scholarly journals Prognosis of patients operated on for renal cell carcinoma and tumor venous thrombosis: experience of the Urology Clinics, N.N. Blokhin National Medical Research Center of Oncology

2021 ◽  
Vol 17 (3) ◽  
pp. 19-28
Author(s):  
M. I. Volkova ◽  
N. L. Vashakmadze ◽  
A. V. Klimov ◽  
A. K. Begaliev ◽  
K. P. Kuznetsov ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Free Survival ◽  
Tumor Thrombosis ◽  
Regional Metastases ◽  
Prognostic Groups ◽  
Vena Cava Thrombosis ◽  
Inferior Vena Cava Thrombosis

Objective: to identify independent risk factors affecting survival of patients with renal cell carcinoma (RCC) and tumor venous thrombosis who have undergone nephrectomy and thrombectomy.Materials and methods. This study included 768 patients with RCC complicated by tumor venous thrombosis who have undergone nephrectomy and thrombectomy. Median age was 58 years (range: 16-82 years); the male to female ratio was 2.3:1. The symptoms of tumor venous thrombosis were identified in 232 patients (30.2 %); laboratory abnormalities at baseline were observed in 456 patients (59.3 %). Grade I and II tumor thrombosis was diagnosed in 456 (59.3 %) and 201 (26.2 %) patients, respectively; grade III and IV thrombosis was found in 171 (22.3 %) and 177 (23.0 %) patients, respectively. One hundred and twenty-nine participants (16.8 %) had infrarenal inferior vena cava thrombosis. Regional metastases were detected in 188 individuals (24.4 %), distant metastases were registered in 274 patients (35.7 %). All patients have undergone surgery: either radical (n = 555; 72.3 %) or cytoreductive (n = 213; 27.7 %). All primary tumors were histologically classified as RCC (G3-4 in 337 cases; 43.9 %). A total of 719 patients (93.6 %) survived the perioperative period; 183 patients with metastasis (23.8 %) received systemic antitumor therapy.Results. The median follow-up was 24 months (range: 1-200 months). The 24-month overall and cancer-specific survival of all patients were 96.9 and 99.7 %, respectively; recurrence-free survival of patients after radical surgery reached 92.9 %. Progression-free survival among those patients who underwent cytoreductive surgery and received first-line therapy/follow-up was 41.7 %. Negative predictive factors of overall survival included hepatomegaly (p = 0.024), ascites (p = 0.033), level IV tumor thrombosis (p <0.0001), infrarenal inferior vena cava thrombosis (p = 0.002), regional metastases (p <0.0001), and cytoreductive surgery (p = 0.012). Depending on the number of risk factors, we have identified 3 prognostic groups: favorable (0 factors), intermediate (1-2 factors), and poor (3-6 factors). Median overall survival differed significantly between the groups and was 128.6 ± 11.8; 40.9 ± 6.7 and 12.3 ± 2.2 months, respectively (p <0.0001 for all).Conclusion. Stratification of patients operated on for RCC and venous tumor thrombosis with their allocation to prognostic groups will ensure the choice of an optimal management strategy.

scholarly journals Ly6CLo Monocyte/Macrophages are Essential for Thrombus Resolution in a Murine Model of Venous Thrombosis

2019 ◽  
Vol 120 (02) ◽  
pp. 289-299 ◽  
Author(s):  
Andrew Scott Kimball ◽  
Andrea Tara Obi ◽  
Catherine E. Luke ◽  
Abigail R. Dowling ◽  
Qing Cai ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Extracellular Traps ◽  
Complex Process ◽  
Diphtheria Toxin Receptor ◽  
Similar Phenotype ◽  
Vena Cava Thrombosis ◽  
Toxin Receptor ◽  
Inferior Vena Cava Thrombosis

AbstractVenous thrombosis (VT) resolution is a complex process, resembling sterile wound healing. Infiltrating blood-derived monocyte/macrophages (Mo/MΦs) are essential for the regulation of inflammation in tissue repair. These cells differentiate into inflammatory (CD11b+Ly6CHi) or proreparative (CD11b+Ly6CLo) subtypes. Previous studies have shown that infiltrating Mo/MΦs are important for VT resolution, but the precise roles of different Mo/MΦs subsets are not well understood. Utilizing murine models of stasis and stenosis inferior vena cava thrombosis in concert with a Mo/MΦ depletion model (CD11b-diphtheria toxin receptor [DTR]-expressing mice), we examined the effect of Mo/MΦ depletion on thrombogenesis and VT resolution. In the setting of an 80 to 90% reduction in circulating CD11b+Mo/MΦs, we demonstrated that Mo/MΦs are not essential for thrombogenesis, with no difference in thrombus size, neutrophil recruitment, or neutrophil extracellular traps found. Conversely, CD11b+Mo/MΦ are essential for VT resolution. Diphtheria toxoid (DTx)-mediated depletion after thrombus creation depleted primarily CD11b+Ly6CLo Mo/MΦs and resulted in larger thrombi. DTx-mediated depletion did not alter CD11b+Ly6CHi Mo/MΦ recruitment, suggesting a protective effect of CD11b+Ly6CLo Mo/MΦs in VT resolution. Confirmatory Mo/MΦ depletion with clodronate lysosomes showed a similar phenotype, with failure to resolve VT. Adoptive transfer of CD11b+Ly6CLo Mo/MΦs into Mo/MΦ-depleted mice reversed the phenotype, restoring normal thrombus resolution. These findings suggest that CD11b+Ly6CLo Mo/MΦs are essential for normal VT resolution, consistent with the known proreparative function of this subset, and that further study of Mo/MΦ subsets may identify targets for immunomodulation to accelerate and improve thrombosis resolution.

scholarly journals A Cohort Study of Inferior Vena Cava Thrombosis in Taiwan: An Under-recognized Entity

2021 ◽  
Author(s):  
Hsuan-Yu Lin ◽  
Ching-Yeh Lin ◽  
Ming-Ching Shen
Keyword(s):  
Risk Factors ◽  
Inferior Vena Cava ◽  
Venous Thrombosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Antithrombin Deficiency ◽  
Lupus Anticoagulants ◽  
Ivc Filters ◽  
Vena Cava Thrombosis ◽  
Inferior Vena Cava Thrombosis

Abstract Background: Inferior vena cava thrombosis (IVCT) is a rare clinical condition. Herein, we report eight cases of IVCT in Taiwanese patients.Methods: Eight Taiwanese patients diagnosed with IVCT between May 2012 and December 2019 were included in this study. The patients’ demographics, presenting characteristics, additional sites of venous thromboembolism, extent of IVCT, prothrombotic risk factors, and IVCT-related adverse events were evaluated.Results: All eight patients with IVCT presented with other coexisting venous thromboembolic manifestations, such as deep venous thrombosis (DVT, 100%) or pulmonary embolism (62.5%). The clinical presentations, including DVT in both lower extremities coexisting with the dilatation of the superficial veins of the abdominal wall (50%), were reported. No congenital anomalies of the inferior vena cava (IVC) were noted. Various thromboembolic risk factors, such as unretrieved IVC filters (25%), pregnancy (37.5%), lupus anticoagulants (37.5%), surgery (25%), antithrombin deficiency (12.5%), hemoglobin H disease (12.5%), and essential thrombocythemia (12.5%), were identified. All patients were administered anticoagulants. One patient (12.5%) developed post-thrombotic syndrome. No mortality was reported in our cohort. Conclusions: This is the first report of IVCT in Taiwanese patients. Typical clinical features of IVC occlusion coexisting with predisposing factors of venous thrombosis, such as lupus anticoagulants, pregnancy, or unretrieved IVC filters, could indicate a diagnosis of IVCT. Moreover, IVCT presenting as a complication resulting from the unretrieved IVC filter was observed, highlighting the potential risks of chronic indwelling filters.

scholarly journals A Case of Inferior Vena Cava Thrombosis Induced by Left Iliac Vein Stents

2018 ◽  
Vol 07 (01) ◽  
pp. e39-e42 ◽  
Author(s):  
Wei Wei ◽  
Xuemei Jiang ◽  
Bo Xu ◽  
Yikuan Chen
Keyword(s):  
Case Report ◽  
Inferior Vena Cava ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vena Cava Thrombosis ◽  
Inferior Vena Cava Thrombosis

AbstractStents have been widely used to restore the patency of the iliac vein in the treatment of its obstruction. However, various complications related to those stents have been reported. This case report covers a 67-year-old male who was diagnosed with left iliofemoral venous post-thrombotic syndrome with recurrent acute deep venous thrombosis. Thrombosis of the inferior vena cava was induced by pronounced extension of left iliac vein stents. Extending stents in this way covers the outlet of the contralateral common iliac vein and may induce thrombosis in the inferior vena cava.

Pediatric child abuse victim with posttraumatic inferior vena cava thrombosis

2014 ◽  
Vol 30 (5) ◽  
pp. 569-571 ◽  
Author(s):  
Meggan L. Goodpasture ◽  
Kristen A. Zeller ◽  
John K. Petty
Keyword(s):  
Child Abuse ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Thrombosis ◽  
Inferior Vena Cava Thrombosis

Retrieval of Bard Simon Nitinol inferior vena cava filters: Approaches, technical successes, complications, and clinical outcomes

2021 ◽  
pp. 026835552092598
Author(s):  
Jacob J Bundy ◽  
Jeffrey Forris Beecham Chick ◽  
Ravi N Srinivasa ◽  
Kyle J Cooper ◽  
Joseph J Gemmete ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Inferior Vena Cava Filters ◽  
Vena Cava Filters ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Vena Cava Thrombosis ◽  
Inferior Vena Cava Thrombosis

Objective The Simon Nitinol filter is a bi-level filtration device designed for permanent implantation that is no longer commercially available, but may result in similar complications to current commercially available long term indwelling temporary or permanent filters. Complications related to indwelling inferior vena cava filters include inferior vena cava thrombosis, inferior vena cava penetration, filter migration, and filter fracture. There is a paucity of reports describing the technical aspects related to retrieval of Simon Nitinol filters. Materials and methods This study consisted of five patients with Simon Nitinol filters and describes the indication for retrieval, the retrieval techniques used to remove the filters, technical success, complications, and clinical course. Results The indications for retrieval included: abdominal pain ( n = 2; 40%), iliocaval thrombosis ( n = 1; 20%), identification of an intracardiac filter fragment ( n = 1; 20%), and recurrent venous thromboembolic events ( n = 1; 20%). Retrieval techniques included: biopsy forceps ( n = 3; 60%), excimer laser extraction sheaths ( n = 3; 60%), hangman modified loop snares ( n = 3; 60%), rigid endobronchial forceps ( n = 2; 40%), and balloon deflection ( n = 2; 40%). All filters were successfully retrieved. One patient developed a post-procedural intramuscular hematoma near the site of right internal jugular sheath placement. Conclusions Simon Nitinol filters may be retrieved safely and effectively using advanced inferior vena cava filter retrieval techniques.

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