Clinical Outcomes of Large-Bore Aspiration Thrombectomy for Tumor Pulmonary Embolism in Renal Cell Carcinoma

Abstract

We present a 4-year longitudinal follow-up of a previously reported case involving a 66-year-old man with renal cell carcinoma who underwent radical nephrectomy, complicated by a massive pulmonary artery tumor embolism treated with large-bore aspiration thrombectomy. Serial clinical evaluations and imaging over 4 years have shown no evidence of disease recurrence following the initial intervention. This case underscores the evolving role of emergent large-bore aspiration thrombectomy in oncologic settings, not only as a therapeutic intervention but also for its diagnostic utility in enabling histopathologic characterization and guiding oncologic management. TAKE-HOME MESSAGES: Large-bore aspiration thrombectomy may offer long-term disease control in cases of tumor pulmonary embolism. This procedure can aid diagnosis and inform oncologic treatment planning through tissue acquisition.

Keywords: cancer; pulmonary circulation; thrombus.

Graphical abstract

Figure 1

Preprocedural CT, Intraprocedural Angiography, and Postprocedural CT Images of Pulmonary Arterial Tumor Thromboembolism (A) (left to right) Axial and coronal contrast-enhanced computed tomography (CT) chest demonstrating near-occlusive left pulmonary artery thrombus. Coronal contrast-enhanced CT abdomen and pelvis demonstrating infrahepatic inferior vena cava thrombus. (B) (left to right) Intraprocedural pulmonary angiograms before and after thrombectomy demonstrating near-occlusive left pulmonary artery filling defect (arrows), which resolved with thrombectomy. (C) (left to right) Most recent follow-up axial and coronal contrast-enhanced CT chest demonstrating patent left pulmonary artery. Coronal contrast-enhanced CT abdomen and pelvis demonstrating patent infrahepatic inferior vena.