[Cancer of the kidney with inferior caval thrombus. Value of a temporary caval clip].

In renal cancers with malignant thrombus in the inferior vena cava, extension and migration of the thrombus towards the right cardiac cavities may be prevented for a long time by the efferent flow of the hepatic veins acting as a haemodynamic barrier. The authors describe a new technique in which a temporary caval clip is placed in a downstream position without opening the right atrium. After thrombectomy and enlarged nephrectomy the clip is removed and a classical barrier upstreams of the renal veins/vena cava junction is installed.

[Indications of the different routes of inferior vena cava for inserting the clip of Adams De Weese (author's transl)].

Partial occlusion of inferior vena cava with clip of Adams De Weese is now currently performed in cavo-iliac thrombosis. The authors recall technical modalities for inserting clip and they try to bring to light the indications of each modality according to following parameters: upper level thrombosis, state of abdominal cavity, general condition of the patient and researched result: temporary or definitive artial oclusion, with or without associated thrombectomy. In localizations under renal veins, a definitive partial occlusion is indicated by sub-mesocolic way, eventually retro-peritoneal way in case of poor risk; it is a fact that associated thrombectomy will be realized easily, only by transmesenteric and submesocolic way.