دورية أكاديمية
Technical and Anatomic Factors Influencing the Success of Inferior Vena Caval Stent Placement for Malignant Obstruction.
| العنوان: | Technical and Anatomic Factors Influencing the Success of Inferior Vena Caval Stent Placement for Malignant Obstruction. |
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| المؤلفون: | Devcic Z; Division of Interventional Radiology, Stanford University School of Medicine, H-3646, 300 Pasteur Dr., Stanford, CA 94305., Techasith T; Division of Interventional Radiology, Stanford University School of Medicine, H-3646, 300 Pasteur Dr., Stanford, CA 94305., Banerjee A; Division of Interventional Radiology, Stanford University School of Medicine, H-3646, 300 Pasteur Dr., Stanford, CA 94305., Rosenberg JK; Radiology Sciences Laboratory, Stanford University School of Medicine, H-3646, 300 Pasteur Dr., Stanford, CA 94305., Sze DY; Division of Interventional Radiology, Stanford University School of Medicine, H-3646, 300 Pasteur Dr., Stanford, CA 94305. Electronic address: dansze@stanford.edu. |
| المصدر: | Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2016 Sep; Vol. 27 (9), pp. 1350-1360.e1. Date of Electronic Publication: 2016 Apr 23. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Society of Cardiovascular and Interventional Radiology Country of Publication: United States NLM ID: 9203369 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1535-7732 (Electronic) Linking ISSN: 10510443 NLM ISO Abbreviation: J Vasc Interv Radiol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Reston, Va. : Society of Cardiovascular and Interventional Radiology, c1990- |
| مواضيع طبية MeSH: | Stents* , Vena Cava, Inferior*/diagnostic imaging , Vena Cava, Inferior*/physiopathology, Endovascular Procedures/*instrumentation , Neoplasms/*complications , Vascular Diseases/*therapy, Adult ; Aged ; Aged, 80 and over ; Ascites/etiology ; Constriction, Pathologic ; Edema/etiology ; Endovascular Procedures/adverse effects ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasms/diagnostic imaging ; Palliative Care ; Phlebography ; Prosthesis Design ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Vascular Diseases/diagnostic imaging ; Vascular Diseases/etiology ; Vascular Diseases/physiopathology ; Vascular Patency ; Young Adult |
| مستخلص: | Purpose: To evaluate the outcomes of inferior vena cava (IVC) stent placement for malignant obstruction and to identify anatomic and procedural factors influencing technical and clinical success. Materials and Methods: A total of 57 patients (37 male, 20 female; age range, 22-86 y) underwent 62 IVC stent placement procedures using 97 stents (47 Wallstents, 15 S.M.A.R.T. stents, 18 Wallflex stents, 17 others) from 2005 to 2016 for malignant IVC obstruction caused by hepatic metastases (n = 22; 39%), primary hepatic malignancy (n = 16; 28%), retroperitoneal metastases (n = 16; 28%), or other primary malignancy (n = 5; 9%). Presenting symptoms included lower-extremity edema (n = 54; 95%), ascites (n = 28; 50%), and perineal edema (n = 14; 25%). Sixteen percent (n = 10) and 10% (n = 6) of the procedures involved tumor and bland thrombus, respectively. Results: Stent placements resulted in 100% venographic patency and significantly decreased pressure gradients (P < .0001). Lower-extremity swelling, perineal swelling, and abdominal distension improved within 7 days in 83% (35 of 42), 100% (9 of 9), and 40% (6 of 15) of patients, respectively, and at 30 days after the procedure in 86% (25 of 29), 89% (8 of 9), and 80% (4 of 5) of patients, respectively. Increased pre- and post-stent placement pressure gradients were associated with worse outcomes. A 4% stent misplacement rate (4 of 97) was related to the use of Wallstents with caudal stent tapering, asymmetric deployment superior to the obstruction, suprahepatic IVC involvement, and decreased stent adherence to the IVC wall as a result of local mechanical factors. Conclusions: Stent placement is reliable, rapid, and durable in improving malignant IVC syndrome. Understanding of technical and anatomic factors can improve accuracy and avoid complications of stent misplacement. (Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.) |
| تواريخ الأحداث: | Date Created: 20160428 Date Completed: 20170717 Latest Revision: 20170922 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.jvir.2016.02.030 |
| PMID: | 27117949 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1535-7732 |
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| DOI: | 10.1016/j.jvir.2016.02.030 |