Renal cell carcinoma (RCC) has a potential to metastasize to almost any site and this may occur many years following nephrectomy. We present six cases with uncommon sites of metastasis: four patients presented with distal pancreatic metastasis and two with duodenal/head of the pancreas metastasis. Time to metastatic disease varied from 1 to 19 years following renal surgery. For patients are alive and two succumbed to their disease. Long-term survival can be achieved with aggressive surgical excision of disease.

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In this limited performance and safety evaluation, the Trellis-8 thrombectomy system combined with adjunctive therapies, such as mechanical thrombectomy and balloon angioplasty, was effective in 75% of patients with IVC filter-related acute caval occlusion.

Objetivo: Describir la distribución, el mecanismo de las lesiones, el tratamiento y la evolución de los pacientes con trauma vascular periférico, atendidos en un hospital general. Material y métodos: Estudio descriptivo, realizado en pacientes con traumatismos vasculares periféricos atendidos en el HNCH entre 2010 y 2012. La información se obtuvo de las historias clínicas. Resultados: Se encontraron 46 pacientes, observándose 55 lesiones vasculares, 43 arteriales y 12 venosas. El mecanismo de lesión más frecuente fue la herida por arma de fuego (43,5%), siendo la causa más frecuente la agresión (57%). De las lesiones arteriales, 27 fueron en miembros superiores y 16 en miembros inferiores, siendo el tipo de lesión más frecuente la sección completa (61%) y el tratamiento más empleado el injerto de vena safena en el segmento de la arteria lesionada en el 40%. Las lesiones venosas fueron 6 en miembros superiores e inferiores, siendo el tipo de lesión más frecuente la sección completa (59%) y el método de reparación más utilizado la ligadura (58%). La condición al alta según el momento operatorio en los pacientes que sufrieron lesión arterial fue: de los 30 pacientes que recibieron atención temprana, 14 no tuvieron limitación funcional, 13 tuvieron algún grado de limitación funcional y 3 tuvieron que ser amputados. Conclusiones: Los traumas vasculares periféricos siguen siendo una patología frecuente y las causas y tipos de lesión son semejantes a las descritas en la literatura. Una atención temprana con un manejo adecuado permitiría reducir el grado de limitación funcional.

Objective Inferior vena cava occlusion is a potentially life-threatening complication related to caval filters. We present our experience with filter-induced inferior vena cava occlusion in order to assess the feasibility, safety, and effectiveness of endovascular management. Methods A retrospective review of all patients undergoing inferior vena cava filter placement over a 60-month study period was performed. From this cohort, a total of 10 cases of inferior vena cava occlusion after filter placement were identified. Demographics, clinical data, procedures, and outcomes were extracted. Patients were followed to the last clinic visit or until they died. Results One-hundred eighty filters were placed by our group practice during the study period. Of those, a total of 10 patients were identified. Overall, there were 7 males; the mean age was 57.1 years (25-78 years). The median time between inferior vena cava filter placement and filter occlusion was 105 days (range 5-4745 days). All patients were clinically symptomatic at the time of their presentation. Nine out of 10 patients were successfully managed endovascularly. Trellis™-8 thrombectomy was the most common endovascular strategy performed ( n = 9). Four patients had balloon angioplasty, two of those with stent placement for chronically occluded inferior vena cava/iliac veins. No thromboembolic complications developed during a median follow-up period of 233 days (range 4-1083 days). Conclusions Endovascular management of inferior vena cava occlusion is feasible, safe, and effective in decreasing thrombus burden in the presence of an inferior vena cava filter. Further studies evaluating long-term inferior vena cava patency and optimal surveillance regimen after endovascular management of filter-related inferior vena cava occlusion are warranted.