scholarly journals Pulmonary Embolism Saddle

2021 ◽  
Vol 8 (6) ◽  
Author(s):  
Behyamet O ◽  
◽  
Daoud MA ◽  
Boris AA ◽  
Rachida L ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Main Pulmonary Artery ◽  
Vena Cava ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Assessment And Evaluation ◽  
Adenocarcinoma Of The Prostate ◽  
The Right ◽  
Preventive Methods

Pulmonary embolism remains a fatal and frequent complication of thromboembolic disease despite the development of preventive methods. Cancer patients are at higher risk of thromboembolism than those in the general population [1]. The thoracic CT angiography is the standard examination; it makes the diagnosis with certainty by showing the endoluminal thrombus. Saddle pulmonary embolism is a radiological term; it is defined by the presence of a thrombus overlapping the bifurcation of the main pulmonary artery extending to both right and left. It represents 2 to 5% of pulmonary embolisms [2]. We present the image of a hemodynamically stable 69-year-old patient followed for adenocarcinoma of the prostate who was referred in our training to a thoraco-abdomino-pelvic scanner for assessment and evaluation of his pathology. The chest CT revealed a hypo dense endoluminal thrombus of the pulmonary artery trunk extended to its right and left dividing branches (Figure 1). Abdominal sections showed an endoluminal thrombus of the right common iliac vein extending to the inferior vena cava (Figure 2).

Iliocaval Compression Syndrome

1987 ◽  
Vol 2 (3) ◽  
pp. 173-179 ◽  
Author(s):  
Syde A. Taheri ◽  
Paul Nowakowski ◽  
David Pendergast ◽  
Julie Cullen ◽  
Steve Pisano ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Common Iliac Artery ◽  
Vena Cava ◽  
Signs And Symptoms ◽  
Iliac Vein ◽  
Venous Hypertension ◽  
Common Iliac Vein ◽  
Compression Syndrome ◽  
Extrinsic Compression ◽  
The Right

The iliocaval compression syndrome is a disorder, frequently found in young women, in which extrinsic compression of the left iliocaval junction produces signs and symptoms of lower extremity venous insufficiency. The anatomic variant which gives rise to this syndrome consists of compression of the left common iliac vein by the overlying right common iliac artery, near its junction with the vena cava. Additional reduction of outflow results from intraluminal venous webs and tight adhesions between the iliac artery and vein. Pain, swelling, pigmentation, and venous claudication characterize this syndrome, which affects predominantly the left leg. The syndrome may progress to iliofemoral thrombosis, phlegmasia cerulea dolens, and venous gangrene. Longstanding iliocaval stenosis may produce valvular incompetence. Exercise plethysmography is a non-invasive test useful in screening patients for iliocaval compression. The definitive diagnosis is made by venography, both ascending and descending, to determine the degree of outflow stenosis. Iliocaval patch angioplasty with retrocaval positioning of the right iliac artery, decreases venous hypertension and leads to improvement in the clinical condition. To date, we have performed iliocaval angioplasty, with retrocaval repositioning of the right common iliac artery, on 18 patients. Of these, 83% have had good results as determined by hemodynamic and clinical assessment.

scholarly journals Saddle pulmonary emboli: an unusual presentation

CJEM ◽  
2009 ◽  
Vol 11 (06) ◽  
pp. 558-559
Author(s):  
Truptesh H. Kothari ◽  
Shivangi Kothari ◽  
Mahima Pandey ◽  
Harshit Khara ◽  
Nishant Dhungel
Keyword(s):  
Pulmonary Artery ◽  
Troponin I ◽  
Femoral Vein ◽  
Main Pulmonary Artery ◽  
Vena Cava ◽  
Factor V Leiden ◽  
Superficial Femoral Vein ◽  
Presenting Symptoms ◽  
Coronary Syndrome ◽  
The Right

A 38-year-old man with a history of polyposis syndrome diagnosed 3 years previously, with poor compliance for follow-up, presented to the emergency department with symptoms of retrosternal chest pain associated with dizziness and shortness of breath. His blood pressure was 94/43 mm Hg, his pulse was 123 beats/min and he had an oxygen saturation of 84% on room air. The patient’s initial laboratory results showed a hemoglobin of 80 g/L and blood gas with a pH of 7.23. He had a normal chest radiograph and electrocardiogram, but had an elevated troponin I at 0.12 μg/L. He was given acetylsalicylic acid for suspicion of acute coronary syndrome. On physical examination, the patient was found to have right calf tenderness. With this finding and the presenting symptoms, he underwent computed tomography angiography (CTA) of the chest. The chest CTA showed a massive saddle embolus with a filling defect completely occluding the right pulmonary artery and extending through the main pulmonary artery segment to involve the left pulmonary artery. There were also diffuse filling defects involving bilateral pulmonary segmental arteries (Fig. 1 and Fig. 2). The patient received alteplase and underwent a workup for a hypercoagulable state. His workup revealed positive anticardiolipin antibodies and factor V Leiden. The Doppler ultrasound of his lower extremities showed an extensive thrombus measuring more than 6 cm extending in the right superficial femoral vein. The patient was then referred for placement of an inferior vena cava filter.

scholarly journals Presentation and management of IVC and iliac vein encroachment by lumbar pedicle screws: a case-report

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Keith George ◽  
Shane Burke ◽  
Sandra Park ◽  
Luis Suarez ◽  
Ron Riesenburger
Keyword(s):  
Multidisciplinary Approach ◽  
Treatment Algorithm ◽  
Vena Cava ◽  
Pedicle Screws ◽  
Operative Management ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vascular Integrity ◽  
The Right ◽  
Case Basis

Abstract Pedicle screws are commonly used in spinal surgeries and are relatively safe, with venous complications occurring rarely. We report a patient with imaging following a L4–5 fusion that showed indentation of the inferior vena cava and right common iliac vein by the right L4 and L5 pedicle screws. She underwent revision surgery in which the hardware was removed and no bleeding was observed. Intraoperative venogram confirmed vascular integrity and absence of indentation on the venous structures following screw removal. The patient recovered without complications. Venous contact by pedicle screws should be treated on a case-by-case basis in a multidisciplinary approach with vascular surgery. We discuss a treatment algorithm for the operative management of this problem.

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 Low-Grade Endometrial Stromal Sarcoma with Intravenous and Intracardiac Extension: A Multidisciplinary Approach

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Wataru Kudaka ◽  
Hitoshi Inafuku ◽  
Yuko Iraha ◽  
Tomoko Nakamoto ◽  
Yusuke Taira ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Tumor Resection ◽  
Vena Cava ◽  
Endometrial Stromal Sarcoma ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Histopathological Analysis ◽  
Low Grade ◽  
Stromal Sarcoma ◽  
The Right

Background. A rare case of low-grade endometrial stromal sarcoma (LG-ESS) extending to inferior vena cava (IVC) and cardiac chambers.Case Report. A 40-year-old woman had IVC tumor, which was incidentally detected by abdominal ultrasonography during a routine medical checkup. CT scan revealed a tumor in IVC, right iliac and ovarian veins, which was derived from the uterus and extended into the right atrium and ventricle. The operation was performed, the heart and IVC were exposed, and cardiopulmonary bypass was initiated. A right atriotomy was performed, and the intracardiac mass was removed. Then the tumor in IVC and the right internal iliac vein were removed after longitudinal venotomies in the suprarenal and infrarenal vena cava, the right common iliac vein. Next the pelvis was explored. Tumors were found originating from the posterior wall of the uterus and continuing into both the right uterine and ovarian vein. The patient underwent total hysterectomy with bilateral salpingooophorectomy. Complete tumor resection was achieved. Histopathological analysis confirmed a diagnosis of LG-ESS. She showed no evidence of disease for 2 years and 3 months.Conclusions. Our case highlights the importance of a multidisciplinary approach in treating this rare cardiovascular pathological condition through preoperative assessment to final operation.

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.

Extensive venous thrombosis and hind-limb edema associated with adrenocortical carcinoma in a dog

1999 ◽  
Vol 35 (4) ◽  
pp. 306-310 ◽  
Author(s):  
MH Jaffe ◽  
AM Grooters ◽  
BP Partington ◽  
AC Camus ◽  
G Hosgood
Keyword(s):  
Venous Thrombosis ◽  
Adrenocortical Carcinoma ◽  
Femoral Vein ◽  
Vena Cava ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Abdominal Ultrasonography ◽  
Mixed Breed ◽  
Limb Edema ◽  
The Right

A 10-year-old, spayed female, mixed-breed dog was referred for evaluation of bilateral hindlimb edema and weakness. Abdominal ultrasonography showed increased echogenicity of the lumen of the caudal vena cava from the level of the urinary bladder to the level of the cranial pole of the right kidney. Bilateral saphenous venograms displayed numerous filling defects in the caudal vena cava, right external iliac vein, right femoral vein, and the right common iliac vein. Extensive venous thrombosis was diagnosed, and the animal was euthanized. Necropsy confirmed the presence of venous thrombosis and revealed a right adrenocortical carcinoma that had invaded the caudal vena cava.

scholarly journals Radioechocardiography in the evaluation of pulmonary hypertension

2016 ◽  
Vol 97 (6) ◽  
pp. 982-988
Author(s):  
R F Akberov ◽  
S R Zogot ◽  
N A Tsibul’kin
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Inferior Vena Cava ◽  
Digital Radiography ◽  
Right Atrium ◽  
Inferior Vena ◽  
Vena Cava ◽  
Lower Limbs ◽  
The Right

Aim. To study the capabilities of radioechocardigraphy in the evaluation of pulmonary hypertension of various causes, early non-invasive detection of pressure increase in the pulmonary artery.Methods. The study included 800 patients with congenital (269) and acquired (217) mitral valve diseases, pulmonary embolism (140), primary pulmonary hypertension (57), coronary heart disease with acute myocardial infarction (117) of different age and gender. Digital radiography, linear tomography of chest, ECG, echocardiography, multidetector computed tomography angiography, and ultrasound of inferior vena cava were performed.Results. Radiocardiography combined with linear tomography and measurement of Moore index, right atrium index, transpulmonary distance, and width of right descending pulmonary artery at the level of intermediate bronchus, allows determining the degree, type (arterial, venous, capillary, and mixed) and cause of pulmonary hypertension. Digital radiography and linear tomography in 80% cases reveal signs of pulmonary embolism. Echocardiography makes it possible to study hemodynamics in pulmonary hypertension, to detect the dilation of the right heart, inferior vena cava, and renal veins, and to calculate the systolic pressure in the right ventricle, pulmonary artery, and right atrium. Radioechocardigraphy allows determining the cause and degree of pulmonary hypertension, and hemodynamic disorders. Sensitivity of the method for diagnosis of pulmonary hypertension is 89%, specificity is 90%, and precision is 92%.Conclusion. Radioechocardigraphy is a highly effective method for diagnosis of pulmonary hypertension; ultrasound of inferior vena cava, iliac veins, and veins of the lower limbs allows to determine the source of pulmonary embolism, to diagnose embologenicity of thromboses and to evaluate the need for vena cava filters.

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