case_images: PMC11116682_01
case_images: (A) is preoperative coronal CT. (B) and C is preoperative horizontal CT.
case_images: fonc-14-1385073-g001.jpg
case_images: PMC11116682_01_fonc-14-1385073-g001.jpg
case_images: f1
case_images: Improved enhanced CT and MRI showed that right renal carcinoma, about 12.1*8.5*11.8cm in size, invaded the renal pelvis, and invaded the inferior vena cava through the renal vein, forming a grade IV cancer thrombus ( Figure 1 ).
case_images: Preoperative cardiac ultrasound, the arrow points to a cancer embolus.
case_images: fonc-14-1385073-g002.jpg
case_images: PMC11116682_01_fonc-14-1385073-g002.jpg
case_images: f2
case_images: Echocardiography showed that a 16*13mm space could be detected in the right atrium, which seemed to have pedicle and inferior vena cava continuation, and could reach the tricuspid valve opening with blood flow ( Figure 2 ).
case_images: Tumor and surrounding organs.
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case_images: PMC11116682_01_fonc-14-1385073-g003.jpg
case_images: f3
case_images: Intracardiac ultrasound showed no intracardiac thrombosis or pulmonary artery thrombosis, and the residual IVC was insufficient for vascular repair ( Figure 3 ).
case_images: An artificial vascular replacement has been performed.
case_images: fonc-14-1385073-g004.jpg
case_images: PMC11116682_01_fonc-14-1385073-g004.jpg
case_images: f4
case_images: Therefore, Dacron fiber braided material was used to replace the defective IVC ( Figure 4 ).
case_images: Postoperative, the red arrow points to right atrial tumor thrombus, the black arrow points to right renal and tumor, the ellipse is the wall of the inferior vena cava invaded by the tumor.
case_images: fonc-14-1385073-g005.jpg
case_images: PMC11116682_01_fonc-14-1385073-g005.jpg
case_images: f5
case_images: On the first day after surgery, a small amount of liquid diet and exercise were allowed ( Figure 5 ).
case_images: Postoperative ct, the arrow points to artificial vascular replacement.
case_images: fonc-14-1385073-g006.jpg
case_images: PMC11116682_01_fonc-14-1385073-g006.jpg
case_images: f6
case_images: CT angiography (CTV) was re-examined, and a small number of sheet filling defects were observed in the artificial blood vessel replacement segment ( Figure 6 ). Considering thrombosis, enoxparin, 4000U, bid, subcutaneous injection was given.