Key result
Preoperative insertion of two vena cava filters in the supra- and infrarenal IVC allowed for safe tumor removal, with the patient alive and free of recurrence or PE at 1.5 years.
Case Report (n=1)
Preoperative insertion of supra- and infrarenal IVC filters may be a safe and effective strategy to prevent fatal perioperative pulmonary embolism in patients with large abdominal tumors complicated by DVT and PE.
Should not yet change practice for perioperative PE prevention; leaves open prospective evaluation of dual IVC filters.
A preoperative inferior vena cava (IVC) filter is reported to be effective in surgical cases with proximal deep venous thrombosis (DVT) or in which pulmonary embolism (PE) has already developed, and considered to be at high risk of developing secondary fatal PE during or after surgery. However, guidelines for using an IVC filter have yet to be established. The patient in the present report had two huge tumors, ascending colon cancer and renal angiomyolipoma, which occupied the entire right half of the abdomen, coexisting PE, DVT and tumor thrombus in the right renal vein. Secondary PE is fatal in the perioperative period, therefore, the vena cava filters were preoperatively inserted into the supra- and the infrarenal IVC. We successfully removed the tumors without complications. The patient is alive without tumor recurrence and PE or recurrent DVT 1 year and 6 months after surgery. The coexistence of two huge abdominal tumors as potential causes of PE and DVT is extremely rare, and we could have safely undergone the operation, using two vena cava filters in the supra- and infrarenal IVC.
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Ban et al. (2008) conducted a case report in Ascending colon cancer, renal angiomyolipoma, pulmonary embolism, deep venous thrombosis (n=1). Preoperative insertion of vena cava filters into supra- and infrarenal IVC was evaluated on Tumor recurrence, PE, or recurrent DVT. Preoperative insertion of two vena cava filters in the supra- and infrarenal IVC allowed for safe tumor removal, with the patient alive and free of recurrence or PE at 1.5 years.
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