Cornman-Homonoff Joshua, Li David, Schiffman Marc
Department of Radiology, New York-Presbyterian Hospital, Weill Cornell Medical Center, 525 East 68th Street, Box 141, New York, NY 10065, USA.
Division of Interventional Radiology, New York-Presbyterian Hospital, Weill Cornell Medical Center, 525 East 68th Street, Box 141, New York, NY 10065, USA.
Clin Imaging. 2017 May-Jun;43:24-27. doi: 10.1016/j.clinimag.2017.01.012. Epub 2017 Jan 26.
Though generally considered benign, angiomyolipomas can invade through the renal vein into the inferior vena cava, putting patients at risk of catastrophic pulmonary fat embolization. Venous invasion is thus an indication for surgical resection but is thought to increase the risk of adverse operative outcomes including intraoperative hemorrhage and embolization of fat and/or tumor thrombus. We report a novel approach to mitigating these complications illustrated in the case of a 43-year-old woman with IVC-invasive renal AML who underwent successful radical nephrectomy after concurrent pre-operative renal artery embolization and placement of a retrievable suprarenal IVC filter.
虽然血管平滑肌脂肪瘤通常被认为是良性的，但它可以通过肾静脉侵入下腔静脉，使患者面临灾难性肺脂肪栓塞的风险。因此，静脉侵犯是手术切除的指征，但被认为会增加不良手术结果的风险，包括术中出血以及脂肪和/或肿瘤血栓的栓塞。我们报告了一种减轻这些并发症的新方法，该方法体现在一名43岁患有下腔静脉侵犯性肾血管平滑肌脂肪瘤的女性病例中，该患者在术前同时进行肾动脉栓塞和放置可回收的肾上腺下腔静脉滤器后成功接受了根治性肾切除术。
