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Thrombolysis and iliofemoral vein stent placement in cancer patients with lower extremity swelling attributed to lymphedema.

Authors :
O'Sullivan GJ
Waldron D
Mannion E
Keane M
Donnellan PP
Source :
Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2015 Jan; Vol. 26 (1), pp. 39-45.
Publication Year :
2015

Abstract

Purpose: To assess the effects of iliofemoral vein stent placement on symptomatic lower extremity swelling (LES), presumed to be lymphedema, in patients with cancer.<br />Materials and Methods: During the period 2005-2013, 62 patients (38 female; age, 60.4 y ± 15.4) with histology-proven metastatic disease and LES resistant to standard therapies were evaluated and found to have venous outflow obstruction. Stents were placed in the iliofemoral veins or inferior vena cava, or both, and evaluated by color Doppler ultrasound or contrast-enhanced computed tomography during the follow-up period. Patient symptoms were assessed using the Venous Disability Score (VDS) and the Galway Limb Swelling score, a patient-directed, 5-question symptom scoring system.<br />Results: Stents were successfully placed in all patients. During the follow-up period, in-stent thrombosis occurred in 13 patients, and additional stents were placed in 3 patients to treat luminal narrowing. The mean VDS improved significantly (P < .05): from 3.0 ± 0 on the day of the procedure to 2.95 ± 0.22 on day 3, 2.0 ± 0.33 on day 7, and 1.87 ± 0.34 on day 30. The mean Galway Limb Swelling score also improved significantly (P < 0.001): from 3.6 ± 0.74 on the day of the procedure to 1.96 ± 0.91 on day 3, 1.06 ± 0.78 on day 7, and 0.6 ± 0.66 on day 30. During the follow-up period, 60 patients died as a result of their underlying malignancy (mean, 230 d; range, 5-1,080 d).<br />Conclusions: Iliofemoral or iliocaval venous stent placement may have a valuable role in patients with metastatic disease and symptomatic LES associated with venous obstruction.<br /> (Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1535-7732
Volume :
26
Issue :
1
Database :
MEDLINE
Journal :
Journal of vascular and interventional radiology : JVIR
Publication Type :
Academic Journal
Accession number :
25541444
Full Text :
https://doi.org/10.1016/j.jvir.2014.10.010