title: Palliative endovascular treatment of cancer-related iliocaval obstructive disease: technical and clinical outcomes.
abstract: BACKGROUND
  Cancer-related obstruction of large abdominal and pelvic veins might become symptomatic with clinical signs of lower limb venous congestion. Technical and clinical outcome after interventional treatment is not well studied yet.
  
  
  OBJECTIVE
  To retrospectively assess the technical and clinical outcome of endovascular management of symptomatic cancer-related iliocaval venous obstructive disease.
  
  
  METHODS
  From 1998 to 2013, 19 patients (15 men, 4 women; mean age, 63.6 years) referred for interventional treatment of cancer-related iliocaval obstructive disease were identified. Patients' symptoms included unilateral (n = 16; 84%) or bilateral (n = 3; 16%) painful swelling of the lower limbs. Patients' demographics as well as interventional and clinical outcome data were collected.
  
  
  RESULTS
  All 19 patients underwent, under local anesthesia, stenting of the iliac vein (n = 16; 84%) or inferior vena cava (n = 3; 16%). Immediate technical success (n = 19) was 100%; immediate clinical success (n = 18) was 94.7%. During follow-up, seven patients (36.8%) presented with recurrent symptoms of painful limb swelling. Estimated survival after 3 and 6 months was 68.4% (95% confidence interval [CI], 47.8-82.3%) and 19.8% (95% CI, 11.9-29.2%), respectively.
  
  
  CONCLUSIONS
  Endovascular stenting of cancer-related iliocaval venous obstructive disease is safe and results in immediate relief of symptoms. However, recurrent venous obstruction is common. At 3 months follow-up, the majority of patients with iliac vein stenting were still alive.
authors.affiliation: Department of Radiology, University Hospitals Leuven - Department of Imaging and Pathology, KU Leuven, Belgium geert.maleux@uzleuven.be.
authors.forename: Geert
authors.initials: G
authors.lastname: Maleux
authors.affiliation: Department of Radiology, University Hospitals Leuven - Department of Imaging and Pathology, KU Leuven, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: Vertenten
authors.affiliation: Interuniversity Institute for Biostatistics and Statistical Bioinformatics, KU Leuven and Universiteit Hasselt, Leuven, Belgium.
authors.forename: Annouschka
authors.initials: A
authors.lastname: Laenen
authors.affiliation: Department of Radiology, University Hospitals Leuven - Department of Imaging and Pathology, KU Leuven, Belgium.
authors.forename: Liesbeth
authors.initials: L
authors.lastname: De Wever
authors.affiliation: Department of Radiology, University Hospitals Leuven - Department of Imaging and Pathology, KU Leuven, Belgium.
authors.forename: Sam
authors.initials: S
authors.lastname: Heye
authors.affiliation: Department of General Oncology, University Hospitals Leuven, Belgium.
authors.forename: Paul
authors.initials: P
authors.lastname: Clement
authors.affiliation: Department of Radiology, University Hospitals Leuven - Department of Imaging and Pathology, KU Leuven, Belgium.
authors.forename: Raymond
authors.initials: R
authors.lastname: Oyen
mesh_terms: D000005:Abdomen / Q000098:blood supply; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010166:Palliative Care / Q000379:methods*; D010388:Pelvis / Q000098:blood supply; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Vascular; adults; interventional; primary neoplasms; retroperitoneum; stents