Profilaktička primena Angel® katetera kod bolesnika sa paraneoplastičnim sindromom planiranim za hiruršku resekciju tumora – prikaz bolesnika i pregled literature
Sažetak
Uvod. Angel® kateter (BiO2 Medical Inc, San Antonio, Texas, USA) predstavlja kombinaciju trolumenskog centralnog venskog katetera i vena kava filtera koji se koristi u prevenciji plućnog embolizma (IVC filter-kateter). Prikaz bolesnika. U radu je prikazan bolesnik, starosti 53 godine, kod koga je planirana radikalna nefrektomija zbog dijagnostikovanog renalnog karcinoma. Duboka venska tromboza (DVT) je prethodila dijagnozi tumora, zbog čega je bolesnik bio na terapiji oralnim antikoagulantima. Uzevši u obzir rizike vezane za ranije tretiranu DVT, odlučili smo se za preoperativno plasiranje Angel® katetera u cilju obezbeđivanja centralnog venskog pristupa i sniženja rizika od nastanka plućne embolije. Prvog postoperativnog dana došlo je do pojave aktivnog gastričnog krvarenja, što je dovelo do ukidanja primene nadroparina. Kavagram urađen po protokolu, pre uklanjanja Angel® katetera, prikazao je veliku trombotičnu masu u filteru. Nakon plasiranja trajnog vena kava filtera, pristupilo se hirurškom uklanjanju Angel® katetera. Zaključak. Primena kombinovanog Angel® IVC filter/3-lumenskog centralnog venskog katetera, može predstavljati spasonosnu meru profilakse plućne embolije ukoliko je planiran hirurški zahvat kod bolesnika sa visokim rizikom nastanka DVT, kao što su bolesnici sa malignom bolešću, paraneoplastičnim sindromom i hemioterapijom.
Reference
Serednicki W, Dobrowolska E, Kałuża K, Kopacz M, Wordliczek J. Angel(®) Catheter use for pulmonary embolism prophylaxis in a polytrauma patient. Injury 2015; 46(6): 1167–70.
Cadavid CA, Gil B, Restrepo A, Alvarez S, Echeverry S, Angel LF, et al. Pilot study evaluating the safety of a combined cen-tral venous catheter and inferior vena cava filter in critically ill patients at high risk of pulmonary embolism. J Vasc Interv Radiol 2013; 24(4): 581–5.
FDA. 510(k) Premarket Notification. Silver Spring, Mary-land: U.S. Food & Drug Administration; 2016.
Siskin GP, Bartholomew K. Inferior vena cava filters. Available from: http://emedicine.com/radio/topic762.htm. [updated 2005 December]
Montgomery JP, Kaufman JA. Inferior Vena Cava Filters: Indica-tions, Outcomes, and Evidence. Curr Treat Options Cardio-vasc Med 2015; 17(9): 401.
Stein PD, Matta F. Vena cava filters in unstable elderly patients with acute pulmonary embolism. Am J Med 2014; 127(3): 222–5.
Ozturk C, Ganiyusufoglu K, Alanay A, Aydogan M, Onat L, Ham-zaoglu A. Efficacy of prophylactic placement of inferior vena cava filter in patients undergoing spinal surgery. Spine (Phila Pa 1976) 2010; 35(20): 1893–6.
Knudson MM, Ikossi DG, Khaw L, Morabito D, Speetzen LS. Thromboembolism after trauma: an analysis of 1602 episodes from the American College of Surgeons National Trauma Da-ta Bank. Ann Surg 2004; 240(3): 490–6; discussion 496–8.
Spencer FA, Bates SM, Goldberg RJ, Lessard D, Emery C, Glush-chenko A, et al. A population-based study of inferior vena cava filters in patients with acute venous thromboembolism. Arch Intern Med 2010; 170(16): 1456–62.
Moore PS, Andrews JS, Craven TE, Davis RP, Corriere MA, God-shall CJ, et al. Trends in vena caval interruption. J Vasc Surg 2010; 52(1): 118–25.e3; discussion 125–6.
Duszak R Jr, Parker L, Levin DC, Rao VM. Placement and removal of inferior vena cava filters: national trends in the medicare population. J Am Coll Radiol 2011; 8(7): 483–9.
Stein PD, Matta F, Hull RD. Increasing use of vena cava filters for prevention of pulmonary embolism. Am J Med 2011; 124(7): 655–61.
Haut ER, Garcia LJ, Shihab HM, Brotman DJ, Stevens KA, Sharma R, et al. The effectiveness of prophylactic inferior ve-na cava filters in trauma patients: a systematic review and me-ta-analysis. JAMA Surg 2014; 149(2): 194–202.
Taccone FS, Bunker N, Waldmann C, De Backer D, Brohi K, Jones RG, et al. A new device for the prevention of pulmonary em-bolism in critically ill patients: Results of the European Angel Catheter Registry. J Trauma Acute Care Surg 2015; 79(3): 456–62.
Paul R, Mordhorst J, Leyh H, Hartung R. Incidence and outcome of patients with adrenal metastases of renal cell cancer. Urolo-gy 2001; 57(5): 878–82.
Ljungberg B, Bensalah K, Canfield S, Dabestani S, Hofmann F, Ho-ra M, et al. EAU guidelines on renal cell carcinoma: 2014 up-date. Eur Urol 2015; 67(5): 913–24.
Puskás A, Balogh Z, Hadadi L, Imre M, Orbán E, Kósa K, et al. Spontaneous recanalization in deep venous thrombosis: a pro-spective duplex ultrasound study. Int Angiol 2007; 26(1): 53–63.
Caprini JA, Arcelus JI, Hasty JH, Tamhane AC, Fabrega F. Clin-ical assessment of venous thromboembolic risk in surgical pa-tients. Semin Thromb Hemost 1991; 17 Suppl 3: 304–12.
BiO2 Medical I. Angel® Catheter & Angel® Catheter Acces-sory Kit Instructions for Use. 2016. Available from: http://www.bio2medical.com/angel-catheter. 2016.
BiO2 Medical I. Angel® Catheter Care & Maintenance Guidelines. 2016. Available from: www.aquilantinterventional.com/.../ AD-023_Rev_A_Nursing
Lee AY, Levine MN. Venous thromboembolism and cancer: risks and outcomes. Circulation 2003; 107(23 Suppl 1): I17–21.
Yokom DW, Ihaddadene R, Moretto P, Canil CM, Reaume N, Le Gal G, et al. Increased risk of preoperative venous thrombo-embolism in patients with renal cell carcinoma and tumor thrombus. J Thromb Haemost 2014; 12(2): 169–71.
González J, Ciancio G. Increased risk of preoperative venous thromboembolism in patients with renal cell carcinoma and tumor thrombus: comment. J Thromb Haemost 2014; 12(4): 577–8.
Palapattu GS, Kristo B, Rajfer J. Paraneoplastic syndromes in urologic malignancy: the many faces of renal cell carcinoma. Rev Urol 2002; 4(4): 163–70.
Heit JA, O'Fallon WM, Petterson TM, Lohse CM, Silverstein MD, Mohr DN, et al. Relative impact of risk factors for deep vein thrombosis and pulmonary embolism: a population-based study. Arch Intern Med 2002; 162(11): 1245–8.
Donnellan E, Kevane B, Bird BR, Ainle FN. Cancer and venous thromboembolic disease: from molecular mechanisms to clini-cal management. Curr Oncol 2014; 21(3): 134–43.
Hull RD, Pineo GF, Brant RF, Mah AF, Burke N, Dear R, Wong T, Cook R, Solymoss S, Poon MC, Raskob G; LITE Trial Investigators. Long-term low-molecular-weight heparin versus usual care in proximal-vein thrombosis patients with cancer. Am J Med 2006; 119(12): 1062–72.
Leizorovicz A, Cohen AT, Turpie AG, Olsson CG, Vaitkus PT, Goldhaber SZ. PREVENT Medical Thromboprophylaxis Study Group. Randomized, placebo-controlled trial of dalteparin for the prevention of venous thromboembolism in acutely ill medical patients. Circulation 2004; 110(7): 874–9.
Cohen AT, Zaw HM, Alikhan R. Benefits of deep-vein throm-bosis prophylaxis in the nonsurgical patient: The MEDENOX trial. Semin Hematol 2001; 38(2 Suppl 5): 31–8.
Kontny F, Dale J, Abildgaard U, Pedersen TR. Randomized trial of low molecular weight heparin (dalteparin) in preven-tion of left ventricular thrombus formation and arterial embo-lism after acute anterior myocardial infarction: the Fragmin in Acute Myocardial Infarction (FRAMI) Study. J Am Coll Car-diol 1997; 30(4): 962–9.
Simonneau G, Laporte S, Mismetti P, Derlon A, Samii K, Samama CM, et al. FX140 Study Investigators. A randomized study comparing the efficacy and safety of nadroparin 2850 IU (0.3 mL) vs. enoxaparin 4000 IU (40 mg) in the prevention of ve-nous thromboembolism after colorectal surgery for cancer. J Thromb Haemost 2006; 4(8): 1693–700.
Easaw JC, Shea-Budgell MA, Wu CM, Czaykowski PM, Kassis J, Kuehl B, et al. Canadian consensus recommendations on the management of venous thromboembolism in patients with cancer. Part 1: prophylaxis. Curr Oncol 2015; 22(2): 133–43.
Laryea J, Champagne B. Venous thromboembolism prophylaxis. Clin Colon Rectal Surg 2013; 26(3): 153–9.
Spyropoulos AC, Douketis JD. How I treat anticoagulated pa-tients undergoing an elective procedure or surgery. Blood 2012; 120(15): 2954–62.