{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T22:09:09Z","timestamp":1766441349336,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T00:00:00Z","timestamp":1720483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Northern British Columbia Northern Medical Program Research Award"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Inferior vena cava (IVC) compression secondary to mass effect is accompanied by edema, ascites, back and abdominal pain, and central nervous system symptoms. Most IVC syndrome cases described in the literature focus on the focal treatment of IVC lesions, and reports of complete iliocaval reconstructions secondary to malignant IVC syndrome in the palliative context are limited. In this case report, we describe the clinical presentation, technical approach, and symptomatic outcomes of a patient with extensive malignant compression and invasion of the iliofemoral venous system. An 82-year-old male with metastatic lung cancer invading the right upper quadrant of the abdomen presented with scrotal and bilateral lower extremity edema, as well as anasarca. Computed tomography (CT) demonstrated an 11 cm right adrenal metastasis and extensive retroperitoneal lymphadenopathy resulting in the compression of the IVC and iliac veins. Femoral venography demonstrated extensive collateral venous pathway formation with the opacification of the para-lumbar and vertebral veins, in addition to the vertebral\/sacral venous plexus. Iliocaval reconstruction was performed using venous-dedicated stents. This case report highlights a technically successful total iliocaval reconstruction in a complex palliative patient with diffuse metastatic disease resulting in IVC compression and syndrome.<\/jats:p>","DOI":"10.3390\/curroncol31070294","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T15:27:20Z","timestamp":1720538840000},"page":"3978-3984","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Total Iliocaval Reconstruction in a Complex Palliative Patient with Malignant Inferior Vena Cava Syndrome"],"prefix":"10.3390","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0963-0805","authenticated-orcid":false,"given":"Jack","family":"Lofroth","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir","family":"Pourghadiri","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasia","family":"Hadjivassiliou","sequence":"additional","affiliation":[{"name":"Department of Radiology, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manraj","family":"Heran","sequence":"additional","affiliation":[{"name":"Department of Radiology, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerald","family":"Legiehn","sequence":"additional","affiliation":[{"name":"Department of Radiology, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Radiology, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8769-4281","authenticated-orcid":false,"given":"Ravjot","family":"Dhatt","sequence":"additional","affiliation":[{"name":"Department of Radiology, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1024\/0301-1526\/a000919","article-title":"Inferior vena cava-syndrome","volume":"50","author":"Elitok","year":"2021","journal-title":"Vasa"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.jcin.2015.12.268","article-title":"Inferior Vena Cava Thrombosis","volume":"9","author":"Alkhouli","year":"2016","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1007\/s00270-017-1740-z","article-title":"Endovascular Management of Malignant Inferior Vena Cava Syndromes","volume":"40","author":"Kuetting","year":"2017","journal-title":"Cardiovasc. Intervent Radiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.jvscit.2020.03.004","article-title":"Reconstruction of the iliocaval venous confluence using arterial stent technology","volume":"6","author":"Delaney","year":"2020","journal-title":"J. Vasc. Surg. Cases Innov. Tech."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1007\/s00270-014-0980-4","article-title":"Efficacy and safety of endovascular intervention for the management of primary entire-inferior vena cava occlusion","volume":"38","author":"Zhang","year":"2015","journal-title":"Cardiovasc. Intervent Radiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1177\/0284185115582059","article-title":"Palliative endovascular treatment of cancer-related iliocaval obstructive disease: Technical and clinical outcomes","volume":"57","author":"Maleux","year":"2016","journal-title":"Acta Radiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3604","DOI":"10.1007\/s00261-022-03587-1","article-title":"Malignant obstruction of the inferior vena cava: Clinical experience with the self-expanding Sinus-XL stent system","volume":"47","author":"Augustin","year":"2022","journal-title":"Abdom. Radiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/s42155-024-00438-6","article-title":"Iliocaval and iliofemoral venous stenting for obstruction secondary to tumor compression","volume":"7","author":"Aly","year":"2024","journal-title":"CVIR Endovasc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1002\/1097-0142(19930101)71:1<142::AID-CNCR2820710123>3.0.CO;2-C","article-title":"Stenting in malignant vena caval obstruction","volume":"71","author":"Oudkerk","year":"1993","journal-title":"Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1148\/radiology.161.2.3763891","article-title":"Stenosis of the vena cava: Preliminary assessment of treatment with expandable metallic stents","volume":"161","author":"Charnsangavej","year":"1986","journal-title":"Radiology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1016\/j.jvsv.2017.04.007","article-title":"Venography versus intravascular ultrasound for diagnosing and treating iliofemoral vein obstruction","volume":"5","author":"Gagne","year":"2017","journal-title":"J. Vasc. Surg. Venous Lymphat. Disord."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.jvir.2023.11.006","article-title":"Intravascular Ultrasound Use in Peripheral Arterial and Deep Venous Interventions: Multidisciplinary Expert Opinion From SCAI\/AVF\/AVLS\/SIR\/SVM\/SVS","volume":"35","author":"Secemsky","year":"2024","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e010960","DOI":"10.1161\/CIRCINTERVENTIONS.121.010960","article-title":"Pivotal Study Evaluating the Safety and Effectiveness of the Abre Venous Self-Expanding Stent System in Patients With Symptomatic Iliofemoral Venous Outflow Obstruction","volume":"15","author":"Murphy","year":"2022","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1148\/radiol.12120517","article-title":"Malignant superior vena cava syndrome: A comparative cohort study of treatment with covered stents versus uncovered stents","volume":"266","author":"Gwon","year":"2013","journal-title":"Radiology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1080\/13645706.2019.1653925","article-title":"Covered versus uncovered stent insertion for malignant superior vena cava obstruction","volume":"29","author":"Wang","year":"2020","journal-title":"Minim. Invasive Ther. Allied Technol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1177\/1358863X18754695","article-title":"Endovascular iliocaval reconstruction for the treatment of iliocaval thrombosis: From imaging to intervention","volume":"23","author":"Hage","year":"2018","journal-title":"Vasc. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1055\/s-0042-1757936","article-title":"Iliocaval Reconstruction: Review of Technique, Challenges, and Outcomes","volume":"39","author":"Kinariwala","year":"2022","journal-title":"Semin. Intervent Radiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/s005200000173","article-title":"Superior vena cava obstruction: Is stenting necessary?","volume":"9","author":"Marcy","year":"2001","journal-title":"Support. Care Cancer."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1186\/s13256-021-03132-6","article-title":"Inferior vena cava thrombosis as a possible cause of nephrotic-range proteinuria: Two case reports","volume":"15","author":"Apostolova","year":"2021","journal-title":"J. Med. Case Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1016\/j.avsg.2013.05.019","article-title":"Endovascular treatment for symptomatic iliac vein compression syndrome: A prospective consecutive series of 48 patients","volume":"28","author":"Liu","year":"2014","journal-title":"Ann. Vasc. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1016\/j.jvs.2007.06.046","article-title":"Stenting of the venous outflow in chronic venous disease: Long-term stent-related outcome, clinical, and hemodynamic result","volume":"46","author":"Neglen","year":"2007","journal-title":"J. Vasc. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/j.jvsv.2017.01.018","article-title":"Routine extended follow-up surveillance of iliac vein stents for iliocaval venous obstruction may not be warranted","volume":"5","author":"Novak","year":"2017","journal-title":"J. Vasc. Surg. Venous Lymphat. Disord."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"175","DOI":"10.2214\/AJR.22.27413","article-title":"Antithrombotic Therapy After Venous Interventions: AJR Expert Panel Narrative Review","volume":"219","author":"Kishore","year":"2022","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1055\/s-0042-1757340","article-title":"Antithrombotic Therapy after Deep Venous Intervention","volume":"39","author":"Xiao","year":"2022","journal-title":"Semin. Intervent Radiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1007\/s00520-018-4397-5","article-title":"Evaluation of stent placement for vena cava syndrome: Phase II trial and phase III randomized controlled trial","volume":"27","author":"Takeuchi","year":"2019","journal-title":"Support. Care Cancer"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.jvsv.2017.10.017","article-title":"Endovascular recanalization for nonmalignant obstruction of the inferior vena cava","volume":"6","author":"Erben","year":"2018","journal-title":"J. Vasc. Surg. Venous Lymphat. Disord."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/j.avsg.2020.01.104","article-title":"Inferior Vena Cava Reconstruction in Symptomatic Patients Using Palmaz Stents: A Retrospective Single-Center Experience","volume":"66","author":"Barrette","year":"2020","journal-title":"Ann. Vasc. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2885","DOI":"10.2169\/internalmedicine.5033-20","article-title":"Stent Placement for Malignant Inferior Vena Cava Syndrome in a Patient with Recurrent Colon Cancer","volume":"59","author":"Morita","year":"2020","journal-title":"Intern. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1016\/j.jvs.2005.08.012","article-title":"Mid-term results of endovascular treatment for symptomatic chronic nonmalignant iliocaval venous occlusive disease","volume":"42","author":"Hartung","year":"2005","journal-title":"J. Vasc. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.ejvs.2009.03.004","article-title":"Endovascular management of chronic disabling ilio-caval obstructive lesions: Long-term results","volume":"38","author":"Hartung","year":"2009","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.ejvs.2022.11.006","article-title":"A Systematic Review of the Safety and Efficacy of Inferior Vena Cava Stenting","volume":"65","author":"Morris","year":"2023","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_32","unstructured":"Chick, J., Bundy, J., Srinivasa, R., Hage, A., and Gemmete, J. (2024, July 03). Iliocaval Reconstruction Value Analysis Using a Time-Driven Activity-Based Costing Approach, Available online: https:\/\/www.jvascsurg.org\/article\/S0741-5214(18)30781-X\/fulltext."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/31\/7\/294\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:12:05Z","timestamp":1760109125000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/31\/7\/294"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,9]]},"references-count":32,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["curroncol31070294"],"URL":"https:\/\/doi.org\/10.3390\/curroncol31070294","relation":{},"ISSN":["1718-7729"],"issn-type":[{"type":"electronic","value":"1718-7729"}],"subject":[],"published":{"date-parts":[[2024,7,9]]}}}