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Angiología

versão On-line ISSN 1695-2987versão impressa ISSN 0003-3170

Resumo

GONZALEZ-RODRIGUEZ, Paloma et al. Rheolytic mechanical thrombectomy in an oncological emergency. Angiología [online]. 2022, vol.74, n.4, pp.181-185.  Epub 24-Out-2022. ISSN 1695-2987.  https://dx.doi.org/10.20960/angiologia.00381.

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 complica- tion was registered, due to Budd-Chiari syndrome and a biliary fi stula 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 fi lling defect of the infra and supradiaphragmatic inferior vena cava. a rheolytic mechanical thrombectomy with an AngioJet™ 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.

Palavras-chave : Inferior vena cava syndrome; rheolytic mechanical thrombectomy; Endovascular surgery.

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