior vena cava (IVC) thrombectomy for advanced renal cell carcinoma (RCC) is a challenging and morbid surgical case. We describe the use of a simple endoluminal technique to occlude the suprahepatic IVC during thrombectomy. A 60-year-old male presented with a large right-sided RCC and IVC tumour thrombus. The tip of the thrombus, which was nonadherent to the caval wall, extended to the level of the hepatic veins. After complete dissection of the kidney, we obtained suprahepatic control of the IVC by a large compliant balloon, introduced through the right internal jugular vein and inflated just below the level of the diaphragm. The IVC thrombectomy was performed in a bloodless field. Mean blood pressure remained stable during IVC balloon inflation with a total occlusion time of 10 minutes. Intraprocedural completion cavogram and postoperative Doppler ultrasonography showed no residual IVC clot. Blood loss during the thrombectomy portion of the case was scant. The patient's postoperative course was uncomplicated and, at the last followup, he had stable metastatic disease on sunitinib therapy. For the surgical treatment of RCC with retrohepatic IVC tumour extension, transjugular balloon occlusion of the suprahepatic IVC offers an alternative to extensive hepatic mobilization to obtain suprahepatic thrombus control. Advantages over traditional surgical methods may include decreased surgical time, lower risk of liver injury and tumour embolism. We suggest this method for further evaluation.

show abstract

Section: Discussionmentioning

confidence: 99%

Antegrade balloon occlusion of inferior vena cava during thrombectomy for renal cell carcinoma

Metcalfe

Chang-Kit

Dumitru

et al. 2013

CUAJ

View full text Add to dashboard Cite

show abstract

“…We are thankful to this preoperative information, as we could predict, to some extent, that the predominant symptoms in our patient-including hypotension followed by a decrease in SpO 2 and a sudden increase in CVP during the hepatic lobectomy - were due to the migration of the tumor embolus into the right side of the heart. Perhaps the use of TEE should have been considered in advance before the start of surgery, because TEE has been reported to be useful in the diagnosis of tricuspid valve obstructions and pulmonary emboli 6,7…”

Section: Discussionmentioning

confidence: 99%

Reperfusion Pulmonary Edema after the Removal of Hepatocellular Carcinoma Embolus

Lee

Kim

2006

Yonsei Med J

View full text Add to dashboard Cite

To report a non-fatal case of reperfusion pulmonary edema (RPE) after the removal of a hepatocellular carcinoma embolus, which had caused an acute obstruction of the tricuspid valve and pulmonary vasculature during a hepatic lobectomy. Pulmonary embolism caused by hepatocellular carcinoma embolus is extremely rare, and, in the present case, it was associated with unusual clinical features. A 69-year-old ASA II woman with hepatocellular carcinoma was presented for an elective left hepatic lobectomy. During the surgery, the tumor embolus was dislodged from the interior of the lumen of the inferior vena cava (IVC), which then drifted into the tricuspid valve area and pulmonary vasculature. The patient showed the specific signs of acute pulmonary embolism, such as a reduction in end-tidal carbon dioxide, an increase in central venous pressure, and a decrease in arterial pressure. The patient exhibited the symptoms for about 10 minutes. After this period, however, cardiovascular variables became relatively stable, even during a mechanical obstruction due to cross-clamping the pulmonary artery for embolectomy. After several hours of pulmonary embolectomy, the patient experienced an episode of RPE. The ventilatory supports for the treatment of RPE were successful, and the patient recovered without any complications. The patient's case in the present study demonstrates that pulmonary embolism may occur as a result of a hepatocellular carcinoma extending into the IVC during operative management. The anesthesiologist should be careful of the possibilities of RPE after removal of the tumor embolus.

show abstract

“…In patients without evidence of disseminated disease, surgical removal of the primary lesion, including any tumor thrombus, is desirable for improved survival, as well as avoiding sudden death from pulmonary embolism 1 . However, mortality and morbidity have been reported to be 0–9.1% and 0–27.3%, respectively 1,2 , 5–11 . To our knowledge, there have been seven reports in the English literature of cases surviving after intraoperative massive pulmonary embolism from an IVC tumor thrombus 3 .…”

Section: Discussionmentioning

confidence: 99%

Successful recovery from a massive pulmonary artery tumor embolism occurring during surgery for renal cell carcinoma

Kobayashi¹,

Ogura²,

Nishizawa³

et al. 2004

Int J of Urology

View full text Add to dashboard Cite

We report herein on a case of renal cell carcinoma with retrohepatic inferior vena cava tumor thrombus in which intraoperative cardiac arrest from a massive pulmonary embolism was managed successfully with emergency sternotomy and cardiopulmonary bypass, followed by the removal of the primary site and pulmonary artery embolus.Key words cardiopulmonary bypass, inferior vena cava tumor thrombus, intraoperative pulmonary embolism, renal cell carcinoma.

show abstract

Usefulness of Cardiopulmonary Bypass in Reconstruction of Inferior Vena Cava Occupied by Renal Cell Carcinoma Tumor Thrombus

Cited by 26 publications

References 16 publications

Antegrade balloon occlusion of inferior vena cava during thrombectomy for renal cell carcinoma

Antegrade balloon occlusion of inferior vena cava during thrombectomy for renal cell carcinoma

Reperfusion Pulmonary Edema after the Removal of Hepatocellular Carcinoma Embolus

Successful recovery from a massive pulmonary artery tumor embolism occurring during surgery for renal cell carcinoma

Contact Info

Product

Resources

About