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Croatian Medical Journal, Vol. 56 No. 2, 2015.

Original scientific paper

https://doi.org/10.3325/cmj.2015.56.139

New method for treatment of inferior vena cava tumor thrombus – case study

Zoltán Nagy ; Department of Surgery, Bajcsy-Zsilinszky Hospital, Budapest,Hungary
Endre Gyurkovics ; Department of Surgery, Bajcsy-Zsilinszky Hospital, Budapest,Hungary
Péter Pajor ; Department of Surgery, Bajcsy-Zsilinszky Hospital, Budapest,Hungary
Mária Tarjányi ; 1st. Department of Surgery,Semmelweis University, Budapest,Hungary
Attila Szijártó ; 1st. Department of Surgery,Semmelweis University, Budapest,Hungary
Sandor G. Vari ; International Research and Innovation Management Program Cedars-Sinai Medical Center, Los Angeles, CA, USA

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page 139-144

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Abstract

Conventional surgical therapy for advanced renal venous
tumor thrombi results in high morbidity, so there is a need
for less invasive techniques. This report presents the first
case of a successful inferior vena cava (IVC) tumor thrombus
removal without complications with balloon catheter
(BC) via internal jugular vein (IJV), called the venous tumor
thrombus pushing with balloon catheter (VTTP BC). Under
the control of transesophageal echocardiogram and
fluoroscope, a balloon catheter was sleeved on the guide
wire, which was already inserted into the right internal jugular
vein (IJV) and was driven distally above the IVC tumor
thrombus. The balloon was inflated to occlude the IVC for
prevention of pulmonary embolization. After the occlusion,
the guide wire was driven to the cavotomy and was
opened at the ostium of the right renal vein. It was pulled at
both ends and stretched to serve as a rail. The balloon was
gently pushed toward the cavotomy and the thrombectomy
was completed. This is a less invasive method for treatment
of venous tumor thrombus level 3 that can reduce
surgical time, blood loss, and complication rates compared
to the existing surgical methods. Also, it can be performed
without thoracotomy, cardiopulmonary bypass, hypothermic
circulatory arrest, and liver mobilization

Keywords

Hrčak ID:

139305

URI

https://hrcak.srce.hr/139305

Publication date:

15.4.2015.

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