Endovascular Treatment of Inferior Vena Cava Thrombosis in Metastatic Malignancy: A Case Report and Review of Literature

2019 ◽  
Vol 53 (6) ◽  
pp. 507-511 ◽  
Author(s):  
Kayle S. Shapero ◽  
Qurat-Ul-Ain Jelani ◽  
Carlos Mena
Keyword(s):  
Inferior Vena Cava ◽  
Lower Extremity ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Inferior Vena ◽  
Hospice Care ◽  
Vena Cava ◽  
Caudate Lobe ◽  
Lower Extremity Edema ◽  
Ivc Thrombosis

Inferior vena cava (IVC) thrombosis is a specific form of thromboembolism that occurs at a rate of 1.5% in all patients hospitalized with a deep vein thrombosis. Malignant IVC thrombosis may occur due to compression from a tumor mass or metastasis or may also occur through tumor invasion of the venous vasculature. Obstruction of the IVC can lead to IVC syndrome, marked by ascites, lower extremity edema, and even congestive hepatic failure. We present a case of extensive IVC thrombosis in a 69-year-old female with metastatic adrenal cell carcinoma, presenting with severe bilateral lower extremity edema and ascites. Computed tomography showed IVC compression by the caudate lobe due to a metastatic liver mass and extensive clot burden of the IVC extending from the renal veins to the right atrium (RA). She underwent percutaneous IVC stenting with 4 stents placed in tandem from the IVC to the RA. Her hospital course was complicated by gastrointestinal bleed requiring clipping, acute liver failure, and hypophysitis due to trial therapy. Although her IVC symptoms were partially relieved with percutaneous intervention, her acute liver failure worsened and she was ultimately transitioned to hospice care.

Iatrogenic Inferior Vena Cava Resection Requiring Reconstruction

2021 ◽  
pp. 153857442110129
Author(s):  
Hossam Alslaim ◽  
Jane Chung ◽  
Edward Kruse ◽  
Mrinal Shukla ◽  
Gautam Agarwal
Keyword(s):  
Pulmonary Embolism ◽  
Inferior Vena Cava ◽  
Lower Extremity ◽  
Inferior Vena ◽  
Vena Cava ◽  
Percutaneous Intervention ◽  
Bovine Pericardium ◽  
Lower Extremity Edema ◽  
Inferior Vena Cava Resection ◽  
Ivc Reconstruction

This is a report of an iatrogenic inferior vena cava (IVC) segmental resection and reconstruction utilizing bovine pericardium. A 48-year-old female patient presented for a planned right nephrectomy by the urology service secondary to xanthogranulomatous pyelonephritis. This was complicated by inadvertent resection of an 8 cm segment of the infrarenal IVC. Postoperatively, the patient did not tolerate IVC ligation due to severe lower extremity edema. She then underwent reconstruction with a bovine pericardium conduit as an interposition graft. The post-operative course was complicated by pulmonary embolism requiring percutaneous intervention. This report addresses the utility of bovine pericardium for IVC reconstruction in an infected field.

Patients with inferior vena cava thrombosis frequently present with lower back pain and bilateral lower-extremity deep vein thrombosis

VASA ◽  
2013 ◽  
Vol 42 (4) ◽  
pp. 275-283 ◽  
Author(s):  
Christiane Kraft ◽  
Carola Hecking ◽  
Jan Schwonberg ◽  
Marc Schindewolf ◽  
Edelgard Lindhoff-Last ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Inferior Vena Cava ◽  
Lower Extremity ◽  
Malignant Disease ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vein Thrombosis ◽  
Lower Back ◽  
Ivc Thrombosis ◽  
Deep Vein

Background: Inferior vena cava (IVC) thrombosis is rare, and data about the clinical presentation of patients are scarce. Therefore, we reviewed all cases of IVC thrombosis consecutively registered in the MAISTHRO (MAin-ISar-THROmbosis) database and described patients’ characteristics in terms of their clinical presentations in the acute setting of IVC thrombosis. Patients and methods: From the MAISTHRO registry, which enrolled 1470 consecutive patients with documented histories of venous thromboembolism, we identified 60 patients (0,4 %; females 60 %) with IVC thrombosis and 888 patients (60.4 %; females 55 %) with isolated lower-extremity deep vein thrombosis (LE-DVT). Results: The median age at the time of IVC thrombosis manifestation was 36.5 years (9 to 83). IVC thrombosis was the initial VTE event in 47 patients (78 %). In the majority of cases, IVC thrombosis extended to the lower-extremity veins, and both lower extremities were affected in 17 cases (28 %). The initial clinical symptom of IVC thrombosis was lower back or abdominal pain which preceded typical symptoms of LE-DVT in 29 (48 %) patients. Symptomatic pulmonary embolism was more frequently observed in IVC thrombosis patients when compared to a sex- and age-matched subgroup of LE-DVT patients, although the difference was not significant (27 % vs. 12 %; p = 0.064). Malignant disease was the only established VTE risk factor with a higher prevalence among IVC thrombosis patients than patients with isolated LE-DVT (27 % vs. 9 %; p = 0.015). Congenital IVC anomalies were identified in another eight IVC thrombosis patients (13 %). Conclusions: IVC thrombosis should be considered a differential diagnosis for inexplicable lower back or abdominal pain especially in young patients. Malignant disease and congenital IVC anomalies seem to be predisposing factors for thrombosis involving the inferior vena cava.

Leiomyosarcoma of the Inferior Vena Cava: Surgical Management and Clinical Results

2005 ◽  
Vol 71 (6) ◽  
pp. 497-501 ◽  
Author(s):  
Jason Dew ◽  
Kimberly Hansen ◽  
John Hammon ◽  
Thomas McCoy ◽  
Edward A. Levine ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Lower Extremity ◽  
Surgical Management ◽  
Inferior Vena ◽  
Primary Repair ◽  
Vena Cava ◽  
Lower Extremity Edema ◽  
Tumor Excision ◽  
Ivc Reconstruction

Leiomyosarcoma of the inferior vena cava (IVC) is a rare lesion with less than 300 cases reported. Optimal management and long-term outcomes are not well described. From August 1984 to June 2004, eight patients with leiomyosarcoma of the IVC were treated at our institution. Clinical and pathologic data, surgical management, and outcomes were assessed. Eight cases were identified (4 males) with a median age of 52 (range 29–66). Presenting symptoms included abdominal pain (n = 5, 63%), lower extremity edema (n = 2, 25%), and palpable mass (n = 2, 25%). Tumor location was between the renal and iliac veins (low) (n = 4, 50%), between the hepatic and renal veins (middle) (n = 3, 38%), and above the hepatic veins with right atrial extension (high) (n = 1, 12%). Two patients with preoperative IVC occlusion were managed with tumor excision and IVC ligation. Three patients had primary repair of the IVC after tumor excision. A polytetrafluorothylene (PTFE) tube graft was used for IVC reconstruction in three cases. There was no postoperative mortality. Postoperative morbidity included deep venous thrombosis (DVT) (n = 1), lower extremity edema (mild n = 1; moderate n = 1), GI bleed (n = 1), and chronic renal insufficiency (n = 1). One patient is currently receiving adjuvant chemotherapy. Four patients received chemotherapy after recurrence, and one received palliative radiation therapy as well. Median survival to this point was 60 months with a median follow-up of 39 months. The 5-year overall survival and disease-free survival was 31 per cent for both (CI 0.1–1.0). The type of IVC reconstruction had no effect on survival ( P = 0.22). Recurrence was discovered in four patients (50%) at a median time of 14 months. Resection of leiomyosarcoma of the IVC should be attempted whenever feasible. The management of the IVC can be managed with primary repair, ligation, or prosthetic graft. Long-term survival is possible if complete resection can be achieved.

Inferior vena cava atresia predisposing to acute lower extremity deep vein thrombosis in children: A descriptive dual-center study

2017 ◽  
Vol 65 (2) ◽  
pp. e26785 ◽  
Author(s):  
Cristina Tarango ◽  
Riten Kumar ◽  
Manish Patel ◽  
Anne Blackmore ◽  
Patrick Warren ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Inferior Vena Cava ◽  
Lower Extremity ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Center Study

scholarly journals A rare case of arteriovenous fistula formation in a patient with inferior vena cava thrombosis, successfully managed with endovascular recanalisation

2019 ◽  
Vol 5 (4) ◽  
pp. 20190007
Author(s):  
Vanya Joshi ◽  
Frances Sheehan ◽  
Alexander Chapman
Keyword(s):  
Inferior Vena Cava ◽  
Arteriovenous Fistula ◽  
Animal Studies ◽  
Inferior Vena ◽  
Vena Cava ◽  
Lower Extremities ◽  
Venous Hypertension ◽  
Fistula Formation ◽  
Ivc Thrombosis ◽  
Ivc Filters

Inferior vena cava (IVC) filters are recommended for patients with proximal deep vein thrombosis (DVT) who are not eligible for anticoagulation. Long-dwelling filters are well-known to be associated with the development of IVC thrombosis. Chronic caval occlusion can lead to a severe post-thrombotic syndrome (PTS), with manifestations of chronic venous insufficiency in the lower extremities. Animal studies have shown that post-thrombotic inflammation can trigger the development of an arteriovenous fistula (AVF), however, there is limited evidence for this phenomenon in patients with PTS. We describe the case of a spontaneous AVF in a patient with long-standing IVC thrombosis. It was postulated that the AVF could be compounding the venous hypertension and severe swelling of his lower extremities. The case additionally demonstrates the successful results of endovascular recanalisation for an occluded filter in the presence of an AVF.

scholarly journals Rare case of a kidney and inferior vena cava abnormalities with extensive lower extremity deep vein thrombosis in a young healthy male

2018 ◽  
Vol 8 (4) ◽  
Author(s):  
Muhammad Khalid ◽  
Manisha Nukavarapu ◽  
Rupal Shah ◽  
Timir K. Paul
Keyword(s):  
Deep Vein Thrombosis ◽  
Inferior Vena Cava ◽  
Lower Extremity ◽  
Rare Case ◽  
Inferior Vena ◽  
Left Kidney ◽  
Vena Cava ◽  
Healthy Male ◽  
Vein Thrombosis ◽  
Deep Vein

Kidney and inferior vena cava (IVC) abnormalities with extensive deep vein thrombosis (DVT) is a very rare cause of DVT and has a diverse clinical presentation. Computed tomography (CT) angiography is the gold standard for diagnosis and treatment including thrombectomy, thrombolysis and systemic anticoagulation. We present a rare case of active young healthy male admitted with acute onset of right lower extremity pain and swelling who was found to have extensive DVT on doppler ultrasound. CT abdomen showed extensive clot burden involving right common femoral vein extending into internal and external iliac veins associated with IVC hypoplasia and hypoplastic left kidney. Patient underwent urgent thrombectomy, catheter directed thrombolysis and was discharged home in stable condition on oral anticoagulation.

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