Phlebolymphology N°118 – Editorial
Dear Readers,
This issue explores an important topic: therapeutic interventions targeting deep venous involvement that affects the overall condition of patients with oncological disease and may shorten their life expectancy.
Unlike conventional procedures, the goal is not to achieve long-term technical success
but primarily to relieve disabling symptoms.
Significant venous involvement impacting overall health in cancer patients can mainly present in 2 forms: acute and chronic. The first involves episodes of acute or subacute venous thrombosis, with or without pulmonary embolism. The second results from obstructed venous outflow, which may be caused by intrinsic factors or external compression.
M. J. MULLINS and G. O’SULLIVAN (Ireland) have extensive experience in treating the
first condition: acute and subacute venous thrombosis.
The authors note that cancer-related thrombosis increases morbidity and mortality. Early thrombus removal is a vital treatment option for these patients. However, there is debate about when to treat due to limited data on life expectancy and potential complications, such as bleeding risks. Without specific trials in these cases, treatment decisions depend on individual patient factors.
The other scenario involves obstructed venous outflow.
A. RODRÍGUEZ-MORATA and colleagues (Spain) describe obstruction caused by an endovenous expansion process and potential correction via open surgery. The high surgical complexity of these procedures is evident, especially when tumors extend into the heart.
When flow obstruction is due to external compression, endoluminal techniques can be employed. O. HARTUNG (France) describes how minimally invasive procedures can improve quality of life by resolving inferior vena cava obstructions hemodynamically. A recent meta-analysis reports excellent technical results in primary and cumulative patency rates, along with immediate symptom relief after stenting.
Similar to inferior vena cava obstruction, treatments for superior vena cava obstructions, with endovascular stenting, are discussed by S. M. HABIB and colleagues (Saudi Arabia). The authors present findings from a meta-analysis of over 2249 patients, showing favorable outcomes and manageable complications.
Enjoy reading!
Editor in chief
Dr Oscar Maleti
