Volume 70, Issue 5, Pages (November 2016)

Slides:

Advertisements

Similar presentations

Volume 14, Issue 2, Pages (May 2008)

Advertisements

GAETANO CIANCIO, CHRISTOPHER HAWKE, MARK SOLOWAY

Custom-made versus off-the-shelf multibranched endografts for endovascular repair of thoracoabdominal aortic aneurysms Theodosios Bisdas, MD, Konstantinos.

Primary leiomyosarcoma of the inferior vena cava: Reports of infrarenal and suprahepatic caval involvement Michael N. Tameo, MD, Keith D. Calligaro,

Transvesical Robotic Simple Prostatectomy: Initial Clinical Experience

Volume 59, Issue 4, Pages (April 2011)

Volume 53, Issue 4, Pages (April 2008)

Volume 62, Issue 2, Pages (August 2012)

Ziya Kirkali, Hein Van Poppel European Urology

Single-session total endovascular iliocaval reconstruction with stent grafting for the treatment of inferior vena cava agenesis and concurrent iliac venous.

G. Brancaccio, G. Celoria, S. Berti, E. Falco EJVES Extra

Traumatic inferior vena cava dissection

Volume 69, Issue 6, Pages (June 2016)

Aorto-caval fistula from acute rupture of an abdominal aortic aneurysm treated with a hybrid approach Matthias Siepe, MD, Sabrina Koeppe, MD, Wulf Euringer,

Volume 59, Issue 1, Pages (January 2011)

Successful thrombolysis, angioplasty, and stenting of delayed thrombosis in the vena cava following percutaneous vertebroplasty with polymethylmethacrylate.

Inferior vena cava graft-enteric fistula after extended hepatectomy with caval replacement Pietro Addeo, MD, Edoardo Rosso, MD, Elie Oussoultzoglou,

Joyce Ji, MD, J. Trevor Posenau, MD, Kathryn J. Lindley, MD, Alan C

Volume 47, Issue 3, Pages (March 2005)

Open surgical inferior vena cava filter retrieval for caval perforation and a novel technique for minimal cavotomy filter extraction Peter H. Connolly,

Novel Approach to Recurrent Cavoatrial Renal Cell Carcinoma

William D. Turnipseed, MD Journal of Vascular Surgery

Contemporary Management of Postchemotherapy Testis Cancer

Novel Techniques for Tumor Thrombectomy for Renal Cell Carcinoma With Intraatrial Tumor Thrombus Ujjwal K. Chowdhury, MCh, Anand K. Mishra, MS, Amlesh.

Organ-Preserving Endoscopic Kidney Cancer Resection

Michael B. Silva, MD, H. Colleen Silva, MD, Gail P

Volume 66, Issue 5, Pages (November 2014)

Single-session total endovascular iliocaval reconstruction with stent grafting for the treatment of inferior vena cava agenesis and concurrent iliac venous.

Volume 54, Issue 4, Pages (October 2008)

Traumatic inferior vena cava dissection

A Case of Renal Capsular Liposarcoma with Intracaval Fat Thrombus

Fenestrated Fontan for Hypoplastic Left Heart Syndrome

Single Port Access Renal Cryoablation (SPARC): A New Approach

Impact of transrenal aortic endograft placement on endovascular graft repair of abdominal aortic aneurysms Michael L. Marin, MD, Richard E. Parsons,

Correction Journal of Vascular Surgery

Endovascular repair of thoracoabdominal aortic aneurysm using the off-the-shelf multibranched t-Branch stent graft Bernardo C. Mendes, MD, Gustavo S.

Surgical Management of Renal Cell Carcinoma (RCC) with Vena Cava Tumour Thrombus Emanuele Belgrano, Carlo Trombetta, Salvatore Siracusano, Giorgio Carmignani,

Roger A. Orsini, M.D., Bruce E. Jarrell, M.D.

Anthony J. Comerota, MD, Steven S. Gale, MD

Repair Techniques for Ischemic Mitral Regurgitation

Patch Repair for a Subepicardial Aneurysm With an Approach From Inside the Heart Yoshitaka Yamane, MD, Shogo Mukai, MD, Hironobu Morimoto, MD, Hiroshi.

Ambulatory venovenous extracorporeal respiratory support as a bridge for cystic fibrosis patients to emergent lung transplantation Don Hayes, Jasleen.

Inferior vena cava reconstruction using fresh inferior vena cava allograft following caval resection for leiomyosarcoma: Midterm results Marlon A. Guerrero,

Endovascular treatment of obliterative hepatocavopathy with inferior vena cava occlusion and renal vein thrombosis Charles S. Thompson, MD, Michael J.

Fatal Tumor Thrombosis Due to an Inferior Vena Cava Leiomyosarcoma in a Patient With Antiphospholipid Antibody Syndrome Joseph D. Espiritu, MD, Michael.

Is external compression on the IVC a risk factor for IVC filter abutment? A single center experience of 141 infrarenal celect filter insertions Sang.

Gary W. Barone, MD, Mark B. Kahn, MD, James M. Cook, MD, Timothy C

Leiomyosarcoma of the Inferior Vena Cava: Segment II

Laparoscopic Ureteroureterostomy for Retrocaval Ureter

Prosthetic replacement of the inferior vena cava for malignancy

Surgical strategy for treating renal cell carcinoma with thrombus extending into the inferior vena cava Masatoshi Jibiki, MD, PhD, Takehisa Iwai, MD,

Technical aspects of repair of juxtarenal abdominal aortic aneurysms using the Zenith fenestrated endovascular stent graft Gustavo S. Oderich, MD, Mateus.

The role of cinefluoroscopy and intravascular ultrasonography in evaluating the deployment of experimental endovascular prostheses Rodney A. White, MD,

Flow control technique to prevent distal embolization during mechanical thrombectomy Mathew Wooster, MD, Daniel Kloda, DO, Jacob Robison, MD, Joseph Hart,

Primary angiosarcoma of the aorta, great vessels, and the heart

R. Karmeli, A. Eyal, S. Eldar, S. Fajer EJVES Extra

Georges-Pascal Haber, Sebastien Crouzet, Inderbir S. Gill

Endovascular treatment of ruptured axillary and large internal mammary artery aneurysms in a patient with Marfan syndrome Jessica F. Rose, DO, Layla.

Perinatal inferior vena cava thrombosis and absence of the infrarenal inferior vena cava Tharumenthiran Ramanathan, MBBS, T. Michael, D. Hughes, FRACS,

Aorto-caval fistula from acute rupture of an abdominal aortic aneurysm treated with a hybrid approach Matthias Siepe, MD, Sabrina Koeppe, MD, Wulf Euringer,

Bedside placement of inferior vena cava filters by using transabdominal duplex ultrasonography and intravascular ultrasound imaging Marc A. Passman,

Linda M. Harris, MD, Constantine P. Karakousis, MD

Robot-assisted laparoscopic renal artery aneurysm reconstruction

Volume 86, Issue 4, (October 2014)

Volume 52, Issue 3, Pages (September 2007)

Extensive deep vein thrombosis in a postpartum woman with Behçet's disease associated with nephrotic syndrome H. Komaba, Y. Takeda, M. Fukagawa Kidney.

Pancreatic Pseudocyst That Compressed the Inferior Vena Cava and Resulted in Edema of the Lower Extremities MORRIS W. BROWMAN, M.D. Mayo Clinic Proceedings

Palliative iliac vein-to-right atrium bypass in a patient with a prior vena cava ligation for invasive renal cell carcinoma Joshua C. Grimm, MD, Robert.

Renal cell carcinoma with inferior vena caval involvement

Late complication from a retrievable inferior vena cava filter with associated caval, aortic, and duodenal perforation: A case report Massimiliano Veroux,

Presentation transcript:

Volume 70, Issue 5, Pages 884-890 (November 2016) Advances in Robotic Vena Cava Tumor Thrombectomy: Intracaval Balloon Occlusion, Patch Grafting, and Vena Cavoscopy Chandan Kundavaram, Andre Luis de Castro Abreu, Sameer Chopra, Giuseppe Simone, Rene Sotelo, Monish Aron, Mihir M. Desai, Michele Gallucci, Inderbir S. Gill European Urology Volume 70, Issue 5, Pages 884-890 (November 2016) DOI: 10.1016/j.eururo.2016.06.024 Copyright © 2016 European Association of Urology Terms and Conditions

Fig. 1 Schematics with corresponding intraoperative photos of Rummel tourniquet placement (a, b) at the infrarenal inferior vena cava, (c, d) at the left renal vein, and (e, f) at the right renal vein. Schematics and photos of (g) the Fogarty balloon catheter (9F; Coda LP, Cook Medical, Bloomington, IN, USA); (h, i) Fogarty balloon catheter with balloon inflated with a predetermined volume of saline. European Urology 2016 70, 884-890DOI: (10.1016/j.eururo.2016.06.024) Copyright © 2016 European Association of Urology Terms and Conditions

Fig. 2 Schematics and photos of achieving suprarenal inferior vena cava (IVC) control using an intracaval Fogarty balloon. (a, b) Fogarty balloon catheter insertion through cavotomy. There are three technical caveats in this regard: (1) The 5-mm laparoscopic port for introducing the Fogarty into the abdomen should be located low in the pelvis to allow a gentle curve of the catheter shaft parallel to the IVC, (2) the cavotomy for catheter insertion should be made on the caval wall contralateral to the thrombus to allow smooth atraumatic catheter insertion without rubbing against the thrombus, and (3) test inflation of the balloon prior to insertion should be avoided because after the balloon is deflated it does not regain either its exact preinflation size or its smooth contour; this necessitates a larger cavotomy incision for balloon insertion and may increase the chances of the now-corrugated balloon surface rubbing against the thrombus. The first and only time we inflate the balloon is after we have positioned it at its desired intracaval location. (c, d) Fogarty catheter positioned in the suprarenal IVC cephalad to the thrombus. Note that the Fogarty balloon is 5.5cm long with a maximal diameter of 3.2cm, which is achieved by injecting 30ml of water. The length of catheter insertion into the IVC and the volume of water injected to inflate the balloon are predetermined, based on the individual patient's computed tomography (CT) scan data. In patient 1, for example, the CT-measured thrombus length was 3.5cm and suprarenal IVC diameter was 2.2cm. As such, the catheter was inserted into the IVC for 9.3cm (thrombus length 3.5cm, balloon length 5.5cm, safety margin 3mm; total 9.3cm), and the balloon was inflated with only 17ml of water to reach the predetermined 2.2cm diameter, at which point resistance was felt, indicating the balloon was snug within the IVC. (e, f): Inflated Fogarty balloon proximal to thrombus with confirmation of cessation of IVC flow on intraoperative Doppler ultrasound. (g) Transesophageal echocardiography localizing the IVC thrombus (arrow). European Urology 2016 70, 884-890DOI: (10.1016/j.eururo.2016.06.024) Copyright © 2016 European Association of Urology Terms and Conditions

Fig. 3 Thrombus extraction. (a) Extraction of caval thrombus with demonstration of inflated intracaval balloon providing secure proximal hemostatic control (arrow). (b) Following caval suture repair, demonstration of restored IVC flow on intraoperative color Doppler ultrasound. European Urology 2016 70, 884-890DOI: (10.1016/j.eururo.2016.06.024) Copyright © 2016 European Association of Urology Terms and Conditions

Fig. 4 Robotic cavoscopy. (a) Robot-directed insertion of flexible cystoscope into cavotomy; (b) cavoscopic inspection of caval lumen demonstrating no residual or skip thrombi. European Urology 2016 70, 884-890DOI: (10.1016/j.eururo.2016.06.024) Copyright © 2016 European Association of Urology Terms and Conditions

Fig. 5 Intraoperative phototographs of biologic patch cavoplasty. (a) After thrombus extraction, inspection of the caval lumen revealed possible malignant invasion (*) of a segment of the inferior vena cava (IVC) wall. (b) Sharp excision of diseased IVC wall (*), creating caval luminal narrowing. (c) A precisely measured bovine pericardial patch graft, marked on its nonluminal surface with a blue dot (*) (SJM, EncapTechnologies, St. Jude Medical, St. Paul, MN, USA) is inserted into the abdomen through a laparoscopic port and oriented appropriately. (d, e) Suturing the patch graft (*) cavoplasty using 4-0 Gore-Tex suture (W.L. Gore & Associates, Inc., Newark, DE, USA). (f) Completed cavoplasty (*) with restoration of IVC flow after release of Rummel tourniquets. European Urology 2016 70, 884-890DOI: (10.1016/j.eururo.2016.06.024) Copyright © 2016 European Association of Urology Terms and Conditions

European Urology 2016 70, 884-890DOI: (10.1016/j.eururo.2016.06.024) Copyright © 2016 European Association of Urology Terms and Conditions