Background: Renal cell carcinoma tends to invade venous structures, frequently extending beyond the inferior vena cava and into the heart itself, such as into the right atrium or right ventricle. Resection of tumor burden, particularly tumor thrombus, often requires cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA), which is not feasible for all patients. Methods: Described in this study is a novel, minimally invasive endovascular approach involving endovascular thrombectomy as a viable approach in these select patients. Results: There were no surgical complications, shorter operating times, less blood loss and an average length of stay of 5.5 days in the four patients undergoing this procedure. Conclusions: We demonstrate that this technique can eliminate the need for cardiac bypass and deep hypothermic cardiac arrest and its associated risks, thereby making surgery safer and more accessible for patients with advanced kidney cancers with an inferior vena cava tumor thrombus. Furthermore, it allows for this life-saving surgery to be carried out in medical centers or hospitals where cardiac surgery is unavailable, or when cardiopulmonary bypass is medically contraindicated.
背景：肾细胞癌常侵犯静脉结构，多延伸至下腔静脉甚至心脏内部，如右心房或右心室。肿瘤负荷（尤其是瘤栓）的切除通常需要体外循环和深低温停循环技术，但并非所有患者均适用该方案。 方法：本研究描述了一种新型微创血管内介入技术，即通过血管内取栓术为特定患者群体提供可行治疗方案。 结果：接受该手术的四例患者均未出现手术并发症，且具有手术时间短、失血量少、平均住院日仅5.5天的优势。 结论：本研究表明该技术可避免体外循环和深低温心脏停搏及其相关风险，使伴有下腔静脉瘤栓的晚期肾癌患者获得更安全、更易实施的手术方案。此外，该技术使得在无法开展心脏外科手术的医疗中心，或存在体外循环医学禁忌的情况下实施此类挽救性手术成为可能。
肿瘤(癌症)患者之家