scholarly journals Incidentally Detected Asymptomatic Thrombus in the Inferior Vena Cava Thought to be Caused by Central Venous Catheterization for an Oral Surgical Procedure

Author(s):  
Shigeru Takuma ◽  
Shigeru Takuma ◽  
Yukifumi Kimura ◽  
Nobuhito Kamekura ◽  
Toshiaki Fujisawa

Central venous catheterization (CVC) is a common procedure in the perioperative period, and thrombosis is one of the well-known complications of CVC. If the thrombus comes free from the vascular wall, it may cause serious problems such as pulmonary embolism. However, in some cases of inferior vena cava thrombosis, the patient has no symptoms, and thrombus is detected accidentally. A case in which asymptomatic thrombus in the inferior vena cava was incidentally detected following removal of the CV catheter after an oral surgical procedure is described.

2017 ◽  
Vol 18 (5) ◽  
pp. e66-e69 ◽  
Author(s):  
Biagio Ricciardi ◽  
Carlo Alberto Ricciardi ◽  
Antonio Lacquaniti ◽  
Giuseppe Carella ◽  
Domenico Puzzolo ◽  
...  

Background The coexistence of a double superior vena cava (SVC) and a partially left inferior vena cava (PLIVC) with a circumaortic collar, associated with other congenital malformations, was not described previously. Case Description We present a 33-year-old woman in hemodialysis with complete exhaustion of the brachial routes for vascular access, admitted to our Nephrology Unit for a long-term central venous catheter (CVC) implant, usually by us performed under EchoScopic Technique (EST), an echographic venipuncture followed by continuous radioscopic control of guidewire and catheter in all the steps of implant. An intraoperative venography showed a complete stop of right internal jugular vein, a right SVC, a persistent left SVC, a left inferior vena cava in the iliac and subrenal tracts, a circumaortic venous collar in the renal tract, and normal right suprarenal and hepatic tracts. Conclusions The double SVC was related to the persistence of the caudal part of the anterior cardinal veins. As to the PLIVC, the iliac and subrenal parts of the inferior vena cava can be related to the persistent left supracardinal vein, while the circumaortic venous collar to the persistent intersupracardinal and left subsupracardinal anastomoses. All invasive procedures, and particularly those potentially complicated, must be performed under EST, now considered a mandatory tool for CVC implants, owing to the hypothesis of possible venous congenital anomalies.


2016 ◽  
Vol 1 (1) ◽  

Central venous catheterization (CVC) is a routine technique done in critical care and emergency departments for monitoring patients and giving certain parenteral medications in special conditions. Most common complications associated with CVCs are infection, hematoma, hemothorax, pneumothorax and superior or inferior vena cava trauma while rare complications include cardiac arrhythmias, air embolism and loss of the guide wire [1].


2009 ◽  
Vol 10 (3) ◽  
pp. 219-220 ◽  
Author(s):  
Marco Caruselli ◽  
Gianmarco Piattellini ◽  
Gianfranco Camilletti ◽  
Roberto Giretti ◽  
Raffaella Pagni

A persistent left superior vena cava (PLSVC) is a congenital anomaly of the systemic venous system. This anomaly is often discovered as an incidental result during central venous catheterization passing through the left subclavian or the left internal jugular vein. We report two cases of PLSVC in pediatric patients.


2019 ◽  
Vol 6 (5) ◽  
pp. 1947
Author(s):  
Mohd Kashif Ali ◽  
Eeman Naim

Background: Ultrasound guided fluid assessment in management of septic shock has come up as an adjunct to the current gold standard Central Venous Pressure monitoring. This study was designed to observe the respiro-phasic variation of IVC diameter (RV-IVCD) in invasively mechanically ventilated and spontaneously breathing paediatric patients of fluid refractory septic shock.Methods: This was a prospective observational study done at Paediatric intensive Care Unit (PICU) in Paediatric ward of Jawaharlal Nehru Medical College and Hospital (JNMCH) from February 2016 to June 2017. 107 consecutive patients between 1 year to 16 years age who were in shock despite 40ml/kg of fluid administration were included. Inferior Vena Cava (IVC) diameters were measured at end-expiration and end inspiration and the IVC collapsibility index was calculated. Simultaneously Central Venous Pressure (CVP) was recorded. Both values were obtained in ventilated and non-ventilated patients. Data was analysed to determine to look for the profile of RV-IVCD and CVP in ventilated and non-ventilated cases.Results: Out of 107 patients, 91 were on invasive mechanical ventilation and 16 patients were spontaneously breathing. There was a strong negative correlation between central venous pressure (CVP) and inferior vena cava collapsibility (RV-IVCD) in both spontaneously breathing (-0.810) and mechanically ventilated patients (-0.700). Negative correlation was significant in both study groups in CVP <8 mmHg and only in spontaneously breathing patients in CVP 8-12 mmHg range. IVC collapsibility showed a decreasing trend with rising CVP in both spontaneously breathing and mechanically ventilated patients.Conclusion: Ultrasonography guided IVCCI appears to be a valuable index in assessing fluid status in both spontaneously breathing and mechanically ventilated septic shock patients. However, more data is required from the paediatric population so as to define it as standard of practice.


2020 ◽  
Vol 5 (1) ◽  

Fluid therapy is an essential component part management of critically ill patients. Proper estimation of the amount of needed fluids is of great importance due to the well-established adverse effects of marked negative and positive fluids balance. Central venous pressure has been widely used by ICU physicians for volume status assessment. Several methods have been postulated for volume status assessment, among which is the inferior vena cava collapsibility index. As the inferior vena cava is a thin-walled capacitance vessel that adjusts to the body’s volume status by changing its diameter depending on the total body fluid volume. Giving the fact that bed-side ultrasonographic measurement of inferior vena cava diameters is an available, non-invasive, reproducible and quiet easy-to-learn technique, it can provide a safe and quiet reliable replacement of central venous pressure measurement for assessment of volume status assessment. The aim of this study was to find statistical correlation between central venous pressure and caval index, as a step towards validating the above mentioned replacement. 86 critically ill patients from ICU population were enrolled. Simultaneous measurements of central venous pressure and inferior vena cava collapsibility index were observed and recorded on four sessions. Patients were also grouped based on their mode of ventilation and central venous pressure values in order to compare the strength of correlation between various populations. The results showed that Inferior vena cava collapsibility index has significant inverse correlation with CVP value (r= -85, p value ˂0.001 at 95% CI) and it better correlated with mean arterial blood pressure and lactate clearance as compared to central venous pressure. However it correlated better with CVP in spontaneously breathing patients (r= -0.86, p value ˂0.001) than in mechanically ventilated patients (r= -0.84, p value ˂0.001). Inferior vena cava collapsibility index has shown to correlate better with CVP value in lower values (˂ 10 cmH2O) (r= -0.8, p value ˂0.001) than in higher values (≥ 10 cmH2O) (r= -0.6, p value ˂0.001). In addition, an inferior vena caval collapsibility index cut-off value of 29% was shown to discriminate between CVP values ˂10 cmH2O and values ≥10 cmH2O with high Sensitivity (88.6%) and specificity (80.4%). In conclusion, inferior vena cava collapsibility index has a strong inverse relationship with central venous pressure which is more pronounced at low central venous pressure values. Point-of-care ultrasonographically-measured inferior vena cava collapsibility index is very likely to be a good alternative to central venous pressure measurement with a high degree of precision and reproducibility. However, Wide scale studies are needed to validate its use in different patient populations.


2017 ◽  
Vol 11 (1) ◽  
pp. 271
Author(s):  
GauravSingh Tomar ◽  
Sumit Charan ◽  
Neeraj Mishra ◽  
Shailendra Kumar

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