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.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )