Surgical Treatment of Iliofemoral Vein Thrombosis in Pregnancy

1991 ◽  
Vol 6 (4) ◽  
pp. 255-259 ◽  
Author(s):  
H. Rabl ◽  
H. Fruhwirth ◽  
S. Gutschi ◽  
O. Pascher ◽  
G. Koch
Keyword(s):  
Femoral Vein ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Venous Thrombectomy ◽  
Av Fistula ◽  
Vein Thrombosis ◽  
Life Threatening ◽  
Occlusion Rate ◽  
In Pregnancy

The incidence of deep leg vein thrombosis in pregnancy is estimated at 0.13 per 1000 to 1.4 per 100.1−3 One-third occur as isolated, descending iliofemoral vein thromboses, predominantly left-sided. We report our surgical experiences in venous thrombectomy with arteriovenous fistula (AV-fistula) in the groin between the superficial femoral artery and femoral vein in 29 gravidae with a mean age of 27.5 years (range 19–41 years). Thrombosis occurred between the 20th and 36th week of pregnancy. 25 were antepartum two postpartum and two postsectionem. An iliac spur was seen once, as was an AT III deficiency. At the beginning of our series AV-fistula was not performed in three patients who all suffered from re-thrombosis after 24 h. Re-thrombectomy with an AV-fistula was performed successfully. Three of the 26 gravidae with AV-fistula also developed re-thrombosis. In two patients re-thrombectomy was successful, in the third patient the common iliac vein could not be re-opened by thrombectomy and the functioning AF-fistula had been ligated because extensive vulval oedema had developed. Asymptomatic, late re-thrombosis occurred in two patients who were seen at outpatient follow-up. We have seen one mild, non-life-threatening pulmonary embolism on the first postoperative day. No further intraoperative nor postoperative or postpartum complications developed. The re-occlusion rate is 10.3% (3/29), the complication rate is 6.9% (2/29).

May-Thurner syndrome – Are we aware enough?

VASA ◽  
2019 ◽  
Vol 48 (5) ◽  
pp. 381-388 ◽  
Author(s):  
Katalin Mako ◽  
Attila Puskas
Keyword(s):  
Contraceptive Use ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Compression Syndrome ◽  
Threatening Condition ◽  
Life Threatening ◽  
Iliac Vein Compression ◽  
Iliac Vein Compression Syndrome ◽  
The Right

Summary. Iliac vein compression syndrome (May-Thurner syndrome – MTS) is an anatomically variable clinical condition in which the left common iliac vein is compressed between the right common iliac artery and the underlying spine. This anatomic variant results in an increased incidence of left iliac or iliofemoral vein thrombosis. It predominantly affects young women in the second or third decades of life with preponderance during pregnancy or oral contraceptive use. Although MTS is rare, its true prevalence is underestimated but it can be a life-threatening condition due to development of pulmonary embolism (PE). In this case based review the authors present three cases of MTS. All patients had been previously confirmed with PE, but despite they were admitted to hospital, diagnosed and correctly treated for PE and investigated for thrombophilia, the iliac vein compression syndrome was not suspected or investigated. With this presentation the authors would like to emphasize that MTS is mostly underdiagnosed, and it needs to be ruled out in left iliofemoral vein thrombosis in young individuals.

scholarly journals Percutaneous thrombectomy using a novel single session device for acute iliofemoral deep vein thrombosis

VASA ◽  
2021 ◽  
Vol 50 (1) ◽  
pp. 74-77
Author(s):  
Gerard O’Sullivan
Keyword(s):  
Deep Vein Thrombosis ◽  
Iliac Vein ◽  
Left Thigh ◽  
Common Iliac Vein ◽  
Single Session ◽  
Venous Thrombectomy ◽  
Vein Thrombosis ◽  
Left Common Iliac Vein ◽  
Deep Vein ◽  
Percutaneous Thrombectomy

Summary: A 74-year-old woman presented with acute symptomatic left thigh and calf swelling; imaging demonstrated evidence of occlusive thrombosis from the upper left common iliac vein to the mid-thigh. Single session zero-thrombolysis venous thrombectomy was performed using the ReVeneTM Thrombectomy Catheter.

Proximal deep venous thrombosis following PTA of the superficial femoral artery – an obligation to disclose a complication that is rarely taken into account

VASA ◽  
2006 ◽  
Vol 35 (1) ◽  
pp. 41-44 ◽  
Author(s):  
Klein-Weigel ◽  
Pillokat ◽  
Klemens ◽  
Köning ◽  
Wolbergs ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Rare Complication ◽  
Femoral Vein ◽  
Vein Thrombosis ◽  
Explicit Information ◽  
Life Threatening ◽  
Legal Consequences

We report two cases of femoral vein thrombosis after arterial PTA and subsequent pressure stasis. We discuss the legal consequences of these complications for information policies. Because venous thrombembolism following an arterial PTA might cause serious sequel or life threatening complications, there is a clear obligation for explicit information of the patients about this rare complication.

scholarly journals Treatment and therapeutic strategies for pituitary apoplexy in pregnancy: a case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuya Kato ◽  
Yoshikazu Ogawa ◽  
Teiji Tominaga
Keyword(s):  
Pituitary Apoplexy ◽  
Clinical Symptoms ◽  
Case Series ◽  
Optimal Timing ◽  
Presenting Symptoms ◽  
Pathological Evaluation ◽  
Mother And Child ◽  
Life Threatening ◽  
In Pregnancy

Abstract Background Pregnancy is a known risk factor for pituitary apoplexy, which is life threatening for both mother and child. However, very few clinical interventions have been proposed for managing pituitary apoplexy in pregnancy. Case presentation We describe the management of three cases of pituitary apoplexy during pregnancy and review available literature. Presenting symptoms in our case series were headache and/or visual disturbances, and the etiology in all cases was hemorrhage. Conservative therapy was followed until 34 weeks of gestation, after which babies were delivered by cesarean section with prophylactic bolus hydrocortisone supplementation. Tumor removal was only electively performed after delivery using the transsphenoidal approach. All three patients and their babies had a good clinical course, and postoperative pathological evaluation revealed that all tumors were functional and that they secreted prolactin. Conclusions Although the mechanism of pituitary apoplexy occurrence remains unknown, the most important treatment strategy for pituitary apoplexy in pregnancy remains adequate hydrocortisone supplementation and frequent hormonal investigation. Radiological follow-up should be performed only if clinical symptoms deteriorate, and optimal timing for surgical resection should be discussed by a multidisciplinary team that includes obstetricians and neonatologists.

scholarly journals External iliac vein compression and lower-extremity swelling caused by an iliopectineal ganglion: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Kiyokazu Fukui ◽  
Ayumi Kaneuji ◽  
Norio Kawahara
Keyword(s):  
Lower Extremity ◽  
Femoral Vein ◽  
Signs And Symptoms ◽  
Iliac Vein ◽  
Needle Aspiration ◽  
Case Presentation ◽  
Vein Thrombosis ◽  
External Iliac Vein ◽  
Iliac Vein Compression ◽  
Deep Vein

Abstract Background A hip joint ganglion is a rare cause of lower-extremity swelling. Case presentation We report a case of a Japanese patient with ganglion of the hip with compression of the external iliac/femoral vein that produced signs and symptoms mimicking those of deep vein thrombosis. Conclusions Needle aspiration of the ganglion was performed, and swelling of the lower extremity promptly decreased. At 7.5 years after aspiration, there was no recurrence of swelling of the leg. Although the recurrence rate for ganglions after needle aspiration is high, it is worthwhile trying aspiration first.

Abstract 241: Piggyback and Horseshoe Balloon Catheter Models for Simultaneous Thrombolysis and Venous Angioplasty in Acute Ileofemoral Venous Thrombosis After IVC Filter Insertion

2012 ◽  
Vol 32 (suppl_1) ◽  
Author(s):  
Mark Arokiaraj ◽  
Luis Guerrero ◽  
Robert Levine ◽  
Igor Palacios
Keyword(s):  
Venous Thrombosis ◽  
Balloon Catheter ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Ivc Filter ◽  
Vein Thrombosis ◽  
Internal Iliac ◽  
Filter Insertion ◽  
Venous Angioplasty ◽  
Side Port

Background: To investigate the potential role of balloon mediated thrombolysis and venous angioplasty in acute ileofemoral thrombosis and to develop novel balloon catheter models for the same purpose. Methods: 2 patients and 1 patient on followup with extensive acute ileofemoral and popliteal vein thrombosis and partially extending into the inferior venacava (IVC) with diffuse swelling of lower limb and gluteal region were studied. The second patient stopped anticoagulation and presented with ileofemoral thrombosis in contralateral limb on followup. In both patients Gunther Tulip (Cook) IVC filter was placed. A 5F Multipurpose catheter with sideholes was placed in common iliac vein bifurcation and thrombolysis was done for 18 hours with streptokinase at 5000U/hr. Post thrombolysis IVC angiogram showed mild recanalisation of left common iliac veins leaving a stump. On the next day, the left common iliac vein was cannulated through a 5F Torcon catheter and a Terumo 035 J tipped wire was advanced through the clots. A 5cm x 4mm peripheral balloon was advanced and balloon directed 24 hour thrombolysis with streptokinase was done at 5000U/hr. The balloon was pulled back and multiple serial dilatations were done in femoral, internal iliac and common iliac veins. In both patients thrombolysis was started on the third day after the onset of symptoms. Results: Post procedure the venous channels were opened and were draining adequately. Limb edema subsided and there was no bleeding or embolic complications. Both patients are on oral anticoagulation and now on follow-up for 8 months being asymptomatic at present. Based on these interventions two novel balloon models to thrombolyse and to perform venous angioplasty simultaneously in a single procedure was developed. The first is a piggyback model which has a side port attached to the shaft of the balloon (5cm length and 4mm breath). The other model is a horse shoe balloon catheter which has a 14cm long and 4mm wide compliant balloon with 0.75mm diameter side port for thrombolysis till the balloon tip and on cross section gives a horse shoe appearance. Conclusion: Balloon mediated thrombolysis and venous angioplasty after IVC filter insertion is useful and novel balloon catheter models may be used in ileofemoral venous thrombosis.

Modified Sling Technique for Difficult Filter Retrieval

2021 ◽  
Vol 39 ◽  
Author(s):  
Pasquale Grillo ◽  
◽  
Giuseppe Granata ◽  
Anna Savoldi ◽  
Giovanni Rodà ◽  
...  
Keyword(s):  
Vena Cava ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Filter Retrieval ◽  
Ivc Filters ◽  
The Common ◽  
Deep Vein ◽  
Removal Technique ◽  
Loop Snare

Caval filters are placed in the inferior vena cava (IVC) to prevent pulmonary thromboembolism in patients with deep vein thrombosis. If there is no indication for thrombo-embolic risk prevention, the filter can be removed to reduce potential filter-related complications. Advanced endovascular techniques are frequently used to retrieve IVC filters. We describe an alternative filter-removal technique for use when standard techniques are not practicable. In our method, the filter hook is embedded within the IVC wall. To retrieve it, a long introducer is inserted; a guidewire and the "loop snare" retrieval system are then advanced through it with a coaxial system and positioned below the filter at the level of the common iliac vein confluence. The guidewire is then passed through the loop, creating a "sling" around the filter which allows the application of traction from the bottom upwards, releasing the hook from the wall. The loop is then held under tension with the filter aligned in the IVC lumen, and the introducer is advanced distally to completely cover the filter, allowing complete retrieval of the filter without damaging the vessel walls. This modified Sling technique is a safe and feasible method for complicated IVC filter retrieval.

scholarly journals May-Thurner Syndrome with Large Abdominal Varicosity, Treated Successfully Using Multiple Approaches

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Lori Jia ◽  
Jason Alexander ◽  
Nedaa Skeik
Keyword(s):  
Vena Cava ◽  
Iliac Vein ◽  
Postthrombotic Syndrome ◽  
Common Iliac Vein ◽  
Filter Placement ◽  
Vein Thrombosis ◽  
Left Common Iliac Vein ◽  
Venous Outflow Obstruction ◽  
Angioplasty And Stenting ◽  
Deep Vein

May-Thurner syndrome (MTS) is a venous outflow obstruction disorder characterized by compression of the left common iliac vein by an overriding right common iliac artery. MTS primarily affects young to middle-aged women, although many patients remain entirely asymptomatic. Anatomic variations of MTS, while uncommon, have been described. Treatment usually involves endovascular management, including thrombolysis and/or thrombectomy with or without inferior vena cava filter placement, followed by angioplasty and stenting of the left common iliac vein. We report a unique case of a 31-year-old woman who presented with MTS-related deep vein thrombosis accompanied by symptomatic abdominal and pelvic varicosities. The varicosities were treated successfully using multiple procedures, resulting in complete resolution of all symptoms. Our case discusses a treatment approach for an unusual presentation of MTS-related postthrombotic syndrome, and provides a brief literature review of MTS complications and management.

P1450Deep vein thrombosis after right sided catheter ablation; more common then previously thought?

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
C Bruce ◽  
S Rogers ◽  
K Saraf ◽  
G Kirkwood ◽  
N Kirkland ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Femoral Vein ◽  
Accessory Pathway ◽  
Significant Proportion ◽  
Anticoagulation Therapy ◽  
Vena Cava ◽  
Iliac Vein ◽  
P Value ◽  
Cardiac Catheter ◽  
Vein Thrombosis

Abstract Funding Acknowledgements Bristol-Myers Squibb Background Right sided cardiac catheter ablation has become an indispensable tool to treat supraventricular cardiac dysrhythmias, with ablation of certain arrhythmias having cure rates over 90%. Due to this the frequency of these procedures is increasing annually and it is imperative we understand the incidence of all complication. One lesser studied complication is that of deep vein thrombosis (DVT), for which catheter ablation demonstrates all elements of Virchow"s triad.  As right sided ablations are carried out to treat troublesome palpitations, not to reduce mortality, it is important all risks are identified, especially those which are themselves potentially life threatening and can be modified. Purpose   To determine the incidence of DVT after right sided cardiac catheter ablation. Methods   We undertook a prospective multi-center study recruiting adult patients undergoing clinically indicated cardiac ablation for atrioventricular nodal re-entrant tachycardia and atrioventricular re-entrant tachycardia with right sided accessory pathway. Important exclusion criteria included patients on anticoagulation or antiplatelet therapy. Participants underwent bilateral compression venous duplex ultrasonography from the inferior vena cava to the popliteal vein to access for DVT at 24 hours and between 10 to 14 days post-procedure. The uncannulated contralateral leg acted as a control. Result   At interim analysis 71 participants had completed the study with average age 47 year (+/- 14), procedure duration 67 minutes, and with a female predominance. Seven patients developed acute DVT in either the femoral or internal iliac vein in the access leg. No thrombus was seen in the control leg. This gives an incidence of 10% (95% CI 4-19%) with p value of 0.023 on Chi-square testing. Conclusion We found a statistically significant proportion of patients undergoing right sided cardiac catheter ablation developed acute proximal DVT on ultrasound. All patients were treated with 3 to 6 months of anticoagulation therapy in accordance with NICE guidelines. These results suggest that DVT may occur at a high frequency then previously thought in this cohort and supports the consideration of peri-procedural prophylactic anticoagulation. Abstract Figure. Acute thrombus in the femoral vein

scholarly journals A case of May-Thurner Syndrome: An old anomaly but, a new suggestion: A case report

2019 ◽  
Vol 31 (3) ◽  
pp. 230-232
Author(s):  
Şule Gökçe
Keyword(s):  
Case Report ◽  
Sports Medicine ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Ultrasound Screening ◽  
Vascular Abnormalities ◽  
Vein Thrombosis ◽  
History Of ◽  
The Right ◽  
Deep Vein

May-Thurner syndrome (MTS) is an anatomical condition resulting in compression of the left common iliac vein between the right common iliac artery and the underlying spine. MTS is rarely diagnosed because diagnostic workup is seldom continued once the diagnosis of a deep vein thrombosis (DVT) has been established. Furthermore, patients with DVT generally have several well-known confounding risk factors. We report a 16-year-old girl with a history of left leg swelling who was incidentally diagnosed with MTS. We hope that our case report will create awareness of vascular abnormalities in sports medicine and suggest that routine venous Doppler ultrasound screening may help to detect MTS or associated anatomical prior to the formation of early thrombosis.

Sign in / Sign up

Export Citation Format

Share Document