Highlights
- •Risk of pulmonary fat embolism in cases of IVC-invasive AML requires mechanical protection.
- •Concurrent preoperative RAE and IVC filter placement is feasible at minimal added risk.
- •Optimal timing is 24–48 h before surgery to balance revascularization and tumor shrinkage.
- •Retrievable IVC filters provide continued protection in the postoperative period.
Abstract
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.
Keywords
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Article info
Publication history
Published online: January 25, 2017
Accepted:
January 24,
2017
Received in revised form:
January 10,
2017
Received:
August 27,
2016
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
