Vena Cava Malformations as an Emerging Etiologic Factor for Deep Vein Thrombosis in Young Patients

Abstract Inferior vena cava agenesis is a rare congenital vascular defect often diagnosed as an incidental finding in asymptomatic patients. When symptoms arise, it can present with chronic venous stasis or unprovoked deep vein thrombosis (DVT). A 42-year-old man with history of unprovoked right lower extremity (RLE) DVTs was admitted for swelling, pain and erythema to the RLE, concerning for new DVT. Venous Doppler ultrasound showed a chronic DVT of the right proximal femoral vein in addition to an acute DVT of the distal femoral vein. Extensive thrombophilia workup was negative and additional imaging with abdominal computed tomography scan revealed the absence of the infrarenal inferior vena cava. Patient was treated with oral anticoagulation and compression stockings and discharged with clinical improvement. At 3-month follow-up, patient was completely asymptomatic. Recurrent unprovoked DVTs in young patients require exhaustive work up including imaging studies to rule out vascular anomalies.

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Vena Cava Atresia and Deep Vein Thrombosis: A Case Report and Systematic Review

International Journal of Angiology ◽

10.1055/s-0041-1732434 ◽

2021 ◽

Author(s):

V. Alende Castro ◽

Jose Antonio Díaz-Peromingo

Keyword(s):

Systematic Review ◽

Deep Vein Thrombosis ◽

Incidental Finding ◽

Vena Cava ◽

Young Patients ◽

Clinical Manifestations ◽

Thromboembolic Disease ◽

Vein Thrombosis ◽

Asymptomatic Patients ◽

Deep Vein

AbstractCongenital anomalies of the vena cava often go unnoticed, and their incidental finding is frequent in imaging tests performed for another cause in asymptomatic patients. However, an association with the development of thromboembolic disease has been described, mainly in young patients.We report the case of a young woman with deep vein thrombosis associated with vena cava atresia.We conducted a search of the PubMed/Medline database. The search identified 17 articles, of which 5 were selected for extraction and data analysis. Twelve studies were excluded because they failed to match the main criteria.We identified six new cases of deep vein thrombosis associated with vena cava abnormalities, with a mean age of 42.5 years; 83.3% were male. Regarding clinical manifestations, all patients presented as deep vein thrombosis, one case of recurrence, and another case associated with the kidney and inferior vena cava abnormalities with leg thrombosis syndrome. Only one patient had a target triggering factor (cholecystectomy postoperative). The thrombophilia study was negative in all cases and none of the patients died. Treatment included enoxaparin and vitamin K antagonists.This is the first study to report on a systematic review of vena cava atresia associated with deep vein thrombosis in Spain. It shows that in this region, the disease affects young population—even in the absence of risk factors—and is linked to a low mortality. The most frequent presentation form was deep vein thrombosis. Therefore, congenital abnormalities of the vena cava should be suspected in young patients with thromboembolic disease, due to their implications regarding to the duration of anticoagulant treatment, as well as their possible association with other prothrombotic factors.

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Congenital vena cava inferior agenesis

Phlebologie ◽

10.1055/s-0037-1617287 ◽

2004 ◽

Vol 33 (04) ◽

pp. 128-130 ◽

Cited By ~ 3

Author(s):

T. Urbanek ◽

J. Kostecki ◽

M. Zaniewski

Keyword(s):

Deep Vein Thrombosis ◽

Venous Insufficiency ◽

Congenital Abnormalities ◽

Vena Cava ◽

Young Patients ◽

Vena Cava Inferior ◽

Vein Thrombosis ◽

Thrombotic Complications ◽

Rare Malformation ◽

Deep Vein

SummaryA patient aged 25 years with lower extremity deep vein thrombosis in the course of vena cava inferior agenesis is described. This very rare malformation can be connected with chronic venous insufficiency or thrombotic complications. In such cases other congenital abnormalities should be excluded and suspicion of vena cava inferior agenesis should always be taken into consideration in young patients with idiopathic deep vein thrombosis.

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Primary Iliac Venous Leiomyosarcoma: A Rare Cause of Deep Vein Thrombosis in a Young Patient

Case Reports in Medicine ◽

10.1155/2011/123041 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Nelson Oliveira ◽

Emanuel Dias ◽

Ricardo Lima ◽

Fernando Oliveira ◽

Isabel Cássio

Keyword(s):

Deep Vein Thrombosis ◽

Vena Cava ◽

Young Patients ◽

Iliac Vein ◽

Definitive Diagnosis ◽

Systemic Thrombolysis ◽

Vein Thrombosis ◽

Phlegmasia Alba ◽

The Right ◽

Deep Vein

Introduction. Primary venous tumours are a rare cause of deep vein thrombosis. The authors present a case where the definitive diagnosis was delayed by inconclusive complementary imaging.Clinical Case. A thirty-seven-year-old female presented with an iliofemoral venous thrombosis of the right lower limb. The patient had presented with an episode of femoral-popliteal vein thrombosis five months before and was currently under anticoagulation.Phlegmasia alba dolensinstalled progressively, as thrombus rapidly extended to the inferior vena cava despite systemic thrombolysis and anticoagulation. Diagnostic imaging failed to identify the underlying aetiology of the deep vein thrombosis. The definitive diagnosis of primary venous leiomyosarcoma was reached by a subcutaneous abdominal wall nodule biopsy.Conclusion. Primary venous leiomyosarcoma of the iliac vein is a rare cause of deep vein thrombosis, which must be considered in young patients with recurrent or refractory to treatment deep vein thrombosis.

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Prevention of Pulmonary Embolism by Inferior Vena Cava Filter in Patients With Proximal Deep Vein Thrombosis

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(97)85281-3 ◽

1998 ◽

Vol 31 (2) ◽

pp. 362A

Author(s):

R Faivre

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Inferior Vena Cava ◽

Inferior Vena Cava Filter ◽

Inferior Vena ◽

Vena Cava ◽

Vena Cava Filter ◽

Proximal Deep Vein Thrombosis ◽

Vein Thrombosis ◽

Deep Vein

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Congenital Antithrombin III Deficiency in 3 Families (7 Affected Members)

10.1055/s-0038-1665841 ◽

1979 ◽

Author(s):

J. Conard ◽

M. Samama ◽

M. H. Horellou ◽

B. Cazenave ◽

P. Griguer ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Antithrombin Iii ◽

Oral Anticoagulants ◽

Vena Cava ◽

Oral Contraception ◽

Vein Thrombosis ◽

Heparin Treatment ◽

At Iii ◽

Antithrombin Iii Deficiency ◽

Deep Vein

A congenital Antithrombin III (AT III) deficiency affecting 7 members of 3 families is reported.The first throrabo-embolic accidents were observed between the age of 22 and 35 : they were spontaneous or occured after delivery or oral contraception. in one patient, a deep vein thrombosis was observed during heparin treatment. in 2 cases, recurrent pulmonary embolic episodes required vena cava ligation. No thromboembolic accident was observed during oral anticoagulation.AT III was measured by an amidolytic method and by the Mancini method on plasma and serum ; the antithrombin activity was determined on serum by the von Kaulla method. in 7 patients, a decreased AT III was found by all the methods performed. The AT III level was around 50 % in patients treated or not by oral anticoagulants One patient was studied during heparin treatment and then under oral anticoagulants : AT III levels were lower under heparin.

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Inferior vena cava atresia presenting with bilateral deep-vein thrombosis in a 53-years-old male: it’s never too late

Internal and Emergency Medicine ◽

10.1007/s11739-021-02679-y ◽

2021 ◽

Author(s):

Alberto Calabrese ◽

Marta Quintavalla ◽

Federico Pasin

Keyword(s):

Deep Vein Thrombosis ◽

Inferior Vena Cava ◽

Inferior Vena ◽

Vena Cava ◽

Vein Thrombosis ◽

Deep Vein

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

Vascular and Endovascular Surgery ◽

10.1177/15385744211022517 ◽

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.

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