Geometric changes of the inferior vena cava in trauma patients subjected to volume resuscitation

Vascular ◽  
2014 ◽  
Vol 23 (5) ◽  
pp. 459-467 ◽  
Author(s):  
Samuel L Chen ◽  
Mayil S Krishnam ◽  
Thangavijayan Bosemani ◽  
Sumudu Dissayanake ◽  
Michael D Sgroi ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Vena Cava ◽  
Major Axis ◽  
Minor Axis ◽  
Trauma Patients ◽  
Cross Sectional ◽  
Area And Perimeter ◽  
Left Anterior Oblique

ObjectiveDynamic changes in anatomic geometry of the inferior vena cava from changes in intravascular volume may cause passive stresses on inferior vena cava filters. In this study, we aim to quantify variability in inferior vena cava dimensions and anatomic orientation to determine how intravascular volume changes may impact complications of inferior vena cava filter placement, such as migration, tilting, perforation, and thrombosis.MethodsRetrospective computed tomography measurements of major axis, minor axis, and horizontal diameters of the inferior vena cava at 1 and 5 cm below the lowest renal vein in 58 adult trauma patients in pre-resuscitative (hypovolemic) and post-resuscitative (euvolemic) states were assessed in a blinded fashion by two independent readers. Inferior vena cava perimeter, area, and volume were calculated and correlated with caval orientation.ResultsMean volumes of the inferior vena cava segment on pre- and post-resuscitation scans were 9.0 cm3and 11.0 cm3, respectively, with mean percentage increase of 48.6% ( P < 0.001). At 1 cm and 5 cm below the lowest renal vein, the inferior vena cava expanded anisotropically, with the minor axis expanding by an average of 48.7% ( P < 0.001) and 30.0% ( P = 0.01), respectively, while the major axis changed by only 4.2% ( P = 0.11) and 6.6% ( P = 0.017), respectively. Cross-sectional area and perimeter at 1 cm below the lowest renal vein expanded by 61.6% ( P < 0.001) and 10.7% ( P < 0.01), respectively. At 5 cm below the lowest renal vein, the expansion of cross-sectional area and perimeter were 43.9% ( P < 0.01) and 10.7% ( P = 0.002), respectively. The major axis of the inferior vena cava was oriented in a left-anterior oblique position in all patients, averaging 20° from the horizontal plane. There was significant underestimation of inferior vena cava maximal diameter by horizontal measurement. In pre-resuscitation scans, at 1 cm and 5 cm below the lowest renal vein, the discrepancy between the horizontal and major axis diameter was 2.1 ± 1.2 mm ( P < 0.001) and 1.7 ± 1.0 mm ( P < 0.001), respectively, while post-resuscitation studies showed the same underestimation at 1 cm and 5 cm below the lowest renal vein to be 2.2 ± 1.2 mm ( P < 0.01) and 1.9 ± 1.0 mm ( P < 0.01), respectively.ConclusionsThere is significant anisotropic variability of infrarenal inferior vena cava geometry with significantly greater expansive and compressive forces in the minor axis. There can be significant volumetric changes in the inferior vena cava with associated perimeter changes but the major axis left-anterior oblique caval configuration is always maintained. These significant dynamic forces may impact inferior vena cava filter stability after implantation. The consistent major axis left-anterior oblique obliquity may lead to underestimation of the inferior vena cava diameter used in standard anteroposterior venography, which may influence initial filter selection.

scholarly journals Left Inferior Vena Cava and Right Retroaortic Renal Vein

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Alberto Nania ◽  
Fabio Capilli ◽  
Eugenia Longo
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Vena Cava ◽  
Correct Identification ◽  
Cross Sectional ◽  
Anatomical Variant ◽  
Cross Sectional Imaging ◽  
Potential Risks ◽  
Sectional Imaging

Nowadays, incidental anatomical variants are frequent findings, due to the widespread diffusion of cross-sectional imaging. This case report illustrates a fairly uncommon anatomical variant, that is, the copresence of left inferior vena cava and retroaortic right renal vein reported in a 46-year-old lady, undergoing a staging CT for breast cancer. Although the patient was asymptomatic, the authors highlight potential risks related to the above-mentioned condition and the importance of correct identification and diagnosis of the findings.

scholarly journals Are Aorta Artery Diameter and Inferior Vena Cava Diameter a Reliable Predictor index in Traumatic Patients with Hemorrhagic Shock?

2021 ◽  
Vol 9 (1) ◽  
pp. 14-14
Author(s):  
Kavous Shahsavarinia ◽  
Peyman Habibi ◽  
Ali Taghizadieh ◽  
Payman Moharamzadeh ◽  
Farzad Rahmani ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Hemorrhagic Shock ◽  
Inferior Vena ◽  
Vena Cava ◽  
Cross Sectional Study ◽  
Trauma Patients ◽  
Odds Ratios ◽  
Cross Sectional ◽  
Unit Increase ◽  
Ordinal Regression Model

Background: Intravascular volume is the most important factor in determining patients' hemodynamic status. This present study aimed to assay the predictive value of aorta artery diameter and inferior vena cava (IVC) diameter in trauma patients with hemorrhagic shock. Materials and Methods: This was a cross-sectional study conducted on 69 trauma patients who referred to Imam Reza Hospital in Tabriz. Inclusion criteria were all trauma patients with hemorrhagic shock. Patients with diseases such as liver disease,cardiovascular,coronary heart disease and concurrent dehydration were excluded. Odds ratios and Adjusted odds ratios for the risk of events were obtained using cumulative logit ordinal regression model with version 15 of Stata software. Results: There were 58 men (84/1%) and 11 women (15/9%) with an average age of 36.4±12.4 year. Findings showed that for one unit increase in the diameter of the aorta by controlling the effect of other variables, the odds of mortality decreased for 2% compared with hospitalization in ward or intensive care unit (ICU). The reduction was also statistically significant (P=0.037). Furthermore, by modifying the effect of other variables, one unit increase in the diameter of IVC during inhale and exhale, increases the odds of hospitalization in ward or ICU. Conclusion: This study showed that the diameter of the aorta and also the diameter of IVC during inhale and exhale can be used to predict the outcome of trauma patients with hemorrhagic shock and eventually to take steps for emergent and effective treatment.

scholarly journals Periaortic venous necklace and renal right double arteries; Case report

2021 ◽  
pp. 312-316
Author(s):  
Petru Bordei ◽  
Constantin Rusali ◽  
Constantin Ionescu ◽  
Dragos Serban ◽  
Valeriu Ardeleanu
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Cross Sectional ◽  
Organic Sample ◽  
Cross Sectional Dimension ◽  
The Right ◽  
Venous Branch

The case was found on an organic sample consisting of the two kidneys with the renal pedicles and the corresponding segments of the abdominal aorta and inferior vena cava. From the inferior face of the left renal vein, on the lower side of the aorta, a venous branch with an upward path of 8.02 mm was detached, passing on the anterior face of the aorta, passing before its right side, in order to end on the left side of the inferior vena cava, 13.9 mm above the end of the left renal vein in the inferior vena cava, this branch thus describing a periaortic ring (necklace), in which on the left side of the aorta the inferior adrenal vein ends. The periaortic ring (necklace) had a cross-sectional dimension of 3.2 mm and a vertical one of 1.7 cm. On the right side of the aorta, a 2.9 mm venous branch came out of the renal vein, ending on the left side of the inferior vena cava, 1.2 mm above the end of the left renal vein. At the level of the right kidney there were two renal arteries, superior and inferior. Between the two arteries there was an interval of 5.1 cm.

Leiomyosarcomas of the inferior vena cava: diagnostic features on cross-sectional imaging

2011 ◽  
Vol 66 (1) ◽  
pp. 50-56 ◽  
Author(s):  
S. Ganeshalingam ◽  
G. Rajeswaran ◽  
R.L. Jones ◽  
K. Thway ◽  
E. Moskovic
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Diagnostic Features ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Thrombosed interrupted inferior vena cava and retroaortic left renal vein mimicking retroperitoneal neoplasm

2006 ◽  
Vol 32 (3) ◽  
pp. 403-406 ◽  
Author(s):  
Sevdenur Cizginer ◽  
Servet Tatli ◽  
Jeffrey Girshman ◽  
Joshua A. Beckman ◽  
Stuart G. Silverman
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Retroperitoneal Neoplasm

Prevalence of Congenital Anomalies of the Inferior Vena Cava: CT Assessment in Thai Patients

2021 ◽  
Vol 104 (9) ◽  
pp. 1459-1464
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Renal Veins ◽  
Retrocaval Ureter ◽  
Radiology Reports ◽  
Contrast Enhanced ◽  
Study Population

Objective: To determine the prevalence of inferior vena cava (IVC) anomalies in Thai patients who underwent contrast-enhanced computed tomography (CT) of the abdomen. Materials and Methods: Two radiologists retrospectively and independently reviewed the contrast-enhanced abdominal CT examinations in 1,429 Thai patients between August 1, 2018 and January 25, 2019 who met the inclusion criteria. Patients were included, if (a) their CT showed well visualized IVC, renal veins, and right ureter that were not obliterated by tumor, cyst, fluid collection, or intraperitoneal free fluid, (b) they had not undergone previous abdominal surgery that altered anatomical configuration of the IVC, renal veins, and right ureter. The presence of all IVC anomalies were recorded. Results: Among the 1,429 studied patients, 678 were male (47.4%) and 751 were female (52.6%). The prevalence of IVC anomalies was 3.5%. Five types of IVC anomalies were presented. The most common was circumaortic left renal vein in 24 patients or 48.0% of all IVC anomalies and 1.7% of the study population, followed by retroaortic left renal vein in 15 patients or 30.0 % of all IVC anomalies and 1.0% of the study population. Other IVC anomalies included double IVC, left IVC, and retrocaval ureter at 0.5%, 0.2%, and 0.1% of the study population, respectively. Conclusion: The prevalence of IVC anomalies in the present study differed from the previous studies conducted in other countries, which may be attributable to differences in race and ethnicity. Awareness of these anomalies is essential when evaluating routine CT examinations in asymptomatic patients. Their presence should be carefully noted in radiology reports to avoid anomaly-related complications. Keywords: Prevalence; IVC anomalies; Circumaortic left renal vein; Retroaortic left renal vein; Double IVC; Left IVC; Retrocaval ureter

scholarly journals A Rare Cause of Renal Vein and Inferior Vena Cava Thrombosis: A Case of Embryonal Testicular Carcinoma

2020 ◽  
Vol 5 (4) ◽  
pp. 229-231
Author(s):  
Sevgi Aras ◽  
Murat Yakın ◽  
İsmail Şerifoğlu ◽  
İsmail Ulus ◽  
Abdülkadir Zengin ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Vena Cava ◽  
Testicular Carcinoma ◽  
Vena Cava Thrombosis ◽  
Inferior Vena Cava Thrombosis
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