A non-cardiac cause of bilateral leg swellingBMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5306 (Published 30 November 2017) Cite this as: BMJ 2017;359:j5306
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Thank you very much for this interesting article to elucidate us on retroperitoneal fibrosis (RF) and pharmacological management of its endovascular complications. Even though RF in itself is a rare condition (prevalence of only 1.4/100000), inferior vena cava syndrome which may result from that could be frequently seen in some other conditions as well, such as malignancy, Deep Vein Thrombosis and pregnancy. The mainstay of treatment is to clear the blockage by resolving the underlying cause.
We are aware of the use of intravascular stenting as an effective way to provide immediate symptom relief in Superior Vena Cava obstruction (SVCO) syndrome, with success rates as high as 100% in some studies (1). As for Inferior Vena Cava (IVC) blockage, there is IVC filter as a long-term management plan for persistent lower limb Deep Vein Thrombosis for those unable to tolerate anticoagulation (2). I would be interested to hear if there is a role in using IVC filter or stenting, either by itself or as an adjunct to pharmacological treatments, in relieving intravascular obstruction secondary to retroperitoneal fibrosis?
(1) N. T. (2007, September 30). Follow-up results of 71 patients undergoing metallic stent placement for the treatment of a malignant obstruction of the superior vena cava. Retrieved October 28, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/17546400/
(2) B. M. (2013, February 25). Inferior vena cava thrombosis: A review of current practice. Retrieved October 28, 2018, from http://journals.sagepub.com/doi/full/10.1177/1358863X12471967
Competing interests: No competing interests