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 Suppurative Thrombophlebitis of the Inferior Vena Cava Resolved with Intravenous Antibiotic Therapy: A Case Report

2018 ◽  
Author(s):  
Mahshid Talebi-Taher ◽  
MPH MD ◽  
Shokoufeh Hajsadeghi ◽  
Aida Iranpour ◽  
Seyed Mahdi Pahlavani
Keyword(s):  
Inferior Vena Cava ◽  
Antibiotic Therapy ◽  
Right Atrium ◽  
Inferior Vena ◽  
Vena Cava ◽  
Intravenous Antibiotic ◽  
Ivc Thrombosis ◽  
Intravenous Antibiotic Therapy ◽  
Ivc Filters ◽  
The Right

  Inferior vena cava (IVC) thrombosis is a rare medical condition. Suppurative thrombophlebitis of the IVC is even a more uncommon subtype of IVC thrombosis and is mostly associated with IVC filters or venous catheters. We describe a 66-year-old man with persistent fever and history of pyonephrosis secondary to transurethral lithotripsy 1 month before recent admission. Computed tomography scan of the chest and abdomen revealed a filling defect in the IVC protruding into the right atrium. Transesophageal echocardiogram (TEE) revealed a large mass at the origin of the IVC entering into the right atrium, suggestive of a clot. Diagnosis of suppurative thrombophlebitis of the IVC secondary to a retroperitoneal abscess was made, and intravenous antibiotic therapy for 6 weeks without anticoagulation conferred ample thrombus resolution. Follow-up TEE in week 16 showed no residual thrombus in the IVC.

Sacral preservation in cauda equina syndrome from inferior vena cava thrombosis

2009 ◽  
Vol 10 (3) ◽  
pp. 257-259 ◽  
Author(s):  
Alik S. Widge ◽  
Nestor D. Tomycz ◽  
Adam S. Kanter
Keyword(s):  
Inferior Vena Cava ◽  
Cauda Equina Syndrome ◽  
Inferior Vena ◽  
Relevant Literature ◽  
Cauda Equina ◽  
Vena Cava ◽  
Perioperative Period ◽  
Ivc Thrombosis ◽  
Ivc Filters ◽  
Acute Paraparesis

Acute cauda equina syndrome can occur due to a variety of causes. Inferior vena cava (IVC) thrombosis has been reported as the causal source of this phenomenon twice in the relevant literature, both cases of which presented in a form complete with a component of bowel and/or bladder dysfunction. The authors report an atypical case of cauda equina syndrome in a patient in a hypercoagulable state with an extensive IVC thrombosis, resulting in acute paraparesis in the absence of incontinence or perineal anesthesia. An increasing number of prophylactic and/or therapeutic IVC filters placed in the perioperative period should engender an increased clinical suspicion for IVC thrombosis in patients presenting with acute paraparesis.

scholarly journals Idiopathic Thrombosis of the Inferior Vena Cava and Bilateral Femoral Veins in an Otherwise Healthy Male Soldier

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Sarah Gordon ◽  
Tamie Kerns ◽  
William Londeree ◽  
Brian Ching
Keyword(s):  
Inferior Vena Cava ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Lower Extremities ◽  
Hypercoagulable State ◽  
Healthy Male ◽  
Ivc Thrombosis

Thrombosis of the inferior vena cava is less common than deep venous thrombosis of the lower extremities, particularly in the absence of an obvious congenital caval abnormality or hypercoagulable state. We present a case of IVC thrombosis in an otherwise healthy and active 28-year-old male soldier secondary to dehydration and venous webbing. IVC thrombosis is an uncommon and underrecognized condition; in this case, the patient’s caval thrombosis was initially mistaken for acute back strain. Prompt recognition is necessary to minimize long-term sequelae.

Retroperitoneal Laparoscopic-Assisted Retrieval of Wall-Penetrating Inferior Vena Cava Filter After Endovascular Techniques Failed: An Initial Clinical Outcome

2021 ◽  
pp. 153857442110225
Author(s):  
Haidong Wang ◽  
Zhenhua Liu ◽  
Xiaofei Zhu ◽  
Jianlong Liu ◽  
Libo Man
Keyword(s):  
Deep Vein Thrombosis ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Ivc Filter ◽  
Endovascular Techniques ◽  
Vein Thrombosis ◽  
Ivc Filters ◽  
Laparoscopic Assisted ◽  
Deep Vein

Background: Inferior vena cava (IVC) filters are commonly used in China to prevent pulmonary embolisms in patients with deep vein thrombosis. However, IVC filter removal is complicated when the filter has penetrated the IVC wall and endovascular techniques usually fail. The purpose of this study was to evaluate the effectiveness and safety of retroperitoneal laparoscopic-assisted retrieval of wall-penetrating IVC filters after endovascular techniques have failed. Patients and Methods: We retrospectively evaluated a series of 8 patients who underwent retroperitoneal laparoscopic-assisted retrieval of a wall-penetrating IVC filter between December 2017 and November 2019. All patients had experienced at least 1 failure with endovascular retrieval before the study. The filters were slanted and the proximal retrieval hooks penetrated the posterior lateral IVC wall in all patients on computed tomography. Demographic information, operation parameters, and complications were recorded and analyzed. All patients were followed up for at least 12 months. Results: The procedure was successful in all patients. The median surgery time was 53.6 ± 12.7 min and the average blood loss was 45.0 ± 13.5 ml. No serious complication occurred during the patients’ hospitalization, which was an average of 6.4 days. The median follow-up time was 15.1 months, and no patient had deep vein thrombosis recurrence. Conclusions: Retroperitoneal laparoscopic-assisted retrieval is a feasible and effective technique, particularly when proximal retrieval hooks penetrate the posterior lateral wall of the IVC after endovascular techniques have failed. To some extent, the development of this technique at our institution has increased the success rate of filter removal and improved patient satisfaction.

scholarly journals Practice patterns of retrievable inferior vena cava filters and predictors of filter retrieval in patients with pulmonary embolism

2017 ◽  
Vol 22 (6) ◽  
pp. 512-517 ◽  
Author(s):  
Jieun Kang ◽  
Heung-Kyu Ko ◽  
Ji Hoon Shin ◽  
Gi-Young Ko ◽  
Kyung-Wook Jo ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Inferior Vena Cava ◽  
Predictive Factors ◽  
Inferior Vena ◽  
Vena Cava ◽  
Ivc Filter ◽  
Retrieval Rate ◽  
Filter Retrieval ◽  
Ivc Filters ◽  
Filter Insertion

Retrievable inferior vena cava (IVC) filters are increasingly used in patients with venous thromboembolism (VTE) who have contraindications to anticoagulant therapy. However, previous studies have shown that many retrievable filters are left permanently in patients. This study aimed to identify the common indications for IVC filter insertion, the filter retrieval rate, and the predictive factors for filter retrieval attempts. To this end, a retrospective cohort study was performed at a tertiary care center in South Korea between January 2010 and May 2016. Electronic medical charts were reviewed for patients with pulmonary embolism (PE) who underwent IVC filter insertion. A total of 439 cases were reviewed. The most common indication for filter insertion was a preoperative/procedural aim, followed by extensive iliofemoral deep vein thrombosis (DVT). Retrieval of the IVC filter was attempted in 44.9% of patients. The retrieval success rate was 93.9%. History of cerebral hemorrhage, malignancy, and admission to a nonsurgical department were the significant predictive factors of a lower retrieval attempt rate in multivariate analysis. With the increased use of IVC filters, more issues should be addressed before placing a filter and physicians should attempt to improve the filter retrieval rate.

scholarly journals Optimal Time of Extraction Retrievable Inferior Vena Cava Filters in Venous Thromboembolic Treatment: Evidence Based Case Report

2021 ◽  
Vol 2 (1) ◽  
pp. 41-47
Author(s):  
Akhmadu Muradi ◽  
Rudi Hermansyah
Keyword(s):  
Inferior Vena Cava ◽  
Dwell Time ◽  
Inferior Vena ◽  
Vena Cava ◽  
Optimal Time ◽  
Standard Time ◽  
Ivc Filters ◽  
Vena Cava Filters ◽  
Adjacent Structures ◽  
Successful Retrieval

Background: Inferior vena cava (IVC) filters have been proven to be significantly advantageous and clinically efficacious in the prevention of deathly venous thromboembolism, but also carry long-term risks, such as device failure, filter fracture, migration, penetration into adjacent structures, etc. Retrievable filters offer the same degree of protection, and subsequently lower those risk by removing them after they aren’t needed. Unfortunately, increasing use of retrievable filters leads to one alarming trend: there’s massive number of filters that are left for an extended time. Whether the time between deployment and retrieval affects filter’s technical success of retrieval remains questionable. Here is a case of a 45-year old woman who had undergone retrievable IVC filter due to pulmonary embolism risk. The patient only came to clinician for routine follow- up once, one month after deployment. One year later, the patient felt abdominal pain and asked to remove the filter. After one failed attempt, the clinician decided to leave the filter in situ as permanent filter. Method: Literature searching was conducted in several databases (ScienceDirect, EbscoHost, and ClinicalKey) using specified keywords. Six articles that had been passed exclusion and inclusion criteria, were eventually appraised and extracted. Results: Of all six articles that are included in this study, there are no standard time of retrieval. Each study provides data regarding their attempted retrieval, successful retrieval, and dwell time. Only two articles (Uberoi et al and Glocker et al) analyze the relationship between time of retrieval and successful retrieval. Uberoi et al claims filter retrieval statistically more successful if the dwell time is less than 9 weeks, whereas Glocker et al states the procedure is considerably more successful within 3-4 months (117 days) after deployment. The reasons of retrieval failure in these studies are varied, including device angulation, filter incorporation with IVC wall, and penetration to IVC wall and adjacent structures, or significant thrombus inside the filter. Conclusion: There are no standard time of retrieval, but clinicians could follow FDA recommendation by removing the filter when it isn’t necessarily needed. However, a time span of 3-4 months between implantation and retrieval can be respectable choice to make sure the maximum chance at retrieval success.

Application of Inferior Vena Cava Nanofilter Combined with Thrombolytic Catheter for Intravenous Thrombolysis in Deep Vein Thrombosis of Lower Extremities

2021 ◽  
Vol 11 (6) ◽  
pp. 1187-1193
Author(s):  
Hongwei Liao ◽  
Yi Wang
Keyword(s):  
Deep Vein Thrombosis ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Intravenous Thrombolysis ◽  
Lower Extremities ◽  
High Sensitivity ◽  
Clinical Value ◽  
Vein Thrombosis ◽  
Deep Vein

Deep vein thrombosis (DVT) of the lower extremities has a high incidence and is insidiously fatal. Detachment of the thrombus can quickly cause death. Early detection and timely treatment are key to the treatment of DVT. This study is the first to report the clinical value of an inferior vena cava nanofilter combined with thrombolytic catheter for intravenous thrombolysis in DVT. The study found that the inferior vena cava nanofilter combined with the thrombolytic catheter has a significant effect on the treatment of DVT, which greatly reduces the circumference difference of the upper and lower legs, reduces the levels of fibrinogen, high-sensitivity C-reactive protein, and D-dimer, reduces the occurrence of complications, and is safe and worthwhile promotion.

The Role for Prophylaxis Inferior Vena Cava Filters in Patients Undergoing Bariatric Surgery: Replacing Anecdote with Evidence

2012 ◽  
Vol 78 (12) ◽  
pp. 1349-1361 ◽  
Author(s):  
Ben Shamian ◽  
Ronald S. Chamberlain
Keyword(s):  
Bariatric Surgery ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Early Mobilization ◽  
Vein Thrombosis ◽  
Ivc Filters ◽  
Vena Cava Filters ◽  
Number Of Patients ◽  
Bariatric Patients

The number of patients choosing surgical alternatives for weight reduction continues to increase. Despite common thromboembolic preventive methods, which include perioperative subcutaneous heparin injections, early mobilization, and sequential compression devices, postoperative deep vein thrombosis/pulmonary embolism remains a devastating complication after bariatric surgery. The role prophylactic inferior vena cava (IVC) filters may play in bariatric surgery remains controversial, and this article aims to address the risks and benefits of prophylactic IVC filters in high-risk bariatric patients and suggest an evidence-based algorithm for their use.

Respiratory changes in biometry of suprarenal inferior vena cava in patients with varicose veins of lower extremities

2020 ◽  
pp. 026835552097413
Author(s):  
Yury Rusinovich ◽  
Volha Rusinovich
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Venous Return ◽  
Varicose Veins ◽  
Vena Cava ◽  
Lower Extremities ◽  
P Value ◽  
Venous Disease ◽  
Venous Compliance ◽  
Collapsibility Index

Aim This study examines respiratory biometry of inferior vena cava in patients with varicose veins of lower extremities. Material and Methods We performed retrospective analysis of clinical and ultrasound data of 67 patients with primary varicose veins. Results The largest expiratory (mean 16.2 mm, p-value 0.09) and inspiratory (mean 8.2 mm, p-value 0.02) inferior vena cava diameters were in C3 Clinical Etiological Anatomical Pathophysiological clinical class; the smallest expiratory diameters (mean 13.1 mm, p-value 0.5) were in C6 class; the smallest inspiratory diameters (mean 4.6 mm, intercept) were in C2 class. C2 class was associated with highest inferior vena cava collapsibility index (mean 68.2%, intercept); C6 class was associated with lowest collapsibility index (mean 48.3%, p-value 0.04). Recurrent varices in comparison with previously untreated were associated with smaller inspiratory diameters of inferior vena cava (mean 4.4 mm, p-value 0.005), smaller expiratory diameters (mean 13.4 mm, p-value 0.06) and higher collapsibility index (mean 68.5%, p-value 0.005). Patients with recurrent and bilateral varicose veins had identical respiratory biometry of inferior vena cava. Older age was associated with smaller inferior vena cava diameters (p-value <0.01). Conclusion Clinical presentation of varicose veins is associated with different respiratory biometry of suprarenal inferior vena cava. C6 clinical class in comparison with C2 clinical class is associated with lower central venous compliance possible due to the narrowing of inferior vena cava. Smaller inferior vena cava diameters and higher collapsibility index in recurrent subgroup in comparison with previously untreated can be a sign of the significantly altered pressure gradient between the systemic capillaries and the right heart and impaired peripheral venous return. Narrowing of inferior vena cava with age can be a sign of more profound changes in systemic venous return with age in patients with varicose veins in comparison to those without chronic venous disease.

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