Inferior vena cava filter placement for prevention of pulmonary tumor emboli of renal cancer with renal vein or vena caval tumor thrombus: prophylactic usage prior to transcatheter arterial embolization.

PURPOSE

To prevent pulmonary embolization of necrotic intravenous tumor thrombus after transcatheter embolization of renal cell carcinoma, we placed suprarenal inferior vena cava (IVC) filters.

MATERIALS AND METHODS

Suprarenal IVC filters were placed prior to transcatheter arterial embolization (TAE) in four patients, two women and two men, with renal cancer accompanied by renal vein in one and vena caval tumor thrombus in three patients. We used one bird's nest filter for the patient with renal vein tumor thrombus and a titanium Greenfield filter for each of the three patients with vena caval tumor thrombus. TAE was performed with pure ethanol under balloon occlusion of the renal artery.

RESULTS

IVC filters were successfully placed at the suprarenal position. The patients tolerated the procedure well and had extensive tumor infarction, including the tumor thrombus, on follow-up computed tomography (CT). No pulmonary infarction or adverse effects were seen during the follow-up period. One patient died from diabetic renal failure, two patients have been alive for 8.5 and 7.5 months respectively, the other one is lost to follow-up.

CONCLUSIONS

Suprarenal IVC filter placement prior to TAE for advanced renal cell carcinoma invading the renal vein or the IVC is an effective procedure to prevent pulmonary thromboemboli and may contribute to longer survival.