Could EUS be useful for evaluating right renal vein and inferior vena cava thrombosis due to renal cell carcinoma? Report of 3 cases

Mangiavillano, Benedetto; Arcidiacono, Paolo Giorgio; Pasta, A.; Bertini, Roberto; Boemo, Cinzia; Testoni, Pier Alberto

doi:10.1016/j.gie.2006.12.042

Cited by 5 publications

(5 citation statements)

References 6 publications

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“…Specifically, surgeons may use these prognostic features to assist in patient counselling and preoperative planning, in concert with vascular surgeons, for cases in which reconstruction of the IVC beyond cavorrhaphy alone is likely to be employed. These features may be helpful adjuncts to intraoperative studies such as duplex ultrasonography and/or transoesophageal echocardiography in the characterization of the tumour thrombus with respect to the upper extent, consistency, and mobility of the thrombus, ultimately informing the determination of need for IVC resection . Although we acknowledge that the need for partial or segmental IVC resection is generally determined intraoperatively, this model may be used to assist a surgeon in calculating the prior probability of need for complex IVC resection, and thus, the need to reserve specific operative resources such as cardiopulmonary bypass, as well as the need to involve a vascular surgeon early in the operative planning.…”

Section: Discussionmentioning

confidence: 99%

Clinical and radiographic predictors of the need for inferior vena cava resection during nephrectomy for patients with renal cell carcinoma and caval tumour thrombus

et al. 2015

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ObjectiveTo evaluate the clinical and radiographic predictors of the need for partial or circumferential resection of the inferior vena cava (IVC) requiring complex vascular reconstruction during venous tumour thrombectomy for renal cell carcinoma (RCC). Patients and MethodsData were collected on 172 patients with RCC and IVC (levels I-IV) venous tumour thrombus who underwent radical nephrectomy with tumour thrombectomy at the Mayo Clinic between 2000 and 2010. Preoperative imaging was rereviewed by one of two radiologists blinded to details of the patient's surgical procedure. Univariable and multivariable associations of clinical and radiographic features with IVC resection were evaluated by logistic regression. A secondary analysis was used to assess the ability of the model to predict histological invasion of the IVC by the tumour thrombus. ResultsOf the 172 patients, 38 (22%) underwent IVC resection procedures during nephrectomy. Optimum radiographic thresholds were determined to predict the need for IVC resection based on preoperative imaging included a renal vein diameter at the renal vein ostium (RVo) of 15.5 mm, maximum anterior-posterior (AP) diameter of the IVC of 34.0 mm and AP and coronal diameters of the IVC at the RVo of 24 and 19 mm, respectively. On multivariable analysis, the presence of a right-sided tumour (odds ratio 3.3; P = 0.017), an AP diameter of the IVC at the RVo of ≥24.0 mm (odds ratio 4.4; P = 0.017), and radiographic identification of complete occlusion of the IVC at the RVo (odds ratio 4.9; P < 0.001) were associated with a significantly increased risk of IVC resection. The c-index for the model was 0.81. ConclusionsWe present a multivariable model of the radiographic features associated with the need for IVC resection during tumour thrombectomy. Pending external validation, this model may be used for preoperative planning, patient counselling and planned involvement of vascular surgical colleagues in anticipation of the need for complex vascular repair.

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Section: Discussionmentioning

confidence: 99%

Clinical and radiographic predictors of the need for inferior vena cava resection during nephrectomy for patients with renal cell carcinoma and caval tumour thrombus

et al. 2015

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“…[8][9][10] The utility of EUS for evaluation of metastatic renal tumors has been well described. 11,12 To date, the use of EUS for the primary renal or perirenal region has been limited to evaluation of renal vein thrombosis, 13 Liesegang rings, 14 and 3 reported cases [15][16][17] of EUS-FNA of a renal mass. The purpose of this study was to describe a multicenter U.S. experience with the indications, yield, and complications from attempted EUS-guided FNA (EUS-FNA) of a kidney mass.…”

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confidence: 99%

EUS-guided FNA aspiration of kidney masses: a multicenter U.S. experience

DeWitt

Gress

Levy

et al. 2009

Gastrointestinal Endoscopy

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“…These concepts are further supported by several prior studies, in which, EUS was successfully used in the evaluation and diagnostic management of renal lesions [1–3], renal vein thrombosis [4], aortic intramural lesions [5], inferior vena cava thrombosis [4], pleural fluid collections [6] and pelvic diseases [7]. In particular, we would like to mention the expanding role of EUS-FNA in the management of lung masses located close to the oesophagus, since recent data suggest a 97% diagnostic accuracy, with a low complication rate of 1.6% [8].…”

Section: Discussionmentioning

confidence: 53%

Expanding the horizons of endoscopic ultrasound: diagnosis of non-digestive pathologies

Mavrogenis

Hassaini

Sibille

et al. 2014

Gastroenterology Report

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Endoscopic ultrasound (EUS) is mainly used for the evaluation and sampling of mediastinal and abdominal lymph nodes, luminal and submucosal lesions of the upper and lower gastrointestinal tract, as well as in the diagnostic approach for pancreatic, biliary and liver disease. However, several non-digestive pathologies may be encountered as well, expanding the diagnostic potential of EUS. In this article, we present nine examples of extra-digestive abnormalities detected by means of EUS, including pathologies of the thyroid gland, mediastinal and abdominal vessels, lungs, kidney and the urinary bladder. The purpose of this article is to review the capabilities of EUS beyond routine evaluation of gastrointestinal organs.

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Could EUS be useful for evaluating right renal vein and inferior vena cava thrombosis due to renal cell carcinoma? Report of 3 cases

Cited by 5 publications

References 6 publications

Clinical and radiographic predictors of the need for inferior vena cava resection during nephrectomy for patients with renal cell carcinoma and caval tumour thrombus

Clinical and radiographic predictors of the need for inferior vena cava resection during nephrectomy for patients with renal cell carcinoma and caval tumour thrombus

EUS-guided FNA aspiration of kidney masses: a multicenter U.S. experience

Expanding the horizons of endoscopic ultrasound: diagnosis of non-digestive pathologies

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