Selection of retroperitoneal access during intervertebral disc endoprosthesis in lumbar spine

2021 ◽  
Vol 23 (1) ◽  
pp. 73-80
Author(s):  
Maxim A. Priymak ◽  
Ivan A. Kruglov ◽  
Alexei I. Gaivoronski ◽  
Maksim N. Kravtsov ◽  
Gennady G. Bulyshchenko
Keyword(s):  
Lumbar Spine ◽  
Inferior Vena Cava ◽  
Intervertebral Disc ◽  
Inferior Vena ◽  
Vena Cava ◽  
Iliac Vein ◽  
Intervertebral Discs ◽  
Skin Incision ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein

The morphometric parameters and surgical areas of risk of retroperitoneal approach were studied for endoprosthetics of intervertebral discs in the lumbar spine to reduce trauma and reduce the risk of complications. The study included 110 patients operated on in the period from 2017 to 2020 (72 men, 38 women) in the neurosurgical department of the 1586 Military Clinical Hospital. The average age of the patients was 44.9 15.4 years. According to the localization of access to the lumbar spine, the patients were distributed as follows: LIIILIV 8 (7.3%), LIVLV 46 (41.7%), LVSI 56 (51%). It was found that, for the intervertebral disc LV SI, the length of the skin incision was 92.5 (80; 100) mm, the length of the surgical wound was 80 (80; 110) mm, the thickness of the subcutaneous fat layer was 30 (15; 40) mm, the depth of the wound was to the spine 85 (70; 120) mm, the depth of the wound to the spinal canal 125 (107.5; 152.5) mm, the angle of operation in the horizontal plane at the level of the spine 52 (47; 59.5) degrees. On the basis of the anthropometric data of patients, the optimal length of the skin incision was determined for performing the retroperitoneal approach (120 mm for level LIIILIV, 100 mm for level LIVLV). Three variants of the inferior vena cava bifurcation have been identified for different levels of intervertebral discs in the lumbar spine: high bifurcation, left common iliac vein mainly overlaps the left half of the LIVLV intervertebral disc and does not overlap the LVSI intervertebral disc; middle bifurcation, left common iliac vein overlaps the central part of the intervertebral discs LIVLV and LVSI; low bifurcation, inferior vena cava overlaps the right side of the intervertebral disc LIVLV, inferior vena cava and left common iliac vein completely overlap the intervertebral disc LVSI. The data obtained can be used when planning retroperitoneal access to the lumbar spine in order to reduce the trauma of the operation.

Unusual Case of Right-Sided May-Thurner Syndrome and Review of Its Management

Vascular ◽  
2006 ◽  
Vol 14 (1) ◽  
pp. 47-50 ◽  
Author(s):  
Renee M. Burke ◽  
Sunil S. Rayan ◽  
Karthikeshwar Kasirajan ◽  
Elliot L. Chaikof ◽  
Ross Milner
Keyword(s):  
Inferior Vena Cava ◽  
Iliac Artery ◽  
Unusual Case ◽  
Inferior Vena ◽  
Common Iliac Artery ◽  
Vena Cava ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein ◽  
Endoluminal Stent

May-Thurner syndrome is a phenomenon commonly described as an acquired stenosis of the left common iliac vein as a result of right common iliac artery compression. We report an unusual case of right-sided May-Thurner syndrome in a patient found to have a left-sided inferior vena cava. We also review the management of this patient using angioplasty, intraoperative thrombolysis, and endoluminal stent placement.

Unusual Case of Parkes Weber Syndrome with Aneurysm of the Left Common Iliac Vein and Thrombus in Inferior Vena Cava

2015 ◽  
Vol 29 (7) ◽  
pp. 1450.e17-1450.e19 ◽  
Author(s):  
Igor Banzic ◽  
Milos Brankovic ◽  
Igor Koncar ◽  
Nikola Ilic ◽  
Lazar Davidovic
Keyword(s):  
Inferior Vena Cava ◽  
Unusual Case ◽  
Inferior Vena ◽  
Vena Cava ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein ◽  
Weber Syndrome

scholarly journals ANOMALOUS COMMUNICATION BETWEEN RIGHT INTERNAL ILIAC VEIN AND LEFT COMMON ILIAC VEIN - A CASE REPORT

2014 ◽  
Vol 04 (03) ◽  
pp. 119-120
Author(s):  
Huban Thomas R. ◽  
Prakashbabu B. ◽  
Radhakrishnan P.
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Lumbar Vertebra ◽  
Iliac Vein ◽  
The Body ◽  
Common Iliac Vein ◽  
Left Common Iliac Vein ◽  
Internal Iliac Vein ◽  
Internal Iliac

AbstractInferior vena cava (IVC) is formed by the union of the common iliac veins anterior to the body of the fifth lumbar vertebra, a little to its right side. It conveys blood to the right atrium from all the structures below the diaphragm. During routine educational dissection for medical undergraduates, we have come across a case of an anomalous communication between right internal iliac vein and left common iliac vein and a variation in the formation of inferior vena cava in a 55-year-old male cadaver. Due to its complex embryogenesis and relationship with other abdominal and thoracic structures, IVC may develop abnormally. These anatomical variations are often clinically silent and discovered incidentally. Knowledge of these variations may be helpful to clinicians and anatomists during surgical exploration, atypical clinical presentations and cadaveric findings.

scholarly journals Simultaneous Extrahepatic Portal and Iliac Veins Thrombosis After Abdominal Surgery - A Case Report and Review of Literature

2017 ◽  
Vol 63 (4) ◽  
pp. 190-193
Author(s):  
Ioan Tilea ◽  
Anca Elena Negovan ◽  
Cristina Maria Tatar ◽  
Elena Ardeleanu ◽  
Radu Mircea Neagoe ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Inferior Vena Cava ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Left Common Iliac Vein

AbstractIntroduction: Extrahepatic portal vein thrombosis (EPVT) is the most frequent cause that leads to portal hypertension in non-cirrhotic patients. This condition is related to systemic and local risk factors (such as inflammatory lesions, injuries to portal venous system by surgery, vascular procedures).Case presentation: A case of extended extrahepatic portal vein thrombosis and simultaneous thrombosis of left common iliac vein and inferior vena cava, appeared after abdominal surgery in a hypertensive, diabetic, 50 y.o. man is presented. An acute episode of abdominal pain was interpreted as an emergency and a surgical (initially laparoscopic and then open) procedure was planned in order to perform an appendectomy. Discharge diagnosis was hemoperitoneum secondary to iatrogenic rupture of sigmoid mesocolon provoked by trocar manipulation. Repeated imaging studies performed later revealed the thrombosis of portal vein with extension into right portal branch associated with superior mesenteric thrombosis and free-floating thrombus into left common iliac vein extended towards inferior vena cava. Surgical manoeuvres are considered as triggers of these thrombotic events. After 4 weeks of parenteral anticoagulation a partial recanalization of thrombi was identified, without bleedings.Conclusions: Acute EPVT needs a carefully management. Case is linked to abdominal surgery and requires prolonged anticoagulation related to simultaneous portal and iliac vein thrombosis. Associated conditions (hypertension and diabetes mellitus) must have an appropriate approach. After our knowledge this is the first case published in literature.

Horseshoes Are Not Always Lucky: A Rare Cause of Varicose Veins

2009 ◽  
Vol 33 (1) ◽  
pp. 36-39
Author(s):  
Kathryn Busch ◽  
Judith Doyle ◽  
Martin Forbes ◽  
Geoffrey White ◽  
John Harris ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Varicose Veins ◽  
Vena Cava ◽  
Horseshoe Kidney ◽  
Duplex Ultrasound ◽  
Iliac Vein ◽  
Venous Hypertension ◽  
Common Iliac Vein ◽  
True Nature

Introduction Color duplex ultrasound (CDU) assessment for patients with varicose veins has increased in prevalence as new techniques for treatment continue to emerge. Occasionally, patients present with atypical varicosities that warrant the typical study to be extended to unveil the true underlying cause of the condition. Clinical Details A 41 year old man presented to our laboratory for assessment of bilateral varicose veins. He had recently developed venous eczema. Examination of the patient revealed large varicose veins associated with the long saphenous system, especially prominent on the left side. Methods Using a standard venous incompetence study protocol, CDU was performed with a Philips IU22 machine. The lower-extremity deep and superficial venous systems were assessed for patency and competency. Measurements of incompetent venous junctions and noteworthy vessel diameters were included. The examination was extended to include the pelvic and abdominal veins on the basis of unusual findings during the CDU imaging of the legs. Results Superficial venous insufficiency was detected involving the saphenofemoral junctions (SFJs), long saphenous veins (LSVs), and tributaries bilaterally. Bilateral incompetent calf perforators were identified. On the left, two large SFJs were identified and the LSV measured up to 2.1 cm in diameter. On both sides, an incompetent superficial pelvic vein arising from the SFJ was identified tracking proximally. Examination of the iliac veins revealed normal right iliac veins. On the left, the common iliac vein was extrinsically compressed as was the inferior vena cava. Further examination revealed a horseshoe kidney. The confluence of the lower poles of the kidneys were anterior to the aorta, inferior vena cava, and left common iliac vein, compressing the venous vasculature, accounting for the venous hypertension and left sided prominence. Further management included confirmatory radiological imaging and intervention. Conclusion Atypical varicose veins may be a result of a plethora of causes. It is crucial to the patient's outcome to reveal the true nature of the underlying cause. Abdominal sources of venous incompetence need appropriately tailored intervention to prevent recurrence and potential worsening of symptoms.

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.

Rectal Cancer Presenting Tumor Thrombosis in the Inferior Vena Cava and Common Iliac Vein: Case Report

2008 ◽  
Vol 59 (4) ◽  
pp. 265
Author(s):  
Sun Jung Rhee ◽  
Seong Jin Park ◽  
Hae Kyung Lee ◽  
Boem Ha Yi ◽  
Sung Il Park ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Case Report ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Tumor Thrombosis

Clinical correlation of the area of inferior vena cava, iliac and femoral veins for stent use

Vascular ◽  
2017 ◽  
Vol 26 (2) ◽  
pp. 126-131 ◽  
Author(s):  
Afsha Aurshina ◽  
Arkady Ganelin ◽  
Anil Hingorani ◽  
Sheila Blumberg ◽  
Yuriy Ostrozhynskyy ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Intravascular Ultrasound ◽  
Inferior Vena ◽  
Femoral Vein ◽  
Vena Cava ◽  
Lower Extremities ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Presenting Symptoms ◽  
Significant Difference

Objective The purpose of the study is to evaluate normal anatomical areas of infrarenal inferior vena cava, common iliac, external iliac and common femoral veins by intravascular ultrasound with the goal of assisting the development of venous-specific stents in the treatment of iliac vein stenosis. Method From February 2012 to December 2013, 656 office-based venograms were performed in our facility. Among them, 576 were stented and 80 were not. The measurements of veins were done intraoperatively using an intravascular ultrasound catheter to record areas of the inferior vena cava, proximal, middle and distal segments of common iliac vein, external iliac vein and common femoral vein. The data were compared between non-diseased segments of patients who were stented and those not stented. The stented diseased segments were excluded. Results The mean patient age was 67.33 years (range 22–96, SD ±13.99). Our data included 218 males, 438 females and 324 right lower extremities and 332 left lower extremities. The presenting symptoms of these patients based on CEAP were C1(0), C2 (185), C3(233), C4(107), C5(89) and C6(42). No correlation was found between area of veins and age, gender, laterality and CEAP score (P > .13). Comparison of the areas of non-diseased iliac vein segments between patients not stented and patients who underwent stenting showed a significant difference, with larger areas in non-stented patients in the distal common iliac vein (P = .039) and inferior vena cava (P = .012). Younger age (P = .03) and male gender (P < .0001) were associated with increased area of iliac vein segments. Conclusion Utilizing the intravascular ultrasound-guided technique, we were able to define normal anatomical areas of non-diseased inferior vena cava, iliac and femoral veins, which could be employed to guide the development of appropriate-sized stents and other tools needed for the treatment of venous insufficiency. There is specific variability in areas of normal vein segments with age and gender with/without stents.

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