scholarly journals Management of Phlegmasia Cerulea Dolens Caused by a Giant Leiomyoma

2021 ◽  
Author(s):  
Elisabeth Ekkel ◽  
Tara Chandran ◽  
Ryan Qasawa ◽  
Michael Trpkovski ◽  
Sachinder Hans
Keyword(s):  
Uterine Leiomyoma ◽  
Inferior Vena ◽  
Mechanical Thrombectomy ◽  
Vena Cava ◽  
Iliac Vein ◽  
Young Female ◽  
Common Iliac Vein ◽  
Venous Obstruction ◽  
Recurrent Thrombosis ◽  
Phlegmasia Cerulea Dolens

Abstract This case is of a young female with a large uterine leiomyoma causing phlegmasia cerulea dolens with thrombosis of the left common and left external iliac veins. She underwent mechanical thrombectomy to temporize the condition until she could be evaluated by gynecology-oncologist to remove the cause of venous obstruction. Prior to hysterectomy, suprarenal inferior vena cava filter was placed. Less than 12 hours post hysterectomy she developed recurrent thrombosis involving the left common and external iliac veins. She underwent repeat mechanical thrombectomy with wall stent placement in the left common iliac vein with resolution of her symptoms.

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.

scholarly journals Successful removal of a Gunther tulip vena cava filter with wall-embedded hook and migration during a retrieval attempt

2013 ◽  
Vol 2 (1) ◽  
pp. 1-3
Author(s):  
Takuji Yamagami ◽  
Rika Yoshimatsu ◽  
Tomohiro Matsumoto ◽  
Tsunehiko Nishimura
Keyword(s):  
Inferior Vena ◽  
Vena Cava ◽  
Iliac Vein ◽  
Vena Cava Filter ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Successful Removal ◽  
And Migration ◽  
The Right ◽  
Iliac Vein Thrombosis

Retrieval of a Gunther tulip vena cava filter implanted in a patient with inferior vena cava and right common iliac vein thrombosis was attempted by the standard method. Because the filter was tilted, the hook became attached to the vena cava wall and could not be snared. During attempts at removal by an alternative method, the filter migrated toward the right atrium. However, it was finally successfully removed.

scholarly journals An Eminent Absence: Agenesis of Inferior Vena Cava Underlying Bilateral Iliac Vein Thrombosis

2020 ◽  
Author(s):  
Giorgia Protti ◽  
Fabrizio Elia ◽  
Francesca Bosco ◽  
Franco Aprà
Keyword(s):  
Risk Factors ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Mechanical Thrombectomy ◽  
Vena Cava ◽  
Iliac Vein ◽  
Abdominal Ct ◽  
Vein Thrombosis ◽  
Abdominal Ct Scan ◽  
Iliac Vein Thrombosis

Among thrombophilic risk factors for deep venous thrombosis (DVT), agenesis of the inferior vena cava (AIVC) is very rare, but it must be considered in specific settings. Here, we present the case of an 18-year-old woman who was admitted to the Emergency Department with swelling and pain of her left leg. Clinical examination and ultrasonography detected extensive proximal DVT of the left leg. After attempted mechanical thrombectomy failed, an abdominal CT scan was obtained, which demonstrated bilateral thrombosis of the iliac-femoral axis in the context of congenital AIVC.

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.

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.

scholarly journals ​Venous anomalies in renal transplantation: an accessory left-sided IVC in a live kidney donor

2019 ◽  
Vol 12 (12) ◽  
pp. e232695
Author(s):  
Jack Whooley ◽  
Atakelet Ferede ◽  
Gordon Smyth ◽  
Dilly Little
Keyword(s):  
Rare Case ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vascular Anomaly ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Kidney Donor ◽  
Left Common Iliac Vein ◽  
Live Kidney Donor ◽  
The Right

Duplication of the inferior vena cava (IVC) resulting in an accessory left-sided IVC is a relatively rare vascular anomaly with a reported prevalence of 0.7%. Radiologically, a duplicated left-sided IVC is usually seen as a continuation of the left common iliac vein, crossing anterior to the aorta at the level of the renal vein to join the right-sided IVC. We present a rare case in which an accessory left-sided IVC was discovered intraoperatively, in a 47-year-old living donor, posing significant intraoperative challenges regarding extraction and subsequent transplantation.

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