scholarly journals P1451 Massive fatal venous thrombosis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M M De La Torre Carpente ◽  
B Redondo Bermejo ◽  
T M Perez Sanz ◽  
M A Acuna Lorenzo ◽  
M I Revilla Martinez ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Lower Extremity ◽  
Right Ventricle ◽  
Right Atrium ◽  
Vena Cava ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Increased Risk ◽  
The Right ◽  
In Transit

Abstract We present the case of a 63-year old woman with previous history of high-grade liposarcoma. of the lower extremity. She had been treated with radiotherapy and chemotherapy and then she underwent surgical treatment with wide local excision several months ago. She was awaiting a new surgical procedure to remove a right suprarrenal metastasis. The patient presented with lower extremity edema and abdomen and increasing weight in the previuos week. A thoracic and abdominal CT showed the suprarrenal mass had become of greater size. Enlargement of superior vena cava, partial filling defects in several segments of the right lung suggestive of acute pulmonary embolism. Extensive thrombosis from right iliac vein, common iliac vein, intrahepatic cava vein, inferior vena cava, right atrium and right ventricle. Bilateral pleural effusion and ascites. A transthoracic echocardiogram revealed a big mass (6.1 cm) in the right atrium prolapsing into the right ventricle. There was a mean diastolic gradient of 3 mmHg and maximal gradient of 6 mmHg in the tricuspid valve. Left ventricle systolic function was moderately depressed due to abnormal movement of the interventricular septum suggestive of pulmonary hypertension. The clinical course was characterized by rapid deterioration and the patient died from cardiogenic shock. The source of thrombi in the right side of the heart most of the times is venous thrombi that have embolized. Cancer patients have an increased risk of venous thromboembolism compared with the general population. The risk varies depending on the type and the stage of the cancer. Metastatic disease has the highest risk. Most clinically significant pulmonary embolisms originate as venous thromboembolism in the lower extremities or pelvic veins. However in most of the cases it is difficult to image the thrombus "in-transit". In this case the most striking feature is not imaging the thrombus "in-transit" but its massive size. Abstract P1451 Figure. liposarcoma Euro Echo 2019

Iliocaval Compression Syndrome

1987 ◽  
Vol 2 (3) ◽  
pp. 173-179 ◽  
Author(s):  
Syde A. Taheri ◽  
Paul Nowakowski ◽  
David Pendergast ◽  
Julie Cullen ◽  
Steve Pisano ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Common Iliac Artery ◽  
Vena Cava ◽  
Signs And Symptoms ◽  
Iliac Vein ◽  
Venous Hypertension ◽  
Common Iliac Vein ◽  
Compression Syndrome ◽  
Extrinsic Compression ◽  
The Right

The iliocaval compression syndrome is a disorder, frequently found in young women, in which extrinsic compression of the left iliocaval junction produces signs and symptoms of lower extremity venous insufficiency. The anatomic variant which gives rise to this syndrome consists of compression of the left common iliac vein by the overlying right common iliac artery, near its junction with the vena cava. Additional reduction of outflow results from intraluminal venous webs and tight adhesions between the iliac artery and vein. Pain, swelling, pigmentation, and venous claudication characterize this syndrome, which affects predominantly the left leg. The syndrome may progress to iliofemoral thrombosis, phlegmasia cerulea dolens, and venous gangrene. Longstanding iliocaval stenosis may produce valvular incompetence. Exercise plethysmography is a non-invasive test useful in screening patients for iliocaval compression. The definitive diagnosis is made by venography, both ascending and descending, to determine the degree of outflow stenosis. Iliocaval patch angioplasty with retrocaval positioning of the right iliac artery, decreases venous hypertension and leads to improvement in the clinical condition. To date, we have performed iliocaval angioplasty, with retrocaval repositioning of the right common iliac artery, on 18 patients. Of these, 83% have had good results as determined by hemodynamic and clinical assessment.

Inferior Vena Caval Bullet Embolism

1996 ◽  
Vol 4 (3) ◽  
pp. 176-177
Author(s):  
Rajendar K Suri ◽  
Neerod K Jha ◽  
Virendar Sarwal ◽  
Arunanshu Behera ◽  
Ashok Attri ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Right Atrium ◽  
Inferior Vena ◽  
Vena Cava ◽  
Iliac Vein ◽  
Inferior Vena Caval ◽  
And Migration ◽  
The Right

We report a case of bullet penetration into the left iliac vein, with embolus into the inferior vena cava and migration up to the junction of the inferior vena cava and the right atrium. The bullet was subsequently extracted through laparotomy from the infrarenal segment of the inferior vena cava, just above its bifurcation.

scholarly journals A Case of Intravenous Leiomyomatosis Extending into the Right Ventricle through the Internal Iliac Vein and Inferior Vena Cava.

2001 ◽  
Vol 30 (1) ◽  
pp. 36-39
Author(s):  
Toshiaki Ohto ◽  
Masahisa Masuda ◽  
Naoki Hayashida ◽  
Yoko Pearce ◽  
Mitsuru Nakaya ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Right Ventricle ◽  
Inferior Vena ◽  
Vena Cava ◽  
Iliac Vein ◽  
Intravenous Leiomyomatosis ◽  
Internal Iliac Vein ◽  
Internal Iliac ◽  
The Right

scholarly journals The Potential for Arrhythmia during Central Venous Catheter Insertion- to where does the guidewire migrate?

2021 ◽  
Author(s):  
Daphna Reichmann ◽  
Re'em Sadeh ◽  
Ori Galante ◽  
Yaniv Almog ◽  
Victor Novack ◽  
...  
Keyword(s):  
Intensive Care ◽  
Right Ventricle ◽  
Real Time ◽  
Right Atrium ◽  
Medical Center ◽  
Insertion Site ◽  
Vena Cava ◽  
Venous Catheter ◽  
Seldinger Technique ◽  
The Right

Abstract BackgroundCentral Venous Catheters (CVC) are being used in both intensive care units and general wards for multiple purposes. A previous study1 observed that during CVC insertion through Subclavian Vein (SCV) or the Internal Jugular Vein (IJV) the guidewire is sometimes advanced to the Inferior Vena Cava (IVC), and at other times to the right atrium. The rate of IVC wire cannulation and the association with side and point of insertion is unknown.ObjectiveIn this study, we describe guidewire migration location during real time CVC cannulation (right atrium versus IVC) and report the association between the insertion site and side of the CVC and the location of guidewire migration, Right Atrium (RA)/Right Ventricle (RV) versus IVC guidewire migration.DesignThis is a retrospective study of the prospectively and systematically collected data on CVC insertion under real time trans thoracic ultrasound.SettingThe medical Intensive Care Unit in Soroka Medical Center, among patients that have received CVC during the study years 2014–2020.Main outcome measures:The rate of IVC versus right atrium/right ventricle wire migration during the procedure were analyzed. The association between the side and point of CVC insertion and the wire migration site was analyzed as well.ResultsOne hundred and sixty-six patients were enrolled. 33.7% of wires migrated to the IVC and 66.3% to the versus right atrium/right ventricle. The rate of wire migration to the IVC was similar in the IJV site and the SCV site. There was no association between the side of CVC insertion and wire migration to the IVC.ConclusionAbout a third of all wire migrations, during CVC Seldinger technique insertion, were identified in the IVC, with no potential for wire associated arrhythmia. There was no association between CVC insertion point (SCV versus IJV) nor the side of insertion and the site of guidewire migration.

scholarly journals Presentation and management of IVC and iliac vein encroachment by lumbar pedicle screws: a case-report

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Keith George ◽  
Shane Burke ◽  
Sandra Park ◽  
Luis Suarez ◽  
Ron Riesenburger
Keyword(s):  
Multidisciplinary Approach ◽  
Treatment Algorithm ◽  
Vena Cava ◽  
Pedicle Screws ◽  
Operative Management ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vascular Integrity ◽  
The Right ◽  
Case Basis

Abstract Pedicle screws are commonly used in spinal surgeries and are relatively safe, with venous complications occurring rarely. We report a patient with imaging following a L4–5 fusion that showed indentation of the inferior vena cava and right common iliac vein by the right L4 and L5 pedicle screws. She underwent revision surgery in which the hardware was removed and no bleeding was observed. Intraoperative venogram confirmed vascular integrity and absence of indentation on the venous structures following screw removal. The patient recovered without complications. Venous contact by pedicle screws should be treated on a case-by-case basis in a multidisciplinary approach with vascular surgery. We discuss a treatment algorithm for the operative management of this problem.

OptEase Retrievable Inferior Vena Cava Filter: Initial Multicenter Experience

Vascular ◽  
2005 ◽  
Vol 13 (5) ◽  
pp. 286-289 ◽  
Author(s):  
David Rosenthal ◽  
James L. Swischuk ◽  
Sidney A. Cohen ◽  
Eric D. Wellons
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena Cava Filter ◽  
Inferior Vena ◽  
Vena Cava ◽  
Iliac Vein ◽  
Vena Cava Filter ◽  
Common Iliac Vein ◽  
Implantation Time ◽  
The Right ◽  
Age Range

The purpose of this article is to describe our experience with the retrievable OptEase inferior vena cava filter (IVCF) (Cordis Corporation, Miami Lakes, FL) in the prevention of pulmonary embolus (PE). Forty patients (24 men, age range 15–85 years, mean age 38 years) who were at temporary risk of PE underwent insertion and retrieval of the OptEase IVCF at two institutions. Eleven patients were treated with filter implantation and subsequent repositioning in the inferior vena cava (IVC) to extend implantation time. All patients were followed up for 24 hours after retrieval, with additional follow-up at the physician's discretion. Forty patients had successful filter insertion. Two patients who underwent intravascular ultrasound guidance for filter deployment required filter repositioning within 24 hours owing to inadvertent placement in the right common iliac vein. All 40 patients underwent successful filter retrieval with no adverse events. In those patients who did not undergo IVCF repositioning, the time to retrieval ranged from 3 to 48 days (mean ± SD 16.38 ± 7.20 days). One patient had a successful retrieval at 48 days, but all other retrieval experiences were performed within 23 days. The second strategy involved implantation, with repositioning at least once before final retrieval. This latter strategy occurred in 11 patients, and the time to first capture ranged from 4 to 30 days (mean ± SD 13.82 ± 6.13 days). No symptomatic PE, IVC injury or stenosis, significant bleeding, filter fracture, or filter migration was observed. In this feasibility study, the OptEase IVCF prevented symptomatic PE, was safely retrieved or repositioned up to 48 days after implantation, and served as an effective bridge to anticoagulation. In patients who require extended IVCF placement, the OptEase IVCF can be successfully repositioned within the IVC, thereby extending the overall implantation time of this retrievable IVCF.

scholarly journals Successful removal of a Gunther tulip vena cava filter with wall-embedded hook and migration during a retrieval attempt

2013 ◽  
Vol 2 (1) ◽  
pp. 1-3
Author(s):  
Takuji Yamagami ◽  
Rika Yoshimatsu ◽  
Tomohiro Matsumoto ◽  
Tsunehiko Nishimura
Keyword(s):  
Inferior Vena ◽  
Vena Cava ◽  
Iliac Vein ◽  
Vena Cava Filter ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Successful Removal ◽  
And Migration ◽  
The Right ◽  
Iliac Vein Thrombosis

Retrieval of a Gunther tulip vena cava filter implanted in a patient with inferior vena cava and right common iliac vein thrombosis was attempted by the standard method. Because the filter was tilted, the hook became attached to the vena cava wall and could not be snared. During attempts at removal by an alternative method, the filter migrated toward the right atrium. However, it was finally successfully removed.

CARDIAC ARREST DURING STRENUOUS EXERCISE IN A PATIENT WITH CONGENITAL HEART DISEASE

PEDIATRICS ◽  
1963 ◽  
Vol 32 (4) ◽  
pp. 776-777
Author(s):  
Albert A. Kattus
Keyword(s):  
Heart Disease ◽  
Medical Student ◽  
Pulmonary Artery ◽  
Right Ventricle ◽  
Right Atrium ◽  
Vena Cava ◽  
Systolic Pressure ◽  
Strenuous Exercise ◽  
Heart Catheterization ◽  
The Right

THE FOLLOWING CASE is presented in order to introduce a note of caution into consideration of the advisability of recommending unmonitored exercise for patients with heart disease. The patient is a 24 year old third year medical student who had been known to have a heart murmur since birth. He had lived a vigorously active life and had participated in high school football as well as snow skiing in more recent years. At the age of 19 he underwent a detailed cardiac work-up including right heart catheterization at another hospital. The findings at that time included a normal examination except for a grade III/VI blowing pansystolic murmur at the 4th left intercostal space. The chest x-ray disclosed a normal cardiac silhouette with normal pulmonary vascularity. The electrocardiogram disclosed right bundle branch block and left axis deviation. Cardiac catheterization disclosed systolic pressure of 30 mm. Hg. in the right ventricle and 23 in the pulmonary artery. There was O2 saturation of 78 per cent in the superior vena cava and 75 per cent in the inferior vena cava. In the high and mid right atrium O2 saturations ranged from 76 per cent to 80 per cent. Low in the atrium, just above the tricuspid valve, there was a small step-up of O2 saturation to 83 per cent and similar saturations were found in the right ventricle and pulmonary artery. The findings suggested a small shunt from left ventricle to right atrium of the type seen in the transitional form of atrio-ventricular communis. During the two weeks prior to the present event the patient and his roommate who was also a third year medical student, had undertaken to improve their physical conditioning by performing the Canadian Air Force series of calisthenic exercises.

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