Inferior vena cava reconstruction with a superficial femoral vein graft after resection of a venous leiomyosarcoma

Background —Motexafin lutetium (Lu-Tex) is a photosensitizer that targets atheromatous plaque. Subsequent photoactivation (photodynamic therapy [PDT]) induces local cytotoxic effects. The aim of the present study was to investigate whether Lu-Tex targets vein graft intimal hyperplasia and whether subsequent photoactivation attenuates the disease process. Methods and Results —The subcellular localization of Lu-Tex and postillumination viability were studied in cultured human vein graft smooth muscle cells. Inferior vena cava–grafted rats were injected with Lu-Tex (10 mg/kg) 4 or 12 weeks after grafting. Biodistribution was assessed in a subgroup 24 hours after administration. Light therapy (742 nm) was performed 24 hours after Lu-Tex injection by illuminating intraperitoneally placed isografts using a laparotomy. Animals were divided into the following 4 groups: PDT (n=15), Lu-Tex injection and laparotomy (n=13), light treatment (n=14), and laparotomy only (n=13). Grafts were harvested 14 days after treatment for histochemical analysis. Lu-Tex localized within subcellular organelles of smooth muscle cells, and subsequent photoactivation induced cell death via apoptosis. The Lu-Tex concentrations present in the vein grafts were 9.3 times higher than those in the normal inferior vena cava. Postoperative PDT at 4 weeks after surgery significantly reduced the intima/media ratio, whereas treatment at 12 weeks did not reduce the intima/media ratio. Activated macrophages were observed 4 weeks after grafting; however, a significant reduction occurred in these cells by 12 weeks. The mechanism by which PDT works may be related to the presence of activated macrophages. Conclusions —PDT significantly reduces the intima/media ratio in the early phase of vein graft disease. Lu-Tex–mediated PDT may be a viable method for the attenuation of atherosclerotic disease in vein grafts.

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The Influence of Intra-arterial Administration of Histamine upon the Circulating Leukocytes of Man

Blood ◽

10.1182/blood.v8.4.315.315 ◽

1953 ◽

Vol 8 (4) ◽

pp. 315-323 ◽

Cited By ~ 7

Author(s):

H. R. BIERMAN ◽

R. L. BYRON ◽

K. H. KELLY ◽

F. CORDES ◽

L. P. WHITE ◽

...

Keyword(s):

Pulmonary Artery ◽

Inferior Vena Cava ◽

Lower Extremity ◽

Femoral Artery ◽

Inferior Vena ◽

Femoral Vein ◽

Venous Blood ◽

Vena Cava ◽

Leukocyte Counts ◽

Leukocyte Number

Abstract 1. The leukocyte content of femoral arterial and venous blood was determined simultaneously following the administration of 0.1 to 0.3 mg. of histamine (as base) directly into the femoral artery in 5 patients at rates varying from 1.1 to 6.7 µg. per second. 2. A marked and prompt decrease in leukocyte number was found in the blood from the femoral vein of the same leg after the histamine infusion started; this preceded the changes in the blood from the femoral artery. 3. The discrepancy between the venous and arterial counts indicates the withdrawal of leukocytes within the circulation of the lower extremity which is generally related to the rate and amount of histamine administered. 4. In 6 patients, histamine (0.15 to 0.4 mg.) was administered directly into the aorta at levels from T3 to L2. In five of nine instances, blood from the pulmonary artery or inferior vena cava initially showed a prompt fall in leukocyte number, which exceeded the leukopenia observed in blood sampled from the aorta. In two instances, the leukocyte counts from the aorta exhibited no significant change. 5. The venous leukopenia following the administration of histamine into the aorta probably occurs as a result of sequestration of leukocytes in the peripheral capillaries which accompanies the arterial leukopenia due to a similar effect in the pulmonary circulation.

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Inferior vena cava thrombosis as a complication of femoral vein catheterisation.

Archives of Disease in Childhood ◽

10.1136/adc.72.4.343 ◽

1995 ◽

Vol 72 (4) ◽

pp. 343-345 ◽

Cited By ~ 40

Author(s):

A Shefler ◽

J Gillis ◽

A Lam ◽

A J O'Connell ◽

D Schell ◽

...

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Femoral Vein ◽

Vena Cava ◽

Vena Cava Thrombosis ◽

Inferior Vena Cava Thrombosis

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Embryological and surgical considerations of absent infra-renal part of inferior venacava and left renal vein

Asian Journal of Medical Sciences ◽

10.3126/ajms.v11i5.29744 ◽

2020 ◽

Vol 11 (5) ◽

pp. 83-86

Author(s):

Indira CK ◽

Arunkumar KG

Keyword(s):

Inferior Vena Cava ◽

Renal Vein ◽

Inferior Vena ◽

Femoral Vein ◽

Left Renal Vein ◽

Abdominal Cavity ◽

Vena Cava ◽

Complex Process ◽

Long Course ◽

The Right

Background: Development of inferior vena cava (IVC) is a complex process that involves the anastomoses between three pairs of embryonic veins. Specific permutations exist in the venous plane of the abdomen and pelvis resulting in variations such as single left IVC, double IVC, and left renal retroaortic vein. Anomalies of the inferior vena cava and renal veins occur infrequently but may contribute to serious morbidity throughout surgical exploration if unidentified. Most anomalies remain asymptomatic until surgical intervention or clinical presentation with thromboembolic complications. Aims and Objective: Our research is aimed to link embryology with developmental disorder and the complications associated with the anomalous vessels in the field of surgery. Materials and Methods: Ten IUD fetuses (ranging from 20 weeks to term fetuses) were collected from the O&G department of the college and injected locally with dilute formalin and placed in containers filled with formalin. Dissection of the fetuses was done to identify congenital anomalies. Results: The external appearance of the 28-week-old fetus showed no gross anomaly. Examination abdominal cavity showed absent infrarenal segment of IVC and left renal vein. The right renal vein was seen running a long course to the left side with tributaries of lumbar veins and was seen continuing as the left femoral vein medial to the femoral artery. Segments of suprarenal and renal IVC were present. Conclusion: Correlating anomalies and variations of IVC and its tributaries to embryology. However, understanding of such anomaly is necessary to avoid significant diagnostic pitfalls and in preoperative surgicaland radiological intervention planning.

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Infrarenal inferior vena cava agenesis and recurrent deep vein thrombosis: a case report and literature review

Oxford Medical Case Reports ◽

10.1093/omcr/omaa104 ◽

2021 ◽

Vol 2021 (1) ◽

Author(s):

Victor E Prado ◽

Juan Pablo Rey-Mendoza ◽

Connor J Wakefield ◽

Sheeba Ba Aqeel ◽

Admasu Kumssa

Keyword(s):

Deep Vein Thrombosis ◽

Inferior Vena Cava ◽

Inferior Vena ◽

Femoral Vein ◽

Vena Cava ◽

Young Patients ◽

Venous Stasis ◽

Vein Thrombosis ◽

Asymptomatic Patients ◽

Deep Vein

Abstract Inferior vena cava agenesis is a rare congenital vascular defect often diagnosed as an incidental finding in asymptomatic patients. When symptoms arise, it can present with chronic venous stasis or unprovoked deep vein thrombosis (DVT). A 42-year-old man with history of unprovoked right lower extremity (RLE) DVTs was admitted for swelling, pain and erythema to the RLE, concerning for new DVT. Venous Doppler ultrasound showed a chronic DVT of the right proximal femoral vein in addition to an acute DVT of the distal femoral vein. Extensive thrombophilia workup was negative and additional imaging with abdominal computed tomography scan revealed the absence of the infrarenal inferior vena cava. Patient was treated with oral anticoagulation and compression stockings and discharged with clinical improvement. At 3-month follow-up, patient was completely asymptomatic. Recurrent unprovoked DVTs in young patients require exhaustive work up including imaging studies to rule out vascular anomalies.

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Mayer-Rokitansky-Kuster-Hauser Syndrome Associated with Severe Inferior Vena Cava Stenosis

Case Reports in Obstetrics and Gynecology ◽

10.1155/2014/745658 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3

Author(s):

Laura Londra ◽

Kyle Tobler ◽

John Wu ◽

Lisa Kolp

Keyword(s):

Inferior Vena Cava ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Inferior Vena ◽

Femoral Vein ◽

Vena Cava ◽

Mrkh Syndrome ◽

Postoperative Course ◽

Therapeutic Anticoagulation ◽

Vena Cava Stenosis

Precis. The postoperative course of a neovagina creation procedure in a young woman with Meyer-Rokitansky-Kuster-Hauser syndrome was complicated, despite prophylaxis, by extensive pelvic deep venous thrombosis secondary to unsuspected severe inferior vena cava stenosis.Background. Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is characterized by congenital vaginal agenesis and an absent or rudimentary uterus in genotypical females. Malformations of the inferior vena cava (IVC) are not commonly associated with MRKH syndrome. We report a case of a patient with MRKH syndrome with severe IVC stenosis that was diagnosed when the patient presented with extensive pelvic deep venous thrombosis (DVT) during the postoperative course of a neovagina creation.Case. A 19-year-old female underwent a McIndoe procedure. Despite DVT prophylaxis, extensive pelvic DVT of the femoral vein was diagnosed on postoperative day 7. Therapeutic anticoagulation was initiated, and pharmacological and mechanical thrombolysis were performed. During these procedures, a hypoplastic IVC was noted.Conclusion. MRKH syndrome can be associated with IVC malformations, which constitute an anatomical risk factor for postoperative DVT.

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Customized femoral vein grafts for inferior vena cava reconstruction

Journal of Vascular Surgery Venous and Lymphatic Disorders ◽

10.1016/j.jvsv.2013.08.010 ◽

2014 ◽

Vol 2 (2) ◽

pp. 200-203 ◽

Cited By ~ 4

Author(s):

Nirvana Sadaghianloo ◽

Matthieu Durand ◽

Emmanuel I. Benizri ◽

Serge Declemy ◽

Elixène Jean-Baptiste ◽

...

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Femoral Vein ◽

Vena Cava ◽

Vein Grafts

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Thrombus Formation on Catheters in New Born Lambs

Anaesthesia and Intensive Care ◽

10.1177/0310057x7900700305 ◽

1979 ◽

Vol 7 (3) ◽

pp. 239-243 ◽

Cited By ~ 4

Author(s):

J. F. Hecker ◽

G. C. Fisk ◽

J. M. Gupta ◽

N. Abrahams ◽

R. A. Cockington ◽

...

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Thrombus Formation ◽

Umbilical Vein ◽

Femoral Vein ◽

Vena Cava ◽

Ductus Venosus ◽

Renal Infarction ◽

Different Types ◽

Femoral Vessels

Catheters were inserted into the aorta and inferior vena cava of newborn lambs by cutdown on the femoral vessels and directly into the umbilical vein. The lambs were killed after six days and the amounts of thrombus surrounding the catheters were measured. Most catheters inserted into the umbilical vein looped within the liver and only a few passed directly into the portal vein or through the ductus venosus into the vena cava. On different types of catheters inserted via the femoral artery or femoral vein, there were significant differences both in the proportion with thrombus and the amount of thrombus. There were also significant differences in renal infarction caused by different types of catheters.

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Clinical correlation of the area of inferior vena cava, iliac and femoral veins for stent use

Vascular ◽

10.1177/1708538117715343 ◽

2017 ◽

Vol 26 (2) ◽

pp. 126-131 ◽

Cited By ~ 2

Author(s):

Afsha Aurshina ◽

Arkady Ganelin ◽

Anil Hingorani ◽

Sheila Blumberg ◽

Yuriy Ostrozhynskyy ◽

...

Keyword(s):

Inferior Vena Cava ◽

Intravascular Ultrasound ◽

Inferior Vena ◽

Femoral Vein ◽

Vena Cava ◽

Lower Extremities ◽

Iliac Vein ◽

Common Iliac Vein ◽

Presenting Symptoms ◽

Significant Difference

Objective The purpose of the study is to evaluate normal anatomical areas of infrarenal inferior vena cava, common iliac, external iliac and common femoral veins by intravascular ultrasound with the goal of assisting the development of venous-specific stents in the treatment of iliac vein stenosis. Method From February 2012 to December 2013, 656 office-based venograms were performed in our facility. Among them, 576 were stented and 80 were not. The measurements of veins were done intraoperatively using an intravascular ultrasound catheter to record areas of the inferior vena cava, proximal, middle and distal segments of common iliac vein, external iliac vein and common femoral vein. The data were compared between non-diseased segments of patients who were stented and those not stented. The stented diseased segments were excluded. Results The mean patient age was 67.33 years (range 22–96, SD ±13.99). Our data included 218 males, 438 females and 324 right lower extremities and 332 left lower extremities. The presenting symptoms of these patients based on CEAP were C1(0), C2 (185), C3(233), C4(107), C5(89) and C6(42). No correlation was found between area of veins and age, gender, laterality and CEAP score (P > .13). Comparison of the areas of non-diseased iliac vein segments between patients not stented and patients who underwent stenting showed a significant difference, with larger areas in non-stented patients in the distal common iliac vein (P = .039) and inferior vena cava (P = .012). Younger age (P = .03) and male gender (P < .0001) were associated with increased area of iliac vein segments. Conclusion Utilizing the intravascular ultrasound-guided technique, we were able to define normal anatomical areas of non-diseased inferior vena cava, iliac and femoral veins, which could be employed to guide the development of appropriate-sized stents and other tools needed for the treatment of venous insufficiency. There is specific variability in areas of normal vein segments with age and gender with/without stents.

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