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1

Superior vena cava occlusion caused by Behcet disease.  

UK PubMed Central (United Kingdom)

This case report described a patient of Behçet disease (BD)-related vascular lesions that initially presented as occlusion of superior vena cava (SVC) without any evidence of thrombosis. The patient was treated first by percutaneous transluminal angioplasty and stent implantation, and he developed thrombosis in the stent and then received open bypass operation. Pathologic examination of the SVC specimen and the postoperative manifestations revealed that the underlying cause of his symptoms as BD. Afterward, methylprednisolone plus anticoagulant therapy was routinely given, which relieved the symptoms of the patient.

Yu M; Shi A; Jin B; Jiang X; Liang H; Ouyang C

2012-05-01

2

The superior vena cava syndrome caused by malignant disease  

Energy Technology Data Exchange (ETDEWEB)

Objective: The superior vena cava (SVC) obstruction by malignant diseases is either by direct invasion and compression or by tumour thrombus of the SVC. Whatever is its cause, obstruction of the SVC causes elevated pressure in the veins draining into the SVC and increased or reversed blood flow through collateral vessels. Severity of the syndrome depends on the collateral vascular system development. Therefore, imaging of the collateral veins with variable location and connection is important in determining the extension and management of the disease. Our aims are to describe collateral vessels of the superior vena cava syndrome (SVCS) related with the malignant diseases and to assess the ability of multi-detector row CT with multiplanar and 3D volume rendering techniques in determining and describing collateral circulations. Materials and methods: We present CT angiography findings of seven patients with small cell carcinoma of the lung (n = 2), squamous cell carcinoma of the lung (n = 3), Hodgkin disease of the thorax (n = 1), and squamous cell carcinoma of the oesophagus (n = 1). The patients received contrast-enhanced CT scans of the chest and abdomen on a multi-detector row CT during breath holding at suspended inspiration. Results: CT images revealed the cause and level of the SVC obstruction in all patients with axial and multiplanar reconstructed images. The SVC showed total obstruction in five patients and partial obstruction in two patients. The most common experienced collateral vessels were azygos vein (6), intercostal veins (6), mediastinal veins (6), paravertebral veins (5), hemiazygos vein (5), thoracoepigastric vein (5), internal mammary vein (5), thoracoacromioclavicular venous plexus (5), and anterior chest wall veins (5). While one case showed the portal-systemic shunt, V. cordis media and sinus coronarius with phrenic veins were enlarged in two cases, and the left adrenal vein was enlarged in a patient. In one case, the azygos vein with reversed blood flow was drained into both inferior vena cava and hemiazygos vein with the left renal vein. Conclusion: Multi-detector row CT with multiplanar and 3D imaging is an effective tool in evaluation of the SVCS and has a greater advantage than the other imaging techniques. 3D volume rendering is a useful technique in determining and describing collateral circulations in addition to the primary disease process.

Eren, Suat [Department of Radiology, Faculty of Medicine, Atatuerk University, 25240 Erzurum (Turkey)]. E-mail: suateren@atauni.edu.tr; Karaman, Adem [Department of Radiology, Faculty of Medicine, Atatuerk University, 25240 Erzurum (Turkey); Okur, Adnan [Department of Radiology, Faculty of Medicine, Atatuerk University, 25240 Erzurum (Turkey)

2006-07-15

3

Thrombosis of the inferior vena cava related to Ormond's disease.  

UK PubMed Central (United Kingdom)

A 46-year-old female patient presenting with unspecific lower back pain, diffuse abdominal pain, and slightly elevated body temperature was referred to the hospital. The X-ray of the spine detected an unspecific sclerotic lesion of the third lumbar vertebra; an abdominal computed tomography (CT) scan was performed. In this scan, a sheeting of the infrarenal abdominal aorta, a streaky densification of the periaortal fatty tissue, and a nearly complete thrombotic occlusion of the inferior vena cava and both iliac veins was detected. As these findings are typical for acute aortitis and this is a life-threatening disease, the patient was transferred to a university hospital. Imaging work-up including ultrasound, magnetic resonance imaging, and 18-flourodeoxyglucose positron emission tomography were performed after transfer. These examinations showed acute aortitis due to Ormond's disease. Furthermore, there was a thrombotic occlusion of the inferior vena cava due to a compression of the vein by inflamed connective tissue. This is a rare finding in Ormond's disease. We decided to treat our patient with a combined therapy including glucocorticoids and tamoxifen for 2 years. During these 2 years and the further follow-up period, the patient showed no relapse of the inflammatory disease. Retroperitoneal fibrosis is a rare but increasingly recognized disease characterized by the presence of fibro-inflammatory tissue, usually surrounding the abdominal aorta and the iliac arteries. This fibrotic tissue extends into the retroperitoneum and thus encases structures, for example, the ureters. Retroperitoneal fibrosis is generally idiopathic. It can also be secondary to certain drugs, malignant diseases, infections, surgery, and other triggering factors. Ormond's disease may lead to serious complications like renal failure. This can be avoided by successful treatment when diagnosed early.

Paetzold S; Gary T; Hafner F; Brodmann M

2013-03-01

4

Thrombosis of the inferior vena cava related to Ormond's disease.  

Science.gov (United States)

A 46-year-old female patient presenting with unspecific lower back pain, diffuse abdominal pain, and slightly elevated body temperature was referred to the hospital. The X-ray of the spine detected an unspecific sclerotic lesion of the third lumbar vertebra; an abdominal computed tomography (CT) scan was performed. In this scan, a sheeting of the infrarenal abdominal aorta, a streaky densification of the periaortal fatty tissue, and a nearly complete thrombotic occlusion of the inferior vena cava and both iliac veins was detected. As these findings are typical for acute aortitis and this is a life-threatening disease, the patient was transferred to a university hospital. Imaging work-up including ultrasound, magnetic resonance imaging, and 18-flourodeoxyglucose positron emission tomography were performed after transfer. These examinations showed acute aortitis due to Ormond's disease. Furthermore, there was a thrombotic occlusion of the inferior vena cava due to a compression of the vein by inflamed connective tissue. This is a rare finding in Ormond's disease. We decided to treat our patient with a combined therapy including glucocorticoids and tamoxifen for 2 years. During these 2 years and the further follow-up period, the patient showed no relapse of the inflammatory disease. Retroperitoneal fibrosis is a rare but increasingly recognized disease characterized by the presence of fibro-inflammatory tissue, usually surrounding the abdominal aorta and the iliac arteries. This fibrotic tissue extends into the retroperitoneum and thus encases structures, for example, the ureters. Retroperitoneal fibrosis is generally idiopathic. It can also be secondary to certain drugs, malignant diseases, infections, surgery, and other triggering factors. Ormond's disease may lead to serious complications like renal failure. This can be avoided by successful treatment when diagnosed early. PMID:23599947

Paetzold, Sascha; Gary, Thomas; Hafner, Franz; Brodmann, Marianne

2010-04-15

5

[Thrombosis of the superior vena cava in Behcet's disease. Apropos of 13 cases  

UK PubMed Central (United Kingdom)

The author reports 13 cases of Behçet's disease with thrombosis of superior vena cava. The thrombosis of superior vena cava achieve to superior cava syndrome. In all cases, the X ray of the chest showed a discreet widening of the superior mediastinum related to collateral circulation confirmed by angiography. The thrombosis interest the brachial veins in 9 cases. The analysis of the results point out to the importance of the chest X ray in orientating the diagnosis. The etiological diagnosis is always clinical.

Ousehal A; Abdelouafi A; Thrombati; Kadiri R

1992-06-01

6

Vena cava filter; Vena-cava-Filter  

Energy Technology Data Exchange (ETDEWEB)

Fulminant pulmonary embolism is one of the major causes of death in the Western World. In most cases, deep leg and pelvic venous thrombosis are the cause. If an anticoagulant/thrombotic therapy is no longer possible or ineffective, a vena cava filter implant may be indicated if an embolism is threatening. Implantation of the filter is a simple and safe intervention. Nevertheless, it is necessary to take into consideration that the data base for determining the indications for this treatment are very limited. Currently, a reduction in the risk of thromboembolism with the use of filters of about 30%, of recurrences of almost 5% and fatal pulmonary embolism of 1% has been reported, with a risk of up to 20% of filter induced vena cava thrombosis. (orig.) [German] Die fulminante Lungenembolie zaehlt zu den Haupttodesursachen in der westlichen Welt. In der Mehrzahl der Faelle sind tiefe Bein- und Beckenvenenthrombosen ursaechlich verantwortlich. Ist eine antikoagulative/-thrombotische Therapie nicht (mehr) moeglich oder unwirksam, kann bei drohender Emboliegefahr die Vena-cava-Filterimplantation indiziert sein. Die Filterimplantation ist eine einfache und sehr sichere Intervention. Dennoch muss bei der Indikationsstellung beruecksichtigt werden, dass die Datenlage zur Wirksamkeit sehr limitiert ist. So wird aktuell ueber eine Reduktion des Thrombembolierisikos um 30% bei Embolierezidiven von knapp 5% und fatalen Lungenembolien von 1% unter Filterprophylaxe berichtet, bei einem Risiko von bis zu 20% fuer die filterinduzierte Vena-cava-Thrombose. (orig.)

Helmberger, T. [Klinikum Bogenhausen, Institut fuer Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Muenchen (Germany)

2007-05-15

7

Pseudodisplacements of superior vena cava catheter in the persistent left superior vena cava  

Energy Technology Data Exchange (ETDEWEB)

Pseudodisplacement of a left sided superior vena cava catheter in a persistent superior vena cava may be expected in adults in 0,37% and in a group of children with congenital heart disease in 2,5%. Embryology, anatomy and clinical implications is discussed on the basis of our own cases. The vena cava superior sinistra persitents is depending on a sufficient calibre a suitable vessel for a superior cava catheter.

Jantsch, H.; Draxler, V.; Muhar, U.; Schlemmer, M.; Waneck, R.

1983-01-01

8

Vena cava filter  

International Nuclear Information System (INIS)

Fulminant pulmonary embolism is one of the major causes of death in the Western World. In most cases, deep leg and pelvic venous thrombosis are the cause. If an anticoagulant/thrombotic therapy is no longer possible or ineffective, a vena cava filter implant may be indicated if an embolism is threatening. Implantation of the filter is a simple and safe intervention. Nevertheless, it is necessary to take into consideration that the data base for determining the indications for this treatment are very limited. Currently, a reduction in the risk of thromboembolism with the use of filters of about 30%, of recurrences of almost 5% and fatal pulmonary embolism of 1% has been reported, with a risk of up to 20% of filter induced vena cava thrombosis. (orig.)

2007-01-01

9

Helical Vena Cava Filter  

UK PubMed Central (United Kingdom)

A vena cava filter is described, having at least one member arranged helically along a longitudinal axis of the filter. The filter may include a plurality of legs around which is arranged one or more filaments traveling in a helical path, or an elongated wire member arranged to define a first and second helecal path. The filter may include hooks and/or a retreival member.

HARRIS KEITH S; LERDAHL ROBERT G; TA KHOI Q

10

Persistent left superior vena cava with absent right superior vena cava: image findings  

International Nuclear Information System (INIS)

[en] Persistent left superior vena cava absent right superior vena cava is a rare anomaly, with less than 150 cases reported in the literature. Congenitally persistent left superior vena cava is the most common variant of systemic venous return to the heart, resulting embryologically from failure of the left anterior cardinal vein to become obliterated. Its incidence varies from 0.3% in patients with otherwise normal heart to 4.3% in patients with congenital heart disease. In the majority of the patients, a right superior vena cava is present as well, but rarely the right anterior cardinal vein degenerates resulting in the absence of the normal right superior vena cava. The blood from the right side is carried by the persistent left superior vena cava to the right atrium through the coronary sinus. We report the case of a patient with a persistent left superior vena cava and absence of right superior vena cava identified by chance during a chest radiograph and computed tomography examination for investigation of chronic pulmonary obstructive disease. The patient had no congenital heart disease and the blood from the right side was drained by the persistent left superior vena cava into the right atrium through the coronary sinus. (author)

2003-01-01

11

Mediastinal Fibrosis and Superior Vena Cava Syndrome.  

UK PubMed Central (United Kingdom)

Superior vena cava syndrome is a clear sign for clinicians of infiltrative mediastinal involvement, usually caused by neoplasms in this location, and it is an indicator of poor prognosis. However, other diseases of benign origin can also cause these alterations. We present the case of a 34-year-old patient who debuted with symptoms of superior vena cava syndrome due to idiopathic mediastinal fibrosis, which presented a torpid evolution and few therapeutic alternatives.

Novella Sánchez L; Sanz Herrero F; Berraondo Fraile J; Fernández Fabrellas E

2013-02-01

12

Absence of right superior vena cava and persistence of left superior vena cava in fetus: Presenting two cases.  

Directory of Open Access Journals (Sweden)

Full Text Available Persistent Left Superior Vena Cava is the most common congenital vascular anomaly. In the vast majority of cases its persistence coincides with thepresence of the right superior vena cava. The absence of the latter with persistent left superior vena cava is a rare variant. We describe the ultrasonographicsigns that identify this rare malformation on fetus. The study was conducted in two pregnant women referred to the national reference center ofcongenital heart disease, showing a left superior vena cava draining into a dilated coronary sinus and the absence of right superior vena cava. Thepresence of a Persistent Left Superior Vena Cava with the absence of a Right Superior Vena Cava is a rare variant of systemic venous return that canbe diagnosed prenatally.

Yamelic Bernal; Carlos García Guevara; Elsa F. Ruisanchez; Pablo Marantz; Carlos García Morejón; Andrés Savío Benavides

2011-01-01

13

Fibrosing mediastinitis and thrombosis of superior vena cava associated with Behcet's disease  

International Nuclear Information System (INIS)

We present CT, MRI and venography findings in 13-year boy with mediastinal fibrosis and superior vena cava (SVC) thrombosis associated with Behcet's disease. Fibrosing mediastinitis is an excessive fibrotic reaction that occurs in the mediastinum and may lead to compression of mediastinal structures (especially vascular). This condition is usually idiopathic, though many (and perhaps most) cases in the USA are thought to be caused by an abnormal immunologic response to Histoplasma capsulatum infection. SVC syndrome secondary to extrinsic compression by mediastinal fibrosis combined with Behcet's disease has rarely been described. Radiological investigations of this syndrome are necessary to avoid a useless anticoagulant therapy.

2003-01-01

14

Fibrosing mediastinitis and thrombosis of superior vena cava associated with Behcet's disease  

Energy Technology Data Exchange (ETDEWEB)

We present CT, MRI and venography findings in 13-year boy with mediastinal fibrosis and superior vena cava (SVC) thrombosis associated with Behcet's disease. Fibrosing mediastinitis is an excessive fibrotic reaction that occurs in the mediastinum and may lead to compression of mediastinal structures (especially vascular). This condition is usually idiopathic, though many (and perhaps most) cases in the USA are thought to be caused by an abnormal immunologic response to Histoplasma capsulatum infection. SVC syndrome secondary to extrinsic compression by mediastinal fibrosis combined with Behcet's disease has rarely been described. Radiological investigations of this syndrome are necessary to avoid a useless anticoagulant therapy.

Harman, Mustafa E-mail: drmharman@hotmail.com; Sayarlioglu, Mehmet; Arslan, Halil; Ayakta, Hayati; Harman, Ece

2003-11-01

15

Vena cava filters and inferior vena cava thrombosis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Retrievable vena cava filters (R-VCF) are a recent addition to the therapeutic armamentarium for the prevention of pulmonary embolism. However, unlike permanent vena cava filters (P-VCF), outcomes data are limited regarding complication rates. METHODS: This was a retrospective comparative analysis of consecutive patients undergoing placement of R-VCF vs P-VCF at Wake Forest University School of Medicine from January 2000 to December 2004. Data collected included demographics, procedural specifics, filter type, indications, and complications. Summary data are expressed as number (percentage) or mean +/- SD. Continuous and categorical variables were analyzed by using t and Fisher exact testing, as appropriate. Four additional patients with vena cava thrombosis were also referred to our institution for treatment during the study period, all with opposed biconical VCFs (OptEase and TrapEase filters) recently placed at other facilities. This last group of patients is described but not included in the analysis. RESULTS: A total of 189 VCF (165 P-VCF and 24 R-VCF) cases were examined. No significant differences in VCF groups were observed according to age, documented hypercoagulability, or concomitant anticoagulation. Significant differences were observed according to sex (30.3% of P-VCF vs 62.5% of R-VCF patients were female), morbid obesity (4.2% of P-VCF vs 25% of R-VCF patients), active malignancy (20% of P-VCF vs 41.7% of R-VCF patients), and indication for VCF placement. Over a median follow-up of 8.5 months, no case of significant hemorrhage, no VCF migration, and four cases of vena cava thrombosis were observed. Vena cava thrombosis was observed more frequently in the presence of R-VCF when compared with P-VCF (12.5% vs 0.6%; P = .007). All observed vena cava thromboses were associated with severe clinical symptoms and occurred in patients who received opposed biconical VCF designs. CONCLUSIONS: In our experience, both P-VCF and R-VCF can be placed safely. Among both permanent and retrievable devices, however, opposed biconical designs seem to be associated with an increased risk for vena cava thrombosis. Although causative factors remain unclear, filter design and resultant flow dynamics may play an important role, because all episodes of vena cava thrombosis occurred in patients with a single-filter design.

Corriere MA; Sauve KJ; Suave KJ; Ayerdi J; Craven BL; Stafford JM; Geary RL; Edwards MS

2007-04-01

16

Coronary pseudoaneurysm and superior vena cava occlusion in a young patient with multicentric Castleman's disease and antiphospholipid antibody positivity.  

Science.gov (United States)

Castleman disease is a non-malignant proliferative disease of the lymphoid system. It can be unicentric or multicentric. In this report, we present a case of multicentric Castleman disease to which coronary artery pseudoaneurysm, vena cava superior occlusion, and antiphospholipid antibody positivity was accompanying. PMID:21729930

Isilak, Zafer; Uzun, Mehmet; Incedayi, Mehmet; Haholu, Abdullah; Ozturk, Ersin; Cebeci, Bekir Sitki

2011-07-04

17

Coronary pseudoaneurysm and superior vena cava occlusion in a young patient with multicentric Castleman's disease and antiphospholipid antibody positivity.  

UK PubMed Central (United Kingdom)

Castleman disease is a non-malignant proliferative disease of the lymphoid system. It can be unicentric or multicentric. In this report, we present a case of multicentric Castleman disease to which coronary artery pseudoaneurysm, vena cava superior occlusion, and antiphospholipid antibody positivity was accompanying.

Isilak Z; Uzun M; Incedayi M; Haholu A; Ozturk E; Cebeci BS

2011-08-01

18

Doença de Behçet cursando com trombose de veia cava superior/ Behçet's disease presenting with superior vena cava thrombosis  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese A trombose venosa é o principal acometimento do sistema vascular na doença de Behçet, sendo uma complicação freqüente na evolução clínica dessa patologia, e está mais associada ao sexo masculino. Os autores relatam o caso de uma paciente do sexo feminino que apresentou início da doença há 3 anos com úlceras orais, além de úlceras genitais, e que vem cursando com episódios recorrentes de trombose venosa, sendo a primeira uma trombose venosa profunda no membro inferior direito; a segunda, de jugular interna esquerda; e, por último, uma trombose da veia cava superior. Abstract in english Venous thrombosis is the main hazard to the vascular system in Behçet's disease. It is a frequent complication throughout the clinical evolution of this illness, which is more associated with the male gender. The authors report the case of a female patient with disease onset 3 years ago, showing oral and genital ulcers presenting with recurring episodes of venous thrombosis. The first one was a deep venous thrombosis in the right leg; the second was in the left internal jugular vein; and finally a superior vena cava thrombosis.

Silva Júnior, Otacílio Figueiredo da; Araújo, Ricardo Henrique de Sousa; Freire, Eutília Andrade Medeiros; Travassos Júnior, Ronaldo Rangel; Cavalcante, Thiago Emanuel Rodrigues; Lucena, Tarcísio José Pinheiro; Nogueira Neto, Norberto de Castro; Melo, Alessandra Vanessa de Albuquerque

2006-03-01

19

Doença de Behçet cursando com trombose de veia cava superior Behçet's disease presenting with superior vena cava thrombosis  

Directory of Open Access Journals (Sweden)

Full Text Available A trombose venosa é o principal acometimento do sistema vascular na doença de Behçet, sendo uma complicação freqüente na evolução clínica dessa patologia, e está mais associada ao sexo masculino. Os autores relatam o caso de uma paciente do sexo feminino que apresentou início da doença há 3 anos com úlceras orais, além de úlceras genitais, e que vem cursando com episódios recorrentes de trombose venosa, sendo a primeira uma trombose venosa profunda no membro inferior direito; a segunda, de jugular interna esquerda; e, por último, uma trombose da veia cava superior.Venous thrombosis is the main hazard to the vascular system in Behçet's disease. It is a frequent complication throughout the clinical evolution of this illness, which is more associated with the male gender. The authors report the case of a female patient with disease onset 3 years ago, showing oral and genital ulcers presenting with recurring episodes of venous thrombosis. The first one was a deep venous thrombosis in the right leg; the second was in the left internal jugular vein; and finally a superior vena cava thrombosis.

Otacílio Figueiredo da Silva Júnior; Ricardo Henrique de Sousa Araújo; Eutília Andrade Medeiros Freire; Ronaldo Rangel Travassos Júnior; Thiago Emanuel Rodrigues Cavalcante; Tarcísio José Pinheiro Lucena; Norberto de Castro Nogueira Neto; Alessandra Vanessa de Albuquerque Melo

2006-01-01

20

Hemodialysis through persistent left superior vena cava  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We report a case of end stage renal disease patient who displayed a persistent left superior vena cava (PLSVC) after placement of hemodialysis (HD) catheter through left internal jugular vein, as revealed by routine post-procedure X-ray chest. The diagnosis of PLSVC was confirmed by arterial blood g...

Kute V; Vanikar A; Gumber M; Shah P; Goplani K; Trivedi H

 
 
 
 
21

Immunoglobulin G4-related sclerosing disease invading the trachea and superior vena cava in mediastinum.  

UK PubMed Central (United Kingdom)

It is well known that immunoglobulin G4 (IgG4)-related sclerosing disease usually occurs in the pancreas, bile duct and gall bladder, but not in the mediastinum, trachea or superior vena cava (SVC). In this case, a patient underwent mediastinal mass excision and trachea resection and repair for a mediastinal and intratracheal mass 15 years ago. This mass was diagnosed postoperatively as an inflammatory pseudotumour (plasma cell granuloma). Subsequently, a mass was found to have recurred in the SVC. We performed a mass excision and innominate vein to the right atrium auricle bypass operation. The mass was diagnosed as IgG4-related sclerosing disease. This patient is now disease and recurrence free.

Noh D; Park CK; Kwon SY

2013-06-01

22

Intravenous Uterine Leiomyomatosis with Inferior Vena Cava and Intracardiac Extensions  

International Nuclear Information System (INIS)

Intravenous leiomyomatosis originating from the uterus and involving the right ventricle, right atrium, inferior vena cava and iliac veins is an uncommon disease. We report here on a leiomyomatosis in a 35-year-old woman who presented with tumors in her heart and inferior vena cava. The correct diagnosis was achieved by using the transthoracic echocardiographic, cardiac CT and pelvic MRI findings

2009-01-01

23

Sarcoma of the vena cava inferior  

International Nuclear Information System (INIS)

[en] Authors present an infrequent case of a female patient with abdominal tumor a great superficial collateral circulation type cava-cava, the abdominal ultrasound, the transthoracic and transesophageal echocardiogram and the computerized axial tomography (CAT) identified a tumor of the vena cava inferior. The fine-needle aspiration cytology of lesion confirmed the presence of primary fusopleomorphous sarcoma of high degree of malignancy of vena cava inferior

2010-01-01

24

Angiosarcoma of the superior vena cava  

Energy Technology Data Exchange (ETDEWEB)

The first reported case of an angiosarcoma apparently arising from the superior vena cava is presented. The patient, a 20-year-old white man, was treated by surgical excision and reconstruction with dacron grafts from the left and right brachiocephalic veins to the right atrium. This was followed by a course of mediastinal irradiation. The patient remained clinically disease-free at 24 months post-treatment. The patient had occasional occupational exposure to polyvinyl chloride.

Abratt, R.P.; Williams, M.; Raff, M.; Dodd, N.F.; Uys, C.J.

1983-08-15

25

Angiosarcoma of the superior vena cava  

International Nuclear Information System (INIS)

The first reported case of an angiosarcoma apparently arising from the superior vena cava is presented. The patient, a 20-year-old white man, was treated by surgical excision and reconstruction with dacron grafts from the left and right brachiocephalic veins to the right atrium. This was followed by a course of mediastinal irradiation. The patient remained clinically disease-free at 24 months post-treatment. The patient had occasional occupational exposure to polyvinyl chloride

1983-08-15

26

High obstruction of inferior vena cava  

Energy Technology Data Exchange (ETDEWEB)

Two cases with high obstruction of the inferior vena cava are reported. In one case the obstruction was caused by a metastasis from colonic carcinoma and in the other case the obstruction was supposed to be congenital. The angiographic and phlebographic findings are discussed as well as the flow pattern that will suggest such a high obstruction of the inferior vena cava.

Duarte, V.; Lunderquist, A.

1983-02-01

27

Síndrome de compressão da veia cava inferior na paracoccidioidomicose/ Vena cavae compression syndrome in paracoccidioidomycosis  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Os Autores registram o primeiro caso de síndrome de compressão da veia cava inferior devida a paracoccidioidomicose. Resumem a evolução clínica do paciente, tratamento e os achados laboratoriais e ultrassonográficos que evidenciaram o diagnóstico de compressão da veia cava inferior. Abstract in english The Authors report the first description of an inferior vena cavae compression syndrome due to paracoccidioidomycosis. The clinical course of the disease, laboratory and ultrasonographic findings are summarized, providing evidence to the diagnosis of inferior vena cavae compression.

Carvalho, Silvino Alves de; Cerri, Giovanni Guido; Shiroma, Mario; Shikanai-Yasuda, Maria Aparecida; Barone, Antonio Alci; Amato Neto, Vicente

1986-02-01

28

Filtros de vena cava en pacientes con cáncer/ Vena cava filters in cancer patients  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Los pacientes con tromboembolismo venoso (TEV) y cáncer tienen más complicaciones vinculadas al tratamiento anticoagulante que la población general. Los filtros de vena cava constituyen una herramienta útil para el tratamiento del TEV y su utilización es controvertida en estadios avanzados de la enfermedad. En este trabajo se revisaron las indicaciones, complicaciones y frecuencia de retiro de los filtros de vena cava en una población de pacientes oncológicos con T (more) EV. Se analizaron 27 pacientes a quienes se les había colocado filtros de vena cava. Veinticinco tenían tumores sólidos y dos linfomas no Hodgkin. Veinticinco estaban bajo tratamiento activo (cirugía y/o quimioterapia). Diecinueve se hallaban en estadio IV de su enfermedad. El motivo de su indicación fue profilaxis en el período perioperatorio en 14 casos (51.9%), hemorragia (n = 5), trombocitopenia (n = 4), metástasis en sistema nervioso central (n = 2), accidente cerebrovascular (n = 1) y neurocirugía previa no reciente (n = 1). Se retiraron 8 (29.6%) filtros. La mediana del tiempo de permanencia fue 21 días (6-75). No hubo diferencias estadísticamente significativas en la frecuencia de retiro entre los filtros colocados en el perioperatorio (6/14) y los colocados por otras contraindicaciones para la anticoagulación (2/13; p = 0.2087). No hubo fracasos ni complicaciones en los procedimientos de colocación y retiro. Abstract in english Cancer patients with venous thromboembolism (VTE) have more complications related to the anticoagulation treatment than the general population. Vena cava filters are a useful tool in cancer patients, but their use in advanced disease is controversial. In this paper, we reviewed the indications, complications and frequency of retrieval of vena cava filters in cancer patients with VTE. Twenty seven patients with vena cava filter placements were analyzed. Twenty five had sol (more) id tumors and two non Hodgkin lymphomas. Twenty five were under active treatment (surgery and/or chemotherapy). Nineteen were classified as stage IV of disease. Indications for filter placement were perioperative prophylaxis in 14 cases (51.9%), hemorrhage (n = 5), thrombocytopenia (n = 4), central nervous system metastases (n = 2), stroke (n = 1) and previous neurosurgery (n = 1). Eight (29.6%) filters were retrieved. The median time to retrieval was 21 days (range: 6-75). There was no statistically significant difference in the frequency of retrieval between perioperative prophylaxis placement (6/14) and other contraindications for anticoagulation treatment (2/13; p = 0.2087). There were no adverse events related to the placement or retrieval procedures.

Díaz Couselo, Fernando A.; Crerar, Silvina; Cravero, Patricia; Santaera, Omar; Eisele, Guillermo; Zylberman, Marcelo

2012-08-01

29

Filtros de vena cava en pacientes con cáncer Vena cava filters in cancer patients  

Directory of Open Access Journals (Sweden)

Full Text Available Los pacientes con tromboembolismo venoso (TEV) y cáncer tienen más complicaciones vinculadas al tratamiento anticoagulante que la población general. Los filtros de vena cava constituyen una herramienta útil para el tratamiento del TEV y su utilización es controvertida en estadios avanzados de la enfermedad. En este trabajo se revisaron las indicaciones, complicaciones y frecuencia de retiro de los filtros de vena cava en una población de pacientes oncológicos con TEV. Se analizaron 27 pacientes a quienes se les había colocado filtros de vena cava. Veinticinco tenían tumores sólidos y dos linfomas no Hodgkin. Veinticinco estaban bajo tratamiento activo (cirugía y/o quimioterapia). Diecinueve se hallaban en estadio IV de su enfermedad. El motivo de su indicación fue profilaxis en el período perioperatorio en 14 casos (51.9%), hemorragia (n = 5), trombocitopenia (n = 4), metástasis en sistema nervioso central (n = 2), accidente cerebrovascular (n = 1) y neurocirugía previa no reciente (n = 1). Se retiraron 8 (29.6%) filtros. La mediana del tiempo de permanencia fue 21 días (6-75). No hubo diferencias estadísticamente significativas en la frecuencia de retiro entre los filtros colocados en el perioperatorio (6/14) y los colocados por otras contraindicaciones para la anticoagulación (2/13; p = 0.2087). No hubo fracasos ni complicaciones en los procedimientos de colocación y retiro.Cancer patients with venous thromboembolism (VTE) have more complications related to the anticoagulation treatment than the general population. Vena cava filters are a useful tool in cancer patients, but their use in advanced disease is controversial. In this paper, we reviewed the indications, complications and frequency of retrieval of vena cava filters in cancer patients with VTE. Twenty seven patients with vena cava filter placements were analyzed. Twenty five had solid tumors and two non Hodgkin lymphomas. Twenty five were under active treatment (surgery and/or chemotherapy). Nineteen were classified as stage IV of disease. Indications for filter placement were perioperative prophylaxis in 14 cases (51.9%), hemorrhage (n = 5), thrombocytopenia (n = 4), central nervous system metastases (n = 2), stroke (n = 1) and previous neurosurgery (n = 1). Eight (29.6%) filters were retrieved. The median time to retrieval was 21 days (range: 6-75). There was no statistically significant difference in the frequency of retrieval between perioperative prophylaxis placement (6/14) and other contraindications for anticoagulation treatment (2/13; p = 0.2087). There were no adverse events related to the placement or retrieval procedures.

Fernando A. Díaz Couselo; Silvina Crerar; Patricia Cravero; Omar Santaera; Guillermo Eisele; Marcelo Zylberman

2012-01-01

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Therapeutic approach to "downhill" esophageal varices bleeding due to superior vena cava syndrome in Behcet's disease: a case report  

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Full Text Available Abstract Background One of the rare presentations of superior vena cava syndrome is bleeding of "downhill" esophageal varices (DEV) and different approaches have been used to control it. This is a case report whose DEV was eradicated by band ligation for the first time. Case presentation We report a 42-year-old man who is a known case of Behcet's disease. The patient's first presentation was superior vena cava syndrome due to thrombosis followed by bipolar ulcers and arthralgia. He received warfarin, prednisolone and azathioprine. The clinical course of the patient was complicated by one episode of hematemesis without abdominal pain when the patient's PT was in therapeutic range. After resuscitation and correction of PT with fresh frozen plasma transfusion, upper gastrointestinal endoscopy was done. Prominent varices were seen in the upper third of the esophagus, tapering to the middle part without acute bleeding. Stomach and duodenum were normal. Color ultrasonography evaluation of the portal, hepatic and splenic veins was negative for thrombosis. Band ligation was done and the patient's bleeding did not recur. Conclusion Band ligation is a safe and effective method for controlling DEV bleeding in patients with uncorrectable underlying disorders.

Tavakkoli Hamid; Asadi Mehrnaz; Haghighi Mahshid; Esmaeili Abbas

2006-01-01

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[Saccular aneurysm of the superior vena cava  

UK PubMed Central (United Kingdom)

The authors report a case of a saccular aneurysm of the superior vena cava in a 38 year old female. The diagnosis could only be made at thoracotomy because of the additional difficulty posed by a complete thrombosis of the aneurysmal pocket, which produced a particularly deceptive CT image. This type of lesion is exceptionally rare as a cause of a mediastinal "tumour" since only 24 cases of congenital aneurysm of the superior vena cava have been reported, of which only 4 were of the saccular type.

Gaucher L; Dezile G; Roullier A; Bouvier B; Aloin M; Delvert JC; Belda G; Vandooren M

1988-01-01

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Hemodialysis through persistent left superior vena cava  

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Full Text Available We report a case of end stage renal disease patient who displayed a persistent left superior vena cava (PLSVC) after placement of hemodialysis (HD) catheter through left internal jugular vein, as revealed by routine post-procedure X-ray chest. The diagnosis of PLSVC was confirmed by arterial blood gas, two-dimensional echocardiography, computed tomography thorax and angiographic examination. This anomaly is rather rare; few studies on safety of PLSVC for HD have been reported. The catheter was uneventfully used for HD for 2 months with careful continuous monitoring and removed after arteriovenous fistula was successfully cannulated. Physicians who place HD catheters in the left jugular/subclavian vein should be aware of the existence of PLSVC.

Kute V; Vanikar A; Gumber M; Shah P; Goplani K; Trivedi H

2011-01-01

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IgG4-related sclerosing disease involving the superior vena cava and the atrial septum of the heart.  

UK PubMed Central (United Kingdom)

A 55-year-old woman presented with frequent episodes of syncope due to sinus pauses. During ambulatory Holter monitoring, atrial fibrillation and first-degree atrioventricular nodal block were observed. Magnetic resonance imaging and CT scans showed a tumor-like mass from the superior vena cava to the right atrial septum. Open chest cardiac biopsy was performed. The tumor was composed of proliferating IgG4-positive plasma cells and lymphocytes with surrounding sclerosis. The patient was diagnosed with IgG4-related sclerosing disease. Because of frequent sinus pauses and syncope, a permanent pacemaker was implanted. The cardiac mass was inoperable, but it did not progress during the one-year follow-up.

Song C; Koh MJ; Yoon YN; Joung B; Kim SH

2013-09-01

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IgG4-Related Sclerosing Disease Involving the Superior Vena Cava and the Atrial Septum of the Heart  

Science.gov (United States)

A 55-year-old woman presented with frequent episodes of syncope due to sinus pauses. During ambulatory Holter monitoring, atrial fibrillation and first-degree atrioventricular nodal block were observed. Magnetic resonance imaging and CT scans showed a tumor-like mass from the superior vena cava to the right atrial septum. Open chest cardiac biopsy was performed. The tumor was composed of proliferating IgG4-positive plasma cells and lymphocytes with surrounding sclerosis. The patient was diagnosed with IgG4-related sclerosing disease. Because of frequent sinus pauses and syncope, a permanent pacemaker was implanted. The cardiac mass was inoperable, but it did not progress during the one-year follow-up.

Song, Changho; Koh, Myoung Ju; Yoon, Yong-Nam; Joung, Boyoung

2013-01-01

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Leiomyosarcoma of the inferior vena cava  

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Vascular leiomyosarcoma (LMS) are unique. The inferior vena cava (IVC) is the most affected organ (about 38% cases). We report the observation of a 50-year old woman who consulted for right upper quadrant pain. Imaging studies revealed a retroperitoneal mass that mimic a LMS of the IVC. The patient ...

Ben Abid Sadri; Attaoui Mohamed Amine; Mzoughi Zeineb; Miloudi Nizar; Gharbi Lassad; Mohamed Tahar Khalfallah

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Experience with three percutaneous vena cava filters  

International Nuclear Information System (INIS)

[en] Twenty-one Kimray-Greenfield, 33 bird's nest, and 19 Amplatz vena cava filters were placed percutaneously. The Kimray-Greenfield filter was the most difficult to insert. The major problem was the insertion site, which required venipuncture with a 24-F catheter. Minor hemorrhage was frequent, and femoral vein thrombosis occurred in four patients. No migration, caval thrombosis, or pulmonary emboli were seen after Kimray-Greenfield filter placement. The bird's nest filter was relatively easy to insert, although in two cases the filter prongs could not be adequately seated in the wall of the inferior vena cava. Three patients with bird's nest filters had thrombosis below the filter, and three filters migrated to the heart. One migrated filter could not be removed. One patient had multiple small pulmonary emboli at autopsy. No other pulmonary emboli after filter placement were noted. The Amplatz filter was the easiest of the three filters to insert. Only one patient with an Amplatz filter had thrombosis of the vena cava below the filter. No filter migrations were documented, and no recurrent pulmonary emboli were found on clinical or radiologic follow-up. The Amplatz vena cava filter is easier to place than percutaneous Kimray-Greenfield or bird's nest filters, has a low complication rate, and has proven to be clinically effective in preventing pulmonary emboli

1987-12-04

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Prosthetic replacement of the infrahepatic inferior vena cava for leiomyosarcoma.  

UK PubMed Central (United Kingdom)

HYPOTHESIS: Resection of the infrahepatic inferior vena cava associated with prosthetic graft replacement for caval leiomyosarcoma is an acceptable procedure to obtain prolonged and good-quality survival. DESIGN: A consecutive sample clinical study with a mean follow-up of 40 months. SETTING: The surgical department of an academic tertiary center and an affiliated secondary care center. PATIENTS: Eleven patients, with a mean age of 51 years, who have primary leiomyosarcoma of the infrahepatic inferior vena cava. INTERVENTIONS: All of the patients underwent radical resection of the tumor en bloc with the affected segment of the vena cava. Reconstruction consisted of 10 cavocaval polytetrafluoroethylene grafts and 1 cavobiliac graft. An associated right nephrectomy was performed in 2 cases. The left renal vein was reimplanted in the graft in 3 cases. MAIN OUTCOME MEASURES: Cumulative disease-specific survival, disease-free survival, and graft patency rates expressed by standard life-table analysis. RESULTS: No patients died in the postoperative period. The cumulative (SE) disease-specific survival rate was 53% (21%) at 5 years. The cumulative (SE) disease-free survival rate was 44% (19%) at 5 years. The cumulative (SE) graft patency rate was 67% (22%) at 5 years. CONCLUSION: Radical resection followed by prosthetic graft reconstruction is a valuable method for treating primary leiomyosarcoma of the infrahepatic inferior vena cava.

Illuminati G; Calio' FG; D'Urso A; Giacobbi D; Papaspyropoulos V; Ceccanei G

2006-09-01

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Cardiac metastasis in renal cell carcinoma without vena cava or atrial involvement: an unusual presentation of metastatic disease  

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Cardiac metastasis in renal cell carcinoma is a very rare entity, with only a few previously reported cases. In this series, we report two cases of ventricular metastases from renal cell carcinoma without vena cava or right atrial involvement. The first case involves an initially isolated inoperable...

Ben Zhang; Joseph Malouf; Phillip Young; Manish Kohli; Roxana Dronca

39

Intracardiac thrombus, superior vena cava syndrome, and pulmonary embolism in a patient with Behcet's disease: a case report and literature review.  

UK PubMed Central (United Kingdom)

A 26-year-old woman with intermittent fever was admitted to our hospital, and gradually developed facial edema. Examinations including computed tomography, transesophageal echocardiography, digital subtraction angiography, and pulmonary perfusion scintigraphy revealed intracardiac thrombus, superior vena cava syndrome, and pulmonary embolism. Clinical findings and laboratory data led us to make a diagnosis of Behçet's disease. Combination of intracardiac thrombus, superior vena cava syndrome, and pulmonary embolism are rare complications in Behçet's disease. Behçet's disease should be considered in the differential diagnosis of intracardiac mass of the right heart, and early diagnosis and treatment are essential for the management of Behçet's disease especially with large-vessel manifestations. In addition to a case report, we review the literature and report the characteristics of intracardiac thrombus in Behçet's disease.

Kajiya T; Anan R; Kameko M; Mizukami N; Minagoe S; Hamasaki S; Maruyama I; Sakata R; Tei C

2007-07-01

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Tratamento da síndrome da veia cava superior Treatment of superior vena cava syndrome  

Directory of Open Access Journals (Sweden)

Full Text Available A veia cava superior é formada pela união das duas veias inominadas, direita e esquerda, e localiza-se no mediastino médio, à direita da artéria aorta e anteriormente à traquéia. A síndrome da veia cava superior representa um conjunto de sinais (dilatação das veias do pescoço, pletora facial, edema de membros superiores, cianose) e sintomas (cefaléia, dispnéia, tosse, edema de membro superior, ortopnéia e disfagia) decorrentes da obstrução do fluxo sanguíneo através da veia cava superior em direção ao átrio direito. A obstrução pode ser causada por compressão extrínseca, invasão tumoral, trombose ou por dificuldade do retorno venoso ao coração secundária a doenças intra-atriais ou intraluminais. Aproximadamente 73% a 97% dos casos de síndrome da veia cava superior ocorrem durante a evolução de processos malignos intratorácicos. A maioria dos pacientes com a síndrome secundária a neoplasias malignas é tratada sem necessidade de cirurgia, através de radioterapia ou quimioterapia, ou através da colocação de stents endoluminais. Quando a síndrome é de etiologia benigna, o tratamento é feito através de medidas clínicas (anticoagulação, elevação da cabeça, etc.) ou, em casos refratários, através de angioplastia, colocação de stents endoluminais e cirurgia.The superior vena cava is formed by the union of the right and left brachiocephalic veins. It is located in the middle mediastinum, to the right of the aorta and anterior to the trachea. Superior vena cava syndrome consists of a group of signs (dilation of the veins in the neck, facial swelling, edema of the upper limbs, and cyanosis) and symptoms (headache, dyspnea, cough, orthopnea and dysphagia) caused by the obstruction of blood flow through the superior vena cava to the right atrium. This obstruction can be caused by extrinsic compression, tumor invasion or thrombosis. Such obstruction may also occur as a result of insufficient venous return secondary to intra-atrial or intraluminal diseases. From 73% to 93% of all cases of superior vena cava syndrome occur during the development of an intrathoracic tumor. Most patients presenting superior vena cava syndrome secondary to malignant neoplasms are treated without surgery, through radiotherapy, chemotherapy or the use of intraluminal stents. When the etiology of superior vena cava syndrome is benign, it can be treated with clinical measures (anticoagulation, raising the head, etc.) or, in refractory cases, with angioplasty, stents or surgery.

Luís Marcelo Inaco Cirino; Rafael Ferreira Coelho; Ivan Dias da Rocha; Bernardo Pinheiro de Senna Nogueira Batista

2005-01-01

 
 
 
 
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Spiral CT in aplasia of the pre-renal inferior vena cava as a cause of phlebothrombosis from the femoral veins to the inferior vena cava  

International Nuclear Information System (INIS)

The case report focuses on the computed tomography of the thrombotic okklusion of the inferior vena cava, venae iliacae and femorales communes due to congenital interruption of the prerenal inferior vena cava. The embryology of the abnormality was discussed. (orig.).

1994-01-01

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Retroperitoneal arteriovenous malformation extending through the inferior vena cava into the heart and causing inferior vena cava dissection  

Energy Technology Data Exchange (ETDEWEB)

We present a case of retroperitoneal arteriovenous malformation extending through the inferior vena cava into the heart, which was associated with dissection of the inferior vena cava in a 32-year-old female. Computed tomography and magnetic resonance imaging showed a double-lumen inferior vena cava and a rod-like solid component attached to a sac-like lesion in the right heart chambers. Digital subtraction angiography showed an arteriovenous malformation draining to the inner lumen of the inferior vena cava. (orig.)

Sung, Yon Mi [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea); Choe, Yeon Hyeon [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea); Sungkyunkwan University School of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Seoul (Korea); Park, Seung Woo [Sungkyunkwan University School of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Seoul (Korea); Sungkyunkwan University School of Medicine, Department of Internal Medicine, Division of Cardiology, Seoul (Korea); Park, Pyo Won [Sungkyunkwan University School of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Seoul (Korea); Sungkyunkwan University School of Medicine, Department of Thoracic and Cardiovascular Surgery, Seoul (Korea); Sung, Chang Ohk [Sungkyunkwan University School of Medicine, Department of Pathology, Seoul (Korea)

2005-06-01

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Cardiac metastasis in renal cell carcinoma without vena cava or atrial involvement: an unusual presentation of metastatic disease  

Directory of Open Access Journals (Sweden)

Full Text Available Cardiac metastasis in renal cell carcinoma is a very rare entity, with only a few previously reported cases. In this series, we report two cases of ventricular metastases from renal cell carcinoma without vena cava or right atrial involvement. The first case involves an initially isolated inoperable metastasis to the left ventricle, which was treated with systemic targeted therapy with favorable local response. Our second case illustrates a patient with an isolated cardiac metastasis in the interventricular septum with extension into the right ventricle, which has also remained stable in size on systemic targeted therapy. Although anti-angiogenic agents such as tyrosine kinase inhibitors have transformed the treatment of metastatic renal cell carcinoma in recent years, their efficacy and safety in treating patients with metastatic disease in highly vascular organs such as the heart are currently unknown, with no prior reports on this topic. We describe our novel management of these unique cases and discuss the current medical and surgical approaches to treating cardiac metastases from renal cell carcinoma.

Ben Zhang; Joseph Malouf; Phillip Young; Manish Kohli; Roxana Dronca

2013-01-01

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High prevalence rate of left superior vena cava determined by echocardiography in patients with congenital heart disease in Saudi Arabia  

Science.gov (United States)

Background Persistent left superior vena cava (LSVC) is one of the common anomalies of the systemic veins. Its prevalence is 0.1–0.3% in the general population and is more common with congenital heart disease (CHD). The importance of detecting persistent LSVC prior to cardiac surgery is paramount for systemic veins cannulations. Aim The aim was to evaluate the prevalence of persistent LSVC in patients with CHD in Saudi Arabia. Methods All patients referred to our institution had echocardiography. All complete studies were reviewed for the presence of persistent LSVC. A computerized database was created including the demographic data, CHD diagnoses, and the presence of persistent LSVC. Results A total of 2,042 were examined with an age range of 1 day to 16 years. The complete echocardiographic studies were 1,832 (90%) of whom 738 (40%) patients had CHD. The prevalence of persistent LSVC in patients with CHD was 7.8% (OR 9.26, 95% CI 4.7–18.2, p1). The most common cardiac defect associated with persistent LSVC was complete atrioventricular septal defect (AVSD); all patients with AVSD had Down syndrome. The total number of patients with AVSD was 41, and persistent LSVC was found in 11 (26%) of them (odds ratio 5.1, 95% CI 2.4–10.8, p1). Conclusions The prevalence of persistent LSVC in the current population is almost double the reported prevalence obtained using the same echocardiographic screening tool.

Eldin, Ghada Shiekh; El-Segaier, Milad; Galal, Mohammed Omer

2013-01-01

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Tratamiento endovascular del síndrome de vena cava superior/ Endovascular treatment of superior vena cava syndrome  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english Background: Superior vena cava syndrome (SVCS) is caused by the obstruction of venous drainage from the upper portion of the body. Common clinical findings are headache and cervical, facial and upper limb edema. Occasionally, clouding of consciousness appears. Aim: to report our experience with endovascular treatment of SVCS. Material and methods: Retrospective review of all patients with SVCS subjected to endovascular treatment between 1999 and 2005. Results: Eight patie (more) nts were treated, all of them with malignancies. Six had a benign obstruction due to the presence of a chemotherapy catheter located in the superior vena cava, one had obstruction secondary to radiation therapy and one a tumor compression of the superior vena cava. Two patients underwent thrombolytic therapy. Angioplasty and stenting was performed in all patients. The chemotherapy catheter was removed to all patients and installed again in one. One patient had a hemothorax secondary to a simultaneous needle lung biopsy under video thoracoscopy. No patient died in relation to the procedure. Congestive signs and symptoms subsided in all patients within 24 hours after the procedure. During follow up, only one patient had symptoms related to vena cava obstruction and three died due to their malignant tumor. Conclusions: Endovascular treatment of SVCS has a low rate of complications and provides immediate and mid-term symptom relief

Bergoeing R, Michel; Mertens M, Renato; Valdés E, Francisco; Krämer Sch, Albrecht; Alvarez Z, Manuel; Bertin C, Pablo; Sagüés C, Rodrigo; Orellana U, Eric; Galindo A, Héctor; Vergara G, Jeannette; Valdebenito C, Magaly

2006-07-01

46

Tratamiento endovascular del síndrome de vena cava superior Endovascular treatment of superior vena cava syndrome  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Superior vena cava syndrome (SVCS) is caused by the obstruction of venous drainage from the upper portion of the body. Common clinical findings are headache and cervical, facial and upper limb edema. Occasionally, clouding of consciousness appears. Aim: to report our experience with endovascular treatment of SVCS. Material and methods: Retrospective review of all patients with SVCS subjected to endovascular treatment between 1999 and 2005. Results: Eight patients were treated, all of them with malignancies. Six had a benign obstruction due to the presence of a chemotherapy catheter located in the superior vena cava, one had obstruction secondary to radiation therapy and one a tumor compression of the superior vena cava. Two patients underwent thrombolytic therapy. Angioplasty and stenting was performed in all patients. The chemotherapy catheter was removed to all patients and installed again in one. One patient had a hemothorax secondary to a simultaneous needle lung biopsy under video thoracoscopy. No patient died in relation to the procedure. Congestive signs and symptoms subsided in all patients within 24 hours after the procedure. During follow up, only one patient had symptoms related to vena cava obstruction and three died due to their malignant tumor. Conclusions: Endovascular treatment of SVCS has a low rate of complications and provides immediate and mid-term symptom relief

Michel Bergoeing R; Renato Mertens M; Francisco Valdés E; Albrecht Krämer Sch; Manuel Alvarez Z; Pablo Bertin C; Rodrigo Sagüés C; Eric Orellana U; Héctor Galindo A; Jeannette Vergara G; Magaly Valdebenito C

2006-01-01

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Superior vena cava syndrome caused by epitheloid hemangioma  

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Aim. A case is presented of the surgical treatment of epitheloid hemangioma as a rare cause of superior vena cava syndrome. Case report. A 53-year old woman was admitted to the clinic with the symptoms and signs of superior vena cava syndrome. After clinical evaluation and diagnostic tests, she was ...

Ili? Radoje; Trifunovi? Zoran; Mandari? Vladimir; Tišma Svetislav

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Intracardiac invasive thymoma presenting as superior vena cava syndrome.  

Science.gov (United States)

A case of invasive thymoma with intra-caval and intracardiac extension presenting as superior vena cava syndrome is reported. The tumor is excised on cardiopulmonary bypass, and superior vena cava is bypassed using a Dacron graft (DuPont, Wilmington, DE). Five-year follow-up of the patient showed a patent graft. PMID:19379928

Amirghofran, Ahmad Ali; Emaminia, Abbas; Rayatpisheh, Shahrzad; Malek-Hosseini, Seyed Ali; Attaran, Yahya

2009-05-01

49

Intracardiac invasive thymoma presenting as superior vena cava syndrome.  

UK PubMed Central (United Kingdom)

A case of invasive thymoma with intra-caval and intracardiac extension presenting as superior vena cava syndrome is reported. The tumor is excised on cardiopulmonary bypass, and superior vena cava is bypassed using a Dacron graft (DuPont, Wilmington, DE). Five-year follow-up of the patient showed a patent graft.

Amirghofran AA; Emaminia A; Rayatpisheh S; Malek-Hosseini SA; Attaran Y

2009-05-01

50

Caudal vena cava thrombosis-like syndrome in a horse  

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A 9-year-old Quarter horse was presented for chronic refractory pneumonia. On necropsy, an hepatic abscess, caudal vena cava thrombosis, pulmonary thromboembolism, and embolic pneumonia were identified. Similar lesions have been reported in cattle as caudal vena cava thrombosis syndrome, however thi...

Schoster, Angelika; Anderson, Maureen E.C.

51

Magnetic resonance venography of double inferior vena cava  

International Nuclear Information System (INIS)

Duplication of the inferior vena cava IVC is the most common anomaly affecting the vena cava. Variations of the IVC are diagnosed in routine dissection studies, in retroperitoneal surgeries, or in radiological studies for various reasons. In this paper, we present a case of double IVC with its magnetic resonance imaging findings. (author)

2005-01-01

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Inferior vena cava filters: indications and management.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: The purpose of this review was to examine recent studies concerning the use of inferior vena cava (IVC) filters. RECENT FINDINGS: In the past 18 months, the American College of Chest Physicians released the 9th edition of their guideline for the prevention and treatment of venous thromboembolism. There have also been a number of studies reviewing the use of IVC filters in select populations for the prophylactic prevention of pulmonary embolism. Trauma continues to be the leading indication for prophylactic filters in a number of series, but further studies have demonstrated some benefit of prophylactic filters in the bariatric and spine surgery populations. The IVC filter complication rate remains low; however, so does the retrieval rate for potentially removable filters. These retrieval rates are increased with use of dedicated patient tracking mechanisms. Finally, there have been a number of technology updates in the hardware itself, focusing on strut design. SUMMARY: Despite little change in the society guidelines, the use of vena cava filters (VCFs) continues to rise. Overall, the use of IVC filters, especially in prophylactic situations, will remain controversial until randomized, controlled trials are performed within each specific patient population.

Sing RF; Fischer PE

2013-11-01

53

[Surgery of inferior vena cava-associated urological tumor lesions.  

UK PubMed Central (United Kingdom)

BACKGROUND: Tumor lesions of the inferior vena cava are extremely challenging with regard to adequate therapeutic management also in advanced malignant urological tumor lesions which can be caused by malignant adhesion, impression and tumor infiltration from the surrounding tissue. This can be the case with metastases from a seminoma or testicular carcinoma (differential diagnosis: primary vena cava leiomyosarcoma), tumor-associated growth into and within the inferior vena cava originating from renal cell carcinoma or carcinoma of the pararenal gland. The aim of this overview was to summarize current clinical and operative experiences in the treatment of inferior vena cava-associated urological tumor lesions, perioperative management, individual-specific and finding-adapted surgical technique and possible outcome, including prognostic considerations from clinical daily practice and representative data found in the literature. BASIC STATEMENTS: The primary aim of the surgical approach is to achieve R0 resection with reconstruction of the inferior vena cava lumen providing a reasonable risk-benefit ratio, which comprises i) complete resection and substitution of the inferior vena cava by a prosthesis along the previous extent of tumor growth, ii) partial resection of the vena cava wall with subsequent patch-plasty or tangential resection with primary suture or iii) removal of the vena cava thrombus after cavotomy. Particular attention should be paid to tumor thrombi reaching the right atrium which need to be extracted after sternotomy and atriotomy using an extracorporeal circulation (cardiac surgeon). For surgical planning, subdivision of the inferior vena cava into three segments, infracardiac, infrahepatic and infrarenal third, has been proven and tested. CONCLUSIONS: The current development status and advances in surgical approaches as well as advances in medical technology allow the successful approach to such advanced stage urological tumor manifestations. A deciding factor is the abdominal and cardiovascular surgical expertise of each surgeon after formation of a team of surgical specialists (including urologists) and only then prognostic advantages can be achieved.

Weber M; Meyer F; Liehr UB; Halloul Z

2013-08-01

54

Evaluation of superior vena cava syndrome by axial CT and CT phlebography  

Energy Technology Data Exchange (ETDEWEB)

Transverse axial computed tomography (CT) has been combined with CT digital phlebography to study nine patients with superior vena cava syndrome. Six were due to malignancy, two were secondary to benign disease, and one was a paraneoplastic manifestation. This combined CT approach successfully identified the abnormal morphology of the superior vena cava, demonstrating external compression, encasement, or intraluminal thrombus in all patients and the collateral venous channels in eight. This technique is a rapid, informative, and cost-effective method for the workup of superior vena cava syndrome. The CT digital phlebogram, however, is not successful in regularly and optimally opacifying the normal superior vena cava because of the limited amount of contrast material, dilution effect of the nonopacified incoming flow from the jugular and azygos veins, and the lack of image enhancement from the CT digital scanograms.

Moncada, R.; Cardella, R.; Demos, T.C.; Churchill, R.J.; Cardoso, M.; Love, L.; Reynes, C.J.

1984-10-01

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[Leiomyosarcoma of the inferior vena cava (case report)].  

UK PubMed Central (United Kingdom)

The occur of resecable retroperitoneal tumours invading into inferiér vena cava is rare. The authors report in detail a case of fibrosarcoma of the inferior vena cava In article is presented case of 49-year-old female presented with echographic and computed tomographic evidence of solid formation below porta hepatis and ower head of pankreas, behinde duodenum, growed into inferior vena cava with trombus. Treatment of the abdominal and retroperitoneal tumours closely related to major blood vessels must be interdisciplinary, considering diagnostics, operability estimation and additional measures. The radical resection rate for involving important vesel may bee improved with vascular technique.

Sváb J; Lindner J; Krska Z; Plocová K; Vondrácková M

2011-10-01

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Symplastic Leiomyoma in the Suprarenal Inferior Vena Cava  

Science.gov (United States)

Leiomyomas are benign tumors of the soft tissue and may develop in any location where smooth muscle is present. Leiomyoma in the inferior vena cava is a rarely seen pathology, and symplastic leiomyoma is also a rare histological variant of leiomyoma. In this case, we present a rare histological variant of symplastic leiomyoma in the inferior vena cava (IVC). This is the first radiologically reported case of a symplastic leiomyoma of the IVC.

Kahveci, Volkan; Ogur, Torel; Cipe, Gokhan; Ozdemir, Sevim; Hazinedaroglu, Selcuk

2012-01-01

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Terapia endovascular en el sindrome de vena cava superior: caso clínico/ Endovascular treatment of superior vena cava syndrome: Report of one case  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english The treatment of superior vena cava syndrome is usually oriented to the underlying cause, that can be too slow in emergency cases. We report a 49 years old woman with a multiple myeloma that was admitted due to a superior vena cava syndrome caused by a central venous catheter used for chemotherapy for 20 weeks. She was successfully treated with thrombolysis, angioplasty and stent placement. The patient died 7 months later due to the underlying disease. Long term catheters (more) are the responsible for 20 to 30% of superior vena cava syndromes. Endovascular treatment of the syndrome is successful in 60 to 100% of cases with a symptomatic relapse in 4 to 45% of patients. (Rev Méd Chile 2001; 129: 421-6)

Boza W, Camilo; Mertens M, Renato; Valdés E, Francisco; Kramer Sch, Albrecht; Mariné M, Leopoldo; Vergara G, Jeanette

2001-04-01

58

Traumatismos de veia cava inferior Inferior vena cava injuries  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: Avaliar a incidência, o perfil clínico e as estratégias operatórias dos ferimentos de Veia Cava Inferior (VCI). MÉTODOS: Foram analisados retrospectivamente os prontuários de 76 doentes com ferimento de VCI atendidos nos dois prontossocorros de Manaus, no período de janeiro de 1997 a julho de 2002. Mecanismo de lesão, mortalidade, estado hemodinâmico, índice de trauma abdominal penetrante (PATI), achados intra-operatórios e conduta cirúrgica foram estudados. RESULTADOS: Quarenta e nove (65%) doentes sofreram lesão por arma branca, 26 (34%) por arma de fogo e um por traumatismo abdominal fechado. Quarenta e um (54%) doentes sobreviveram. Quase todos chegaram acordados, entretanto 40% estavam hipotensos (pressão arterial sistólica BACKGROUND: Injuries of inferior vena cava (IVC) require immediate and definitive action. Our objective is to evaluate the incidence, the clinical findings and the operative approach to IVC injuries. METHODS: We retrospectively studied 76 patients with IVC injuries treated in two Emergency Hospitals of Manaus, AM, Brazil, from January 1997 to July 2002. Mechanisms of injuries, mortality, hemodynamic status, penetrating abdominal trauma index (PATI), intraoperative findings and surgical approach were among assessed data. RESULTS: Fourty-nine patients (65%) had stab wounds, 26 (34%) gunshot wounds, and one had blunt abdominal trauma. Fourty-one (54%) patients survived. Almost all patients entered the emergency room awake, although 40% were hypotensive (systolic blood pressure < 70 mmHg), and the penetrating abdominal trauma index average was above 40. At laparotomy, active retroperitoneal bleeding or an expanding retroperitoneal hematoma were detected in all cases. Caval injury was retro-hepatic in 21 patients, and infrahepatic in the other 55. The prevailing surgical approach was lateral repair in 65 patients. Atrial-caval shunting was tried in six patients, with only three survivals. CONCLUSIONS: We concluded that IVC injury remains a highly lethal injury and there is a close relationship with urban violence. This study emphasizes that successful outcome depends on prompt volume restoration, avoidance of hypothermia and a stratified selective surgical approach.

Cleinaldo de Almeida Costa; José Carlos Costa Baptista-Silva; Lana Márcia Esteves Rodrigues; Fabiana Lo Presti Mendonça; Thiago Silveira Paiva; Emil Burihan

2005-01-01

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Multicentric pheochromocytoma and involvement of the inferior vena cava  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese CONTEXTO: Feocromocitoma com invasão de veia cava inferior é raro. Tumores multicêntricos são igualmente raros, estando presentes em até 10% dos casos. A cirurgia é o tratamento de escolha, uma vez que a sobrevida livre da doença é longa. TIPO DE ESTUDO: Relato de caso. RELATO DE CASO: Relatamos um caso de feocromocitoma de adrenal direita com extensão para veia cava inferior supra-diafragmática, retirado cirúrgicamente através de tóraco-freno-laparotomia, se (more) m a necessidade de circulação extra-corpórea. Após seis anos de seguimento, outro feocromocitoma foi achado no órgão de Zuckerkandl. A excisão cirúrgica completa do tumor foi realizada através de laparotomia mediana e dissecção retroperitoneal. Em ambos os casos, margens cirúrgicas livres do tumor e níveis pós-operatórios normais de catecolaminas garantiram remoção total do feocromocitoma. O estudo anatomopatológico revelou feocromocitoma maligno com margens livres de neoplasia em ambos os espécimes. Abstract in english CONTEXT: Extension of pheochromocytomas to the inferior vena cava is rare. Multicentric tumors are rare as well, being present in up to 10% of cases. Surgery is the treatment of choice because of the long-term survival free of disease. DESIGN: Case report. CASE REPORT: We report on a case of right adrenal pheochromocytoma with extension to the supra-diaphragmatic vena cava, which underwent surgical excision through thoracophrenic laparotomy without the need for cardiopulm (more) onary bypass. In a 6-year follow-up, another pheochromocytoma was found in the infra-renal Zuckerkandl's organ. Complete surgical excision of the tumor was performed by a median laparotomy and complete retroperitoneal dissection. In both cases, the total removal of the pheochromocytoma has been guaranteed by having margins free of tumor and a normal post-operative level of catecholamines. The pathological study revealed a malignant pheochromocytoma with margins free of neoplasia in both specimens.

Lucon, Antonio Marmo; Falci Júnior, Renato; Praxedes, José Nery; Machado, Marcel Cerqueira Cesar; Saldanha, Luis Balthazar; Machado, Marcelo Marcondes; Arap, Sami

2001-03-01

60

Leiomiosarcoma de cava inferior: Hallazgo incidental/ Leimyosarcoma of the inferior vena cava: Incidental finding  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Objetivo: El leiomiosarcoma de cava inferior es una entidad poco frecuente, clínicamente insidiosa o silente y detectable en muchas ocasiones únicamente mediante estudios de imagen. Se presenta un caso intervenido en nuestro servicio y se revisa la literatura al respecto. Método: Mujer de 58 años con una masa suprarrenal derecha de 6 cm evidenciando su origen en la pared de vena cava durante el acto quirúrgico. Se realiza exeresis completa de la tumoración, y poster (more) iormente , radioterapia adyuvante sobre el lecho quirúrgico. Resultados: Tras más de 2 años de evolución, la paciente se encuentra libre de enfermedad. Conclusiones: Esta entidad presenta una escasa prevalencia, y en muchas ocasiones su hallazgo es incidental. La resección quirúrgica completa es la clave del tratamiento, aunque la probabilidad de recidiva local es elevada. Abstract in english Objective: Leiomyosarcoma of the inferior vena cava is a rare tumor, clinically silent which often remains undiagnosed for much longer. Imaging methods allow us to detect these entities. We report a single case and perform a bibliographic review. Methods: 58-year-old woman with a 6 cm adrenal mass, which during surgery was found to be a tumor from the wall of the vena cava. We performed complete removal of the mass. Radiotherapy of the surgical area was applied within thr (more) ee months following surgery. Results: Two years later, there is no evidence of disease recurrence. Conclusion: This is a rare entity, with low prevalence. Complete surgical excision is the gold standard for treatment. Local recurrence is a common finding during follow up.

Rodríguez Gómez, Ignacio; Rodríguez-Rivera García, J.; Álvarez Castelo, Luis; Gómez Veiga, Francisco; Lancina Martín, Alberto; Chantada Abal, Venancio; González Martín, M.

2007-11-01

 
 
 
 
61

[Inferior vena cava filters: any indications anymore?].  

UK PubMed Central (United Kingdom)

Inferior vena cava filters (IVCFs) are metal alloy devices that mechanically trap fragmented thromboemboli from the deep leg veins en route to the pulmonary circulation. Filters are introduced (and in the case of retrievable filters, removed) percutaneously. Although their deployment seems of theoretical benefit, their clinical efficacy and adverse event profile are unclear because there are very few controlled and randomized data. IVCFs are most frequently used in patients with contraindications to anticoagulation and in anticoagulated patients with recurrent pulmonary embolism, but few data are available in the literature about their efficacy. The indications for filters are based largely on custom, historical practice patterns and physician preferences, and their use is increasing: more trials are needed to confirm their benefit and accurately assess their safety. The care of patients with or at risk of venous thromboembolism is as variable and challenging as the range of patients who suffer from venous thrombosis. Careful, individualized decision regarding IVCF placement will be required for many years as we strive to learn more about these devices.

Santoro G; Innocenti D; Meucci F; Squillantini G; Agostini C; Rosso G

2011-09-01

62

Vena cava thrombosis after vena cava filter placement: Incidence and risk factors.  

UK PubMed Central (United Kingdom)

BACKGROUND: The objective of this study was to assess the clinical safety and efficacy of vena cava filter (VCF) placement, with particular emphasis on the incidence and risk factors of inferior vena cava thrombosis (VCT) after VCF placement. METHODS: Clinical data of patients with venous thromboembolism (VTE), with or without placement of VCF, were analyzed in a retrospective single-center audit of medical records from January 2005 to June 2009. The collected data included demographics, procedural details, filter type, indications, and complications. RESULTS: A total of 168 cases of VTE (82 with VCF; 86 without VCF) were examined. Over a median follow-up of 24.2 months, VCT occurred in 18 of 82 patients with VCFs (11 males, 7 females, mean age 55.4 years). In 86 patients without VCFs, VCT occurred in only 6 individuals (4 males, 2 females) during the study period. VCT was observed more frequently in patients fitted with VCFs than in those without VCFs (22% vs. 7.0%). CONCLUSIONS: The incidence of VCT in patients with VTE after VCF implantation was 22% approximately. Anticoagulation therapy should be continued for all patients with VCF placement, unless there is a specific contraindication. Almost all instances of VCT in patients with VCF implants in our study occurred after stopping anticoagulation treatment. The use of VCFs is increasing, and more trials are needed to confirm their benefit and accurately assess their safety.

Guo YJ; Feng J; Qu TR; Qu Y; Liu YM; Zhang YS; Tian HY; Ma AQ

2011-06-01

63

Neuroimaging findings in neonates and infants from superior vena cava obstruction after cardiac operation  

Energy Technology Data Exchange (ETDEWEB)

Extraventricular obstructive hydrocephalus may develop after superior vena cava obstruction, an uncommon complication after cardiac surgery.Objective. To describe the neuroimaging findings in neonates and infants with superior vena cava thrombosis after cardiac surgery for congenital heart disease.Materials and methods. Between 1993 and 2001, 333 neonates and infants in our hospital underwent cardiac surgery, of whom 13 (3.9%) subsequently acquired superior vena cava syndrome. Eleven of these 13 children (7 boys, 4 girls) were evaluated by head ultrasound and computed tomography scans.Results. One child had normal findings on head ultrasound, and 10 children had extraventricular obstructive hydrocephalus (EVOH). In 6 children, aggravation of the hydrocephalus was noted up to 11.4 months after cardiac surgery; in 3 of them, the hydrocephalus was shunted to the peritoneum. One child had thrombosis of the dural sinuses, and 1 had hemorrhagic infarction. Two children died during follow-up.Conclusion. EVOH is a common complication of superior vena cava thrombosis, and head ultrasound should be performed in all neonates and infants with superior vena cava thrombosis after cardiac surgery. Long-term follow-up is needed, as the hydrocephalus may worsen even months after surgery. (orig.)

Karmazyn, Boaz; Horev, Gadi; Kornreich, Liora [Department of Pediatric Radiology, Schneider Children' s Medical Center of Israel, 14 Kaplan Street, Petah Tiqva 49202, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Dagan, Ovdi; Vidne, Bernado A. [Department of Pediatric Cardiothoracic Surgery, Schneider Children' s Medical Center of Israel, Petah Tiqva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel)

2002-11-01

64

Detection of atrial septal defect with left-to-right shunt by inferior vena cava contrast echocardiography.  

Science.gov (United States)

Contrast echocardiography was used before cardiac catheterisation in 37 patients with atrial septal defect and a left-to-right shunt and in 18 patients with a raised right atrial and ventricular pressure to assess the contrast echo effect in the inferior vena cava. Using two dimensional contrast apical echocardiography we found a negative contrast echo effect within the right atrium in many but not all patients with atrial defect. Contrast echoes entering the inferior vena cava during presystole or early to mid-diastole were detected in patients with heart disease causing raised right atrial and ventricular pressures and also in all patients with atrial septal defect. No contrast echo effect in the inferior vena cava was detected in 10 normal subjects. The sensitivity of this contrast pattern in the inferior vena cava in diagnosing atrial septal defect was 100%. When other conditions causing raised right atrial pressure were excluded, the specificity and predictive accuracy were 100% for both. The presystolic contrast echo effect in the inferior vena cava, semiquantitatively graded, correlated with the size of the shunt determined by oximetry. In 20 patients re-examined after the surgical correction of the atrial septal defect, no presystolic contrast echo effect was detected in the inferior vena cava. Contrast echocardiography of the inferior vena cava is a valuable and reliable method for diagnosing atrial septal defect with left-to-right shunt. Images

Gullace, G; Savoia, M T; Ravizza, P; Knippel, M; Ranzi, C

1982-01-01

65

Superior vena cava stenting in the 21st century.  

UK PubMed Central (United Kingdom)

Superior vena cava obstruction (SVCO) is most commonly due to malignant or thrombotic causes. The traditional treatments of surgery, radiotherapy or chemotherapy either have a high morbidity and mortality rate, or a lag period of a few weeks prior to response. Superior vena cava stenting is able to provide rapid relief of symptoms safely in the vast majority of patients. It has now become the first-line treatment for malignant SVCO, and is increasingly being used in benign SVCO. The complication and success rates compare very favourably with the other treatment modalities.

Warner P; Uberoi R

2013-04-01

66

Cor triloculare biventriculare with left superior vena cava.  

Science.gov (United States)

Cor triloculare biventriculare is a rare congenital malformation of the heart in which there is a complete absence of the atrial septum. It is usually associated with other anomalies like complete atrioventricular canal defect, polysplenic syndrome, isolated dextrocardia, Ellis-van Creveld syndrome, or persistent left superior vena cava. We report a case of a stillborn male foetus of 35 weeks gestation with common atrium, complete atrioventricular canal defect, and persistent left superior vena cava. The possible embryological basis and clinical implication of this variation are discussed. PMID:21630236

Sangam, M R; Devi, S S Sarada; Krupadanam, K; Anasuya, K

2011-05-01

67

Cor triloculare biventriculare with left superior vena cava.  

UK PubMed Central (United Kingdom)

Cor triloculare biventriculare is a rare congenital malformation of the heart in which there is a complete absence of the atrial septum. It is usually associated with other anomalies like complete atrioventricular canal defect, polysplenic syndrome, isolated dextrocardia, Ellis-van Creveld syndrome, or persistent left superior vena cava. We report a case of a stillborn male foetus of 35 weeks gestation with common atrium, complete atrioventricular canal defect, and persistent left superior vena cava. The possible embryological basis and clinical implication of this variation are discussed.

Sangam MR; Devi SS; Krupadanam K; Anasuya K

2011-05-01

68

Vena cava superior izquierda persistente asociada con cardiopatías congénitas  

Directory of Open Access Journals (Sweden)

Full Text Available La persistencia de la vena cava superior izquierda asociada con cardiopatías congénitas suele ser un hallazgo benigno, sin repercusión hemodinámica ni quirúrgica. Sin embargo, en ocasiones su presencia puede constituir una entidad fisiopatológica que requiere tratamiento o conducir a modificaciones en las técnicas quirúrgicas utilizadas para otras malformaciones. Estas situaciones en las que la presencia de la vena cava superior izquierda requiere un abordaje quirúrgico específico son motivo de revisión en el presente trabajo. Asimismo, se comenta una técnica quirúrgica original utilizada en estos pacientes, y recientemente comunicada por nuestro grupo, en relación con cada una de las diferentes presentaciones anatómicas.

Florentino J. Vargas

2008-01-01

69

Primary lung lymphoma involving the superior vena cava  

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Full Text Available Abstract Primary lung lymphoma (PLL) presenting as a primary pulmonary lesion is rare and usually affects elderly people. Here we describe a 25-year-old Chinese man diagnosed with primary lung lymphoma, which presented as a huge lung tumor mimicking a primary lung cancer and involving the superior vena cava. He underwent double-sleeve reconstructions of bronchus and pulmonary arteries with right upper- and middle-lobe lobectomy along with replacement of the superior vena cava with a graft, and was then given standard chemotherapy of CHOP plus Rituximab. The patient has been well, showing no local recurrence or distal metastasis during a 27-month follow-up.

Wei Sen; Li Xin; Qiu Xiaomin; Zhao Honglin; Chen Gang; Chen Jun; Zhou Qinghua

2012-01-01

70

[The superior vena cava syndrome in retrosternal goiter  

UK PubMed Central (United Kingdom)

A case of superior vena cava syndrome in an 82-year-old woman who had been suffering from multinodular hyperfunctioning goiter for a long time is presented. The goiter was partially intrathoracic, benign, but affecting the superior mediastinum. The patient decided not to be operated on because of personal fears and the slow growth produced developments of collateral prethoracic circulation. The etiology of superior vena cava syndrome is of malignant tumor origin in 95% of cases. This case is presented because of its rareness, and the literature is reviewed.

Kessler Sáiz P; Olmedo Moreno M; Jareño Chaumel J; Pascual Cuesta T

1989-09-01

71

Congenital and acquired anomalies of the inferior vena cava  

International Nuclear Information System (INIS)

Segmental aplasias of the inferior vena cava, thrombosis of the vena cava, tumour infiltration (e.g. renal neoplasmas via the renal vein) and external compression (e.g. large hepatic metastases) may produce similar radiomorphologic changes in chest X-ray, DSA and CT. These radiomorphological changes are described by case reports. DSA clearly demonstrates the course of the vessels and the collaterals involved. CT may elucidate the paracaval vascular changes. It is only a synopsis of cavography (DSA) and CT with reference to embryogenesis that will lead to a reliable diagnosis and enable a definite decision on therapy and prognosis. (orig.).

1991-01-01

72

Síndrome de veia cava superior/ Superior vena cava syndrome  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese A obstrução ao fluxo sanguíneo na VCS e suas manifestações clínicas têm hoje como causa principal o câncer de pulmão. A história relata que no século XVIII a sífilis e a tuberculose eram responsáveis por 40% dos casos conhecidos. O conhecimento das alterações hemodinâmicas compreendidas nesta síndrome assim como a apuração das técnicas de diagnóstico de imagem e de citopatologia permitem hoje que o médico possa tratar de seu paciente com mais seguran (more) ça e conforto do que há 10 anos. A TC contrastada e a RM auxiliam no diagnóstico de localização da obstrução e técnicas mais antigas como a cavografia puderam ser abandonadas. O diagnóstico de obstrução da VCS e o estudo por Doppler realizado à beira do leito em muito contribuem para a realização de procedimentos de desobstrução como a angioplastia transluminal percutânea nos casos de trombose ou estenose do vaso. Também a utilização de próteses como PTFE é de importância fundamental na condução de casos de lesão traumática da VCS durante cirurgias para câncer pulmonar ou mediastinal. No campo da radioterapia, a técnica de fracionamento permite que altas doses de irradiação sejam administradas aos pacientes portadores de neoplasias malignas, com benefícios em 70% dos casos. Abstract in english Lung cancer is now the main cause of blood flow obstruction in the superior vena cava and of its clinical manifestations. History tells that in the 18th Century, syphilis and tuberculosis were responsible for 40% of the known cases. The knowledge of hemodynamic changes seen in this syndrome and the improvement of diagnostic and cytopathologic techniques allow for a safer and more comfortable treatment of the patient than 10 years ago. Contrast CT and MR added to the ident (more) ification and location of the obstruction, and older techniques such as cavography could be abandoned. SVC obstruction diagnosis and Doppler studies carried out at the bed of the patient contribute to deobstruction procedures such as transluminal percutaneous angioplasty in cases of thrombosis and venous stenosis. In addition, the use of prostheses is of great importance in the management of cases utilization of traumatic lesion to the SVC during lung or mediastinal cancer surgeries. In the realm of radiotherapy, the fractionating technique allows for the administration of high doses of irradiation to cancer patients with benefits to 70% of the cases on the average.

CORDEIRO, SAMUEL ZUÍNGLIO DE BIASI; CORDEIRO, PAULO DE BIASI

2002-09-01

73

Síndrome de veia cava superior Superior vena cava syndrome  

Directory of Open Access Journals (Sweden)

Full Text Available A obstrução ao fluxo sanguíneo na VCS e suas manifestações clínicas têm hoje como causa principal o câncer de pulmão. A história relata que no século XVIII a sífilis e a tuberculose eram responsáveis por 40% dos casos conhecidos. O conhecimento das alterações hemodinâmicas compreendidas nesta síndrome assim como a apuração das técnicas de diagnóstico de imagem e de citopatologia permitem hoje que o médico possa tratar de seu paciente com mais segurança e conforto do que há 10 anos. A TC contrastada e a RM auxiliam no diagnóstico de localização da obstrução e técnicas mais antigas como a cavografia puderam ser abandonadas. O diagnóstico de obstrução da VCS e o estudo por Doppler realizado à beira do leito em muito contribuem para a realização de procedimentos de desobstrução como a angioplastia transluminal percutânea nos casos de trombose ou estenose do vaso. Também a utilização de próteses como PTFE é de importância fundamental na condução de casos de lesão traumática da VCS durante cirurgias para câncer pulmonar ou mediastinal. No campo da radioterapia, a técnica de fracionamento permite que altas doses de irradiação sejam administradas aos pacientes portadores de neoplasias malignas, com benefícios em 70% dos casos.Lung cancer is now the main cause of blood flow obstruction in the superior vena cava and of its clinical manifestations. History tells that in the 18th Century, syphilis and tuberculosis were responsible for 40% of the known cases. The knowledge of hemodynamic changes seen in this syndrome and the improvement of diagnostic and cytopathologic techniques allow for a safer and more comfortable treatment of the patient than 10 years ago. Contrast CT and MR added to the identification and location of the obstruction, and older techniques such as cavography could be abandoned. SVC obstruction diagnosis and Doppler studies carried out at the bed of the patient contribute to deobstruction procedures such as transluminal percutaneous angioplasty in cases of thrombosis and venous stenosis. In addition, the use of prostheses is of great importance in the management of cases utilization of traumatic lesion to the SVC during lung or mediastinal cancer surgeries. In the realm of radiotherapy, the fractionating technique allows for the administration of high doses of irradiation to cancer patients with benefits to 70% of the cases on the average.

SAMUEL ZUÍNGLIO DE BIASI CORDEIRO; PAULO DE BIASI CORDEIRO

2002-01-01

74

[Polysplenia with duplication of the inferior vena cava. Apropos of a case  

UK PubMed Central (United Kingdom)

A case of polysplenia fortuitously discovered in an adult by sonography, then studied by computed tomography and inferior vena cavography, is reported. In the absence of cardiac anomalies, the different elements of the syndrome are discussed: multiple spleens, abdominal heterotaxia and vascular malformations. The duplication of the inferior vena cava is exceptional in this disease. Its original characteristic is shown by the cavography and brought to its embryologic origin.

Boyer B; Gisserot D; Le Vot J; Muyard B; Abgrall J; Jan P

1987-04-01

75

[Polysplenia with duplication of the inferior vena cava. Apropos of a case].  

Science.gov (United States)

A case of polysplenia fortuitously discovered in an adult by sonography, then studied by computed tomography and inferior vena cavography, is reported. In the absence of cardiac anomalies, the different elements of the syndrome are discussed: multiple spleens, abdominal heterotaxia and vascular malformations. The duplication of the inferior vena cava is exceptional in this disease. Its original characteristic is shown by the cavography and brought to its embryologic origin. PMID:3585859

Boyer, B; Gisserot, D; Le Vot, J; Muyard, B; Abgrall, J; Jan, P

1987-04-01

76

Computed tomographic evaluation of the renal vein and inferior vena cava in renal cell carcinoma  

International Nuclear Information System (INIS)

Renal cell carcinoma not rarely invades the renal vein and inferior vena cava with formation of tumor thrombus. On the other hand, congenital anomalies of these venous channels are occasionally encountered. At the time of surgery of renal cell carcinoma, therefore, preoperative evaluation of the renal vein and inferior vena cava is desirable. In 22 cases of renal cell carcinoma treated at the Jikei University Hospital during 16 months period from Jan. 1979 to apr. 1980, the ranal vein and inferior vena cava were examined by computed tomography (CT). Intravenous tumor thrombus was diagnosed in 4, double inferior vena cava in one and retroaortic left renal vein in one. All these CT diagnosis were confirmed to be correct by surgery. Three of tumor thrombus cases showed involvement of inferior vena cava. CT findings included dilated vein in 4 and filling defect after contrast enhancement in 2. In double inferior vena cava, CT at the level of the upper pole of kidney showed the left inferior vena cava traversing in front of the aorta and conjoining the left inferior vena cava, CT at the level of renal vein the left renal vein draining into the left inferior vena cava and CT at the lower level two round inferior vena cava with the aorta between them. It was a diagnostically useful finding that the left inferior vena cava was markedly stained in CT after contrast enhancement jestas the aorta and the right inferior vena cava. In retroaortic left renal vein, CT showed the left renal vein running behind the aorta and draining into the inferior vena cava. Preoperative information on congenital anomalies of the renal vein and inferior vena cava or tumor thrombus and its extension are very important particularly for radical surgery to be conducted safely without postoperative complications. Computed tomography is quite useful in evaluation of morbid state of the renal vein and inferior vena cava. (author)

1980-01-01

77

[Thrombosis of the superior vena cava revealing a protein S deficiency].  

UK PubMed Central (United Kingdom)

Thrombosis of the superior vena cava is attached to several causes including deficiency of the protein S. It occurs gradually by a superior vena cava syndrome. We report a patient aged 22 years, no toxic habits or bipolar aphthosis, which presented for 3 months a superior vena cava syndrome. The radiological and biological assessments confirmed thrombosis of the superior vena cava and a deficit of the protein S for which the patient was put under anticoagulant therapy with good clinical and radiological improvement. Through this observation, the authors report a rare cause of thrombosis of the superior vena cava which is the isolated protein S deficiency and provide a review of the literature.

Herrak L; Amangar N; El Ftouh M; El Fassy Fihry MT

2012-12-01

78

Estado de hidratación de pacientes en hemodiálisis: método clínico vs. método de la vena cava inferior Hydration state of hemodialysis patients: clinical method versus vena cava inferior method  

Directory of Open Access Journals (Sweden)

Full Text Available Antecedentes: La sobrehidratación crónica contribuye a la mortalidad cardiovascular en hemodiálisis. Objetivo: Dilucidar el dilema método clínico vs. método de la vena cava inferior en la definición del estado de hidratación de pacientes en hemodiálisis. Métodos: Se analizó la relación entre la diferencia relativa del diámetro de la vena cava inferior, en espiración prediálisis y posdiálisis, y los porcentajes de reducción del peso corporal, de la tensión arterial sistólica y diastólica. Se evaluó la sensibilidad y la especificidad del método clínico según método de la vena cava inferior. Resultados: El diámetro de vena cava inferior en espiración disminuyó con la remoción del agua corporal. La sensibilidad del método clínico, según método de vena cava inferior, fue de 57,1 para un IC al 95 % entre 46,0 y 68,3; y una especificidad de 86,1 para un IC al 95 % entre 78,0 y 94,0. Conclusiones: El método clínico es, según el método de la vena cava inferior, más específico que sensible.Backgrounds: The overhydration chronic is a cardiovascular mortality in hemodialysis. Objective: To elucidate the dilemma related to the clinical method versus the vena cava inferior method to define the hydration state in hemodialysis patient. Methods: The relation between the relative difference in the vena cava inferior diameter in predialysis and postdialysis exhalation and the percentages of body weight reduction, of the systolic and diastolic blood pressure. The sensitivity and specificity of clinical method was assessed according to the vena cava inferior method. Results: The vena cava inferior method decreased with reduction on body fluid. The clinical method sensitivity according to vena cava inferior method was of 57.1 for a 95 % CI between 46.0 and 68.3 and a specificity of 86.1 for a 95 % CI between 78.0 and 94.0. Conclusions: The clinical method is according the vena cava inferior method one more specific than sensitive.

Julia Janet Rojas Estrada; Amaury Lorenzo Clemente; Guillermo Guerra Bustillo; Xiomara Castelo Villalón; Natacha Berland de León; Humberto Martínez Canalejo

2010-01-01

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Use of a jugular vein autograft for reconstruction of the cranial vena cava in a dog with invasive thymoma and cranial vena cava syndrome.  

UK PubMed Central (United Kingdom)

A spayed female dog was evaluated because of edema of the ventral cervical region, lethargy, cough, and reduced exercise tolerance. Invasive thymoma and cranial vena cava syndrome were diagnosed by use of ultrasound-guided fine-needle biopsy and contrast-enhanced helical computed tomography. Resection of the cranial vena cava and an autogenous jugular vein graft were used for restoration of normal venous return to the right atrium and alleviation of the cranial vena cava syndrome.

Holsworth IG; Kyles AE; Bailiff NL; Hopper K; Long C; Ilkiw JE

2004-10-01

80

Congenital anomalies of the venae cavae: embryological origin, imaging features and report of three new variants  

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Due to the complexity of their developmental stages, the venae cavae may undergo a very large number of congenital anomalies. All the possible abnormalities which, to our knowledge, have been observed in the literature are reported, differentiating those of the superior vena cava and the azygos system, those of the inferior vena cava and the complex anomalies that concern the venous system as a whole. Moreover, we present three new variants: a right double inferior vena cava with azygos continuation of the posterior-medial vein; an agenesis of the superior vena cava with drainage through the azygos and hemiazygos veins to the inferior vena cava; and a double inferior vena cava with hemiazygos and azygos continuation of the left one. (orig.)

Minniti, S.; Visentini, S.; Procacci, C. [Department of Radiology, University of Verona, Policlinico ' ' GB Rossi' ' , Piazzale LA Scuro, 37134 Verona (Italy)

2002-08-01

 
 
 
 
81

[Resection of leiomyosarcoma of the inferior vena cava].  

UK PubMed Central (United Kingdom)

Experience in treatment of leiomyosarcoma of the retrohepatic segment of the inferior vena cava at any separately taken clinic is scarce. Given a rare nature of the pathology involved, whose diagnosis and management require joint participation of various-specialty physicians, we have considered it wise to present our own clinical case report.

Zotov SP; Pyshkin SA; Malyshev MIu; Safuanov AKh; Borovikov DA; Siniukov DM; Tereshin OS; Panov IO

2013-01-01

82

[Resection of leiomyosarcoma of the inferior vena cava].  

Science.gov (United States)

Experience in treatment of leiomyosarcoma of the retrohepatic segment of the inferior vena cava at any separately taken clinic is scarce. Given a rare nature of the pathology involved, whose diagnosis and management require joint participation of various-specialty physicians, we have considered it wise to present our own clinical case report. PMID:23531676

Zotov, S P; Pyshkin, S A; Malyshev, M Iu; Safuanov, A Kh; Borovikov, D A; Siniukov, D M; Tereshin, O S; Panov, I O

2013-01-01

83

Inferior vena cava obstruction presenting as an abdominal  

International Nuclear Information System (INIS)

Obstruction of the inferior vena cava (IVA) was observed as an abdominal mass on the plain radiograph in an asymptomatic patient. The obstruction had developed immediately below the renal veins, and markedly dilated varices were present. The appearance differed from that of the usual congenital caval variants and may have been the result of caval thrombosis in utero

1983-01-01

84

Inferior vena cava obstruction presenting as an abdominal mass.  

UK PubMed Central (United Kingdom)

Obstruction of the inferior vena cava (IVC) was observed as an abdominal mass on the plain radiograph in an asymptomatic patient. The obstruction had developed immediately below the renal veins, and markedly dilated varices were present. The appearance differed from that of the usual congenital caval variants and may have been the result of caval thrombosis in utero.

Voegeli DR; Lieberman RP; Yandow DR

1983-10-01

85

Injuries of the retrohepatic inferior vena cava and the liver  

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Full Text Available Beckground. Injuries of the retrohepatic inferior vena cava, and the liver have mortality rate up to 71-78%. We presented a patient with combined injury of the retrohepatic inferior vena cava, liver, craniocerebral and thoracic traumas, inflicted in a traffic accident. Case report. Man, 20 years old has been injured in a traffic accident. At admission, 20 minutes after the injury, the patient was comatose and hypotensive. Bloody content was obtained by abdominal tracer. The patient underwent emergent laparotomy, utilizing trifurcated incision and cell saver device. Abdominal exploration revealed two liters of free blood and massive retroperitoneal hematoma. Manual compression of the liver was done, as well as perihepatic packing, complete hepatic vascular exclusion and mobilization of the right liver lobe. Due to impressive chemodynamic instability supraceliac aortic clamping was performed. Upon exposure of the retrohepatic inferior vena cava and right liver lobe, multiple lacerations of retrohepatic inferior vena cava and right hepatic vein, and right hepatic vein avulsion were found. We also identified an injury of VII and VIII segments of the liver (grade V according to the Moore's classification). Nonexpansive hepatoduodenal ligament hematoma and the injury of II and III segments of the liver group II/III according to Moore were found. Venorrhaphy of the inferior vena cava was done in the area of circumference of the right hepatic vein, a portion of which served as autologous vein patch. Continuous prolene 3/0 venorrhaphy of the distal caval laceration was done. Total caval and aorta clamping time of the inferior vena cava was 41 minutes. Atypical resection, debridment, of hepatic segments was done by using a harmonic scalpel. Hepatoduodenal ligament was declamped after 65 minutes. Fibrin glue was applied on the resectioned area of liver. The patient received 3.2 l of autologuos blood transfusion with 5 units of packed red blood cells, 6 units of fresh frozen plasma, 13 units of concentrated thrombocytes and 15 units of cryoprecipitates. Due to coagulopathy, factor rVIIa was administered. Bilateral toracal drainage was done. Small bilateral contusions of the frontal part of the brain were noticed but the patient successfully recovered and was dismissed after three weeks. Conclusion. Combined injuries of the inferior vena cava and the liver befall into the most complex vascular traumas, thus representing a challenge for any complete medical team to manage them. The patient presented in our study was urgently transported to the hospital, immediately operated on applying modern doctrines of anesthesiology, transfusiology and vascular surgery that, all together, resulted into favorable treatment outcome with no distant complications.

Koprivica Radenko; Cvijovi? Radiša; Koprivica Ranka; Smiljani? Radmila

2008-01-01

86

Retrieval of Cement Embolus from Inferior Vena Cava After Percutaneous Vertebroplasty  

International Nuclear Information System (INIS)

Percutaneous vertebroplasty is an accepted treatment for painful vertebral compression fractures caused by osteoporosis and malignant disease. Venous leakage of cement and pulmonary cement embolism have been reported complications. We describe a paravertebral venous cement leak resulting in the deposition of a cement cast in the inferior vena cava and successful retrieval of the cement embolus.

2009-01-01

87

Treatment of malignant obstruction of the superior vena cava with the self-expanding Wallstent.  

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BACKGROUND--Obstruction of the superior vena cava (SVC) in malignant disease can cause considerable distress to patients. Symptomatic relief can be achieved by the percutaneous implantation of a self-expanding stent (Wallstent) into the stenosis. METHODS--Fourteen patients with obstruction of the SV...

Stock, K W; Jacob, A L; Proske, M; Bolliger, C T; Rochlitz, C; Steinbrich, W

88

Manejo exitoso con stent en un prematuro con síndrome de vena cava superior: Reporte de caso/ Successful management with stent in a premature infant with superior vena cava syndrome: A case report  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish El síndrome de vena cava superior en la infancia es una complicación inusual al uso de catéter venoso central en la unidad de cuidados intensivos neonatales. Otras causas en niños son la cirugía para enfermedades congénitas del corazón la cual ocupa la mayoría de los casos, y los linfomas, que constituyen la segunda causa más frecuente de obstrucción. Se describe el caso de un recién nacido prematuro de 25 semanas, con síndrome de vena cava superior secundario (more) al uso de catéter venoso central para manejo de sepsis. Se destaca la importancia de un diagnóstico y tratamiento precoz. Así mismo, se reporta el manejo exitoso con stent para el síndrome de vena cava superior. Abstract in english Superior vena cava syndrome in infancy is an unusual complication of the use of central venous catheters in neonatal intensive care unit. Other causes of this syndrome in children are surgery for congenital heart disease which accounts for most of the cases, and lymphomas, that constitute the second most common cause of obstruction. We describe the case of a premature infant born at 25 weeks with superior vena cava syndrome secondary to a central venous catheter for manag (more) ement of sepsis. The importance of early diagnosis and treatment is highlighted. We also report the successful management with stenting for superior vena cava syndrome.

Gómez, Jhon J; Vallejo, Ernesto; Palma, María A; Rojas, Juan P

2012-08-01

89

Excision of a Permanent Inferior Vena Cava Filter with Multiple Vena Caval Perforations.  

UK PubMed Central (United Kingdom)

Perforation of an inferior vena cava filter by one the filter device hooks is a recognized possible complication of this device. We describe a case of surgical excision of a permanent inferior vena cava filter associated with multiple perforations of surrounding structures by each of the 6 hooks of the device. Structures affected include the third lumbar vertebral body, transverse mesocolon, the infrarenal aorta, the duodenum, and the psoas muscle. A thorough understanding of the filter design and adequate preoperative imaging were vital in planning the safe surgical excision of this device.

Georg Y; Khalife T; Alomran F; Gaudric J; Chiche L; Koskas F

2013-09-01

90

MARCADORES SONOGRAFICOS DE CARDIOPATIAS CONGENITAS: PERSISTENCIA DE LA VENA CAVA SUPERIOR IZQUIERDA: NUESTRA EXPERIENCIA  

Directory of Open Access Journals (Sweden)

Full Text Available Consideramos marcadores de cardiopatías congénitas al grupo de lesiones que, pudiendo ser variantes normales, se asocian a defectos cardíacos. En esta segunda publicación destacamos la importancia del diagnóstico de la persistencia de la vena cava superior izquierda y su drenaje hacia el seno coronario, como un marcador de cardiopatías congénitas. En nuestra serie de cardiopatías congénitas (Cc), hemos diagnosticado 5 persistencias de la vena cava superior izquierda, 4 de ellas drenando hacia el seno coronario; 2 fueron anomalías aisladas, correspondiendo a variantes anatómicas. En otros 2 casos, los fetos eran portadores de cardiopatías congénitas mayores, uno de ellos actualmente vivo después de corrección quirúrgica y el restante fallecido. El quinto caso era un feto portador de anomalías múltiples, sospechándose una cromosomopatía, la que fue confirmada postparto como una trisomía 13. Reportamos los hallazgos in útero, el resultado postnatal de estos casos, la técnica más apropiada para su pesquisa y su asociación a CcWe consider markers of congenital heart disease a group of anomalies which could be a normal variant in general population but might be associated to structural defects of the fetal heart. One of those markers is the persistence of the left superior vena cava and his drainage to the coronary sinus. Among 5 persistence of the left superior vena cava diagnosed in our series, we found 2 associated with major congenital heart disease and another one with abnormal karyotype (trisomy 13). 2 other fetus were diagnosed as an isolated lesion. We discuss in utero abnormalities and fllow-up. We considered that the diagnosis of persistence of the left superior vena cava is a tool for the in utero detection of congenital heart disease

Fernando Viñals L.; Arrigos Giuliano B.

2002-01-01

91

Vena cava filter practices of a regional vascular surgery society.  

UK PubMed Central (United Kingdom)

BACKGROUND: Vena cava filter (VCF) use in the United States has increased dramatically with prophylactic indications for placement and the availability of low-profile retrievable devices, which are overtaking the filter market. We surveyed the practice patterns of a large group of vascular surgeons from a regional vascular surgery society to see whether they mirrored current national trends. METHODS: A 17-question online VCF survey was offered to all members of the Southern Association of Vascular Surgery. The responses were analyzed using the ?(2) goodness of fit tests. RESULTS: Of the 276 members surveyed, 126 (46%) responded, with 118 (93%) indicating that they placed filters during their practice. Highly significant differences were identified with each question (at least P < 0.002). Regarding the inferior vena cava, the preferred permanent filters were the Greenfield (31%), the TrapEase (15%), the Vena Tech (5%), and a variety of retrievable devices (49%). Fifty percent of the respondents placed retrievable filters selectively; 26% always placed them; and 24% never did. Filters were placed for prophylactic indications <50% of the time by 63% of the respondents. Overall, retrievable filters (when not used as permanent filters) were removed <25% of the time by 64% of the respondents and <50% of the time by 78% of the respondents. The femoral vein was the preferred access site for 84% of the respondents. Major complications were few but included filter migration to the atrium (one), atrial perforation (one), abdominal pain requiring surgical filter removal (two), inferior vena cava thrombosis (12 vena cava thrombosis--4 due to TrapEase filters), strut fracture with embolization to heart or lungs (three Bard retrievable filters), and severe tilting precluding percutaneous retrieval and protection from pulmonary emboli (8 filters with severe tilt--7 of which were Bard). Of the respondents, 59% had never placed a superior vena cava filter, and 28% had placed five or fewer. CONCLUSIONS: Although VCF insertion overall appears safe, some complications are specific to biconical and certain retrievable filters. Given the low removal rate and lack of long-term experience with retrievable filters, routine use of these devices as permanent filters should be questioned. If used on a temporary basis, there should be a plan for filter removal at the time of implantation.

Friedell ML; Nelson PR; Cheatham ML

2012-07-01

92

[Surgical treatment of leiomyosarcoma of the inferior vena cava].  

UK PubMed Central (United Kingdom)

The presented review of the literature is generalization of the currently existing data of foreign and Russian literature concerning treatment of a rare non-organic retroperitoneal tumour from smooth-muscle tissue, i. e., leiomyosarcoma of the inferior vena cava. The authors also formulate and lay down the basic principles of surgical interventions depending on the scope and level of the lesion, as well statistical analysis of the outcomes of surgical management of the this severely ill patient cohort.

Zotov SP; Panov IO; Tereshin OS; Vazhenin AV

2012-01-01

93

[Surgical treatment of leiomyosarcoma of the inferior vena cava].  

Science.gov (United States)

The presented review of the literature is generalization of the currently existing data of foreign and Russian literature concerning treatment of a rare non-organic retroperitoneal tumour from smooth-muscle tissue, i. e., leiomyosarcoma of the inferior vena cava. The authors also formulate and lay down the basic principles of surgical interventions depending on the scope and level of the lesion, as well statistical analysis of the outcomes of surgical management of the this severely ill patient cohort. PMID:23383429

Zotov, S P; Panov, I O; Tereshin, O S; Vazhenin, A V

2012-01-01

94

Síndrome de vena cava superior: Una emergencia oncológica en niños con linfoma. Revisión de 5 casos Superior Vena Cava Syndrome: an oncologic emergency in children with lymphoma  

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Full Text Available Introducción: Un niño con cáncer puede presentar durante su enfermedad una emergencia, ya sea como manifestación inicial, en la fase de diagnóstico, durante la evolución o en el periodo terminal. Objetivo: Presentar nuestra experiencia en el manejo del síndrome de Vena Cava Superior en niños con linfoma. Pacientes y Método: Revisión retrospectiva de 44 fichas clínicas de menores de 15 años con linfoma tratados entre enero de 1989 y diciembre de 1999 en la Unidad de Hematología/Oncología Infantil del Hospital Clínico Regional de Valdivia. Resultados: 5 casos presentaron síndrome de Vena Cava Superior: Linfoma de Hodgkin 2. Linfoma no Hodgkin 3. El síndrome de Vena Cava Superior fue la manifestación inicial en 4. En la emergencia todos los pacientes recibieron corticoides y radioterapia. Tres pacientes se encuentran vivos y en remisión completa. Conclusiones: El síndrome de Vena Cava Superior, es poco frecuente en niños con patología tumoral, sin embargo, por constituir una emergencia médica requiere tratamiento inmediato, necesitándose claras pautas de manejoIntroduction: A child with cancer may have an oncologic emergency during one of the following situations: A) Primary manifestation of the disease. B) Diagnostic phase. C) During clinical evolution of the disease. D) Terminal stage. Objective: To review our experience in the management of patients with lymphoma presenting with Superior Vena Cava Syndrome (SVCS). Method: Retrospective analysis of clinical data of 44 patients younger than 15 years-old affected with lymphoma and treated at the Hemathology/Oncology Unit of the Clinical Hospital from Valdivia, between 1989 and 1999. Results: 5 patients presented SVCS; 2 of them had Hodgkin lymphoma and 3 had no-Hodgkin lymphoma. The SVCS was the first clinical manifestation in 4 of them. During the emergency, all patients were treated with steroids and radiotherapy, observing 3 of them still alive and free of disease. Conclusions: The SVCS is a rare complication in pediatric tumoral disease. It constitutes an oncologic emergency that we ought to know in terms of diagnosis and treatment

Miriam Davis G.; Paola Zolezzi R.; Nilda Zumelzu D.

2005-01-01

95

Síndrome de vena cava superior: Una emergencia oncológica en niños con linfoma. Revisión de 5 casos/ Superior Vena Cava Syndrome: an oncologic emergency in children with lymphoma  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Introducción: Un niño con cáncer puede presentar durante su enfermedad una emergencia, ya sea como manifestación inicial, en la fase de diagnóstico, durante la evolución o en el periodo terminal. Objetivo: Presentar nuestra experiencia en el manejo del síndrome de Vena Cava Superior en niños con linfoma. Pacientes y Método: Revisión retrospectiva de 44 fichas clínicas de menores de 15 años con linfoma tratados entre enero de 1989 y diciembre de 1999 en la Unid (more) ad de Hematología/Oncología Infantil del Hospital Clínico Regional de Valdivia. Resultados: 5 casos presentaron síndrome de Vena Cava Superior: Linfoma de Hodgkin 2. Linfoma no Hodgkin 3. El síndrome de Vena Cava Superior fue la manifestación inicial en 4. En la emergencia todos los pacientes recibieron corticoides y radioterapia. Tres pacientes se encuentran vivos y en remisión completa. Conclusiones: El síndrome de Vena Cava Superior, es poco frecuente en niños con patología tumoral, sin embargo, por constituir una emergencia médica requiere tratamiento inmediato, necesitándose claras pautas de manejo Abstract in english Introduction: A child with cancer may have an oncologic emergency during one of the following situations: A) Primary manifestation of the disease. B) Diagnostic phase. C) During clinical evolution of the disease. D) Terminal stage. Objective: To review our experience in the management of patients with lymphoma presenting with Superior Vena Cava Syndrome (SVCS). Method: Retrospective analysis of clinical data of 44 patients younger than 15 years-old affected with lymphoma (more) and treated at the Hemathology/Oncology Unit of the Clinical Hospital from Valdivia, between 1989 and 1999. Results: 5 patients presented SVCS; 2 of them had Hodgkin lymphoma and 3 had no-Hodgkin lymphoma. The SVCS was the first clinical manifestation in 4 of them. During the emergency, all patients were treated with steroids and radiotherapy, observing 3 of them still alive and free of disease. Conclusions: The SVCS is a rare complication in pediatric tumoral disease. It constitutes an oncologic emergency that we ought to know in terms of diagnosis and treatment

Davis G., Miriam; Zolezzi R., Paola; Zumelzu D., Nilda

2005-10-01

96

Aspirin improves the patency rate of seeded vena cava grafts.  

UK PubMed Central (United Kingdom)

The purpose of this study was to evaluate the effectiveness of aspirin (ASA) and porcine endothelial cell seeding in improving the patency rate of vena cava grafts. Thirty-nine dogs underwent infrarenal vena cava replacement by 10 cm lengths of 8 mm I.D. ringed polytetrafluoroethylene grafts. Thirty-one grafts were seeded with 1-1.5 x 10(6) porcine aortic endothelial cells while eight were not (GIII). Of the seeded group, 16 animals received no ASA (GI), while 15 others (GII) were given ASA (325 mg) daily starting two days preoperatively and continuing until sacrifice. Venograms were performed on the fourth postoperative day. Grafts were harvested 32 days after insertion and evaluated for patency rate and endothelialized surfaces. The 32-day patency rate was significantly higher for GII than for GI and III animals (67% vs. 13 and 25% respectively). Endothelialized surface was higher in GII than Gi and III (67% vs. 16% and 18% respectively). We conclude that endothelial cell seeding alone does not prevent graft closure and that a combination of ASA and cell seeding significantly increases the patency rate of vena cava grafts.

Vo NM; Arbogast LY; Friedlander E; Stanton PE; Arbogast B

1989-11-01

97

Aspirin improves the patency rate of seeded vena cava grafts.  

Science.gov (United States)

The purpose of this study was to evaluate the effectiveness of aspirin (ASA) and porcine endothelial cell seeding in improving the patency rate of vena cava grafts. Thirty-nine dogs underwent infrarenal vena cava replacement by 10 cm lengths of 8 mm I.D. ringed polytetrafluoroethylene grafts. Thirty-one grafts were seeded with 1-1.5 x 10(6) porcine aortic endothelial cells while eight were not (GIII). Of the seeded group, 16 animals received no ASA (GI), while 15 others (GII) were given ASA (325 mg) daily starting two days preoperatively and continuing until sacrifice. Venograms were performed on the fourth postoperative day. Grafts were harvested 32 days after insertion and evaluated for patency rate and endothelialized surfaces. The 32-day patency rate was significantly higher for GII than for GI and III animals (67% vs. 13 and 25% respectively). Endothelialized surface was higher in GII than Gi and III (67% vs. 16% and 18% respectively). We conclude that endothelial cell seeding alone does not prevent graft closure and that a combination of ASA and cell seeding significantly increases the patency rate of vena cava grafts. PMID:2600123

Vo, N M; Arbogast, L Y; Friedlander, E; Stanton, P E; Arbogast, B

98

[Inflammatory pseudotumor of the superior vena cava: rare etiology of mediastinal tumor  

UK PubMed Central (United Kingdom)

The patient reported here had no particular past history. He presented with effort dyspnea, jugular turgescence and positional vertigo suggestive of a superior vena cava obstruction syndrome. Bronchial fibroscopy was normal, but chest X-ray, CT scan and phlebography of the superior vena cava revealed an anterior mediastinal tumour compressing the superior vena cava. The tumour was excised with replacement of the vena cava by a PTFE n. 16 graft. Pathological examination showed this to be an inflammatory tumour by fibrosis with plasmocytes. This plasmocyte fibrosis is histologically benign and becomes malignant only when complications occur as a result of its spread.

Brachet A; Thévenet F; Gilly FN; Trillet-Lenoir V; Tabib AZ; Brune J; Loire R; Gamondes JP

1993-01-01

99

[Agenesis of the right superior vena cava associated with total heart block].  

UK PubMed Central (United Kingdom)

The superior left vena cava with the absent superior vena cava is a rare abnormality, especially when associated with total heart block. We report a case of a patient in which the presence of superior left vena cava and the absence of the superior vena cava was detected during the implantation of a pacemaker for the correction of a total heart block, which led us to use a different technique for the fixation of the ventricular electrode. To confirm the supposed absence, several image exams were made showing the difficulty on the diagnosis of the described syndrome.

Couto GJ; Saraiva RS; Deslandes Ade O; Santos PC

2008-01-01

100

Performing a myocardial biopsy in a cardiac transplant patient with a persistent left superior vena cava.  

UK PubMed Central (United Kingdom)

The life expectancy of patients with congenital heart disease is increasing. Thus, as the prevalence of adults with congenital heart disease increases, invasive cardiologists will have more exposure to these patients and will benefit from expertise in the anatomy of congenital heart defects. We present a case of performing right heart catheterization and myocardial biopsy in a cardiac transplant patient with a history of multiple congenital defects including a persistent left superior vena cava.

Rogers K; Bader F; Gilbert E

2009-08-01

 
 
 
 
101

Performing a myocardial biopsy in a cardiac transplant patient with a persistent left superior vena cava.  

Science.gov (United States)

The life expectancy of patients with congenital heart disease is increasing. Thus, as the prevalence of adults with congenital heart disease increases, invasive cardiologists will have more exposure to these patients and will benefit from expertise in the anatomy of congenital heart defects. We present a case of performing right heart catheterization and myocardial biopsy in a cardiac transplant patient with a history of multiple congenital defects including a persistent left superior vena cava. PMID:19199364

Rogers, Kevin; Bader, Feras; Gilbert, Edward

2009-08-01

102

Manifestaciones oculares como presentación de un síndrome de vena cava superior/ Severe ocular symptoms as an initial manifestation of superior vena cava syndrome  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish El síndrome de vena cava superior es una complicación grave de una amplia variedad de procesos (el más frecuente es el cáncer de pulmón) que obstruyen el flujo de la vena cava superior y provocan la aparición de manifestaciones clínicas características, por el aumento de presión en el territorio venoso de la cabeza, los miembros superiores y la parte superior del tórax. Dentro de estas manifestaciones las referidas al ojo son poco frecuentes, y cuando aparecen r (more) aramente son el síntoma de presentación y tienen la expresividad del caso de este varón fumador al que diagnosticamos un síndrome de vena cava superior tras consultar por acusada sintomatología ocular. Abstract in english Superior vena cava syndrome is obstruction of blood flow through the superior vena cava (SVC). It is most commonly caused by neoplasm, especially lung cancer. An obstructed SVC initiates collateral venous return to the heart from the upper half of the body and the classic symptoms and signs become obvious. Superior vena cava síndrome is a rare cause of ocular manifestations. We report a case of periorbital swelling, conjunctival edema an orbital proptosis in a male patient presenting malignant superior vena cava obstruction.

Barquero-Romero, J.; López Cupido, V.; Torrado Sierra, O.; Valencia Terrón, M.

2008-07-01

103

Compression of the inferior vena cava in bowel obstruction.  

Science.gov (United States)

Introduction. We investigated whether (a) the inferior vena cava (IVC) is compressed in bowel obstruction and (b) some tracts are more compressed than others. Methods. Two groups of abdominal computed tomography (CT) examinations were collected retrospectively. Group O (N = 69) scans were positive for bowel obstruction, group C (N = 50) scans were negative for diseases. IVC anteroposterior and lateral diameters (APD, LAD) were assessed at seven levels. Results. In group C, IVC section had an elliptic shape (APD/LAD: .76 ± .14), the area of which increased gradually from 1.9 (confluence of the iliac veins) to 3.1?cm(2)/m(2) of BSA (confluence of the hepatic veins) with a significant narrowing in the hepatic section. In group O, bowel obstruction caused a compression of IVC (APD/LAD: .54 ± .17). Along its course, IVC section area increased from 1.3 to 2.5?cm(2)/m(2). At ROC curve analysis, an APD/LAD ratio lower than 0.63 above the confluence of the iliac veins discriminated between O and C groups with sensitivity of 74% and specificity of 96%. Conclusions. Bowel obstruction caused a compression of IVC, which involved its entire course except for the terminal section. APD/LAD ratio may be useful to monitor the degree of compression. PMID:24151603

Cina, Alessandro; Zamparelli, Roberto; Venturino, Sara; Gargaruti, Riccardo; Semeraro, Vittorio; Cavaliere, Franco

2013-09-14

104

Estado de hidratación de pacientes en hemodiálisis: método clínico vs. método de la vena cava inferior/ Hydration state of hemodialysis patients: clinical method versus vena cava inferior method  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Antecedentes: La sobrehidratación crónica contribuye a la mortalidad cardiovascular en hemodiálisis. Objetivo: Dilucidar el dilema método clínico vs. método de la vena cava inferior en la definición del estado de hidratación de pacientes en hemodiálisis. Métodos: Se analizó la relación entre la diferencia relativa del diámetro de la vena cava inferior, en espiración prediálisis y posdiálisis, y los porcentajes de reducción del peso corporal, de la tensió (more) n arterial sistólica y diastólica. Se evaluó la sensibilidad y la especificidad del método clínico según método de la vena cava inferior. Resultados: El diámetro de vena cava inferior en espiración disminuyó con la remoción del agua corporal. La sensibilidad del método clínico, según método de vena cava inferior, fue de 57,1 para un IC al 95 % entre 46,0 y 68,3; y una especificidad de 86,1 para un IC al 95 % entre 78,0 y 94,0. Conclusiones: El método clínico es, según el método de la vena cava inferior, más específico que sensible. Abstract in english Backgrounds: The overhydration chronic is a cardiovascular mortality in hemodialysis. Objective: To elucidate the dilemma related to the clinical method versus the vena cava inferior method to define the hydration state in hemodialysis patient. Methods: The relation between the relative difference in the vena cava inferior diameter in predialysis and postdialysis exhalation and the percentages of body weight reduction, of the systolic and diastolic blood pressure. The sen (more) sitivity and specificity of clinical method was assessed according to the vena cava inferior method. Results: The vena cava inferior method decreased with reduction on body fluid. The clinical method sensitivity according to vena cava inferior method was of 57.1 for a 95 % CI between 46.0 and 68.3 and a specificity of 86.1 for a 95 % CI between 78.0 and 94.0. Conclusions: The clinical method is according the vena cava inferior method one more specific than sensitive.

Rojas Estrada, Julia Janet; Lorenzo Clemente, Amaury; Guerra Bustillo, Guillermo; Castelo Villalón, Xiomara; Berland de León, Natacha; Martínez Canalejo, Humberto

2010-12-01

105

Chylothorax and chylopericardial tamponade in a hemodialysis patient with catheter-induced superior vena cava stenosis.  

Science.gov (United States)

Chylothorax and chylopericardium refer to the presence of milky, triglyceride-rich chylous fluid in the thoracic and pericardial spaces, respectively. Both conditions are extremely uncommon in end-stage renal disease patients on dialysis. We report the first known case of combined chylothorax and chylous pericardial tamponade in a dialysis patient associated with catheter-induced superior vena cava (SVC) stenosis. A successful outcome was achieved with drainage of both chylous effusions in combination with angioplasty of the SVC stenosis. PMID:19747178

Adekile, Ayoola; Adegoroye, Adeyinka; Tedla, Fasika; Levin, Daniel; Salifu, Moro O

2009-09-11

106

Chylothorax and chylopericardial tamponade in a hemodialysis patient with catheter-induced superior vena cava stenosis.  

UK PubMed Central (United Kingdom)

Chylothorax and chylopericardium refer to the presence of milky, triglyceride-rich chylous fluid in the thoracic and pericardial spaces, respectively. Both conditions are extremely uncommon in end-stage renal disease patients on dialysis. We report the first known case of combined chylothorax and chylous pericardial tamponade in a dialysis patient associated with catheter-induced superior vena cava (SVC) stenosis. A successful outcome was achieved with drainage of both chylous effusions in combination with angioplasty of the SVC stenosis.

Adekile A; Adegoroye A; Tedla F; Levin D; Salifu MO

2009-09-01

107

Leiomiossarcoma de veia cava inferior/ Leiomyosarcoma of the inferior vena cava  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english We present a case of a 56-year-old woman with abdominal pain, normal laboratorial exams, normal carcinoembryonary antigen (CEA) and abdominal tomography exam with tumor formation in hepatic region. A tumor lesion was identified in a surgery in the medial segment of the inferior vena cava. A surgical resection was done, respecting the security limits, and reconstruction of the inferior vein with polytetrafluoroethylene (PTFE) graft was performed. The histological examinati (more) on showed differentiated leiomyossarcoma of the inferior vena cava. This report points to the necessity of differential diagnoses with leiomyossarcoma in the presence of abdominal mass, supra-mesocolic, and non-specific abdominal symptoms, since its pre-surgical diagnoses occurs in only 5% to 10% of the cases.

Larangeira, Lino Luis Sanches; Nabut, Naja; Guembarovski, Alda L.

2006-04-01

108

Percutaneous translumbar inferior vena cava central line placement in a critically ill child  

Energy Technology Data Exchange (ETDEWEB)

In patients requiring long term central venous access, common venous access routes may become occluded. Surgical placement of central venous catheters may not always be possible or optimal. Percutaneous translumbar inferior vena cava central line placement offers an additional access route. The technique of translumbar inferior vena cava central venous access is described in a critically ill child.

Robards, J.B.; Jaques, P.F.; Mauro, M.A.; Azizkhan, R.G.

1989-01-01

109

[Perioperative management of two patients with renal malignant tumor involving the vena cava].  

Science.gov (United States)

Two patients underwent resection of renal malignant tumors involving vena cava. Such tumors occasionally extend to the inferior vena cava with tumor thrombus and invasion to the lymph nodes and adjacent organs. Perioperative management of patients with these tumors is difficult because of the risk of pulmonary embolism and massive bleeding, and requires appropriate cooperation among the surgical team. In case 1, a 56-year-old man, renal cell carcinoma with tumor thrombus had extended into the intrahepatic vena cava. It was resected after isolating the liver from vena cava and incising the cross-clamped inferior vena cava without extracorporeal circulation or blood transfusion. A prosthetic graft replaced the inferior vena cava. In case 2, a 64-year-old woman, renal pelvis cancer adhered to the inferior vena cava and the mesentery with enlarged lymph nodes. It was separated from the inferior vena cava and removed with the ascending colon. The patient received a blood transfusion of approximately 2,000ml. Cardiomyopathy associated with a left ventricular outflow tract pressure gradient of 100mmHg required perioperative management. After surgery, both patients underwent controlled ventilation in the intensive care unit. After recovery, they were discharged without complications. We discuss perioperative management, with regard to the level of the tumor extension and perioperative complications. PMID:23697205

Sato, Tsunehisa; Kikura, Mutsuhito; Kobori, Go; Goto, Shuhei; Yoshikawa, Takeshi; Moroi, Seiji; Koi, Shiro; Iwai, Akira; Inoue, Harutaka; Teratani, Naoki; Kaganoi, Junichi; Nakayama, Noboru; Takatoku, Kazuhiro; Nishio, Hiroomi; Aoki, Takayuki; Nishizawa, Junichiro; Kanda, Hiroshi; Shinoda, Eiji

2013-04-01

110

Use of transoesophageal echocardiography in endovascular stenting for superior vena cava syndrome.  

UK PubMed Central (United Kingdom)

Endovascular stenting is a recommended primary treatment for superior vena cava syndrome in patients with tumours. We describe a case where the vena cava stenosis was located 1 cm above the cavoatrial junction. In order to avoid malpositioning of the stent and its potential complications, such as arrhythmia or cardiac tamponade, transoesophageal echocardiography was used for guidance during the stent deployment.

Nasser F; Cavalcante RN; Galastri FL; Affonso BB

2013-01-01

111

Recurrent cerebral venous infarcts and superior vena cava obstruction: case report  

Energy Technology Data Exchange (ETDEWEB)

We report a patient with repeated venous infarcts in the occipital lobe and occlusion of the superior vena cava. The pathogenetic relationships between the superior vena cava occlusion and the brain infarcts are discussed. High pressure in the superior venous territory and incomplete patency of the transverse sinus are probably responsible for the venous infarcts. (orig.). With 4 figs.

Bozzao, A. [Department of Radiology, University of Rome ``Tor Vergata``, Rome (Italy)]|[Istituto di Radiologia, Ospedale S. Eugenio, Piazzale dell`Umanesimo 10 I-00144 Roma (Italy); Gallucci, M. [Department of Neuroradiology, University of L`Aquila, L`Aquila (Italy); Marsili, L. [Department of Neuroradiology, University of L`Aquila, L`Aquila (Italy); Cerone, G. [Department of Neurology, Collemaggio Hospital, L`Aquila (Italy)

1997-06-01

112

Forceps retrieval of a tip-embedded superior vena cava filter.  

UK PubMed Central (United Kingdom)

The use of rigid endobronchial forceps has been described for the percutaneous retrieval of tip-embedded retrievable inferior vena cava filters, especially when retrieval with the use of traditional devices has failed. The present report describes retrieval of a tip-embedded retrievable filter from the superior vena cava with the use of this technique.

Yan Y; Galfione M; William Stavropoulos S; Trerotola SO

2013-04-01

113

[Perioperative management of two patients with renal malignant tumor involving the vena cava].  

UK PubMed Central (United Kingdom)

Two patients underwent resection of renal malignant tumors involving vena cava. Such tumors occasionally extend to the inferior vena cava with tumor thrombus and invasion to the lymph nodes and adjacent organs. Perioperative management of patients with these tumors is difficult because of the risk of pulmonary embolism and massive bleeding, and requires appropriate cooperation among the surgical team. In case 1, a 56-year-old man, renal cell carcinoma with tumor thrombus had extended into the intrahepatic vena cava. It was resected after isolating the liver from vena cava and incising the cross-clamped inferior vena cava without extracorporeal circulation or blood transfusion. A prosthetic graft replaced the inferior vena cava. In case 2, a 64-year-old woman, renal pelvis cancer adhered to the inferior vena cava and the mesentery with enlarged lymph nodes. It was separated from the inferior vena cava and removed with the ascending colon. The patient received a blood transfusion of approximately 2,000ml. Cardiomyopathy associated with a left ventricular outflow tract pressure gradient of 100mmHg required perioperative management. After surgery, both patients underwent controlled ventilation in the intensive care unit. After recovery, they were discharged without complications. We discuss perioperative management, with regard to the level of the tumor extension and perioperative complications.

Sato T; Kikura M; Kobori G; Goto S; Yoshikawa T; Moroi S; Koi S; Iwai A; Inoue H; Teratani N; Kaganoi J; Nakayama N; Takatoku K; Nishio H; Aoki T; Nishizawa J; Kanda H; Shinoda E

2013-04-01

114

Recurrent cerebral venous infarcts and superior vena cava obstruction: case report  

International Nuclear Information System (INIS)

We report a patient with repeated venous infarcts in the occipital lobe and occlusion of the superior vena cava. The pathogenetic relationships between the superior vena cava occlusion and the brain infarcts are discussed. High pressure in the superior venous territory and incomplete patency of the transverse sinus are probably responsible for the venous infarcts. (orig.). With 4 figs.

1997-01-01

115

Use of transoesophageal echocardiography in endovascular stenting for superior vena cava syndrome.  

Science.gov (United States)

Endovascular stenting is a recommended primary treatment for superior vena cava syndrome in patients with tumours. We describe a case where the vena cava stenosis was located 1 cm above the cavoatrial junction. In order to avoid malpositioning of the stent and its potential complications, such as arrhythmia or cardiac tamponade, transoesophageal echocardiography was used for guidance during the stent deployment. PMID:23997077

Nasser, Felipe; Cavalcante, Rafael Noronha; Galastri, Francisco Leonardo; Affonso, Breno Boueri

2013-08-30

116

A case of coarctation of the aorta associated with the patent ductus arteriosus and the persistent left superior vena cava  

International Nuclear Information System (INIS)

This is a case report of multiple congenital vascular anomalies in which coarctation of the aorta combined with the patent ductus arteriosus and the persistent left superior vena cava. The patient was a 15 year old girl and congenital heart disease was suspected during infancy. However, she heard the disease incurable, so she had been well with herb medicine until admission in our hospital. By physical examination and roentgenological studies including aortography, the diagnosis of the patent ductus arteriosus was detected and the coarctation of the aorta was suspected. The persistent left superior vena cava was found during surgery and it was proved roentgenologically by venography.

1974-01-01

117

Roentgenologic diagnosis of pulmonary veins pathologically inflowing into vena cava inferior  

International Nuclear Information System (INIS)

The authors considered the problem of X-ray semiotics of the right inferior pulmonary vein pathologically inflowing in the vena cava inferior (4 patients) and the false syndrome of the ''Turkish sabre'' (1 patients). Among the patients there were 2 adults and 3 children. It was noted that the abnormal inflowing of the right lower lobe vein in the vena cava inferior was often combined with different types of heart diseases and defects of the major vessels, mainly with the defect of the interatrial septum, the open arterial canal and hypoplasia of the right pulmonary artery. Radiodiagnosis for this group of patients should incorporate, in addition to routine X-ray methods, angiographic investigation, and its volume in each case should be determined on an individual basis.

1986-01-01

118

An unusual cause of intraoperative acute superior vena cava syndrome.  

UK PubMed Central (United Kingdom)

Acute intraoperative superior vena cava (SVC) syndrome is an exceedingly rare complication in the cardiac surgical population. We describe the case of a 71-year-old female undergoing multi-vessel coronary artery bypass grafting who developed acute intraoperative SVC syndrome following internal thoracic artery harvest retractor placement. Her symptoms included severe plethora, facial engorgement and scleral edema, which was associated with hypotension and severe elevation of central venous pressure. Transesophageal echocardiography was crucial in the diagnosis, management, and optimal retractor placement ensuring adequate SVC flow. Potential causes of intraoperative SVC syndrome are reviewed as well as management options.

Amundson AW; Pulido JN; Hayward GL

2013-04-01

119

Decompression of superior vena cava during bidirectional Glenn shunt  

Directory of Open Access Journals (Sweden)

Full Text Available Patients undergoing bi-directional Glenn shunt for various congenital anomalies of the heart will have their superior vena cava (SVC) clamped during the procedure. The duration of the procedure is variable, ranging from five to 30 minutes. This can affect the cerebral perfusion due to raised venous pressure [Cerebral blood flow = Mean arterial pressure ? (Intracranial pressure + Central venous pressure)]. Shunting away the SVC blood is a well known technique to counter this problem, but we describe two cases where a novel technique was successfully used to decompress the SVC.

Kulkarni Venugopal; Mudunuri Ravikiran; Mulavisala Krishnaprasad; Byalal R

2009-01-01

120

Superior vena cava syndrome: do not miss the Ariadne's thread.  

UK PubMed Central (United Kingdom)

A central venous catheter tip located too high into the superior vena cava (SVC) is known to be a strong risk factor for central venous thrombosis and subsequent SVC syndrome. We report herein the usefulness of catheterizing the implanted port catheter lumen as a salvage procedure to circumvent a complete SVC occlusion in a breast cancer patient. Because the standard central vein catheterization attempt is often unsuccessful, the port catheter should always be considered as the Ariadne's thread and used as an attempt for catheterization.

El Hajjam M; Marcy PY; Lacout A; Thariat J; Lacombe P

2013-01-01

 
 
 
 
121

Síndroma da veia cava superior como apresentação de neoplasia/ Superior vena cava syndrome as tumour presentation  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese A síndroma da veia cava superior (SVCS) é causada por uma obstrução/compressão gradual e insidiosa da veia cava superior, caracterizando -se por fácies pletórica, edema e ingurgitamento vascular do pescoço e parte superior do tronco. É geralmente tradutora de neoplasia, sendo o cancro do pulmão a sua causa mais comum. Objectivo: Estudo retrospectivo dos internamentos no Hospital de S. João entre Janeiro de 1995 e Dezembro de 2006 por SVCS de etiologia a esclare (more) cer com a caracterização clínica dos doentes e a avaliação de factores de prognóstico. Material e métodos: Foram seleccionados 60 doentes que à data de admissão não tinham causa para SVCS. Foram avaliados, entre outros, idade, sexo, exposição e carga tabágica, etiologia do SVCS, tratamento e sobrevivência global. Resultados: Dos doentes estudados, 87% apresentavam cancro do pulmão, sendo o tipo histológico mais comum o carcinoma pulmonar de pequenas células (CPPC), com 41% dos casos. Em 10% dos doentes foi diagnosticado linfoma não Hodgkin. Em relação aos factores de prognóstico estudados, verificou-se que a ausência de metastização, o diagnóstico histológico de linfoma, o bom estado geral e a ausência de consumo tabágico se correlacionam positivamente de forma significativa com a sobrevivência. Contrariamente, o diagnóstico de CPPC apresentou igualmente de forma significativa uma menor sobrevivência. Conclusão: Nesta série de doentes com SVCS como apresentação da doença observou -se uma sobrevivência significativamente menor nos casos de CPPC, doentes fumadores (especialmente com ? 40 UMA), naqueles com mau estado geral, bem como nos que apresentavam uma maior progressão da doença, com presença de metastização. Abstract in english Superior vena cava syndrome (SVCS) is characterised by gradual and insidious compression/obstruction of the superior vena cava (SVC). Upper chest and neck ingurgitation, plethoric face and oedema are the common symptoms/signs. It generally means the presence of neoplasm, namely lung cancer. Aim: Retrospective analysis of the patients admitted to S. João Hospital, Porto, Portugal, January 1995-December 2006 with SVCS without previous diagnosis. Patients, tumour characteri (more) stics and prognostic factors were studied. Material and methods: Data was collected by consulting the clinical files of 60 SVCS patients without previous diagnosis. Data was gathered on the patients? demographic characteristics (age, gender, smoking habits), performance status, histology, staging, treatment and overall survival. Results: Lung cancer was observed in 87% of the patients. Small-cell lung cancer (SCLC) was the most frequent histological type; 41% of the patients. It is noticeable that 10% were diagnosed with non- Hodgkin?s lymphoma. In terms of prognostic factors analysed, the absence of metastasis, the lymphoma?s histological diagnosis, good performance status and non-smoker status were positively correlated with the survival rate. On the contrary SCLC was significantly correlated with a worse survival. Conclusions: In our analysis we concluded that SCLC, smokers and a poorer performance status as well as metastatic disease were unfavourable prognostic factors to SVCS as tumour presentation.

Pires, Nuno Filipe; Morais, António; Queiroga, Henrique

2010-01-01

122

Renal cell carcinoma with thrombus in the inferior vena cava: extracorporeal circulation and deep hypothermia without open-chest surgery  

Directory of Open Access Journals (Sweden)

Full Text Available INTRODUCTION: Renal cell carcinoma with thrombus in the inferior vena cava and no apparent metastasis requires immediate surgical treatment. Over the last few years, extracorporeal circulation with deep hypothermia and total circulatory arrest have played an increasingly important role in the treatment of diseases not associated with primary cardiovascular disorders, such as cavoatrial tumor thrombus in uterine tumors, adrenal tumors, Wilms' tumor, as well as renal cell carcinoma. CASE REPORT: A 78-year-old patient with renal cell carcinoma and tumoral thrombus in the inferior vena cava and above the supra-hepatic veins underwent right radical nephrectomy and removal of the thrombus from the vena cava with extracorporeal circulation and deep hypothermia with total circulatory arrest without opening the chest. The patient presented good post-operative evolution.

Carlos A. L. D'Ancona; Orlando Petrucci Jr; Rodrigo Otsuka

2005-01-01

123

Renal cell carcinoma with thrombus in the inferior vena cava: extracorporeal circulation and deep hypothermia without open-chest surgery.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Renal cell carcinoma with thrombus in the inferior vena cava and no apparent metastasis requires immediate surgical treatment. Over the last few years, extracorporeal circulation with deep hypothermia and total circulatory arrest have played an increasingly important role in the treatment of diseases not associated with primary cardiovascular disorders, such as cavoatrial tumor thrombus in uterine tumors, adrenal tumors, Wilms' tumor, as well as renal cell carcinoma. CASE REPORT: A 78-year-old patient with renal cell carcinoma and tumoral thrombus in the inferior vena cava and above the supra-hepatic veins underwent right radical nephrectomy and removal of the thrombus from the vena cava with extracorporeal circulation and deep hypothermia with total circulatory arrest without opening the chest. The patient presented good post-operative evolution.

D'Ancona CA; Petrucci O Jr; Otsuka R

2005-01-01

124

Continuing experience with liver resection and vena cava reconstruction using cardiopulmonary bypass and hypothermic circulatory arrest.  

UK PubMed Central (United Kingdom)

When the suprahepatic vena cava or the hepatic vein confluence with the inferior vena cava (IVC) is obscured by tumor or a clot in the IVC extends above the liver, cross-clamping the IVC during liver or retroperitoneal resection is hazardous. This report describes a 10-year experience with ten patients who had liver (seven) or retroperitoneal (three) resections with vena cava reconstruction using cardiopulmonary bypass and hypothermic circulatory arrest. There were no perioperative deaths. Morbidity consisted of prolonged bile leak (one), pulmonary embolism (one), and stroke (one). Control of the liver was secured in six of seven patients who had a liver resection. There were three significant advantages to this technique. First, the median sternotomy provided superior exposure to the suprahepatic IVC. Second, the bypass technique avoided the risks of hemodynamic instability and prevented air embolism and sudden uncontrolled hemorrhage incurred by resection or IVC cross-clamping. Third, hypothermia provided a method of protection for residual liver function especially in the face of chronic liver disease induced by infection or chemotherapy.

Sener SF; Winchester DJ; Votapka TV; McGuire MS; O'Connor B; Szokol JW

2002-04-01

125

Safety and Efficacy of the Gunther Tulip Retrievable Vena Cava Filter: Midterm Outcomes  

International Nuclear Information System (INIS)

PurposeTo evaluate of the medium-term integrity, efficacy, and complication rate associated with the Gunther Tulip vena cava filter.MethodsA retrospective study was performed of 369 consecutive patients who had infrarenal Gunther Tulip inferior vena cava filters placed over a 5-year period. The mean patient age was 61.8 years, and 59 % were men. Venous thromboembolic disease and a contraindication to or complication of anticoagulation were the indications for filter placement in 86 % of patients; 14 % were placed for prophylaxis in patients with a mean of 2.3 risk factors. Follow-up was obtained by review of medical and radiologic records.ResultsMean clinical follow-up was 780 days. New or recurrent pulmonary embolus occurred in 12 patients (3.3 %). New or recurrent deep-vein thrombosis occurred in 53 patients (14.4 %). There were no symptomatic fractures, migrations, or caval perforations. Imaging follow-up in 287 patients (77.8 %) at a mean of 731 days revealed a single (0.3 %) asymptomatic fracture, migration greater than 2 cm in 36 patients (12.5 %), and no case of embolization. Of 122 patients with CT scans, asymptomatic perforations were identified in 53 patients (43.4 %) at a mean 757 days.ConclusionThe Gunther Tulip filter was safe and effective at 2-year follow-up. Complication rates were similar to those reported for permanent inferior vena cava filters

2013-01-01

126

Percutaneous treatment of superior vena cava syndrome using metallic stents  

International Nuclear Information System (INIS)

The purpose of this study was to evaluate the results of treatment of superior vena cava syndrome (SVCS) in patients with benign and malignant disease using expandable metallic stent. From January 1995 to April 2000, 87 expandable stents were implanted in 82 patients (59 men, 23 women; mean age 57.8 years, age range 39-79 years) for the treatment of SVCS. The SVCS was defined as symptomatic bilateral obstruction of venous drainage from head, neck and upper extremities. In 68 patients SVCS was due to malignant neoplasia, and in 14 cases it was due to benign aetiology. All patients were treated with expandable stent. We implanted 81 Wallstent prostheses and 6 Palmaz stents. Adjuvant thrombolysis was applied in 12 patients who required fibrinolysis. After recanalization, the stent was implanted in all cases in SVC (infra- or supra-azygos vein). All patients were treated with heparin of low molecular weight (HBPM) during 6 months. Patency was analyzed according to clinical symptoms and Doppler US or venograms exploration. Technical success was observed in all cases. Clinical success was reached in 78 of 82 patients (95.1%) (absence of symptoms in 2 or 3 days). Four patients suffered immediate thrombosis which required fibrinolitic treatment with a new prosthesis placement in 1 case. The follow-up for the malignant process was of 7.1 months (range 1-39 months) and in benign cases was 31.2 months (range 11-61 months). Sixty-two (91.1%) patients with malignancy died without SVCS symptomatology. All the patients with benign pathology are alive. Clinical primary patency in malignant cases was 87% with assisted patency of 96.2%. Endovascular therapy using metallic stent and thrombolysis is a successful method to treat SVCS due to benign or malignant aetiology. (orig.)

2003-01-01

127

Percutaneous treatment of superior vena cava syndrome using metallic stents  

Energy Technology Data Exchange (ETDEWEB)

The purpose of this study was to evaluate the results of treatment of superior vena cava syndrome (SVCS) in patients with benign and malignant disease using expandable metallic stent. From January 1995 to April 2000, 87 expandable stents were implanted in 82 patients (59 men, 23 women; mean age 57.8 years, age range 39-79 years) for the treatment of SVCS. The SVCS was defined as symptomatic bilateral obstruction of venous drainage from head, neck and upper extremities. In 68 patients SVCS was due to malignant neoplasia, and in 14 cases it was due to benign aetiology. All patients were treated with expandable stent. We implanted 81 Wallstent prostheses and 6 Palmaz stents. Adjuvant thrombolysis was applied in 12 patients who required fibrinolysis. After recanalization, the stent was implanted in all cases in SVC (infra- or supra-azygos vein). All patients were treated with heparin of low molecular weight (HBPM) during 6 months. Patency was analyzed according to clinical symptoms and Doppler US or venograms exploration. Technical success was observed in all cases. Clinical success was reached in 78 of 82 patients (95.1%) (absence of symptoms in 2 or 3 days). Four patients suffered immediate thrombosis which required fibrinolitic treatment with a new prosthesis placement in 1 case. The follow-up for the malignant process was of 7.1 months (range 1-39 months) and in benign cases was 31.2 months (range 11-61 months). Sixty-two (91.1%) patients with malignancy died without SVCS symptomatology. All the patients with benign pathology are alive. Clinical primary patency in malignant cases was 87% with assisted patency of 96.2%. Endovascular therapy using metallic stent and thrombolysis is a successful method to treat SVCS due to benign or malignant aetiology. (orig.)

De Gregorio Ariza, Miguel Angel; Gimeno, Maria Jose; Alfonso, Eduardo; Mainar, Antonio; Medrano, Joaquin; Lopez-Marin, Paloma [Department of Interventional Radiology, ' ' Lozano Blesa' ' University Hospital, Avda. San Juan Bosco 15, 50009 Zaragoza (Spain); Gamboa, Pablo [Division of Interventional Radiology, Ohio State University Hospital, Columbus, Ohio (United States); Tobio, Ricardo [Interventional Radiology, Clinica de la Zarzuela, Madrid (Spain); Herrera, Marcos [Division of Interventional Radiology, University of Minnesota, Minneapolis, Minnesota (United States)

2003-04-01

128

Pregnancy complicated by superior vena cava thrombosis and pulmonary embolism in a patient with Behcet disease and the use of heparin for treatment  

International Nuclear Information System (INIS)

Batch disease is a multi systemic vasculitis of unknown origin. Vascular involvement has been considered to result from systemic vasculitis, occurs in 5-10% of these patients. We report a 34-year-old pregnant woman complicated by superior vena ca va thrombosis, and pulmonary embolism in a patient with Batch disease. (author)

2006-01-01

129

Retrocaval ureter and anomalies of inferior vena cava  

International Nuclear Information System (INIS)

[en] We report two cases of retrocaval ureter: one with the usual hook-shaped pattern of the course of ureter (Type 1 according to Kenawi and Williams) and the other with the ureter medially displaced in a large curving fashion without kinking or obstruction. (Type 2). The second case was diagnosed on CT without resorting to any invasive procedure. It can be classified as Type 2 of Kenawi and Williams because of the absence of obstruction and kinking of ureter. The first case is associated with a complicated anomaly of inferior vena cava previously not reported which shows the duplication of infrarenal segment of cava with azygos continuation via the right persistent supracardinal vein. This anomaly is also complicated by the persistent posterior cardinal vein which is continuous with the normal prerenal segment of cava after receiving the right renal vein. This persistent posterior cardinal vein is the cause of retrocaval ureter in this case. It is also stressed that the knowledge of various caval anomalies is important in the interpretation of CT. (author)

1980-01-01

130

Clinical results with a detachable temporary vena cava filter; Erfahrungen mit einem abwerfbaren temporaeren Vena cava Filter  

Energy Technology Data Exchange (ETDEWEB)

Purpose: Evaluation of the feasibility of implantation and explantation and evaluation of the efficacy of a detachable and retrievable temporary vena cava filter. Materials and Method: The temporary vena cava filter ''OptEase'' (Cordis) is a nitinol filter derived from the ''TrapEase'' (Cordis) permanent filter, which is implantable transjugularly or transfemorally. In contrast to other temporary filters, this type can be detached and is not fixed on a catheter during implantation. Therefore, it is usable as a temporary as well as a permanent filter which can be retrieved up to 12 days after detachment with a special catheter using the loop technique. The ''OptEase'' filter was implanted in 11 patients ranging in age from 19 to 82 (mean age 30 years). In 10 patients the filter was transfemorally implanted and explanted. In 1 patient implantation was performed transjugularly prior to surgery and explantation was performed transfemorally after surgery. All patients had a deep vein thrombosis or iliac vein thrombosis. In 3 patients the filter was implanted prior to surgery. In 2 patients pulmonary embolism was identified. In 5 patients the filter was implanted prophylactically because of deep vein thrombosis according to interdisciplinary diagnosis. Results: No pulmonary embolism occurred during implantation. All filters were able to be retrieved without complications using the loop technique on the 6th, 8th, 12th and 13th day. No captured thrombus material was in the filter. (orig.)

Adamus, R.; Bolte, R.; Loose, R. [Klinikum Nuernberg Nord (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie

2007-06-15

131

[Investigation of 14 renal cell carcinoma cases with tumor thrombus in the inferior vena cava].  

UK PubMed Central (United Kingdom)

Renal cell carcinoma tends to progress into the renal vein and inferior vena cava. We investigated 14 cases of renal cell carcinoma with tumor thrombus in the inferior vena cava. Surgery was performed in nine cases and mean survival was 53 months. Two cases are alive 8 years after the operation without recurrence or metastasis. The mean survival of 5 cases without operation was 7 months. Surgical management should be considered as a benefit for RCC patients with tumor thrombus in the inferior vena cava.

Tajiri T; Noguchi K; Kishida T; Uemura H; Saito K; Yao M; Takeda M; Kubota Y

2003-08-01

132

Implantation of a Resynchronization Implantable Cardioverter Defibrillator in a Patient with Persistent Left Superior Vena Cava  

Directory of Open Access Journals (Sweden)

Full Text Available Implantation of resynchronization implantable cardioverter defibrillator was performed in a patient with persistent left superior vena cava. A dual coil defibrillation lead was inserted in the right ventricle apex via a small innominate vein. Left ventricular and atrial leads were implanted through persistent left superior vena cava. Left ventricular lead was easily implanted into the postero lateral vein. Pacing thresholds and sensing values were excellent and remained stable at 18 months follow-up. Presence of persistent left superior vena cava generally makes transvenous lead implantation difficult. However when a favorable coronary sinus anatomy is also present, it may facilitate left ventricular lead positioning in the coronary sinus branches.

Dante Antonelli; Nahum Adam Freedberg; Alexander Feldman

2007-01-01

133

Abdominal aortic aneurysm with inferior vena cava obstruction: case report.  

UK PubMed Central (United Kingdom)

Behçet's syndrome, a multisystem disorder, is characterized by recurrent oral and genital aphthous ulcerations, eye lesions, and skin changes. Other manifestations, although rare, may affect the nervous, gastrointestinal, or locomotor system, as well as veins and arteries. Vascular lesions occur in approximately 30% of reported cases. Although thrombosis in the larger veins is frequent, arterial thrombosis is somewhat less likely to occur. Only a few cases of arterial aneurysm have been documented in the literature. This report describes a patient who had suffered from Behçet's syndrome for fifteen years and in whom a complete obstruction of the inferior vena cava was demonstrated. An aortoiliac bypass was performed successfully, and the patient had had a good clinical recovery at long-term follow-up.

Demircioglu FF; Böke E; Demircin M; Dagsali S; Küçükali T

1989-03-01

134

Inferior vena cava thrombosis: a review of current practice.  

Science.gov (United States)

Inferior vena cava (IVC) thrombosis remains under-recognised as it is often not pursued as a primary diagnosis. The aetiology of IVC thrombosis can be divided into congenital versus acquired, with all aetiological factors found among Virchow's triad of stasis, injury and hypercoagulability. Signs and symptoms are related to aetiology and range from no symptoms to cardiovascular collapse. Painful lower limb swelling combined with lower back pain, pyrexia, dilatation of cutaneous abdominal wall veins and a concurrent rise in inflammatory markers are suggestive of IVC thrombosis. Following initial lower limb venous duplex, magnetic resonance imaging (MRI) is the optimal non-invasive imaging tool. Aetiology directs treatment, which ranges from anticoagulation and lower limb compression to open surgery, with endovascular therapies increasingly favoured. The objective of this review is to assess current literature on the aetiology, presentation, investigation, treatment, prognosis and other factors pertaining to IVC thrombosis. PMID:23439778

McAree, B J; O'Donnell, M E; Fitzmaurice, G J; Reid, J A; Spence, R A J; Lee, B

2013-02-01

135

EXTRACTION KIT FOR A FILTER FOR THE VENA CAVA  

UK PubMed Central (United Kingdom)

The invention relates to a withdrawal member for a filter for the vena cava, essentially consisting of a head and shape memory or wrought strands forming a tail, said strands being attached to the head and being located on the same side of the head, said withdrawal member including a rod (7) comprising, at the distal end thereof, a plurality of resilient arms (1, 2, 3, 4, 5, 6) flaring from the rod (7), naturally spaced apart from each other and ending in the form of hooks oriented towards the inside so as to grasp the cap of the filter upon tightening, and including a flexible bent area adjacent to the distal end of the rod (7).

NIGON ALAIN

136

Indications, management, and complications of temporary inferior vena cava filters  

International Nuclear Information System (INIS)

Purpose: We describe the results of a preliminary prospective study using different recently developed temporary and retrievable inferior vena cava (IVC) filters.Methods: Fifty temporary IVC filters (Guenther, Guenther Tulip, Antheor) were inserted in 47 patients when the required period of protection against pulmonary embolism (PE) was estimated to be less than 2 weeks. The indications were documented deep vein thrombosis (DVT) and temporary contraindications for anticoagulation, a high risk for PE, and PE despite DVT prophylaxis.Results: Filters were removed 1-12 days after placement and nine (18%) had captured thrombi. Complications were one PE during and after removal of a filter, two minor filter migrations, and one IVC thrombosis.Conclusion: Temporary filters are effective in trapping clots and protecting against PE, and the complication rate does not exceed that of permanent filters. They are an alternative when protection from PE is required temporarily, and should be considered in patients with a normal life expectancy.

1998-01-01

137

Type A aortic dissection presenting as superior vena cava syndrome.  

UK PubMed Central (United Kingdom)

ABSTRACTA 51-year-old man presented with a 5-day history of progressive facial swelling, sensation of head fullness, increasing shortness of breath and paroxysmal nocturnal dyspnea. He denied chest pain, syncope or presyncope. Past medical history included mechanical aortic valve replacement 7 years prior and atrial fibrillation treated with warfarin. A clinical diagnosis of acute superior vena cava (SVC) syndrome was made. Portable chest radiograph showed a widened superior mediastinum. Computed tomography scan of the thorax demonstrated a large type A aortic dissection almost completely effacing the SVC. Acute type A aortic dissection (AD) is an emergency requiring prompt diagnosis and treatment. Patients typically present with acute onset of chest and/or back pain, classically described as "ripping" or "tearing." SVC syndrome is rarely, if ever, mentioned as a presentation, as it is usually due to more chronic conditions. This case illustrates a rare incidence of type A AD actually presenting as SVC syndrome.

Raja FS; Islam A; Khan M; Abbasi I

2013-01-01

138

Renal vein and inferior vena cava involvement in renal adenocarcinoma  

International Nuclear Information System (INIS)

This paper demonstrates the effectiveness of GRASS sequences for detecting venous extension of renal cell carcinoma. Forty-five consecutive patients with proved renal cell carcinoma were studied with a 1.5-T system. GRASS sequences were performed in addition to spin-echo T1- and T2-weighted sequences. MR images were evaluated by two reviewers in a blinded fashion. MR findings were subsequently correlated with CT and pathologic findings. GRASS images depicted tumor thrombus in the main renal vein in 13/45 patients and in the inferior vena cava (IVC) in 5/45 patients. There were two false-positive and two false-negative findings for renal vein extensions. Patency of the IVC was correctly assessed in all cases; the cephalic extent of the caval thrombus was correctly delineated in 5/5 cases. In all cases, GRASS sequences were superior to spin-echo MR imaging in evaluation of the extent of tumor invasion

1991-01-01

139

A New Method for Semiautomatic Suture Plication of the Inferior Vena Cava.  

Science.gov (United States)

A new method of rapid precise suture plication of the inferior vena cava is described. Although clinical studies have not yet been performed, results in animals have been similar to those with conventional suture plication technics with effective trapping...

I. R. Berman H. F. Hamit R. H. Clauss

1969-01-01

140

Invasion of a peritoneal catheter into the inferior vena cava: report of a unique case.  

Science.gov (United States)

A case is reported in which the peritoneal catheter of a ventriculoperitoneal shunt was found to have eroded into the inferior vena cava. It was working well, draining CSF, even through oriented against the flow of blood. PMID:8677482

Haralampopoulos, F; Iliadis, H; Karniadakis, S; Koutentakis, D

1996-07-01

 
 
 
 
141

Invasion of a peritoneal catheter into the inferior vena cava: report of a unique case.  

UK PubMed Central (United Kingdom)

A case is reported in which the peritoneal catheter of a ventriculoperitoneal shunt was found to have eroded into the inferior vena cava. It was working well, draining CSF, even through oriented against the flow of blood.

Haralampopoulos F; Iliadis H; Karniadakis S; Koutentakis D

1996-07-01

142

Massive benign pericardial cyst presenting with simultaneous superior vena cava and middle lobe syndromes  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract A 66 year old woman presented in extremis with symptoms and clinical and radiological signs of simultaneous obstruction of superior vena cava and middle lobe of right lung secondary to compression by a massive benign anterior mediastinal cyst. Excision of the cyst at median sternotomy resulted in complete resolution of all symptoms. This report is unusual on account of a) the concomitant presence of superior vena cava and middle lobe syndromes caused by a benign cyst because of its sheer size producing obstruction of these structures and b) the complete resolution of all symptoms and signs after removal of the cyst. Benign anterior mediastinal cysts are unknown to cause either of the two syndromes. To our knowledge, it is the first report of a benign anterior mediastinal cyst causing either superior vena cava syndrome or middle lobe syndrome or both simultaneously. Etiologies of both superior vena cava and middle lobe syndromes are discussed in detail.

Kaul Pankaj; Javangula Kalyana; Farook Shahme A

2008-01-01

143

Massive benign pericardial cyst presenting with simultaneous superior vena cava and middle lobe syndromes  

Science.gov (United States)

A 66 year old woman presented in extremis with symptoms and clinical and radiological signs of simultaneous obstruction of superior vena cava and middle lobe of right lung secondary to compression by a massive benign anterior mediastinal cyst. Excision of the cyst at median sternotomy resulted in complete resolution of all symptoms. This report is unusual on account of a) the concomitant presence of superior vena cava and middle lobe syndromes caused by a benign cyst because of its sheer size producing obstruction of these structures and b) the complete resolution of all symptoms and signs after removal of the cyst. Benign anterior mediastinal cysts are unknown to cause either of the two syndromes. To our knowledge, it is the first report of a benign anterior mediastinal cyst causing either superior vena cava syndrome or middle lobe syndrome or both simultaneously. Etiologies of both superior vena cava and middle lobe syndromes are discussed in detail.

Kaul, Pankaj; Javangula, Kalyana; Farook, Shahme A

2008-01-01

144

Atresia of the superior vena cava causing cyanosis and increasing head circumference in an infant.  

UK PubMed Central (United Kingdom)

We report a case of congenital atresia of the superior vena cava (SVC) with stenotic anastomoses between systemic and pulmonary veins, resulting in cyanosis and symptoms consistent with SVC syndrome in an infant.

Lytrivi ID; Avramidis D; Sfyridis P; Kirvassilis G; Sarris G; Papagiannis J

2010-05-01

145

[Ablation of slow pathway in a patient with persistent left superior vena cava].  

UK PubMed Central (United Kingdom)

We describe a case of successful radiofrequency ablation of slow pathway in a 54 year-old woman with persistent left superior vena cava. The ablation was performed using anatomical approach, outside the ostium of coronary sinus.

Majewski J; Karkowski G; Miszalski-Jamka T; Lelakowski J; Urba?czyk M

2013-01-01

146

[Congenital absence of inferior vena cava associated to polispleenism. Case report].  

Science.gov (United States)

Interruption of the inferior vena cava with azygos continuation is an uncommon vascular anomaly that results from aberrant development during embryogenesis. We report a case of this anomaly in a young boy of 19 years old sent for our observation for presenting an hipotransparency in the chest x-ray, which study revealed a prominence of the azygos cross. Further evaluation by CT-scans disclosed the diagnosis of congenital absence of the inferior vena cava, associated to multiple spleens (polispleenism). PMID:17308622

Esteves, Joana; Carvalho, Carmen; Mendes da Costa, Rui; Vale, Sílvio; Morgado, Paulo; Maciel, Jorge

147

[Congenital absence of inferior vena cava associated to polispleenism. Case report].  

UK PubMed Central (United Kingdom)

Interruption of the inferior vena cava with azygos continuation is an uncommon vascular anomaly that results from aberrant development during embryogenesis. We report a case of this anomaly in a young boy of 19 years old sent for our observation for presenting an hipotransparency in the chest x-ray, which study revealed a prominence of the azygos cross. Further evaluation by CT-scans disclosed the diagnosis of congenital absence of the inferior vena cava, associated to multiple spleens (polispleenism).

Esteves J; Carvalho C; Mendes da Costa R; Vale S; Morgado P; Maciel J

2006-10-01

148

Impact of vena cava filters on in-hospital case fatality rate from pulmonary embolism.  

UK PubMed Central (United Kingdom)

BACKGROUND: The effects of vena cava filters on case fatality rate are not clear, although they are used increasingly in patients with pulmonary embolism. The purpose of this investigation is to determine categories of patients with pulmonary embolism in whom vena cava filters reduce in-hospital case fatality rate. METHODS: In-hospital all-cause case fatality rate according to the use of vena cava filters was determined in patients with pulmonary embolism discharged from short-stay hospitals throughout the United States using data from the Nationwide Inpatient Sample. RESULTS: In-hospital case fatality rate was marginally lower in stable patients who received a vena cava filter: 21,420 of 297,700 (7.2%) versus 135,240 of 1,712,800 (7.9%) (P<.0001). Filters did not improve in-hospital case fatality rate if deep venous thrombosis was diagnosed in stable patients. A few stable patients (1.4%) received thrombolytic therapy. Such patients who received a vena cava filter had a lower case fatality rate than those who did not: 550 of 8550 (6.4%) versus 2950 of 19,050 (15%) (P<.0001). Unstable patients who received thrombolytic therapy had a lower in-hospital case fatality rate with vena cava filters than those who did not: 505 of 6630 (7.6%) versus 2600 of 14,760 (18%) (P<.0001). Unstable patients who did not receive thrombolytic therapy also had a lower in-hospital case fatality rate with a vena cava filter: 4260 of 12,850 (33%) versus 19,560 of 38,000 (51%) (P<.0001). CONCLUSION: At present, it seems prudent to consider a vena cava filter in patients with pulmonary embolism who are receiving thrombolytic therapy and in unstable patients who may not be candidates for thrombolytic therapy. Future prospective study is warranted to better define in which patients a filter is appropriate.

Stein PD; Matta F; Keyes DC; Willyerd GL

2012-05-01

149

Agenesia de veia cava inferior associada à trombose venosa profunda Agenesis of inferior vena cava associated with deep venous thrombosis  

Directory of Open Access Journals (Sweden)

Full Text Available A agenesia da veia cava inferior é uma anomalia congênita rara, que foi recentemente identificada como um importante fator de risco para o desenvolvimento e a recorrência de trombose venosa profunda de membros inferiores em jovens. O objetivo deste trabalho foi relatar o caso de uma paciente que apresentou trombose venosa profunda dois meses após a realização de cirurgia de varizes. A angiotomografia computadorizada demonstrou a presença de anomalia venosa complexa com ausência da veia cava inferior.The agenesis of the inferior vena cava is a rare congenital anomaly, which was recently identified as an important risk factor for the development and recurrence of deep venous thrombosis especially in young people. The goal of this work was to report the case of a patient who presented deep venous thrombosis approximately two months after varicose vein surgery. The computerized angiotomography demonstrated the presence of a complex venous anomaly with absence of the inferior vena cava.

Clovis Luis Konopka; Marcelo Salame; Geórgia Andrade Padulla; Raquel Rodrigues Muradás; Julio César Batistella

2010-01-01

150

Inferior vena cava stenosis and pancreatic ascites complicating chronic calcific pancreatitis: a case report.  

UK PubMed Central (United Kingdom)

A 19-year-old Thai male, who was a regular drinker, presented with massive ascites, back pain and leg edema for four months. On examination there was obvious clinical evidence of an inferior vena cava obstruction. Inferior vena cavography showed narrowing of the hepatic portion of IVC with collateral circulation. Surgical dilatation of the inferior vena cava was performed. The ascites were diagnosed four months later as pancreatic ascites with a very high ascitic amylase level. Computerised axial tomography and endoscopic retrograde pancreatography showed evidence of chronic calcific pancreatitis and pseudocyst. After further medical treatment, ascites and inferior vena cava stenosis subsided which was confirmed by repeated vena cavography, computerised axial tomography and magnetic resonance imaging. The cause of inferior vena cava stenosis and clinical obstruction in this case most likely resulted from phlebitis secondary to pancreatitis. The etiology of chronic calcific pancreatitis in this case might be alcoholic abuse and/or nutritional tropical pancreatitis. Inferior vena cava stenosis and associated pancreatic ascites complicating chronic calcific pancreatitis has not been previously reported in Thailand.

Wongpaitoon V; Kurathong S; Pekanan P

1993-08-01

151

Inferior vena cava stenosis and pancreatic ascites complicating chronic calcific pancreatitis: a case report.  

Science.gov (United States)

A 19-year-old Thai male, who was a regular drinker, presented with massive ascites, back pain and leg edema for four months. On examination there was obvious clinical evidence of an inferior vena cava obstruction. Inferior vena cavography showed narrowing of the hepatic portion of IVC with collateral circulation. Surgical dilatation of the inferior vena cava was performed. The ascites were diagnosed four months later as pancreatic ascites with a very high ascitic amylase level. Computerised axial tomography and endoscopic retrograde pancreatography showed evidence of chronic calcific pancreatitis and pseudocyst. After further medical treatment, ascites and inferior vena cava stenosis subsided which was confirmed by repeated vena cavography, computerised axial tomography and magnetic resonance imaging. The cause of inferior vena cava stenosis and clinical obstruction in this case most likely resulted from phlebitis secondary to pancreatitis. The etiology of chronic calcific pancreatitis in this case might be alcoholic abuse and/or nutritional tropical pancreatitis. Inferior vena cava stenosis and associated pancreatic ascites complicating chronic calcific pancreatitis has not been previously reported in Thailand. PMID:7964251

Wongpaitoon, V; Kurathong, S; Pekanan, P

1993-08-01

152

Tumour invasion of the inferior vena cava from carcinoma of the adrenal. Pre-operative diagnosis  

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Tumour invasion of the inferior vena cava from an adrenal carcinoma is not a contraindication to surgical treatment. Pre-operative recognition of the situation is of considerable importance for planning the surgical procedure. Three patients with primary adrenal carcinomas are reported, in whom tumour in the cava was demonstrated by real time and duplex sonography. Sonography proved superior to CT in these cases.

Mildenberger, P.; Lotz, R.; Bierhoff, E.; Schmiedt, W.

1987-08-01

153

Thrombosis of the cranial vena cava in a cow with bronchopneumonia and traumatic reticuloperitonitis  

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This paper reports the clinical findings, surgical and medical management, and necropsy of a 6 year old cow with thrombosis of the cranial vena cava and thrombo embolic pneumonia following traumatic reticuloperitonitis. The clinical diagnosis was confirmed by necropsy. Thrombosis of the caudal vena ...

Gerspach, C; Wirz, M; Knubben-Schweizer, G; Braun, U

154

Percutaneous insertion of Kimray-Greenfield vena cava filter: Case report  

Energy Technology Data Exchange (ETDEWEB)

Transvenous placement of vena caval filtration devices has become more effective alternative in the management of patients in whom anticoagulation is contraindicated or thromboembolism recurs despite anticoagulation. Percutaneous transjugular placement of the Kimray-Greenfield filter in the suprarenal inferior vena cava was successfully accomplished in 34 year old female patient with recurrent pulmonary embolism, who had suffered from bilateral deep vein thrombosis.

Yoon, Yup; Oh, Joo Hyeong; Choi, Woo Suk; Lim, Jae Hoon; Kim, Jin Woo [Kyung Hee University Hospital, Seoul (Korea, Republic of)

1989-06-15

155

Percutaneous insertion of Kimray-Greenfield vena cava filter: Case report  

International Nuclear Information System (INIS)

Transvenous placement of vena caval filtration devices has become more effective alternative in the management of patients in whom anticoagulation is contraindicated or thromboembolism recurs despite anticoagulation. Percutaneous transjugular placement of the Kimray-Greenfield filter in the suprarenal inferior vena cava was successfully accomplished in 34 year old female patient with recurrent pulmonary embolism, who had suffered from bilateral deep vein thrombosis.

1989-01-01

156

Cine computed tomography for diagnosis of superior vena cava obstruction following the mustard operation  

International Nuclear Information System (INIS)

Superior vena caval obstruction is a well described complication following Mustard's repair for transposition of the great arteries. We report a case of a 6-year-old child with superior vena cava obstruction correctly diagnosed by Cine-CT. The advantages of imaging with Cine-CT for this complication are discussed. (orig.)

1987-01-01

157

Right to left shunt as a collateral circulation in a patient with superior vena cava syndrome: a case report  

International Nuclear Information System (INIS)

In patients with superior vena cava syndrome, the form of the collateral circulatory system which communicates with the inferior vena cava via various systemic veins usually varics. We found an instance of unusual collateral circulation : direct communication between the systemic and pulmonary vein in a woman with superior vena cava syndrome caused by metastatic lymph node enlargement. In this report, we describe the CT and radionuclide venographic findings.

1999-01-01

158

Right to left shunt as a collateral circulation in a patient with superior vena cava syndrome: a case report  

Energy Technology Data Exchange (ETDEWEB)

In patients with superior vena cava syndrome, the form of the collateral circulatory system which communicates with the inferior vena cava via various systemic veins usually varics. We found an instance of unusual collateral circulation : direct communication between the systemic and pulmonary vein in a woman with superior vena cava syndrome caused by metastatic lymph node enlargement. In this report, we describe the CT and radionuclide venographic findings.

Kim, Young Sun; Jeon, Seok Chol; Moon, Won Jin; Choi, Yo Won; Seo, Heung Suk; Hahm, Chang Kok; Park, Choong Ki [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

1999-07-01

159

[Biometry of the inferior vena cava (subrenal segment): dissection of 100 recently deceased subjects  

UK PubMed Central (United Kingdom)

The vena cava inferior in its infra-renal part is a selective place to set on anti-thrombosis devices. The biometry of 100 fresh, adult cadavers interested the useful and real lengths, the diameters on several levels and on the corresponding part of the aorta, the end of the iliac venae and the origin of the iliac arteriae . The useful length of the vena cava inferior is 96 mm in mean, and its real diameter is 17 mm, on the middle of the infra-renal part.

Le Floch-Prigent P

1989-12-01

160

Reconstruction of a total avulsion of the hepatic veins and the suprahepatic inferior vena cava secondary to blunt thoracoabdominal trauma.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Blunt injury to the inferior vena cava is a rare but dramatic event having a high mortality up to 80%. The mortality increases after total avulsion especially in combination with secondary intra-abdominal injuries. CASE REPORT: We report on a 15-year-old boy who sustained a blunt trauma with a total, partially covered avulsion of the hepatic veins and the suprahepatic inferior vena cava. DISCUSSION: We treated the patient under internal bypassing of the retrohepatic vena cava by using the heart-lung machine and reconstructed the hepatic veins and suprahepatic vena cava with a conduit made of pericard.

Kaemmerer D; Daffner W; Niwa M; Kuntze T; Hommann M

2011-02-01

 
 
 
 
161

Migration of central lines from the superior vena cava to the azygous vein  

Energy Technology Data Exchange (ETDEWEB)

Aim: To report 11 cases of central venous access catheters migrating from the superior vena cava to the azygos vein in order to raise radiologists' awareness of this possibility. Materials and methods: This is a retrospective review of the clinical history and imaging of 11 patients whose central line migrated from the superior vena cava to the azygos vein. The time course of migration, access route of the catheters, outcome, and depth of placement in the superior vena cava were evaluated. Results: All of these catheters were placed from the left; six through the subclavian vein, four as PICC lines, and one from the left internal jugular vein. Seven of the catheters were originally positioned in the superior vena cava. Four of the catheters were originally positioned in the azygos vein and were repositioned into the superior vena cava at the time of placement. The time to migration ranged from 2 to 126 days, average 43 days. In three cases, the migration was not reported at the first opportunity, resulting in a delay in diagnosis ranging from 10 to 27 days. All but one of the catheters extended at least 3.5 cm (range 1.8-7 cm) below the top of the right mainstem bronchus when in the superior vena cava. Conclusion: Risk factors for migration into the azygos vein include placement from a left-sided approach and original positioning in the azygos vein with correction at placement. The depth of placement in the superior vena cava was not a protective factor. It is important to recognize migration because of the elevated risk of complications when central lines are placed in the azygos vein.

Haygood, T.M., E-mail: tamara.haygood@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); Malhotra, K., E-mail: kmalhotra@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); Ng, C., E-mail: cng@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); Chasen, B., E-mail: beth.chasen@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); McEnery, K.W., E-mail: kmcenery@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); Chasen, M., E-mail: mchasen@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States)

2012-01-15

162

Migration of central lines from the superior vena cava to the azygous vein  

International Nuclear Information System (INIS)

Aim: To report 11 cases of central venous access catheters migrating from the superior vena cava to the azygos vein in order to raise radiologists’ awareness of this possibility. Materials and methods: This is a retrospective review of the clinical history and imaging of 11 patients whose central line migrated from the superior vena cava to the azygos vein. The time course of migration, access route of the catheters, outcome, and depth of placement in the superior vena cava were evaluated. Results: All of these catheters were placed from the left; six through the subclavian vein, four as PICC lines, and one from the left internal jugular vein. Seven of the catheters were originally positioned in the superior vena cava. Four of the catheters were originally positioned in the azygos vein and were repositioned into the superior vena cava at the time of placement. The time to migration ranged from 2 to 126 days, average 43 days. In three cases, the migration was not reported at the first opportunity, resulting in a delay in diagnosis ranging from 10 to 27 days. All but one of the catheters extended at least 3.5 cm (range 1.8–7 cm) below the top of the right mainstem bronchus when in the superior vena cava. Conclusion: Risk factors for migration into the azygos vein include placement from a left-sided approach and original positioning in the azygos vein with correction at placement. The depth of placement in the superior vena cava was not a protective factor. It is important to recognize migration because of the elevated risk of complications when central lines are placed in the azygos vein.

1475-01-00

163

Benign renal angiomyolipoma with inferior vena cava thrombosis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To present a new case of an uncommon complication of a benign renal tumor. To our knowledge, there are only few published cases of benign renal angiomyolipoma (AML) presenting with tumor thrombus in females. Epithelioid angiomyolipoma is a recently described rare variant of renal angiomyolipoma. It can occur in patients with or without tuberous sclerosis, and may potentially be malignant. Benign renal angiomyolipoma AML rarely presents with evidence of extension into the renal vein, inferior vena cava (IVC) or atrium. We report a case of a benign renal AML with a tumor thrombus to the IVC in a 46-year-old female who presented with right-sided flank pain associated with a right sided abdominal mass. METHODS: Right Radical nephrectomy with IVC tumor thrombectomy. RESULTS: Patient is totally asymptomatic. At 1 month after surgery, an abdominal ultrasound showed no evidence of thrombus within the IVC. CT scan of the abdomen at 3 months post-operatively showed no evidence of recurrence. CONCLUSION: Surgical treatment of angiomyolipoma with IVC thrombus is warranted in view of risk of malignancy and to prevent tumor embolus to the heart or lungs.

Mittal V; Aulakh BS; Daga G

2011-06-01

164

Electrolytic Inferior Vena Cava Model (EIM) of Venous Thrombosis  

Science.gov (United States)

Animal models serve a vital role in deep venous thrombosis (DVT) research in order to study thrombus formation, thrombus resolution and to test potential therapeutic compounds (1). New compounds to be utilized in the treatment and prevention of DVT are currently being developed. The delivery of potential therapeutic antagonist compounds to an affected thrombosed vein has been problematic. In the context of therapeutic applications, a model that uses partial stasis and consistently generates thrombi within a major vein has been recently established. The Electrolytic Inferior vena cava Model (EIM) is mouse model of DVT that permits thrombus formation in the presence of continuous blood flow. This model allows therapeutic agents to be in contact with the thrombus in a dynamic fashion, and is more sensitive than other models of DVT (1). In addition, this thrombosis model closely simulates clinical situations of thrombus formation and is ideal to study venous endothelial cell activation, leukocyte migration, venous thrombogenesis, and to test therapeutic applications (1). The EIM model is technically simple, easily reproducible, creates consistent thrombi sizes and allows for a large sample (i.e. thrombus and vein wall) which is required for analytical purposes.

Diaz, Jose A.; Wrobleski, Shirley K.; Hawley, Angela E.; Lucchesi, Benedict R.; Wakefield, Thomas W.; Myers, Jr., Daniel D.

2011-01-01

165

Tratamiento quirúrgico de carcinoma renal con trombo y filtro en vena cava/ Surgical treatment of the renal carcinoma with inferior vena cava thrombus and filter  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Objetivo: La invasión vascular en forma de trombo tumoral sucede en un no desdeñable porcentaje de las neoplasias renales, la importancia de la extensión cefálica del trombo en el pronóstico es discutida actualmente pero en ausencia de metástasis a distancia, el tratamiento quirúrgico es mandatorio. Método: Presentamos el caso de un paciente de 56 años al que intervenimos en nuestro centro, portador de filtro en vena cava inferior mediante abordaje toraco-abdomin (more) al con circulación extracorpórea (CEC), hipotermia profunda (por debajo de los I8ºC) y retroperfusión cerebral. Resultados: Si bien tiempo atrás se pensaba que la presencia de trombo tumoral ensombrecía el pronóstico de estos pacientes, actualmente sabemos que con tratamiento quirúrgico, en casos seleccionados, se obtienen buenos resultados en términos de supervivencia y tiempo libre de enfermedad. Conclusión: Pensamos que el implante de filtros venosos, puede incrementar la complejidad de la cirugía. Abstract in english Objective: Vascular invasion in the form of tumour thrombus appears in a significant percentage of renal neoplasias. The importance of cephalic extension of the thrombus in prognosis is currently under discussion, but surgical treatment is mandatory in the absence of distant metastasis. Methods: We report the case of a 56-year-old male patient with a filter in the inferior vena cava, who underwent surgery in our department through a thoracoabdominal approach with extracor (more) poreal circulation, deep hypothermia (below 18ºC) and cerebral retrograde perfusion. Results: Although in the past it was believed tumour thrombus worsened prognosis in these patients, currently we know that surgical treatment, in selected cases, gives good results in terms of survival and disease-free time. Conclusions: We think the implementation of venous filters may increase the complexity of surgery.

Juan Escudero, Joaquín Ulises; Ramos de Campos, Macarena; Cánovas López, Sergio; Fabuel Deltoro, Milagros; Marqués Vidal, Emilio

2008-08-01

166

SISTEMATIZATION OF THE CRANIAL Vena cava IN BUFFALOS (Bubalus bubalis bubalis _ SIMPSON, 1945) SISTEMATIZACIÓN DE LA VENA CAVA CRANEAL EN BÚFALOS (Bubalus bubalis bubalis - SIMPSON, 1945)  

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Full Text Available The almost complete lack of knowledge of the anatomical characteristics of this race allows us, here, to study the circulatory system in relation to the veined drainage of the large systemic venous trunks _ the cava system. In the literature many reports can be found on the arterial vascular pattern in several areas of the body in domestic animals as well as in savages; conversely, there is a shortage of pertinent data on the veined vascular pattern. For the present work 25 animals were utilized with the object of dissecting and systemizing the vessels, animals were fetuses with ages of between 5 and 9 months, 15 being females and 10 males. In the cranial vena cava the following origin tributaries were observed: External right and left jugular veins and their collateral tributaries; the internal right and left jugular veins; the mediastinial and pericardial; the internal right and left thoracic; thymic; the right and left subclavian and the right and left costocervicalvertebral venous trunk, and occasionally the thoracic duct.Existe un escaso conocimiento de las características anatómicas del sistema circulatorio del búfalo (Bubalus bubalis bubalis) con respecto al drenaje venoso de los grandes troncos venosos sistémicos, como el sistema cava. Sin embargo, pueden encontrarse en la literaratura muchos relatos del modelo vascular arterial, en varias áreas del cuerpo de animales domésticos y salvajes; pero son pocos los datos del modelo vascular venoso. Utilizamos 25 fetos de búfalos (Bubalus bubalis bubalis) con edades entre 5 y 9 meses, 15 hembras y 10 machos, con el objetivo de sistematizar los grandes vasos venosos que conforman la vena cava craneal. En la vena cava craneal se observaron las siguientes venas tributarias: Venas yugulares externas derecha e izquierda y sus colaterales; yugulares internas derecha e izquierda; mediastínicas y pericárdicas; torácicas internas derecha e izquierda; tímica; subclavias derecha e izquierda y los troncos venosos costocervicalvertebrales derecho e izquierdo y, algunas veces, el conducto torácico.

Adelmar Afonso de Amorim Júnior; Marleyne José Afonso Accioly Lins Amorim

2002-01-01

167

Nursing care of the complications caused by vena cava filter placement and thrombolytic therapy  

International Nuclear Information System (INIS)

Objective: To discuss the nursing care and observation measures for the complications occurred after vena cava filter placement and thrombolytic therapy. Methods: During the period of July 2007-March 2010, vena cava filter placement and thrombolytic therapy were employed in 70 patients. The observation for the main procedure-related complications was made. The main complications included bleeding tendency, pulmonary embolism, filter migration or loss, thrombus formation within filter, IVC perforation due to filter, venous insufficiency and skin blisters of the affected lower extremity. Results: The total effective rate of thrombolytic treatment in 70 patients was 95.7%. As reasonable and effective nursing care measures were implemented, no major complications, such as pulmonary embolism, filter migration or loss,thrombus formation within filter, IVC perforation due to filter, infection, etc. occurred. The other complications developed in some patients,which included hematuria (n=4), bleeding at puncturing site (n=3), bleeding at abdominal incision (n=3), subcutaneous ecchymosis (n=3) and skin vesicles of diseased limb (n=3), all of which were cured after proper management. Conclusion: Postoperative nursing is a kind of prospective nursing care, the primary purpose of which is to prevent the occurrence of the potential complications after surgery. Therefore, solid fundamental knowledge, careful observation ability and strong consciousness of responsibility are most important.(authors)

2011-01-01

168

Recurrent Cerebral Abscess Secondary to a Persistent Left Superior Vena Cava.  

UK PubMed Central (United Kingdom)

Cerebral abscess is a serious neurological condition that is often of unclear etiology. Management is usually medical therapy with or without direct drainage, and when patients have recurrent episodes a structural abnormality should be considered. Persistent left superior vena cava is an uncommon condition in the absence of other forms of congenital heart disease. This venous connection most often enters the right-sided atrium through the coronary sinus but occasionally can connect directly to the left atrium near the wall between the orifice of the left pulmonary veins and left atrial appendage. This later congenital connection results in systemic venous return entering the left atrium directly. Thus allowing unfiltered, lower saturation blood entering the systemic system. This then places the patient at risk for systemic hypoxemia, paradoxical embolic events, and cerebral abscess. In our case report with recurrent cerebral abscess and a persistent left superior vena cava, we demonstrate when to consider this diagnosis, how to make the diagnosis, and a nonsurgical approach to repair the veno-atrial shunt.

Menachem JN; Sundaram SN; Rhodes JF

2013-05-01

169

Indicaciones actuales del implante de filtros recuperables en la vena cava inferior  

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Full Text Available El tromboembolismo venoso es una patología que ocurre aproximadamente en 1 de cada 1 000 personas en el mundo, de las cuales más de la mitad corresponde a casos de trombosis venosa profunda. La principal complicación aguda de la trombosis venosa profunda es el embolismo pulmonar, que resulta fatal en 20 %-30 % de los casos. La anticoagulación es la estrategia más eficaz para la prevención de esta complicación, sin embargo, está contraindicada en situaciones frecuentes. Los filtros de vena cava inferior constituyen una alternativa no farmacológica para la prevención del embolismo pulmonar en aquellos pacientes que presentan trombosis venosa profunda. Este artículo hace revisión de los aspectos históricos de estos dispositivos, con especial interés en los denominados filtros recuperables, en cuanto a sus indicaciones, técnica de colocación-retiro, eficacia y seguridad.Venous thromboembolism is a disease which occurs in 1 out of 1 000 people around the world, accounting for about a half of cases of deep venous thrombosis. Deep venous thrombosis major complication is pulmonary embolism, fatal in 20 %-30 % of cases. Anticoagulation is the most effective strategy to prevent pulmonary embolism, however, this is contraindicated in frequent clinical situations. Inferior vena cava filters are a non-pharmacological alternative in these cases. This article reviews historical aspects of these devices, with particular interest in those denominated retrievable filters, describing indications, implantation-retrieval technique, efficacy and safety.

Braulio Vargas; Juan Simón Muñoz R; R Francisco Tortoledo; Leonardo Izaguirre B

2007-01-01

170

Ataques isquêmicos transitórios em paciente com síndrome da veia cava superior: relato de caso Transient ischemic attacks in a patient with superior vena cava obstruction: case report  

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Full Text Available A síndrome da veia cava superior (SVCS) é condição relativamente rara. Relatamos o caso de um paciente de 42 anos, masculino, hipertenso há 15 anos, que evoluiu com dor cervical e torácica há um um ano, sendo evidenciada oclusão de 95% da coronária direita. Submetido a angioplastia, porém com persistência da dor torácica. Posteriormente evoluiu com episódios recorrentes de hemiplegia à direita associados a crises hipertensivas, que melhoravam com medicamentos anti-hipertensivos. Pela presença de coloração vinhosa na face e acentuação durante os períodos de ataques isquêmicos transitórios, foi feita a suspeita diagnóstica de provável acometimento do sistema de drenagem venosa, confirmada à venografia pelo achado de dilatação da veia jugular direita e imagem de estreitamento importante na junção com a veia cava superior. Em conclusão, não foi possível definir com certeza a relação entre as duas patologias no caso aqui apresentado, porém chamou a atenção a melhora dos sintomas neurológicos após o controle da SVCS com o tratamento instituído.The superior vena cava obstruction is a relatively rare condition. We report the case of a 42 year old man suffering of hypertension for about fifteen years. He reported a cervical and thoracic pain for one year, that was related to a 95% of occlusion on the right coronary artery. An angioplasty has been done but the patient still related the thoracic pain. Afterwards the patient had recurrent episodes of right hemiplegia and hypertensive emergencies that have been treated with anti-hypertensive agents. A venous disease was suspected because of cyanosis in the face especially when episodes of transient ischemic attacks occurred. A venography showed obstruction of the right jugular vein near the junction with the superior vena cava. In conclusion, it was not possible to define with certainty the relationship between the two pathologies presented by the patient, even so, we call attention to the improvement of the neurological symptoms after the control of superior vena cava obstruction with the treatment.

ANTÔNIO S. ANDRADE-FILHO; FREDERICO L.S. FIGUEIRÔA; CELSO L. SANTIAGO-FIGUEIRÔA; DANNILO B. SILVEIRA; YURI M. ANDRADE-SOUZA; EDUARDO R.V. BANDEIRA; A.P.Q.U. SOUZA; ANDRÉ G.P. SILVA

1998-01-01

171

CT findings of bilateral inferior vena cava: Differentiation from dilated retroperitoneal veins  

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We experience five cases of bilateral inferior vena cava for recent one year. We evaluated the CT findings of the cases and of dilated veins located in the left retroperitoneum (seven left gonadal, seven inferior mesenteric, and two left ascending lumber veins) in the viewpoints of the size, location and relation with the surrounding structures. Bilateral inferior vena cava (IVC) may be asymmetric and the left IVC may be smaller than other retroperitoneal veins with a round contour. The left IVC was located anterior to the spinal body and corresponded with contralateral vena cava in the anteroposterior plane. The gonadal vein was located anterio or anterolateral side of the psoas and always crossed the ureter. Most of the inferior mesenteric vein showed similar location to the opposite site of the vena cava in the anterolateral side of the muscle, medial to the left ureter without crossing. The left ascending lumbar vein was similarly located to the left vena cava but dilated in a short segment. It is required to trace the vessel upward and downward and observe its continuity for correct differentiation. If it is impossible, some differential points suggested in the results of our study will be helpful for distinguishing them.

1993-01-01

172

Obstruction of superior vena cava following the Mustard operation of transposition of great arteries  

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The obstruction of the superior vena cava is a frequent late complication of the Mustard operation of the transposition of great arteries. Although it is asymptomatic, it threatens the patient as intracranial hypertension develops. Radionuclide angiocardiography can visualize the collateral blood flow from the obturated vena cava superior by the system of the azygos and hemiazygos veins into inferior vena cava. The benefit of this noninvasive method for screening obstruction was tested in a group of 94 patients. The obstruction of the vena cava superior was apparent in 11 patients (11.7%). In all cases, the diagnosis was confirmed by catheterization and angiocardiography. Pulsed Doppler echocardiography proved an abnormal flow in the vena cava superior in 9 patients. In other five patients with abnormal flow, obstruction was not revealed by radionuclide angiocardiography. Radionuclide angiocardiography supplements echocardiography also as regards other late complications and can be thus recommended for routine examinations of patients after the Mustard operation. (author). 1 fig., 1 tab., 16 refs

1987-11-27

173

Rapid progression of a germ cell tumor encasing the inferior vena cava and aorta following a radical orchiectomy.  

UK PubMed Central (United Kingdom)

ABSTRACT: Early stage testicular germ cell tumors are highly curable malignancies, but the need for close radiologic and biomarker surveillance is pivotal. Even in the setting of recurrence, rescue therapy has been successfully implemented. The present report describes a patient that had rapid and aggressive recurrence after radical orchiectomy for a testicular germ cell tumor and presented with bulky disease necessitating reconstruction of the inferior vena cava at the time of salvage retroperitoneal debulking.

Hakiman H; Margulis V; Kapur P; Huerta S

2013-04-01

174

Rapid progression of a germ cell tumor encasing the inferior vena cava and aorta following a radical orchiectomy  

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Full Text Available Early stage testicular germ cell tumors are highly curable malignancies, but the need for close radiologic and biomarker surveillance is pivotal. Even in the setting of recurrence, rescue therapy has been successfully implemented. The present report describes a patient that had rapid and aggressive recurrence after radical orchiectomy for a testicular germ cell tumor and presented with bulky disease necessitating reconstruction of the inferior vena cava at the time of salvage retroperitoneal debulking.

Hekmat Hakiman; Vitaly Margulis; Payal Kapur; Sergio Huerta

2013-01-01

175

Animal experimental study of safety for a self-made vena cava stent-filter  

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Objective: To evaluate the safety of a self-made vena cava stent-filter(VCSF)for prevention of pulmonary embolism. Methods: Fusiform unmhrella-like vena cava filter was made of Nitinol wires and stainless steel metal pole, and then ten mongrel dogs were implanted with these self-made filters and divided into 5 groups according to the different periods (2, 3, 4, 5 and 6 w) of filter placement, with 2 dogs in each group. After the VCSFs were placed in inferior vena cava via the right femoral vein approach, the dogs in each group were bred for 2-6 weeks, respectively. The blood flow of inferior vena cava and the position of the filters were inspected by inferior vena-cavography according to the indwelling periods. Finally the metal pole was retrieved via the femoral vein, leaving the VCSF as permanent venousz stent. The feasibility of retrieval and the free state of filter net with the adhering vascular wall were evaluated. Laparotomies were performed to remove the inferior vena cava from the animals for gross and electron microscopic examinations of the inferior vena cava intimal changes of the involved segment. Results: All 10 VCSFs were placed at the right positions of the dogs successfully. Angiography showed patent inferior vena cava without filter thrombosis at 2-6 weeks. There were no tilting and migration of the filter and all the metal poles were successfully retrieved. The superior and inferior extremities of filter nets could be set free with all the filters turning into venous stents. Postmortem displayed retroperitoneal hemorrhage and caval thrombosis. The barbs of the filters penetrated over the caval adventitial coat. Under electron microscope, a thin layer of neointima already covered the braiding net of VCSFs at 2 weeks after the deployment. The tunica intima became slightly thick at 3-4 weeks and with moderate proliferation at 5-6 weeks. Conclusions: The self-made vena cava stent-filter possesses rather long indwelling period according to the necessity of treatment with simultaneously keeping patent caval flow, stability of the position and easy for displacement and retrieval. (authors)

2008-01-01

176

Bilateral breast swelling secondary to superior vena cava obstruction and subclavian vein thrombosis/ Edema bilateral das mamas secundário a obstrução da veia cava superior e trombose de veia subclávia  

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Full Text Available Abstract in portuguese A síndrome da veia cava superior é definida por um conjunto de sinais e sintomas secundários a uma obstrução da veia cava superior, causada principalmente por neoplasias malignas. Este relato de caso demonstra uma manifestação clínica incomum dessa síndrome, o edema bilateral das mamas, e destaca a importância do conhecimento dos sinais mamográficos de doenças sistêmicas. Abstract in english Superior vena cava syndrome is defined by a set of signs and symptoms secondary to superior vena cava obstruction caused principally by malignant diseases. The present report describes the case of an unusual clinical manifestation of this syndrome with bilateral breast swelling, and emphasizes the relevance of knowledge on mammographic signs of systemic diseases.

Yamada, Ariadne Mayumi; Melo, Ana Lucia Kefalas Oliveira; Lopes, Gesner Pereira; Andrade Neto, Genesio Borges de; Monteiro, Valesca Bizinoto; Soares, Renato Santos

2013-07-01

177

Lesión traumática de la vena cava superior, parénquima e hilio pulmonar Traumatic lesion of the superior vena cava, pulmonary parenchyma and hilum  

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Full Text Available El traumatismo vascular torácico se considera una de las lesiones más complejas dentro de la traumatología, el paciente está grave desde el momento del trauma y empeora rápidamente, lo que impide en muchas ocasiones llevar a cabo medidas salvadoras. Por el pronóstico fatal que presentan los pacientes con lesiones de este tipo, resulta excepcional la curación tras la cirugía. Se presenta una paciente que sufrió una lesión traumática de la vena cava superior unida a una herida transfixiante en el lóbulo superior derecho e hilio pulmonar, la que se intervino quirúrgicamente de urgencia, se le realizó sutura vascular de la cava y lobectomía superior derecha. La paciente se recuperó satisfactoriamente.The vascular thoracic traumatism is considered one of most complex in traumatology. The patient is critical since the trauma occurs and he aggravates rapidly, which impedes many times to take saving measures. Due to the fatal prognosis presented by the patients with these lesions, their cure after surgery is exceptional. A female patient that suffered from a traumatic lesion of the superior vena cava together with a transfixing wound in the upper right lobule and pulmonary hilum, was presented. She underwent emergency surgery and vascular suture of the vena cava and right upper lobectomy were performed. The patient had a satisfactory recovery.

Norkys Martín Bourricaudy; Alberto Ignacio Piquero García; Noel Martín Junco; Osvaldo Gálvez Toledo; Dorvis Mojes Suárez

2008-01-01

178

Four-Year Patency of PTFE Grafts after Replacement of the Superior Vena Cava and the Innominate Veins  

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We describe a simpler alternative to treating vena cava syndrome with composite spiral vein grafts. Instead, we used 2 polytetrafluoroethylene (PTFE) grafts to replace the resected superior vena cava and innominate veins of a man with a malignant thymoma. Both grafts have remained patent more than 4...

Garcia-Rinaldi, Raul; Zamora, Jose L.; Torres-Salichs, Manuel; Desantos, Luis; Vaughan, George D.

179

Temporary and Permanent Inferior Vena Cava Filter Combination in a Young Patient: To Implant or Not to Implant?  

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The decision to implant vena cava filters, either temporary or permanent, is difficult in young patients. We present the case of a young man with pulmonary embolism in whom temporary and permanent inferior vena cava filters were implanted. The decision process is discussed in relation to the current literature.

2003-01-01

180

[Superior vena cava syndrome as initial manifestation of acute aortic dissection: a case report and review of the literature  

UK PubMed Central (United Kingdom)

Aortic dissection usually presents with chest pain, abnormal pulses and a widened mediastinum on chest radiograph. It is rarely associated with the superior vena cava syndrome as the first manifestation. This paper presents a patient who had a superior vena cava syndrome as a result of a painless aortic dissection and compared with other previously reported cases.

Fernández Alonso L; Flórez Pelaez S; Cerezal Garrido J; Echevarría Uribarri JR; Fulquet Carreras E; Herreros González J

1997-12-01

 
 
 
 
181

Scimitar syndrome and azygos continuation of the inferior vena cava diagnosed in an adult--an unusual association.  

UK PubMed Central (United Kingdom)

Anormal drainage of the pulmonary veins into the inferior vena cava is known as scimitar syndrome. Scimitar syndrome often presents during infancy and rarely during adulthood, and the adult patients are mostly asymptomatic. It is usually in association with dextrocardia, hypoplasia of right lung, and congenital heart defects. However, interruption of inferior vena cava with azygous continuation is rarely associated with this syndrome.

Celik M; Celik T; Iyisoy A; Ayten O

2012-09-01

182

Imaging of leiomyosarcoma of the inferior vena cava: comparison of 2 cases and review of the literature  

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Leiomyosarcoma of the inferior vena cava is a rare tumour arising from the smooth muscle fibres of the media with a mean size at diagnosis generally around 12?cm (range 2–38?cm). This study compares a 4-cm leiomyosarcoma of the inferior vena cava discovered incidentally with a symptomatic late stage...

Sessa, Barbara; Iannicelli, Elsa; Caterino, Salvatore; D’Angelo, Francesco; Milione, Massimo; Ziparo, Vincenzo

183

Successful treatment of acute inferior vena cava and unilateral renal vein thrombosis by local infusion of recombinant tissue plasminogen activator.  

Science.gov (United States)

Renal vein thrombosis can occur as a complication of nephrotic syndrome. We present the case of a young man with nephrotic syndrome caused by minimal change disease who developed acute inferior vena cava and left renal vein thrombosis. He was treated initially with intravenous heparin. Because of the persistence of severe left flank pain and gross hematuria, local infusion of recombinant tissue plasminogen activator was tried, with resolution of thrombi and subsidence of symptoms. Functional preservation of the involved kidney is good, as indicated by Tc-99m DMSA scan (involved kidney, 47.4%; uninvolved kidney, 52.6%). Anticoagulation is usually recommended as the treatment of choice in renal vein thrombosis. We believe that in cases with critical presentations, such as bilateral involvement, extension into inferior vena cava, acute renal failure, pulmonary embolism or severe flank pain, thrombolytic therapy should be considered as a second-line treatment if good response is not obtained with heparin. PMID:9856527

Lam, K K; Lui, C C

1998-12-01

184

Successful treatment of acute inferior vena cava and unilateral renal vein thrombosis by local infusion of recombinant tissue plasminogen activator.  

UK PubMed Central (United Kingdom)

Renal vein thrombosis can occur as a complication of nephrotic syndrome. We present the case of a young man with nephrotic syndrome caused by minimal change disease who developed acute inferior vena cava and left renal vein thrombosis. He was treated initially with intravenous heparin. Because of the persistence of severe left flank pain and gross hematuria, local infusion of recombinant tissue plasminogen activator was tried, with resolution of thrombi and subsidence of symptoms. Functional preservation of the involved kidney is good, as indicated by Tc-99m DMSA scan (involved kidney, 47.4%; uninvolved kidney, 52.6%). Anticoagulation is usually recommended as the treatment of choice in renal vein thrombosis. We believe that in cases with critical presentations, such as bilateral involvement, extension into inferior vena cava, acute renal failure, pulmonary embolism or severe flank pain, thrombolytic therapy should be considered as a second-line treatment if good response is not obtained with heparin.

Lam KK; Lui CC

1998-12-01

185

Cement embolization into the vena cava and pulmonal arteries after vertebroplasty: interdisciplinary management.  

UK PubMed Central (United Kingdom)

PURPOSE: To report interdisciplinary management in a case of cement embolization into the inferior vena cava and peripheral pulmonary arteries after percutaneous vertebroplasty. CASE REPORT: A 50-year-old female patient with an osteoporotic compression fracture of the second lumbar vertebra underwent percutaneous vertebroplasty with polymethylmetaacrylate. Thereafter, CT scanning revealed small asymptomatic cement emboli in peripheral pulmonary arteries, along with a hook-shaped cement fragment in the inferior vena cava. Due to the risk that the large cement fragment could migrate to the pulmonary arteries and cause serious complications, they were retrieved from the inferior vena cava by an endovascular technique and extracted through a surgical groin incision. The patient received anticoagulant treatment for 3 months and is free of complaints after 1 year. CONCLUSION: This case shows that this rare complication following vertebroplasty can be successfully managed with an interdisciplinary approach.

Baumann A; Tauss J; Baumann G; Tomka M; Hessinger M; Tiesenhausen K

2006-05-01

186

Vena cava filters for management of venous thromboembolism: A clinical review.  

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Venous thromboembolism (VTE) is the common cause of morbidity and mortality. Vena cava filters (VCF) represent an important alternative to anticoagulation for management of VTE. VCF use has increased dramatically with the availability of retrievable filters. Since indiscriminate use of VCF can be associated with net patient harm, knowledge of the risks and benefits of these devices is essential to optimal evidence-based practice. In this review, we will examine the characteristics of available permanent and optional VCF, their efficacy and safety in management of VTE and discuss appropriate, extended and unsubstantiated indications for VCF use. We will also review the clinical outcomes of VCF in alternative placement sites (supra-renal inferior vena cava and superior vena cava) and in specialized patient populations (bariatric surgery, cancer, etc.), recommendations regarding anticoagulation for prevention of thrombosis as well as recommended follow up for patients with VCF. PMID:23932118

Rajasekhar, Anita; Streiff, Michael B

2013-08-07

187

Surgical treatment of right-sided renal lymphoma with invasion of the caudal vena cava.  

UK PubMed Central (United Kingdom)

An eight-year-old, male castrated basset hound presenting with a three-month history of lethargy was examined. Diagnostic tests including radiography and ultrasonography showed a right-sided renal mass. A 99mTc diethylenetriamine penta-acetic acid scan demonstrated that this kidney was non-functional. At surgery, invasion of the caudal vena cava was found, and the renal segment of the vena cava and the right kidney were resected. The left renal vein was anastomosed to the more proximal vena cava using a polytetrafluoroethylene graft, and the dog recovered well. Two days postsurgery, the dog suffered an acute episode of aspiration pneumonia and was euthanased. The renal mass was diagnosed as lymphoma on histopathology.

Lascelles BD; Monnet E; Liptak JM; Johnson J; Dernell WS

2003-03-01

188

Angiography of azygos continuation of inferior vena cava in situs ambiguus with left isomerism (polysplenia syndrome)  

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We have in our records 11 patients with situs ambiguus and left isomerism (polysplenia). Ten had an interruption of the inferior vena cava (IVC) with azygos continuation; in eight cases the continuation was to the left superior vena cava (LSVC), in one case to the right superior vena cava (RSVC) and in one case to both the LSVC and RSVC. Two patients underwent surgical correction by a buffle procedure of the functioning single atrium. The angiographic confirmation of the azygos system anatomy is important in planning the surgical correction of patients with left isomerism. Clinically, given the same heart defects with normal pressures, the rightsided drainage is probably more favorable, producing less peripheral desaturation.

Roguin, N.; Hammerman, H.; Korman, S.; Riss, E.

1984-02-01

189

Vena cava filters for management of venous thromboembolism: A clinical review.  

UK PubMed Central (United Kingdom)

Venous thromboembolism (VTE) is the common cause of morbidity and mortality. Vena cava filters (VCF) represent an important alternative to anticoagulation for management of VTE. VCF use has increased dramatically with the availability of retrievable filters. Since indiscriminate use of VCF can be associated with net patient harm, knowledge of the risks and benefits of these devices is essential to optimal evidence-based practice. In this review, we will examine the characteristics of available permanent and optional VCF, their efficacy and safety in management of VTE and discuss appropriate, extended and unsubstantiated indications for VCF use. We will also review the clinical outcomes of VCF in alternative placement sites (supra-renal inferior vena cava and superior vena cava) and in specialized patient populations (bariatric surgery, cancer, etc.), recommendations regarding anticoagulation for prevention of thrombosis as well as recommended follow up for patients with VCF.

Rajasekhar A; Streiff MB

2013-09-01

190

MARCADORES SONOGRAFICOS DE CARDIOPATIAS CONGENITAS. INTERRUPCION DE LA VENA CAVA INFERIOR: A PROPOSITO DE NUESTRA EXPERIENCIA Y RESULTADOS  

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Full Text Available Consideramos marcadores de cardiopatías congénitas al grupo de lesiones que, pudiendo ser variantes normales, se asocian a defectos cardíacos. En esta primera publicación destacamos la importancia del diagnóstico de la interrupción de la vena cava inferior (VCI) y su continuación por el sistema azygos, como un marcador de isomerismo auricular y poliesplenia. En toda nuestra serie de cardiopatías congénitas (Cc), hemos diagnosticado 5 anomalías de la VCI, 4 de ellas correspondieron a interrupciones sin Cc asociadas. Reportamos los hallazgos in utero y el seguimiento postnatal de estos casos, la técnica más apropiada para su pesquisa y su asociación a CcWe consider markers of congenital hear disease a group of anomalies which could be a normal variant in general population but might be associated to structural defects of the fetal heart. One of those marks is the interruption of the inferior vena cava with azygos vein continuation. Among 5 abnormalities of the inferior vena cava diagnosed in our series, we found 4 interruption of the IVC. We discuss in utero abnormalities and follow-up. We propose the technique to screen a group of congenital heart disease with the vascular arrangements in the fetal abdomen

Fernando Viñals L.; Marcela Muñoz F.; Arrigo Giuliano B.

2002-01-01

191

A 22-Year-Old Female with Invasive Epithelioid Angiomyolipoma and Tumor Thrombus into the Inferior Vena Cava: Case Report and Literature Review  

Science.gov (United States)

A 22-year-old female presented with back pain and was discovered to have a right-sided abdominal mass. Computed tomography (CT) scan revealed a 9?cm enhancing right upper pole renal mass with suspicion for tumor thrombus into the right renal vein and possibly the inferior vena cava (IVC). Magnetic resonance imaging (MRI) confirmed tumor thrombus into the inferior vena cava approximately 3?cm below the hepatic venous confluence. Open right radical nephrectomy with inferior vena cava thrombectomy was performed with removal of right kidney and tumor thrombus en bloc. Pathology revealed malignant epithelioid angiomyolipoma (EAML or PEComa). Epithelioid angiomyolipoma is a rare tumor of mesenchymal tissue that has the potential for local invasion and disease progression. Diagnosis of EAML was confirmed by pathology and immunohistochemistry. She was referred to medical oncology for discussion of surveillance versus potential adjuvant therapy and ultimately opted for close surveillance.

Grant, Campbell; Lacy, John M.; Strup, Stephen E.

2013-01-01

192

Intracranial hemorrhage due to intracranial hypertension caused by the superior vena cava syndrome.  

Science.gov (United States)

We report a patient with intracranial hemorrhage secondary to venous hypertension as a result of a giant aortic pseudoaneurysm that compressed the superior vena cava and caused obstruction of the venous return from the brain. To our knowledge, this is the first patient reported to have an intracranial hemorrhage secondary to a superior vena cava syndrome. The condition appears to be caused by a reversible transient rise in intracranial pressure, as a result of compression of the venous return from the brain. Treatment consisted of surgery for the aortic pseudoaneurysm, which led to normalization of the intracranial pressure and resorption of the intracranial hemorrhage. PMID:23665082

Bartek, Jiri; Abedi-Valugerdi, Golbarg; Liska, Jan; Nyström, Harriet; Andresen, Morten; Mathiesen, Tiit

2013-05-09

193

Inferior vena cava CT pseudothrombus produced by rapid arm-vein contrast infusion  

International Nuclear Information System (INIS)

Laminar flow within the inferior vena cava can cause artifacts that may simulate thrombus if a foot-vein infusion is used. A pseudothrombus artifact within the suprarenal inferior vena cava produced by rapid infusion of contrast material through an arm vein is reported. This artifact wasa noted in 25 patients in a 6 month period and was believed to be from laminar flow of renal venous effluent of increased opacity around less opacified infrarenal caval contents. Differentiation from true thrombus can be made by the use of delayed scans as well as the increased density and relatively poor margination of the artifact.

1985-01-01

194

Reevaluation of transthoracic fine needle aspiration biopsy in diagnosing superior vena cava syndrome  

Energy Technology Data Exchange (ETDEWEB)

Superior vena cava syndrome has various aetiologies but in the majority of cases it is caused by a malignant mass. Assessment of the underlying pathology as rapidly and reliably as possible is very important for proper therapy management. Dynamic computed tomography examination of the chest can differentiate patients in whom superior vena cava obstruction is caused by a mass, from those with a vascular aetiology. In patients with a mass, fine needle aspiration biopsy guided by the computed tomographic examination may provide cytological diagnosis in a fast and well tolerated manner.

Adler, O.B.; Rosenberger, A.

1988-11-01

195

Scimitar syndrome associated with partial anomalous pulmonary venous draining into superior vena cava.  

UK PubMed Central (United Kingdom)

Scimitar syndrome is a rare congenital cardiopulmonary malformation characterized by hypoplasia of the right lung and drainage of the right pulmonary veins into the vena cava inferior. It may also be associated with cardiac dextroversion and anomalies of the tracheobronchial system, cardiovascular system, and diaphragm. Some cases are asymptomatic with others diagnosed in early-childhood period with pulmonary hypoplasia and other associated malformations. We present here a patient whose venous return of the middle and lower lobes of the right lung is into the superior vena cava, which is a very unusual finding for this disorder.

Demir E; A?kin M; Midyat L; Gülen F; Ulger Z; Tanaç R; Bayraktaro?lu S

2010-10-01

196

Left-sided duplication of inferior vena cava: clinical implications in a patient with sigmoid adenocarcinoma.  

UK PubMed Central (United Kingdom)

Double inferior vena cava is a rare congenital anomaly, usually detected by computed tomography or magnetic resonance imaging. Although asymptomatic, it may have a clinical significance, as it may mimic a para-aortic lymphadenopaty. A case of left-sided duplication of the inferior vena cava in a patient with sigmoid colon cancer is presented. The diagnostic pitfalls and clinical implications are discussed. Accurate preoperative assessment of such an anatomical variant is of utmost importance, this way potentially life-threatening surgical complications, particularly when a minimally invasive approach is planned, are prevented.

Dumitru R; Scarlat A; lonescu M; Dumitrascu T

2012-07-01

197

Radiotherapeutic handling in the compression syndrome of the superior vena cava  

International Nuclear Information System (INIS)

Superior vena cava syndrome is an uncommon emergency occuring in bronchogenic carcionoma and lymphomas, and it is even less frequent in benign diseases. It requires rapid and effective treatment. Dramatic regression can be seen in a few days. This serie analyses clinical characteristics in 29 patients treated in our Department between 1981 and 1986. Four cases were excluded in the study of response. The total dose was around 6000 cGy/6 weeks given in high or standard daily initial doses. Responses were very satisfactory. Some patients were given chemotherapy before or during the radiation course and the results were compared to radiation alone. There was no advantage in combined therapy. Chemotherapy is viewed in the literature as the main choice when oat-cell carcinoma or lymphoma is the underlying disease. (author).

1989-01-01

198

[A case of persistent left superior vena cava with absent right superior vena cava found on the insertion of central venous catheter].  

UK PubMed Central (United Kingdom)

A 77-year-old man was scheduled to undergo the resection of hepatoma. After the induction of general anesthesia, a central venous (CV) catheter was inserted from the right internal jugular vein under the echographic observation. Then, we noticed that the size of the vein was smaller than usual, which caused a little difficulty in the insertion. The post-insertion chest X-ray showed unusual placement of the catheter's tip toward the left side of the trachea. Re-evaluation of preoperative CT revealed the persistent left superior vena cava (PLSVC) with absent right superior vena cava. Post-operative examination with echography of the neck showed that the left internal jugular vein was much greater than the right. When noticing a small right internal jugular vein in pre-procedure echography, existence of PLSVC should be considered, and meticulous CV catheterization is necessary for safety.

Taniguchi N; Kai T; Kandabashi T; Miyazaki R; Hoka S

2013-07-01

199

Herida penetrante en el corazón y en ambas venas cavas. Presentación de un caso. Penetrating injuries in heart and in both venae cavae. A case report.  

Directory of Open Access Journals (Sweden)

Full Text Available Se presenta un caso de herida combinada en el corazón y en los grandes vasos. La lesión interesó aurícula derecha y vena cava superior e inferior, en sus porciones intrapericárdicas. Dichos daños fueron reparados por cardiorrafia y fleborrafía respectivamente. La paciente presentó múltiples complicaciones en el posoperatorio, pero finalmente se recuperó totalmente. Se exponen además algunos aspectos fisiopatológicos y del manejo actual de los traumatismos cardíacos penetrantes. Esta triple lesión es infrecuente y se acompaña de mortalidad elevada. We report a case of a combined wound of the heart and in the great vessels. The injury affected the right auricle and the inferior and the superior vena cava in their intrapericardiac portions. These damages were repaired by cardiorrhaphy and phleborraphy, respectively. The patient had multiple complications in the postoperative period but finally he recovered completely. Some physiopathologic aspects and of the present management of penetrating cardiac traumatisms are approached. This triple injury is not frequent and its mortality is high.

Manuel Espinel González; Eduardo Dopico Reyes; Luis Martínez Arencibia

1997-01-01

200

Design Optimization of Vena Cava Filters: An application to dual filtration devices  

Energy Technology Data Exchange (ETDEWEB)

Pulmonary embolism (PE) is a significant medical problem that results in over 300,000 fatalities per year. A common preventative treatment for PE is the insertion of a metallic filter into the inferior vena cava that traps thrombi before they reach the lungs. The goal of this work is to use methods of mathematical modeling and design optimization to determine the configuration of trapped thrombi that minimizes the hemodynamic disruption. The resulting configuration has implications for constructing an optimally designed vena cava filter. Computational fluid dynamics is coupled with a nonlinear optimization algorithm to determine the optimal configuration of trapped model thrombus in the inferior vena cava. The location and shape of the thrombus are parameterized, and an objective function, based on wall shear stresses, determines the worthiness of a given configuration. The methods are fully automated and demonstrate the capabilities of a design optimization framework that is broadly applicable. Changes to thrombus location and shape alter the velocity contours and wall shear stress profiles significantly. For vena cava filters that trap two thrombi simultaneously, the undesirable flow dynamics past one thrombus can be mitigated by leveraging the flow past the other thrombus. Streamlining the shape of thrombus trapped along the cava wall reduces the disruption to the flow, but increases the area exposed to abnormal wall shear stress. Computer-based design optimization is a useful tool for developing vena cava filters. Characterizing and parameterizing the design requirements and constraints is essential for constructing devices that address clinical complications. In addition, formulating a well-defined objective function that quantifies clinical risks and benefits is needed for designing devices that are clinically viable.

Singer, M A; Wang, S L; Diachin, D P

2009-12-03

 
 
 
 
201

Survival of patients with renal cell carcinoma invading the inferior vena cava.  

UK PubMed Central (United Kingdom)

Renal cell carcinoma with extension of tumor thrombus into the vena cava occurs in 5% to 10% of patients diagnosed. It is important to determine the extent of the thrombus to plan the operative approach. As long as there is no evidence of metastatic disease to viscera or bones or involvement of the lymph nodes, radical nephrectomy with removal of the tumor thrombus remains the best treatment for patients and provides the best opportunity for long-term survival. In properly selected patients, extended operation offers good long-term survival as observed in patients treated at the Lahey-Hitchcock Clinic, where a demonstrated 5-year survival of 64% and a 10-year survival of 57% was achieved.

Mattos RM; Libertino JA

1996-11-01

202

[Surgical treatment of the renal carcinoma with inferior vena cava thrombus and filter].  

UK PubMed Central (United Kingdom)

OBJECTIVE: Vascular invasion in the form of tumour thrombus appears in a significant percentage of renal neoplasias. The importance of cephalic extension of the thrombus in prognosis is currently under discussion, but surgical treatment is mandatory in the absence of distant metastasis. METHODS: We report the case of a 56-year-old male patient with a filter in the inferior vena cava, who underwent surgery in our department through a thoracoabdominal approach with extracorporeal circulation, deep hypothermia (below 18 degrees C) and cerebral retrograde perfusion. RESULTS: Although in the past it was believed tumour thrombus worsened prognosis in these patients, currently we know that surgical treatment, in selected cases, gives good results in terms of survival and disease-free time. CONCLUSIONS: We think the implementation of venous filters may increase the complexity of surgery.

Escudero JU; de Campos MR; López SC; Deltoro MF; Vidal EM

2008-07-01

203

Leiomyosarcoma of inferior vena cava: a case series of four cases.  

Science.gov (United States)

Vascular leiomyosarcomas are rare tumors, arising most frequently from inferior vena cava (IVC). They are mostly seen in sixth decade, with a female predominance. Their diagnosis is often challenging, as patients may present with non-specific complaints such as dyspnea, malaise, weight loss, abdominal pain, or back pain, preceding the diagnosis by several years. Leiomyosarcoma of the IVC most frequently occurs in the middle segment. The final diagnosis can be made by an ultrasound or computed tomography guided biopsy. Because of limited experience with this disease, optimal management of IVC leiomyosarcoma is unknown. Curative surgical resection remains the current treatment of choice for primary leiomyosarcoma of IVC. Neoadjuvant therapy may be given to downsize the tumor and increase resectability rates. Nonetheless, when complete resection is not possible, debulking combined with radiation therapy still provides good palliation. We, hereby, report four cases of this rare entity with emphasis on management. PMID:22499308

Yadav, Rajni; Kataria, Kamal; Mathur, Sandeep R; Seenu, V

204

Mediastinal and pulmonary entomophthoromycosis with superior vena cava syndrome: case report Entomoftoromicose mediastinal e pulmonar com síndrome de veia cava superior: registro de caso  

Directory of Open Access Journals (Sweden)

Full Text Available The first case of mediastinal and pulmonary entomophthoromycosis with supe rior vena cava syndrome is reported. The patient presented with a history of edema of the face, neck and upper limbs as well as collateral circulation in the anterior wall of the chest. Histological examination of tissue from mediastinum revealed a granulomatous reaction with microabscesses surrounded by eosinophilic amorphous material and with broad hyphae in the center. Culture was not performed because a preliminary diagnosis of nonHodgkin's malignant lymphoma was made. Surgical correction of the obstructed area was performed and the patient was sucessfully treated with potassium iodide. The authors propose that mediastinal entomoph thoromycosis must be considered in the differential diagnosis of diseases causing superior vena cava syndrome in tropical and sub-tropical regions. This case enlarges the spectrum of clinical manifestations of the zigomycosis caused by Entomoph-thoraceae.O primeiro caso de entomoftoromicose mediastinal e pulmonar com síndorme de veia cava superior, é descrito. A paciente apresentou-se com historia de edema facial, cervical e de membros superiores, bem como circulação colateral na parede anterior do tórax. O estudo histopatológico do tecido do mediastino, próximo à veia cava, revelou reação granulomatosa com microabscesses, circundados por material amorfo, eosinofílico e com hifas largas no centro. Cultura não foi realizada porque o diagnóstico clínico foi de doença de Hodgkin ou de um linfoma não-Hodgkin. Correção cirúrgica da área obstruída foi realizada e a paciente tratada com iodeto de potássio, nas doses preconizadas, obtendo-se sucesso. Os autores propõem que a entomoftoro-micose mediastinal deva ser considerada no diagnóstico diferencial de doença causando síndrome de veia cava superior em regiões tropicais e subtropicais. Este caso aumenta o espectrum de manifestações clínicas das zigomicoses causadas por Entomophthoraceae.

João Carlos Coelho Filiio; Jorge Pereira; Álvaro Rabello Júnior

1989-01-01

205

Leiomioma benigno metastatizante de veia cava inferior: rara complicação tardia de histerectomia/ Benign metastasizing leiomyoma of inferior vena cava: a rare condition following hysterectomy  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english Large vessel tumors diagnosis is usually difficult. Benign metastasizing leiomyoma is a rare condition occurring inside peripheral vessels. There are few publications about this tumor inside inferior vena cava. A 54 years old female patient is presented with a previous hysterectomy for myomas. She complained of no specific symptoms 18 months after surgery. Computer tomography revealed a 7.5 x 3.5 x 4.0 cm mass at inferior vena cava and right psoas muscle. After surgical m (more) anagement and immunohistochemical screening biopsy, the diagnosis was benign metastasizing leiomyoma of inferior vena cava. The patient recovery was uneventful. Benign metastasizing leiomyoma of inferior vena cava is a very rare condition, and must be suspected in patients with primary leiomyosarcoma, especially in women previously submitted to hysterectomy for leiomyomatosis.

Filgueiras, Marcos; Lima Jr, Antônio Carlos Barros; Baldoni, Walter Giulliano; Milezi, Washington Sérgio Gonçalves; Zorron, Ricardo

2008-08-01

206

Agenesia de vena cava inferior en un caso de autopsia forense/ Absence of the inferior cava vein in a case of forensic autopsy  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish La agenesia de vena cava inferior es una entidad congénita poco frecuente que a menudo se asocia con otras severas anomalías congénitas o malposiciones viscerales. También ha sido descrita como un factor de riesgo de trombosis venosa en pacientes jóvenes. La mayoría de los casos publicados proceden de estudios radiológicos y muy raramente aparece como hallazgo necrópsico. Presentamos un caso de agenesia de vena cava inferior, sin otras anomalías asociadas, que apareció como hallazgo incidental en una autopsia forense. Abstract in english The absence of the inferior vena cava is a rare congenital anomaly, often associated with severe congenital deformities and visceral position abnormalities. It has been described also as a risk factor for deep vein thrombosis in young patients. We present a case of congenital absence of inferior vena cava appeared as an incidental finding in a forensic autopsy.

Subirana Domènech, M.; Galtés Vicente, I.; Font Valsecchi, G.; Xifró Collsamata, A.

2011-06-01

207

Agenesia de vena cava inferior en un caso de autopsia forense Absence of the inferior cava vein in a case of forensic autopsy  

Directory of Open Access Journals (Sweden)

Full Text Available La agenesia de vena cava inferior es una entidad congénita poco frecuente que a menudo se asocia con otras severas anomalías congénitas o malposiciones viscerales. También ha sido descrita como un factor de riesgo de trombosis venosa en pacientes jóvenes. La mayoría de los casos publicados proceden de estudios radiológicos y muy raramente aparece como hallazgo necrópsico. Presentamos un caso de agenesia de vena cava inferior, sin otras anomalías asociadas, que apareció como hallazgo incidental en una autopsia forense.The absence of the inferior vena cava is a rare congenital anomaly, often associated with severe congenital deformities and visceral position abnormalities. It has been described also as a risk factor for deep vein thrombosis in young patients. We present a case of congenital absence of inferior vena cava appeared as an incidental finding in a forensic autopsy.

M. Subirana Domènech; I. Galtés Vicente; G. Font Valsecchi; A. Xifró Collsamata

2011-01-01

208

[Carcinoma of the Pararenal Gland Infiltrating the Surrounding Tissue and Involving the Inferior Vena cava].  

UK PubMed Central (United Kingdom)

A 61-year-old woman presented with a 2-month-history of progressive deterioration, increasing exertional dyspnoea and pain in the right upper abdomen (past medical history: bronchial asthma and hypertension). The physical examination showed mild generalized weakness, tenderness in the right upper abdomen, and ascites.Laboratory studies did not reveal any hormonal abnormalities. A CT angiogram revealed a mass of the right adrenal gland with distinct invasion into the inferior vena cava, and tumour thrombosis that extended proximally into the right atrium. Distally, the tumour ended at the caudate lobe of the liver with an extensive peripherally engulfed thrombus from the inferior vena cava down to the common iliac -veins.An open right adrenalectomy with resection of the periadrenal tissue and exstirpation of the intracaval tumour thrombus (by cavotomy under digital occlusion of the blood flow from the vena cava into the right atrium - cardiac surgeon) was carried out with no significant postoperative complications. Subsequently, the patient underwent adjuvant mitotane therapy for 3 years. So far, no recurrence has occurred during a course of 7 years.Tumour induced thrombotic occlusion of the inferior vena cava and other veins is rare, especially with right atrium involvement. In the absence of other effective treatment options, the combination of radical resection and adjuvant mitotane therapy remains the only successful curative treatment for primary invasive pararenal gland carcinoma.

Dillner J; Meyer F; Lippert H; Huth C; Klose S; Roessner A; Halloul Z

2013-09-01

209

[Carcinoma of the Pararenal Gland Infiltrating the Surrounding Tissue and Involving the Inferior Vena cava].  

Science.gov (United States)

A 61-year-old woman presented with a 2-month-history of progressive deterioration, increasing exertional dyspnoea and pain in the right upper abdomen (past medical history: bronchial asthma and hypertension). The physical examination showed mild generalized weakness, tenderness in the right upper abdomen, and ascites.Laboratory studies did not reveal any hormonal abnormalities. A CT angiogram revealed a mass of the right adrenal gland with distinct invasion into the inferior vena cava, and tumour thrombosis that extended proximally into the right atrium. Distally, the tumour ended at the caudate lobe of the liver with an extensive peripherally engulfed thrombus from the inferior vena cava down to the common iliac -veins.An open right adrenalectomy with resection of the periadrenal tissue and exstirpation of the intracaval tumour thrombus (by cavotomy under digital occlusion of the blood flow from the vena cava into the right atrium - cardiac surgeon) was carried out with no significant postoperative complications. Subsequently, the patient underwent adjuvant mitotane therapy for 3 years. So far, no recurrence has occurred during a course of 7 years.Tumour induced thrombotic occlusion of the inferior vena cava and other veins is rare, especially with right atrium involvement. In the absence of other effective treatment options, the combination of radical resection and adjuvant mitotane therapy remains the only successful curative treatment for primary invasive pararenal gland carcinoma. PMID:24043537

Dillner, J; Meyer, F; Lippert, H; Huth, C; Klose, S; Roessner, A; Halloul, Z

2013-09-16

210

Retrohepatic cavoatrial bypass for coarctation of inferior vena cava with a polytetrafluoroethylene graft.  

Science.gov (United States)

Eight patients with chronic Budd-Chiari syndrome resulting from coarctation of the inferior vena cava underwent operation. Transatrial dilatation was of no avail in the first case. The obstructed segment was directly visualized in the subsequent seven cases by a transthoracic, transdiaphragmatic, retroperitoneal approach. In these latter seven cases, severe hourglass constriction of the inferior vena cava was observed just above the right hepatic vein. There was no evidence of inflammation, extrinsic compression, or thrombosis. Retrohepatic cavoatrial bypass with an antibiotic-sterilized aortic homograft was unsuccessful in three patients. Five patients including one with homograft failure underwent successful retrohepatic cavoatrial bypass with a polytetrafluoroethylene graft (20 mm plain in four cases and 16 mm ringed graft in one case). These patients have been followed up for 21 months to 6 years with no recurrence of symptoms. The term coarctation of the inferior vena cava appears more appropriate than membranous obstruction of the inferior vena cava because of the operative findings in the present series. PMID:3941565

Victor, S; Jayanthi, V; Kandasamy, I; Ratnasabapathy, A; Madanagopalan, N

1986-01-01

211

Retrohepatic cavoatrial bypass for coarctation of inferior vena cava with a polytetrafluoroethylene graft.  

UK PubMed Central (United Kingdom)

Eight patients with chronic Budd-Chiari syndrome resulting from coarctation of the inferior vena cava underwent operation. Transatrial dilatation was of no avail in the first case. The obstructed segment was directly visualized in the subsequent seven cases by a transthoracic, transdiaphragmatic, retroperitoneal approach. In these latter seven cases, severe hourglass constriction of the inferior vena cava was observed just above the right hepatic vein. There was no evidence of inflammation, extrinsic compression, or thrombosis. Retrohepatic cavoatrial bypass with an antibiotic-sterilized aortic homograft was unsuccessful in three patients. Five patients including one with homograft failure underwent successful retrohepatic cavoatrial bypass with a polytetrafluoroethylene graft (20 mm plain in four cases and 16 mm ringed graft in one case). These patients have been followed up for 21 months to 6 years with no recurrence of symptoms. The term coarctation of the inferior vena cava appears more appropriate than membranous obstruction of the inferior vena cava because of the operative findings in the present series.

Victor S; Jayanthi V; Kandasamy I; Ratnasabapathy A; Madanagopalan N

1986-01-01

212

[Hydronephrosis caused by inferior vena cava penetration by a mobin-uddin filter].  

UK PubMed Central (United Kingdom)

The inferior vena cava (IVC) filter placement represents an excellent protection from significant pulmonary embolism in at-risk patients. Perforation of the wall of the IVC by components of caval filters is a recognized complication. We report a case of asymptomatic hydronephrosis caused by transcaval penetration of a Mobin-Uddin filter.

Fugini AV; Mirabella G; Perucchini L; Zani D; Simeone C; Cunico SC

2010-07-01

213

The treatment of recurrent pulmonary embolism: experience with the Kimray Greenfield vena cava filter.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Clinical experience with the Kimray Greenfield vena cava filter in 24 patients, most of whom suffered recurrent pulmonary embolism despite heparin treatment, is presented. The advantages of this filter over previous trans-venous filters is discussed. Initial results show the filter to be both safe a...

Scurr, J. H.; Jarrett, P. E.; Wastell, C.

214

Inferior vena cava thrombosis in a pediatric patient of amebic liver abscess.  

UK PubMed Central (United Kingdom)

Amebic liver abscess (ALA) in pediatric age group is rare. We describe a successful thrombectomy and open drainage of a large left lobe ALA associated with thrombus in the hepatic veins and inferior vena cava extending into the right atrium in a 6-year-old boy.

Gupta A; Dhua AK; Siddiqui MA; Dympep B; Grover V; Gupta VK; Sen A

2013-01-01

215

Cytologic diagnosis of renal carcinoma in the presence of inferior vena cava obstruction: Case report  

International Nuclear Information System (INIS)

Diagnostic work-up and staging of patients with renal tumors usually includes inferior vena cavography. In this case, complete occlusion of the cava was demonstrated by cavography while catheder aspiration yielded tumor fragments diagnostic of renal adenocarcinoma. Transcatheter aspiration in the presence of caval obstruction can provide preoperative tissue diagnosis as well as accurate tumor staging information. (orig.)

1983-01-01

216

Cytologic diagnosis of renal carcinoma in the presence of inferior vena cava obstruction: Case report  

Energy Technology Data Exchange (ETDEWEB)

Diagnostic work-up and staging of patients with renal tumors usually includes inferior vena cavography. In this case, complete occlusion of the cava was demonstrated by cavography while catheder aspiration yielded tumor fragments diagnostic of renal adenocarcinoma. Transcatheter aspiration in the presence of caval obstruction can provide preoperative tissue diagnosis as well as accurate tumor staging information.

Mulligan, B.D.; Mafee, M.; Sahgal, S.

1983-08-01

217

Umbilical vein draining into the inferior vena cava via the internal iliac vein, bypassing the liver  

Energy Technology Data Exchange (ETDEWEB)

This is the third report of an anomalous umbilical vein draining ectopically in a left pelvic vein, probably the left internal iliac, and through the inferior vena cava into the right atrium. The anomaly was encountered in a newborn infant with nonimmune hydrops fetalis, hypertrophic cardiomyopathy, multiorgan failure and possibly Noonan Syndrome. (orig.).

Currarino, G.; Stannard, M.W. (Children' s Medical Center, Dallas, TX (United States). Dept. of Radiology Texas Univ., Dallas, TX (United States). Southwestern Medical Center); Kolni, H. (Methodist Hospital, Dallas, TX (United States). Dept. of Pediatrics)

1991-05-01

218

Sonographic appearance of an advanced invasive mole and associated metastatic thrombus in the inferior vena cava.  

UK PubMed Central (United Kingdom)

We present a case of an advanced invasive mole with a metastatic thrombus in the inferior vena cava in which sonography clearly showed vesicles in the myometrium, ovaries, and metastatic thrombus leading to a diagnosis of invasive mole rather than choriocarcinoma.

Okumura M; Fushida K; Pulcineli Vieira Francisco R; Schultz R; Zugaib M

2013-02-01

219

Ultrasound of the Inferior Vena Cava Does Not Predict Hemodynamic Response to Early Hemorrhage  

DEFF Research Database (Denmark)

Ultrasonographic evaluation of the inferior vena cava (IVC) provides information on central hemodynamics and predicts fluid responsiveness during positive pressure ventilation. In spontaneously breathing patients, the correlations between IVC dynamics and the hemodynamic response to volume shifts remain to be described.

Juhl-Olsen, Peter; Vistisen, Simon T

2013-01-01

220

Cirugía del carcinoma renal con trombo tumoral en vena cava-aurícula/ Surgical management of renal cell carcinoma with vena cava - right atrium thrombus  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Históricamente se consideró la presencia de trombosis tumoral de la vena cava como un factor de mal pronóstico en pacientes con carcinoma renal y controvertido el beneficio de la cirugía radical en estos pacientes. Sin embargo, la trombosis puede presentarse en ausencia de afectación ganglionar o metastásica, en cuyo caso si parece justificada una actitud quirúrgica agresiva con finalidad curativa. Presentamos nuestra experiencia con 25 pacientes con carcinoma rena (more) l y trombo en vena cava-aurícula tratados mediante nefrectomía radical con cavotomía y resección completa del trombo tumoral. La Resonancia Nuclear Magnética (IRM) permitió establecer con exactitud el nivel del trombo en todos los casos: 56% nivel I, 8% nivel II, 26% nivel III. La serie corresponde a 14 pT3b, 8 pT3c, 3 pT4, con 48% de N+. La tasa de complicaciones operatorias fue del 36% con una mortalidad del 16%. Pacientes sin compromiso ganglionar ni metástasis tuvieron una supervivencia media del 64%, 46% y 37% a los 2,3,4 años respectivamente. En los casos con afectación ganglionar y metastásica el pronóstico es claramente peor. No hemos encontrado una relación clara entre el nivel del trombo y la supervivencia. Abstract in english Historically the presence of a thrombus in vena cava was associatted with worse prognosis in patients with renal cell carcinoma, and the effective of surgery limited. However a extensive tumor thrombi can be present without evidence of lymph node and distant metastasis, an aggressive surgical approach with curative intent is justified. We retrospectively reviewed 25 patients with renal cell carcinoma and thrombus in vena cava and they underwent radical nephrectomy and thr (more) ombectomy. The IRM allowed to know the level of the thrombus into vena cava in all patients: 56% level I, 8% level II, 26% level III. There were 14 pT3b, 8 pT3c, 3 pT4, and 48% N+. The rate of complications was 36% and there were 4 perioperative death (16%). Patients without lymph node and no distant metastasis had a mean survival of 64% 46%, 37% to 2,3,4 years respectively. Patients with lymph node invasive an distant metastasis the prognosis was poor. We no noted correlation between level thrombus and prognosis.

Ruibal Moldes, M.; Álvarez Castelo, L.; Chantada Abal, V.; Blanco Díez, A.; Fernández Rosado, E.; González Martín, M.

2003-08-01

 
 
 
 
221

Inserción accidental de catéter para hemodiálisis en vena cava superior izquierda persistente Accidental implantation of hemodialysis catheter in persistent left superior vena cava  

Directory of Open Access Journals (Sweden)

Full Text Available La implantación de catéteres centrales para hemodiálisis en pacientes con falla renal es una práctica común. El acceso venoso por punción percutánea de la vena yugular interna es la ruta más recomendada debido a que genera el menor porcentaje de estenosis. La punción de la vena yugular interna derecha es la más conveniente por su trayecto vertical hacia la aurícula derecha, pero en ocasiones su canalización es imposible siendo necesario puncionar la vena yugular interna izquierda, la cual se continúa con la vena innominada desembocando en la cava superior, de ahí que su trayecto sea muy tortuoso. Se describen tres casos en los cuales el catéter yugular interno izquierdo que se insertó para realizar hemodiálisis, accidentalmente canalizó la vena cava superior izquierda anormalmente persistente. En todos los casos y antes de proceder con la hemodiálisis se demostró bien sea por gases del vaso puncionado, ecocardiograma o medio de contraste que el catéter se encontraba posicionado en el sistema venoso que drena en la aurícula derecha.The implantation of central catheters for hemodialysis in patients with renal failure is a common practice. The venous access to the internal jugular vein through percutaneous puncture is the most recommended procedure because it produces the lowest percentage of stenosis. The right internal jugular vein puncture is the most appropriate one because it goes directly in vertical direction into the right atrium, but in some cases its canalization is impossible making it necessary to puncture the left internal jugular vein, the one next to the innominated vein that ends in the superior cava, with the result that its path is much curved. 3 cases in which the left intern jugular catheter that was inserted to perform hemodialysis accidentally canalized the anomaly in the persistent left superior vena cava were presented. In all the cases and before proceeding with the hemodialysis it was demonstrated by the gases of the punctuated vessel, echocardiogram or contrast medium that the catheter was positioned in the venous system that drains in the right atrium.

Jairo Cruz; César A Restrepo V

2007-01-01

222

A confusing case: pulmonary lesions including cavities, isolated left heart endocarditis and inferior vena cava thrombosis in a patient with perforated diverticulitis.  

Science.gov (United States)

There are numerous causes of pulmonary cavitary lesions as infection (bacterial, parasitic and invasive fungal), Wegener granulomatosis (WG) and other vasculitis, sarcoidosis, malignancy, septic thromboembolism, airways disease (cystic bronchiectasis and bullae), pneumatoceles and traumatic parenchymal laceration. Herein, we present a case with perforated diverticulitis causing pulmonary cavitary lesions and a septic thrombus in the neighboring inferior vena cava. PMID:22453530

I?ik, Metin; Çinar, Esat; Cemal Kizilarslano?lu, M; Özbek, Emre; Etgül, Sezgin; Kiraz, Sedat

2012-03-28

223

A confusing case: pulmonary lesions including cavities, isolated left heart endocarditis and inferior vena cava thrombosis in a patient with perforated diverticulitis.  

UK PubMed Central (United Kingdom)

There are numerous causes of pulmonary cavitary lesions as infection (bacterial, parasitic and invasive fungal), Wegener granulomatosis (WG) and other vasculitis, sarcoidosis, malignancy, septic thromboembolism, airways disease (cystic bronchiectasis and bullae), pneumatoceles and traumatic parenchymal laceration. Herein, we present a case with perforated diverticulitis causing pulmonary cavitary lesions and a septic thrombus in the neighboring inferior vena cava.

I?ik M; Çinar E; Cemal Kizilarslano?lu M; Özbek E; Etgül S; Kiraz S

2013-08-01

224

[Leiomyosarcoma of the vena cava inferior. The correlation: ultrasound and fine-needle puncture biopsy  

UK PubMed Central (United Kingdom)

The leiomyosarcoma of the inferior vena cava is a non-frequent tumor, mesenchymal, that has its origin in the smooth muscular tissue of the vascular wall. Its growth is slow and expansive, more frequently found on females. The symptomatology is related to the cava segment where it is located. The diagnosis is performed by ultrasonics, computed tomography and cavography, actually magnetic resonance acquires more and more importance. The treatment is specifically surgery along with radiotherapy and chemotherapy. A case of leiomyosarcoma of the inferior vena cava is presented in which diagnosis was performed using ultrasonics, tomography and cavography confirmed before surgery by biopsy punction with thin needle. In the diagnosis of this pathology it is described the use of intro-surgery ultrasonics.

Parrilla M; Montilla Y; Alvarez C; Quevedo L; Valls O; Banasco J; Pérez D

1992-10-01

225

Patent abdominal subcutaneous veins caused by congenital absence of the inferior vena cava: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Patent paraumbilical and abdominal subcutaneous veins are found frequently as collaterals in patients due to portal hypertension mainly in liver cirrhosis. Case presentation For evaluation of portal hypertension in a 72-year-old Caucasian man without liver cirrhosis, magnetic resonance imaging with gadolinium contrast-enhancement was performed and demonstrated a missing inferior vena cava. A blood return from the lower extremities was shown through enlarged collateral veins of the abdominal wall, vena azygos and hemiazygos continuation, and multiple liver veins emptying into the right cardiac atrium. We describe a rare case of abdominal subcutaneous wall veins as collaterals caused by a congenitally absent infrarenal inferior vena cava with preservation of a hypoplastic suprarenal segment. Conclusion Knowledge of these congenital variations can be of clinical importance and it is imperative for the reporting radiologist to identify these anomalies as they can have a significant impact on the clinical management of the patient.

Schnedl Wolfgang J; Reittner Pia; Krause Robert; Lipp Rainer W; Tafeit Erwin; Wallner-Liebmann Sandra J

2010-01-01

226

Radiofrequency Catheter Ablation Of Atrioventricular Nodal Reentrant Tachycardia Associated With Anomalous Drainage Of Both Superior Vena Cava Into Coronary Sinus  

Directory of Open Access Journals (Sweden)

Full Text Available Total upper body drainage via left superior vena cava into coronary sinus (i.e. absent right superior vena cava) is a rare anomaly and distorts the anatomy of coronary sinus and triangle of Koch. Herewith we are reporting the first report of ablation in a patient with superior vena cava draining into coronary sinus totally. This patient with atrioventricular nodal re-entrant tachycardia, baseline left bundle branch block, transient complete heart block during electrophysiological study and total upper body venous drainage into coronary sinus had successful slow pathway ablation using anatomical approach.

Rakesh Yadav; Sharad Chandra; Nitish Naik; Rajnish Juneja

2009-01-01

227

Agenesia de cava superior associada a bloqueio atrioventricular de 3º grau/ Agenesis of the right superior vena cava associated with total heart block  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese A persistência de veia cava superior esquerda com ausência da veia cava superior é uma anomalia rara, principalmente quando associada a bloqueio atrioventricular de 3º grau. Relatamos o caso de uma paciente, na qual durante implante de marca-passo definitivo, para a correção de bloqueio atrioventricular total, foi detectada presença de veia cava superior esquerda com suspeição de ausência de veia cava superior, o que levou ao emprego de técnica diferenciada par (more) a fixação do eletrodo ventricular. Para confirmação da provável agenesia, foram realizados diversos exames complementares de imagem, demonstrando-se a dificuldade no diagnóstico da síndrome aqui descrita. Abstract in english The superior left vena cava with the absent superior vena cava is a rare abnormality, especially when associated with total heart block. We report a case of a patient in which the presence of superior left vena cava and the absence of the superior vena cava was detected during the implantation of a pacemaker for the correction of a total heart block, which led us to use a different technique for the fixation of the ventricular electrode. To confirm the supposed absence, several image exams were made showing the difficulty on the diagnosis of the described syndrome.

Couto, Gustavo J. Ventura; Saraiva, Roberto Santos; Deslandes, Alexandre de Oliveira; Santos, Paulo César de Souza

2008-03-01

228

Agenesia de cava superior associada a bloqueio atrioventricular de 3º grau Agenesis of the right superior vena cava associated with total heart block  

Directory of Open Access Journals (Sweden)

Full Text Available A persistência de veia cava superior esquerda com ausência da veia cava superior é uma anomalia rara, principalmente quando associada a bloqueio atrioventricular de 3º grau. Relatamos o caso de uma paciente, na qual durante implante de marca-passo definitivo, para a correção de bloqueio atrioventricular total, foi detectada presença de veia cava superior esquerda com suspeição de ausência de veia cava superior, o que levou ao emprego de técnica diferenciada para fixação do eletrodo ventricular. Para confirmação da provável agenesia, foram realizados diversos exames complementares de imagem, demonstrando-se a dificuldade no diagnóstico da síndrome aqui descrita.The superior left vena cava with the absent superior vena cava is a rare abnormality, especially when associated with total heart block. We report a case of a patient in which the presence of superior left vena cava and the absence of the superior vena cava was detected during the implantation of a pacemaker for the correction of a total heart block, which led us to use a different technique for the fixation of the ventricular electrode. To confirm the supposed absence, several image exams were made showing the difficulty on the diagnosis of the described syndrome.

Gustavo J. Ventura Couto; Roberto Santos Saraiva; Alexandre de Oliveira Deslandes; Paulo César de Souza Santos

2008-01-01

229

Periumbilical uptake of Tc-99m MAA on lung perfusion scanning in a patient with superior vena cava obstruction.  

Science.gov (United States)

A 25-year-old woman with severe parenchymal lung disease of unknown etiology and existing for more than a decade was referred for ventilation-perfusion scintigraphy because of suspicion of pulmonary embolism. Both ventilation and perfusion images showed, apart from perfusion defects from her severe lung disease, a left apical pneumothorax and signs of recurrent pneumonia of the left lower lobe. Noteworthy was the periumbilical uptake of the Tc-99m macroaggregated albumin (MAA). Her medical history revealed iatrogenic superior vena cava (SVC) obstruction. In this case, the main collateral pathway of portosystemic shunting is probably, after recanalization of the left umbilical vein, a network of smaller paraumbilical veins. PMID:16550019

Balink, H; Nabers, J

2006-04-01

230

Vanishing bone metastases--a pitfall in the interpretation of contrast enhanced CT in patients with superior vena cava obstruction.  

Science.gov (United States)

We describe a previously unreported case of vertebral marrow enhancement owing to collateral circulation in a patient with superior vena cava obstruction. Failure to recognise this phenomenon led to the misdiagnosis of sclerotic bone metastases. PMID:21849358

Thomas, N; Oliver, T B; Sudarshan, T

2011-09-01

231

Percutaneous transfemoral placement of inferior vena cava filter to prevent pulmonary embolism in patients with malignant tumor  

International Nuclear Information System (INIS)

Objective: To evaluate the effectiveness and safety of inserting an inferior vena cava filter to prevent the pulmonary embolism (PE) due to detachment of the thrombus in the lower extremities. Methods: Inferior vena cava filter were placed in 37 patients with malignant tumor and deep venous thrombosis from 1998 to 2004. Malignancy was confirmed by pathological or cellular biological examination in all cases. The episode of pulmonary embolism was monitored during a post-intervention follow-up. Results: All the filters were placed in the inferior vena cava safely via a percutaneous femoral venous access. No serious complications such as pulmonary embolism occurred during the follow-up periods. Conclusion: The inferior vena cava filter placement is an effective and safe procedure in preventing the pulmonary embolism in patients with malignant tumor and deep venous thrombosis. (authors)

2005-01-01

232

Vena cava superior izquierda persistente: Implicaciones en la cateterización venosa central Persistent left superior vena cava: Implications in central venous catheterisation  

Directory of Open Access Journals (Sweden)

Full Text Available La colocación de catéteres centrales por vía venosa subclavia y yugular se puede complicar con la canalización de una arteria o de una vía venosa aberrante. La anomalía más frecuente del desarrollo embriológico de la vena cava es la persistencia de la vena cava superior izquierda (VCSI). La implantación de catéteres en la VCSI se puede sospechar por el recorrido anómalo del mismo en la radiografía de tórax. La gasometría y la curva de presión del vaso permiten descartar una cateterización arterial. La confirmación diagnóstica se obtiene mediante angiografía, ecocardiografía, tomografía computerizada o cardio-resonancia. El médico que implanta habitualmente catéteres venosos centrales, debe estar familiarizado con la anatomía del sistema venoso, sus variantes y sus anomalías, ya que su presencia puede influir en el manejo del paciente.The placement of central catheters through the subclavian and jugular venous path can be complicated by the cannulation of an artery or an aberrant venous path. The most frequent anomaly of the embryological development of the caval vein is the persistence of the left superior vena cava (LSVC). The implantation of catheters in the LSVC can be suspected by its anomalous route in thorax radiography. Gasometry and the pressure curve of the vessel make it possible to rule out an arterial catheterisation. Diagnostic confirmation is obtained through angiography, echocardiography, computerised tomography or cardiac resonance. The doctor who regularly implants central venous catheters must be familiar with the anatomy of the venous system and its variants and anomalies, since their presence might influence the handling of the patient.

G. Lacuey; M. Ureña; J. Martínez Basterra; N. Basterra

2009-01-01

233

Scimitar syndrome and azygos continuation of the inferior vena cava diagnosed in an adult--an unusual association.  

Science.gov (United States)

Anormal drainage of the pulmonary veins into the inferior vena cava is known as scimitar syndrome. Scimitar syndrome often presents during infancy and rarely during adulthood, and the adult patients are mostly asymptomatic. It is usually in association with dextrocardia, hypoplasia of right lung, and congenital heart defects. However, interruption of inferior vena cava with azygous continuation is rarely associated with this syndrome. PMID:22469461

Celik, Murat; Celik, Turgay; Iyisoy, Atila; Ayten, Omer

2012-04-02

234

Dual-pump support in the inferior and superior vena cavae of a patient-specific fontan physiology.  

UK PubMed Central (United Kingdom)

The implementation of simultaneous mechanical cavopulmonary assistance having blood pumps located in both of the vena cavae is investigated as an approach to treating patients with an ailing Fontan physiology. Identical intravascular blood pumps are employed to model the hemodynamic support of a patient-specific Fontan. Pressure flow characteristics, energy gain calculations, and blood damage analyses are assessed for each model. The performance of the dual-support scenario is compared to conditions of mechanical support in the inferior vena cava only and to a nonsupported cavopulmonary circuit. The blood pump in the superior vena cava generates pressures ranging from 1 to 22 mm Hg for flow rates of 1-4 L/min at operating speeds of 1250-2500 rpm. The blood pump in the inferior vena cava produces pressures at levels approximately 20% lower. The blood pumps positively augment the hydraulic energy in the total cavopulmonary connection circuit as a function of flow rate and rotational speed. Scalar stress levels and fluid residence times are at acceptable levels. Damage indices for the dual-support case, however, are elevated slightly above 3.5%. These results suggest that concurrent, mechanical assistance of the inferior vena cava and superior vena cava in Fontan patients has the potential to be beneficial, but additional studies are needed to further explore this approach.

Throckmorton AL; Lopez-Isaza S; Moskowitz W

2013-06-01

235

Simultaneous pulmonary and inferior vena cava thromboembolism secondary to pelvic osteosarcoma.  

Science.gov (United States)

Thromboembolism presenting with malignancy is common in adults but rare in children. We describe the case of a 17-year-old boy admitted to our hospital with syncope. Computed tomography revealed thromboembolism in both the lungs. Magnetic resonance imaging found thromboembolism in the inferior vena cava and a large heterogeneous mass in the pelvis. Pelvic osteosarcoma was confirmed by computed tomography-guided biopsy. Despite intensive chemotherapy and local radiation, only transient response was noted, the tumor remaining unresectable. To our knowledge, this is the first reported case of simultaneous pulmonary and inferior vena cava thromboembolism secondary to pelvic osteosarcoma in children. We also emphasize syncope as a unique feature of pulmonary thromboembolism. Accordingly, thromboembolism should be kept in mind as the first manifestation of occult malignancy, even in children. PMID:23274375

Lin, Wei-Ching; Lin, Chien-Heng; Chao, Yu-Hua; Lin, Hsiao-Chuan; Chen, Pei-Yu; Wu, Han-Ping; Wu, Kang-Hsi

2013-11-01

236

Temporary Vena Cava Filters and Ultrahigh Streptokinase Thrombolysis Therapy: A Clinical Study  

International Nuclear Information System (INIS)

Purpose: To assess the efficacy of temporary vena cava filters in patients undergoing ultrahigh-dose streptokinase thrombolysis for iliocaval thrombosis and to determine therapy success and filter and therapy complications.Methods: Forty-five patients were studied regarding extension and characteristics of thrombosis, duration, success, and complications of thrombolysis therapy, filter type, access route, pulmonary embolisms, and filter complications.Results: Complete recanalization was achieved in 57% of cases. Filters were inserted predominantly via a transbrachial route. One fatal pulmonary embolism (2%) occurred 1 day after starting thrombolysis. No other pulmonary embolism was noted. Other complications were induced by thrombolysis alone (n = 12), thrombolysis and filter (n = 9), and filter alone (n = 11).Conclusion: Fatal pulmonary embolisms as a complication of ultrahigh-dose treatment of pelvic or caval thrombosis can not safely be prevented by the temporary vena cava filters currently available. Filter design needs to be improved.

2000-01-01

237

Superior vena cava and right atrium wall infective endocarditis in patients receiving hemodialysis.  

UK PubMed Central (United Kingdom)

Infective endocarditis is significantly more common and causes greater morbidity and mortality in patients receiving hemodialysis than in the general population. Episodes of bacteremia during hemodialysis are primarily the result of frequent vascular access through an arteriovenous fistula, a vascular graft, or an indwelling vascular catheter. This leads to dialysis access infection and secondary bacteremia. We describe 4 cases of patients receiving hemodialysis, with an indwelling intravascular dialysis catheter, who developed right-sided endocarditis with vegetations located exclusively on the superior vena cava and right atrium wall. All patients had persistent bacteremia with Staphylococcus, secondary to an indwelling intravascular hemodialysis catheter, which led to seeding of the right-sided cardiac wall, causing infective endocarditis. The rates of acceptance for hemodialysis are increasing, along with improved survival in this group of patients. This will probably lead to an increase in the incidence of infective endocarditis, with atypical presentations such as superior vena cava and right-sided cardiac wall endocarditis.

Thakar S; Janga KC; Tolchinsky T; Greenberg S; Sharma K; Sadiq A; Lichstein E; Shani J

2012-05-01

238

Computed Tomography Angiography of Situs Inversus, Portosystemic Shunt and Multiple Vena Cava Anomalies in a Dog.  

UK PubMed Central (United Kingdom)

A 5-year-old Shih Tzu was presented with intermittent vomiting and anorexia. Microhepatica and reversed position of the abdominal organs were observed on radiography. Ultrasonographically, portosystemic shunt (PSS) was tentatively diagnosed. On computed tomography (CT), the distended portal vein drained into the left hepatic vein. The caudal vena cava (CdVC) splited postrenally and converged at the renal level. Cranial to this, the azygos continuation of the CdVC was confirmed. On thorax, persistent left cranial vena cava (CrVC) along with right CrVC was found. This is first report of dog with persistent left CrVC in accordance with multiple abdominal malformations. CT angiography was useful to evaluate the characteristics of each vascular anomaly and determine the surgical correction in this complex case.

Oui H; Kim J; Bae Y; Oh J; Park S; Lee G; Hoon J; Choi J

2013-07-01

239

Case report of pelvic arteriovenous malformation treated with transcatheter embolization. Application of vena cava filter  

Energy Technology Data Exchange (ETDEWEB)

A successful case (34-year-old, male) of trans-arterial embolization using Guenther's vena cava filter for controlling massive hemorrhage from a huge arteriovenous malformation in the pelvic region was reported. Some of the conventional embolic materials such as steel coil and cyanoacrylate were used in the initial attempt, it was, however, impossible to control bleeding because of the higher flow in the nidus. In the subsequent trial, Guenther's filter was placed into the right internal iliac artery which was the huge main feeder of the AVM, then it played an important role in the embolization of the feeder to avoid peripheral migration of the other embolic materials. Transarterial embolization in combination with a vena cava filter could be an effective therapy for huge arteriovenous malformations.

Yonetani, Akiko; Onohara, Shinichi; Kobayashi, Hisashi

1987-11-01

240

Síndrome de la vena cava superior en el posoperatorio inmediato de trasplante cardíaco: tratamiento endovascular/ Endovascular Treatment of Superior Vena Cava Syndrome in the Immediate Postoperative Period of Heart Transplantation  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish El trasplante cardíaco está indicado en pacientes con insuficiencia cardíaca terminal sin opción de tratamiento médico, intervencionista o quirúrgico y puede realizarse utilizando fundamentalmente tres variantes técnicas. El beneficio de la técnica bicava en términos de parámetros hemodinámicos y clínicos la ha convertido en la más utilizada, aunque es técnicamente más demandante y puede tener algunas consecuencias, como estenosis en las anastomosis de las (more) venas cavas. En esta presentación se describe el caso de un paciente sometido a trasplante cardíaco ortotópico con técnica bicava que en el primer día del posoperatorio desarrolló el síndrome de la vena cava superior. Durante el segundo día posoperatorio y ante sintomatología progresiva, a pesar de haberse administrado anticoagulación, se decidió realizar una flebografía diagnóstica y al mismo tiempo tratamiento endovascular. En ese procedimiento se recanalizó la vena cava superior y se implantaron tres stents autoexpandibles, con lo que se logró permeabilidad de la anastomosis entre las venas cavas donante y receptora, la vena cava superior y la subclavia derecha. La evolución fue favorable con alivio inmediato de la sintomatología. El paciente fue dado de alta sin complicaciones. Heart transplantation is indicated in patients with end-stage heart failure who have no options with medical, interventional or surgical treatment. Among the three techniques available, the bicaval technique is the one most frequently used due to its hemodynamic and clinical benefits. However, it is technically more demanding and may have some consequences, as vena caval anastomotic stenosis. We describe the case of a patient who developed superior vena cava syndrome at postoperative day one of orthotopic heart transplantation with bicaval technique. At the second day symptoms progressed and, despite having initiated anticoagulation therapy, the patient underwent a diagnostic phlebography followed by endovascular treatment. After dilatation of the superior vena cava three self-expandable stents were implanted producing patent anastomosis between the donor and receptor venae cavae, the superior vena cava and the right subclavian vena. The patient had favorable outcomes with immediate symptoms relief and was discharged without complications.

Marenchino, Ricardo G; Rostagno, Román D; Belziti, César A; Albornoz, Héctor D; Domenech, Alberto; Vulcano, Norberto; García Mónaco, Ricardo D; Batelini, Roberto R

2011-10-01

 
 
 
 
241

[Bilateral deep venous thrombosis and vena cava aplasia treated with local thrombolysis].  

UK PubMed Central (United Kingdom)

In this case report the treatment of a young man with bilateral iliaco-femoral DVT and vena cava aplasia is presented. The patient was treated with catheter-directed thrombolysis; the catheters were introduced in the thrombus of both legs via v. popliteae. The treatment led to almost complete thrombus resolution and no valvular incompetence at three months follow-up. In our opinion this treatment should be offered even in complex cases of acute proximal deep venous thrombosis.

Pelta AM; Jørgensen M; Just SR; Jensen LP

2008-05-01

242

[Bilateral deep venous thrombosis and vena cava aplasia treated with local thrombolysis].  

Science.gov (United States)

In this case report the treatment of a young man with bilateral iliaco-femoral DVT and vena cava aplasia is presented. The patient was treated with catheter-directed thrombolysis; the catheters were introduced in the thrombus of both legs via v. popliteae. The treatment led to almost complete thrombus resolution and no valvular incompetence at three months follow-up. In our opinion this treatment should be offered even in complex cases of acute proximal deep venous thrombosis. PMID:18492458

Pelta, Anna-Monika; Jørgensen, Maja; Just, Sven R Lundgren; Jensen, Leif Panduro

2008-05-19

243

Follow-up studies of vena cava filters: Real-time sonography and abdominal films  

Energy Technology Data Exchange (ETDEWEB)

In 16 patients with vena cava filters (12 Guenther filters, 4 Kimray-Greenfield filters) a follow-up study was performed by ultrasound and abdominal plain film. Ultrasound allows to identify type and location of the filter as well as the entrapment of emboli. Abdominal radiography is useful for exact evaluation of changes in filter position. Combination of sonography and plain films is considered to be most suitable for follow-up studies of caval filters.

Vorwerk, D.; Hollmann, J.; Guenther, R.

1987-05-01

244

[Inferior vena cava cannulation using Forgaty catheter for partial cardiopulmonary bypass].  

Science.gov (United States)

Partial cardiopulmonary bypass is adopted in operation for aneurysm of descending aorta or DeBakey IIIb dissection. Cannulation from left common femoral vein to inferior vena cava (IVC) is often difficult because of operative position and anatomical relation of iliac veins to IVC. In this paper, IVC cannulation using Forgaty catheter is reported to be easy and safe for prevention of IVC perforation. PMID:12428337

Masuda, M; Imamaki, M; Shimura, S; Hirano, M; Nishimura, K; Nakajima, N; Miyazaki, M

2002-11-01

245

Bilateral adrenal cystic neuroblastoma with superior vena cava syndrome and massive intracystic haemorrhage  

International Nuclear Information System (INIS)

[en] Bilateral cystic adrenal tumours are a rare presentation of neuroblastoma. Intratumoural haemorrhage is a frequent finding in neuroblastoma, but is rarely symptomatic. We present an 11-month-old girl with predominantly cystic bilateral neuroblastomas and distant lymph-node metastasis. Massive intracystic haemorrhage and superior vena cava (SVC) syndrome were ominous prognostic factors, leading to death. Large tumours with intracystic haemorrhage might require a conservative approach. (orig.)

2004-01-01

246

Bilateral adrenal cystic neuroblastoma with superior vena cava syndrome and massive intracystic haemorrhage  

Energy Technology Data Exchange (ETDEWEB)

Bilateral cystic adrenal tumours are a rare presentation of neuroblastoma. Intratumoural haemorrhage is a frequent finding in neuroblastoma, but is rarely symptomatic. We present an 11-month-old girl with predominantly cystic bilateral neuroblastomas and distant lymph-node metastasis. Massive intracystic haemorrhage and superior vena cava (SVC) syndrome were ominous prognostic factors, leading to death. Large tumours with intracystic haemorrhage might require a conservative approach. (orig.)

Pinarli, Faruk Guclu [Department of Paediatric Oncology, Medical Faculty, Ondokuz Mayis University, Samsun (Turkey); Medical Faculty, Samsun (Turkey); Danaci, Murat; Diren, Baris [Department of Radiology, Medical Faculty, Ondokuz Mayis University, Samsun (Turkey); Tander, Burak; Rizalar, Riza [Department of Paediatric Surgery, Medical Faculty, Ondokuz Mayis University, Samsun (Turkey); Dagdemir, Ayhan; Acar, Sabri [Department of Paediatric Oncology, Medical Faculty, Ondokuz Mayis University, Samsun (Turkey)

2004-09-01

247

Technical Error During Deployment Leads to Vena Cava Filter Migration and Massive Pulmonary Embolism  

International Nuclear Information System (INIS)

[en] The Guenther Tulip vena cava filter is a safe, effective, well-established device for pulmonary embolism prophylaxis. We report a patient in whom there was migration of the filter to the right atrium, 2 weeks after insertion, caused by a technical error during deployment. An attempt to retrieve the filter percutaneously failed, necessitating removal at open-heart surgery. The potential causes of migration are described and the lessons learned from this unusual case are outlined.

2008-01-01

248

Anomalous inferior vena cava in association with omphalocele: a case report  

Energy Technology Data Exchange (ETDEWEB)

We present the case of a 6-year-old boy who had an omphalocele repaired at day 1 of life. He had a secundum atrial septal defect and an anomalous inferior vena cava of a type which has not been previously reported. Cine-MRI was a useful noninvasive tool for diagnosing the anomalous subaortic innominate vein and four immature vessels which make up the venous drainage systems of the lumbar region. (orig.)

Antoniou, E.E.H. [Dept. of Pediatrics, School of Medicine, Univ. of Tokushima (Japan); Matsuoka, S. [Dept. of Pediatrics, School of Medicine, Univ. of Tokushima (Japan); Mori, K. [Dept. of Pediatrics, School of Medicine, Univ. of Tokushima (Japan); Hayabuchi, Y. [Dept. of Pediatrics, School of Medicine, Univ. of Tokushima (Japan); Kuroda, Y. [Dept. of Pediatrics, School of Medicine, Univ. of Tokushima (Japan)

1995-06-01

249

Importance of a persisting left vena cava superior in pacemaker therapy  

Energy Technology Data Exchange (ETDEWEB)

Basing on the description of a specific case and a review of literature, the article discusses the relationship between persisting left vena cava superior and pacemaker therapy. The article covers the technical problems caused by the vascular anomaly, the complications which can be expected, the possibilities in respect of recognising the vascular anomaly, as well as the methods for coping with the special situation prevailing in a particular case.

Marosi, G.; Sagi, J.; Pokorny, L.; Simon, Z.

1982-01-01

250

Importance of a persisting left vena cava superior in pacemaker therapy  

International Nuclear Information System (INIS)

Basing on the description of a specific case and a review of literature, the article discusses the relationship between persisting left vena cava superior and pacemaker therapy. The article covers the technical problems caused by the vascular anomaly, the complications which can be expected, the possibilities in respect of recognising the vascular anomaly, as well as the methods for coping with the special situation prevailing in a particular case. (orig.)

1982-01-01

251

Case fatality rate with vena cava filters in hospitalized stable patients with cancer and pulmonary embolism.  

UK PubMed Central (United Kingdom)

BACKGROUND: In view of the high risk of pulmonary embolism in patients with cancer, we tested the hypothesis that stable patients with pulmonary embolism who have cancer might be a subset of patients who would show a lower case fatality rate with vena cava filters than without filters. METHODS: Stable patients with pulmonary embolism and cancer at discharge from short-stay hospitals throughout the US from 1998-2009 were identified from the Nationwide Inpatient Sample. Patients with pulmonary embolism who had a diagnostic code for shock, ventilatory support, thrombolytic therapy, or pulmonary embolectomy were excluded because such patients have been shown to have lower case fatality rate with filters. RESULTS: In-hospital all-cause case fatality rate was lower with vena cava filters in stable patients with pulmonary embolism and solid malignant tumors providing they were aged >30 years, but there was variability according to type of tumor and age of patient. On average, case fatality rate among those >30 years with filters was 7070 of 69,350 (10.2%) (95% confidence interval, 10.0-10.4) versus 36,875 of 247,125 (14.9%) (95% confidence interval, 14.8-15.1) without filters (P <.0001) (relative risk 0.68). Among stable patients with hematological malignancies, case fatality rate, except in the elderly, was higher among those with vena cava filters than those without filters. CONCLUSION: Stable patients with pulmonary embolism and solid malignant tumors who are older than age 30 years appear to be a subset of patients with pulmonary embolism who would benefit from vena cava filters, but this needs to be tested prospectively.

Stein PD; Matta F; Sabra MJ

2013-09-01

252

Anaphylaxis and superior vena cava thrombus in a pediatric patient with acute lymphoblastic leukemia.  

Science.gov (United States)

Pediatric patients with malignancies are at significant risk for complications from their underlying condition and medical therapy. Emergency medicine physicians must be quick to suspect life-threatening events, which can present insidiously. We describe a case of anaphylaxis and superior vena cava syndrome in an 18-year-old female patient after polyethylene glycol-conjugated asparaginase chemotherapy for acute lymphoblastic leukemia. Pertinent literature surrounding risk factors, diagnosis, and treatment is also reviewed. PMID:19018221

Creel, Amy M; Crawford, David; Prabhakaran, Priya

2008-11-01

253

Acute superior vena cava syndrome after rupture of Kommerell's diverticulum: a case report.  

UK PubMed Central (United Kingdom)

Kommerell's diverticulum, a rare congenital aortic anomaly, is dilatation at the region in which an aberrant subclavian artery branches from either a left-sided or right-sided thoracic aorta. We report a rare case of acute superior vena cava syndrome that developed in a young healthy male patient who presented to the emergency department in imminent respiratory arrest after rupture of this diverticulum.

Suarez AE; Slivka R

2013-03-01

254

Transvenous defibrillator implantation in a patient with persistent left superior vena cava  

Directory of Open Access Journals (Sweden)

Full Text Available Persistent left superior vena cava (LSVC) can be incidentally detected during pacemaker implantation through left pectoral side. There is technical difficulty of optimal site pacing and lead stability for right ventricle lead in such situation. We hereby report a case of successful single-chamber implantable cardioverter defibrillator (ICD) implantation in a 50 years-old male with LSVC. The practical issues related with right ventricle lead implantation and pacing/defibrillation parameters for ICD device are discussed.

Rajesh Vijayvergiya; Smit Shrivastava; Alok Kumar; Parminder S Otaal

2013-01-01

255

Left cervical aortic arch and persistent left superior vena cava in the SAME patient  

International Nuclear Information System (INIS)

[en] Cervical aortic arch is a rare congenital anomaly in which the aortic arch is located in an outstandingly location. It is usually attributed to abnormal regression of the fourth arch with persistent of the right or left second or third primitive aortic arch. Persistent left superior vena cava is another rare congenital anomaly which results from the failure of the left common cardinal vein to become obliterated. We have experienced these rare congenital anomalies in the SAMe patient

1991-01-01

256

Systemic hypothermia and circulatory arrest combined with arterial perfusion of the superior vena cava. Effective intraoperative cerebral protection.  

UK PubMed Central (United Kingdom)

We have used retrograde arterial perfusion of the superior vena cava as an adjunct to deep hypothermia and systemic circulatory arrest for intraoperative cerebral protection in 43 adult patients (18 of whom were 70 years old or older). The indications for the use of circulatory arrest were thoracic aortic operations (37 patients) and atherosclerosis or calcification of the ascending aorta (6 patients) in patients needing aortic valve or coronary operations. In all patients systemic hypothermia (16 degrees to 18 degrees C) was achieved with cardiopulmonary bypass and the systemic arterial circulation was arrested. Retrograde arterial perfusion of the superior vena cava was established through a wire-reinforced venous cannula (with a superior vena cava tourniquet) at a temperature of 15 degrees C. In 36 patients a separate roller pump system was used for the retrograde cerebral perfusion. Central venous pressure was monitored at 25 to 30 mm Hg; mean flow rate was 250 ml/min. Periods of circulatory arrest and retrograde cerebral perfusion ranged from 4 to 110 minutes (mean 38 minutes), and for seven patients the period of circulatory arrest was longer than 60 minutes. Four postoperative deaths occurred, one related to stroke in a patient who had an aortic dissection during coronary surgery and the others related to noncerebral complications. Three nonfatal cerebral complications occurred, although all had completely resolved by late follow-up. Advantages of retrograde cerebral perfusion are (1) simplicity of use and avoidance of vascular trauma, (2) excellent exposure, (3) retrograde flow that minimizes embolization of air and atherosclerotic debris, and (4) effective cerebral oxygen delivery. Retrograde cerebral perfusion appears to be an important adjunct to hypothermia and circulatory arrest not only for patients undergoing operation for ascending aorta and aortic arch disease but also for patients with diffuse aortic atherosclerosis undergoing coronary or valve operations.

Lytle BW; McCarthy PM; Meaney KM; Stewart RW; Cosgrove DM 3rd

1995-04-01

257

Vena cava filter placement via the antecubital access: a report of 6 cases  

International Nuclear Information System (INIS)

[en] Objective: To study the methods and skill of vena cava filter placement via the antecubital access. Methods: Six patients with DVT (4 males and 2 females, mean age of 62) underwent vena cava filter placement via the antecubital access in Huashan Hospital from Oct. 2004 to May. 2006. The right basilic vein was punctured with the use of micropuncture technique. SNF(Simon nitinol filter, Bard)was inserted through its carrier into the 90-cm-long sheath. The filter was then deployed with a standard fashion in the IVC, 5 cm inferior to the renal vein. Results: The filter was once placed successfully in all six patients within average time of 25 min without complications, but with good healing, exclusion of bleeding and no phlebitis. The position of filter was accurate without deviation and no occurrence of pulmonary embolism. Conclusions: vena cava filter placement via antecubital access is easy, minimal invasive, no need of lying in bed postoperatively. It is beneficial for DVT patients as an alternative for the contra-indication to femoral venous access. (authors)

2008-01-01

258

Neoadjuvant targeted molecular therapies in patients undergoing nephrectomy and inferior vena cava thrombectomy: is it useful?  

Science.gov (United States)

OBJECTIVE: To assess the effect of neoadjuvant targeted molecular therapies (TMTs) on size and level of inferior vena cava tumor thrombi and to evaluate their impact on surgical management. METHODS: We retrospectively analyzed the data of 14 patients treated for a clear cell renal cell carcinoma with inferior vena cava thrombi by neoadjuvant TMT before nephrectomy. Clinical, pathological and perioperative data were gathered retrospectively at each institution. The primitive tumor size and the thrombus size were defined by computed tomography before TMT. The tumor thrombus level was defined according to the Novick's classification. RESULTS: Before TMT, thrombus level was staged I for 1 (7 %), II for 10 (72 %) and III (21 %) for 3 patients. First-line therapy was sunitinib in 11 cases and sorafenib in 3 cases. Median therapy duration was two cycles (1-5). Three patients experienced major adverse effects (grade III) during TMT. Following TMT, 6 (43 %) patients had a measurable decrease, 6 (43 %) had no change, and 2 (14 %) had an increase in the thrombus. One patient (7 %) had a downstage of thrombus level, 12 (85 %) had stable thrombi, and 1 (7 %) had an upstage. Regarding primary tumor, 7 (50 %), 5 (36 %) and 2 (14 %) patients had a decrease, stabilization and an increase in tumor size, respectively. CONCLUSION: Neoadjuvant TMT appears to have limited effects on renal tumor thrombi. This retrospective study failed to demonstrate a significant impact of neoadjuvant TMT on surgical management of clear cell renal cell carcinoma with inferior vena cava tumor thrombi. PMID:23624719

Bigot, Pierre; Fardoun, Tarek; Bernhard, Jean Christophe; Xylinas, Evanguelos; Berger, Julien; Rouprêt, Morgan; Beauval, Jean-Baptiste; Lagabrielle, Samuel; Lebdai, Souhil; Ammi, Myriam; Baumert, Hervé; Escudier, Bernard; Grenier, Nicolas; Hétet, Jean-François; Long, Jean-Alexandre; Paparel, Philippe; Rioux-Leclercq, Nathalie; Soulié, Michel; Azzouzi, Abdel-Rahmène; Bensalah, Karim; Patard, Jean-Jacques

2013-04-27

259

Neoadjuvant targeted molecular therapies in patients undergoing nephrectomy and inferior vena cava thrombectomy: is it useful?  

UK PubMed Central (United Kingdom)

OBJECTIVE: To assess the effect of neoadjuvant targeted molecular therapies (TMTs) on size and level of inferior vena cava tumor thrombi and to evaluate their impact on surgical management. METHODS: We retrospectively analyzed the data of 14 patients treated for a clear cell renal cell carcinoma with inferior vena cava thrombi by neoadjuvant TMT before nephrectomy. Clinical, pathological and perioperative data were gathered retrospectively at each institution. The primitive tumor size and the thrombus size were defined by computed tomography before TMT. The tumor thrombus level was defined according to the Novick's classification. RESULTS: Before TMT, thrombus level was staged I for 1 (7 %), II for 10 (72 %) and III (21 %) for 3 patients. First-line therapy was sunitinib in 11 cases and sorafenib in 3 cases. Median therapy duration was two cycles (1-5). Three patients experienced major adverse effects (grade III) during TMT. Following TMT, 6 (43 %) patients had a measurable decrease, 6 (43 %) had no change, and 2 (14 %) had an increase in the thrombus. One patient (7 %) had a downstage of thrombus level, 12 (85 %) had stable thrombi, and 1 (7 %) had an upstage. Regarding primary tumor, 7 (50 %), 5 (36 %) and 2 (14 %) patients had a decrease, stabilization and an increase in tumor size, respectively. CONCLUSION: Neoadjuvant TMT appears to have limited effects on renal tumor thrombi. This retrospective study failed to demonstrate a significant impact of neoadjuvant TMT on surgical management of clear cell renal cell carcinoma with inferior vena cava tumor thrombi.

Bigot P; Fardoun T; Bernhard JC; Xylinas E; Berger J; Rouprêt M; Beauval JB; Lagabrielle S; Lebdai S; Ammi M; Baumert H; Escudier B; Grenier N; Hétet JF; Long JA; Paparel P; Rioux-Leclercq N; Soulié M; Azzouzi AR; Bensalah K; Patard JJ

2013-04-01

260

Hypofractionated radiation therapy in the treatment of superior vena cava syndrome.  

UK PubMed Central (United Kingdom)

We retrospectively reviewed 46 patients with superior vena cava syndrome during the period 1986-1992. The common symptoms included congestion of collateral veins of the neck, anterior chest wall, face, eyelids and right arm. Dyspoea and cyanosis occurred less frequently. In all but two patients a histological diagnosis was made by invasive and non-invasive examination without complications. In 82% of all patients a primary lung carcinoma was the cause of the superior vena cava syndrome. For 39 patients radiotherapy was the first treatment of choice. To relieve the distressing symptoms patients received one of two regimens employing hypofractionated radiotherapy. In regimen 3F, 25 patients received three weekly high dose fractions of 8 Gy delivering a total dose of 24 Gy. Regimen 2F, applied to seven patients, consisted of two weekly fractions of 8 Gy, giving a total of 24 Gy. In both regimens a good palliative result was established, however the results of the 3F regimen were superior. Using the 3F regimen a partial response was obtained in 96% of all patients, and 56% achieved a complete response. With the 2F regimen a partial response was achieved in 70% of all patients, and a complete response in only 28%. Minimal side effects were noted. After reviewing our experience, the 3F regimen is recommended for rapid and effective relief of the superior vena cava syndrome.

Rodrigues CI; Njo KH; Karim AB

1993-12-01

 
 
 
 
261

Complications in right-sided paraaortic lymphadenectomy: ventral tributaries of the inferior vena cava.  

UK PubMed Central (United Kingdom)

The purpose of this study was to describe the distribution and structure of ventral tributaries leading into the inferior vena cava where right-sided paraaortic lymphadenectomy is performed. The study examined 21 retroperitoneal specimens by graphic reconstruction, statistical evaluation, and histological examination of ventral tributaries (VTs). Seventy VTs were identified. The average number per specimen was 3.33. There were 20, 40, and 40% of VTs found in Levels I, II, and III, respectively. During the preparation, we observed an unusual arrangement of the IVC wall, into which VTs were led through a preformed sleeve-like channel and anchored near the lumen. This finding is a key mechanism that explains the ease with which VTs are extracted during surgery. Knowledge of the distribution and histological structure of VTs allows proper orientation of the retroperitoneal area of the front wall of inferior vena cava, which is essential for uncomplicated right-sided paraaortic lymphadenectomy. The histological structure of the VT ostium within the wall of the inferior vena cava explains why injury is easy during the procedure.

Turyna R; Kachlik D; Kucera E; Kujal P; Feyereisl J; Baca V

2013-07-01

262

A novel way to reduce thrombus build-up in vena cava filters.  

UK PubMed Central (United Kingdom)

OBJECTIVES AND BACKGROUND: The build-up of thromboses in vena cava filters after deployment presents serious problem to the patients. We proposed a novel way to overcome this problem in a belief that intentionally induced swirling flow can optimize blood flow patterns in vena cava filters, enhance the stirring motion of flow, in turn accelerate the dissolution of blood clots captured in the filter and facilitate blood to flow pass through the filters. METHODS: In this study, we experimentally compared the work efficiency of a vena cava filter under swirling flow condition with that of the same filter under normal flow condition. RESULTS: The results show that when compared to the normal flow, the swirling flow indeed has a significantly beneficial effect on a VCF which can decrease its flow-out time nearly 40% and reduce clot build-up in the filter more than 50%. CONCLUSIONS: We therefore believe that the design of an ideal VCF should take how to create swirling flow in the filter into the consideration.

Chen Z; Zhan F; Fan Y; Deng X

2011-11-01

263

A novel deployment design of vena cava filters might be the solution to their blockage problem.  

Science.gov (United States)

The blockage of a vena cava filter (VCF) by the captured blood clots presents a serious problem to the patients. Commercially available cone-shaped VCFs such as the Gunther Tulip filter has an inherent structural flaw that leads the captured blood clots to be trapped in their front spire areas where the flow-induced shear stress is relatively low so that the clots cannot dissolve fast enough and will accumulate, gradually block the central passages of the filters. It is well known that for a Hagen-Poiseuille flow in a circular tube, the flow-induced shear stress is highest at the wall of the tube and lowest along its axis. Herein, we hypothesize that by reversely deploying a cone-shaped filter in the vena cava, the filter's blockage problem might be prevented. First of all, this kind of deployment scenario can force the captured blood clots to stay in the peripheral areas of the vena cava and keep the central passage of the filter unblocked. Secondly, this scenario can expose the captured blood clots to relatively high shear stress that may dissolve the clots faster. PMID:21903340

Chen, Zengsheng; Fan, Yubo; Deng, Xiaoyan

2011-09-07

264

[Diameter and length measurement of infrarenal inferior vena cava in Shandong Peninsula adult and its significance].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To measure the diameter and length of infrarenal inferior vena cava (IVC) in Shandong Peninsula adult through digital subtraction angiography (DSA) for better vena cava filter (VCF) choice and placement. METHODS: From April 2008 to June 2010, 83 discontinuous patients (49 males and 34 females, mean age 56.4 years) with deep venous thrombosis (DVT) of lower extremity were placed VCF through DSA according to ACCP-8. During operation, diameter and length of infrarenal IVC were measured. At the same time, the renal vein location and the type of the IVC were identified to help the VCF choice. RESULTS: All the VCFs were placed successfully, no complications occurred. The diameter of infrarenal IVC was 10 to 26 mm with a mean of (19 ± 5) mm. The average length from beginning of IVC to the lower renal vein was (10.6 ± 2.8) cm. The renal vein was located between the first and second lumbar vertebra, the IVC beginning was located between the fourth and fifth lumbar vertebra. CONCLUSIONS: Diameter and length measurement of infrarenal IVC is helpful to the VCF selection and the domestic VCF research. Vena cava angiography is very important to the accurate placement of VCF.

Yang M; Sun L; Zhang JW; Li LB; Yong J

2011-06-01

265

Systemic-to-pulmonary venous shunt in superior vena cava obstruction: depiction on computed tomography venography  

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PURPOSE: To describe computed tomography (CT) venographic appearances of systemic-to-pulmonary venous shunts with CT venography and three-dimensional reconstruction images from patients with superior vena cava obstruction. MATERIAL AND METHODS: From January 1994 to April 2002, CT venography was performed in 45 patients with superior vena cava obstruction using a single-detector helical CT scanner (n=38) and four-detector row CT scanner (n=7). Analysis of CT scan data included the cause and degree of venous obstruction, the presence of pleural thickening and enhancement, and the attenuation of pulmonary veins. The causative factor for systemic-to-pulmonary venous shunt was evaluated using the Fisher exact test. RESULTS: Systemic-to-pulmonary venous shunts were observed in four patients (9%) who had high-attenuated pulmonary veins and pleural enhancement on CT venography. Pleural thickening (P=0.01) and a history of pulmonary tuberculosis (P=0.034) are statistically significant risk factors. CONCLUSION: CT venography showed strong pleural enhancement and high-attenuated pulmonary veins indicating systemic-to-pulmonary venous shunts. Radiologists should study the earlier enhancement of pulmonary veins in patients with superior vena cava obstruction.

Kim, H.C.; Chung, J.W.; Park, S.H.; Kim, H.B.; Jae, H.J.; Lee, W.; Park, J.H. [Seoul National Univ. College of Medicine, Inst. of Radiation Medicine, Seoul (Korea, Republic of). Dept. of Radiology

2004-05-01

266

Vena Cava Filter Behavior and Endovascular Response: An Experimental In Vivo Study  

International Nuclear Information System (INIS)

Purpose: To evaluate the behavior and endovascular response of a new nitinol permanent vena cava filter, the TrapEase. Methods: Percutaneous implantation of the filter was performed in six goats, with inferior vena cava (IVC)diameter close to that of man. Radiologic data concerning the IVC,filter diameter, patency and stability were collected. At 2, 4, 20 and 26 weeks post-implantation, histopathologic analysis of the IVC wall was performed at the site of filter distension, and distal and proximal to the filter. Results: All filters remained patent.There was no migration and no signs of biological incompatibility.Signs of neointimalization were seen at 2 weeks, with well-developed neointima at 4 weeks. No acute vessel wall perforation was detected by cavography at implantation. During follow-up histologic analysis at 26 weeks, perforation of some of the small fixation barbs was seen,causing minimal damage to the vessel wall and adjacent organ tissue without impairing organ function. These events were well tolerated, probably due to the gradual nature of the penetration of fixation barbsallowing reactive fibrous tissue development. At 26 weeks the parallel filter struts were well covered with neointima and did not perforate the vessel wall. There were no complications associated with the filter implantation. Conclusions: The TrapEase vena cava filter was well tolerated and is suitable for incorporation into the IVC wall of healthy animals without any apparent deleterious reaction due to biological incompatibility.

2003-01-01

267

Leiomyosarcoma of the inferior vena cava level II involvement: curative resection and reconstruction of renal veins  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Leiomyosarcoma of the inferior vena cava (IVCL) is a rare retroperitoneal tumor. We report two cases of level II (middle level, renal veins to hepatic veins) IVCL, who underwent en bloc resection with reconstruction of bilateral or left renal venous return using prosthetic grafts. In our cases, IVCL is documented to be occluded preoperatively, therefore, radical resection of tumor and/or right kidney was performed and the distal end of inferior vena cava was resected and without caval reconstruction. None of the patients developed edema or acute renal failure postoperatively. After surgical resection, adjuvant radiation therapy was administrated. The patients have been free of recurrence 2?years and 3?months, 9?months after surgery, respectively, indicating the complete surgical resection and radiotherapy contribute to the better survival. The reconstruction of inferior vena cava was not considered mandatory in level II IVCL, if the retroperitoneal venous collateral pathways have been established. In addition to the curative resection of IVCL, the renal vascular reconstruction minimized the risks of procedure-related acute renal failure, and was more physiologically preferable. This concept was reflected in the treatment of the two patients reported on.

Wang Quan; Jiang Jing; Wang Chao; Lian Guodong; Jin Mei-Shan; Cao Xueyuan

2012-01-01

268

Primary leiomyosarcoma of the inferior vena cava: a 2-institution analysis of outcomes.  

UK PubMed Central (United Kingdom)

BACKGROUND: Approximately 300 cases of leiomyosarcoma of the inferior vena cava (IVC) have been reported in the literature to date. In this study, we combined the experience from 2 institutions to provide additional clinical outcomes data. METHODS: We performed a retrospective analysis from 1984 to 2009 that included 17 patients treated between the 2 institutions. Clinicopathologic data, surgical and adjuvant therapy, and survival outcomes were obtained. RESULTS: The median age of patients in the study was 48 years. The tumor location was infrarenal in 8 patients, juxtarenal in 6, and suprahepatic in 2 patients; 7 patients had high-grade tumors. All patients underwent complete resection; the IVC was repaired primarily in 5 patients, ligated in 5, and reconstructed with a prosthetic tube graft in 7 patients. There was no perioperative mortality; 6 patients had complications. Median follow-up was 49 months; median survival had not been reached when this paper was written. The 5-year overall and disease -free survival were 56% and 37%, respectively. Of the 17 patients, 10 experienced disease recurrence and underwent numerous treatment modalities for these recurrences. CONCLUSION: Aggressive resection of primary leiomyosarcoma of the IVC can be performed safely and result in long-term survival, irrespective of IVC management. Despite high recurrence rates, no consensus yet exists regarding adjuvant treatment.

Mann GN; Mann LV; Levine EA; Shen P

2012-02-01

269

The RETRIEVE trial: safety and effectiveness of the retrievable crux vena cava filter.  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate the safety and effectiveness of the Crux vena cava filter in patients at risk for pulmonary embolism (PE). MATERIALS AND METHODS: The Crux Biomedical Evaluation of the Crux Inferior Vena Cava Filter System trial was an international prospective, multicenter, single-arm clinical trial in 125 patients implanted with the Crux filter between June 2010 and June 2011. Follow-up was 180 days after filter placement and 30 days after filter retrieval. The primary objective was to determine whether the clinical success rate was at least 80%. Clinical success was defined as technical success of deployment and freedom from definite PE, filter migration, and device-related adverse events requiring intervention. RESULTS: The clinical success rate was 96.0% (120 of 125), with a one-sided lower limit of the 95% confidence interval of 91.8%. The rate of technical success was 98.4% (123 of 125). There were three cases of definite PE (2.4%), two cases of deployment failure, and no cases of device migration, embolization, fracture, or tilting. Investigators observed nine cases of thrombus (all nonocclusive) in or near the filter (six during retrieval evaluation vena cavography, two during computed tomography [CT] scans for PE symptoms, and one during CT for cancer management) and 13 cases of deep vein thrombosis. Device retrieval was attempted at a mean of 84.6 days±57.6 (range, 6-190 d) after implantation and was successful for 98.1% of patients (53 of 54). All deaths (n = 14) were determined to be unrelated to the filter or PE. CONCLUSIONS: The Crux vena cava filter performed safely, with high rates of clinical, technical, and retrieval success.

Smouse HB; Mendes R; Bosiers M; Van Ha TG; Crabtree T

2013-05-01

270

Leiomiosarcoma endovascular en vena cava inferior con síndrome de Budd-Chiari asociado: a propósito de un caso/ Endovascular Leiomyosarcoma ofthe Inferior Vena Cava with Budd-Chiari syndrome: a case report  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Presentamos el caso de una mujer de 56 años de edad, que acude al Servicio de Urgencias de nuestro centro por un cuadro de distensión y dolor abdominal difuso con edemas en extremidades inferiores. En los estudios de imagen realizados (ecografía y TC) se demostró la existencia de ocupación intraluminal de la vena cava inferior, por una masa que se extendía desde el drenaje de las venas renales hasta su confluencia en la aurícula derecha, con signos de obstrucción (more) de las venas suprahepáticas. El diagnóstico anatomopatológico final fue de leiomiosarcoma con síndrome de Budd-Chiari asociado. El leiomiosarcoma de vena cava inferior es una patología poco frecuente y su asociación con síndrome de Budd-Chiari es aún más excepcional. Abstract in english We report the case of a 56-year-old woman who presented at our Emergency Department with symptoms ofdiffuse abdominal pain and distention with lower-extremity edema. Imaging studies (ultrasound and computed tomography) showed an intraluminar inferior vena cava mass extending from the renal veins drain to their confluence at the right atrium, with signs of obstruction of the suprahepatic veins. The final pathology diagnosis was leiomyosarcoma with Budd-Chiari syndrome. The (more) leiomyosarcoma of the inferior vena cava is an infrequent pathology and its association with Budd-Chiari syndrome is even rarer.

Muñoz, David Ibáñez; Almenara, Ana Riaguas; Sota Ochoa, Patricia; Paradisi Chacon, Carlos Eduardo; Mombila, Elena Martínez; de Toledo, Luis Sarria Octavio

2011-09-01

271

Implante de marcapasos a través de la vena cava superior izquierda persistente. Reporte de un caso/ Pacemaker lead implant via the persistent left superior vena cava  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Antecedentes: La persistencia de la vena cava superior izquierda (VCSIP) es una anomalía estructural infrecuente y asintomática, presente en el 0.5% de la población general. Habitualmente se descubre de forma incidental, y es durante el implante de marcapasos cuando adquiere relevancia anatómica. La vía de abordaje venoso para el implante de marcapasos definitivos más utilizada en la actualidad es a través de la subclavia izquierda; la VCSIP dificulta, aunque no im (more) posibilita el implante del o los electrodos para la estimulación eléctrica auricular o ventricular. El presente reporte está enfocado como referencia práctica para el diagnóstico y consideraciones técnicas durante el implante. Presentación del caso: Mujer de 26 años de edad en quien se documentó enfermedad intrínseca del nodo sinusal sintomática, variedad paros sinusales. Durante el abordaje venoso, la clave diagnóstica que hizo sospechar la anomalía fue la trayectoria medial del electrodo, corroborándose por venografía la desembocadura de la VCSIP en el seno coronario y su drenaje al atrio derecho. Se avanzó sin dificultad un electrodo de fijación activa implantándolo en la pared libre anterosuperior de la aurícula derecha. Tras 24 meses de seguimiento no se han presentado complicaciones y la paciente cursa asintomática. Discusión: La VCSIP es una anomalia congénita rara. Además de relacionarse con otras malformaciones congénitas, podría tener implicaciones desde el punto de vista de su desarrollo morfológico en los trastornos de la formación y conducción del impulso cardíaco. La falta de regresión de la vena cardinal izquierda puede influir en gran medida en el desarrollo ontogénico del nodo sinusal, el nodo auriculoventricular y el haz de His, relacionándose por lo tanto con diversos trastornos del ritmo. En casos de difícil manipulación del electrodo a través del seno coronario, se recomienda el abordaje venoso derecho después de visualizar la vena cava por venografía o ecocardiografía pues su ausencia o hipolasia (defecto que se reporta hasta en el 10% de los casos) representa un obstáculo aún mayor y que debiera sugerir el implante epicárdico. Conclusión: Ahora que la mayoría de implantes de marcapasos definitivos se abordan vía vena subclavia izquierda, el operador debe conocer esta anomalía venosa, que puede plantear dificultades técnicas en el implante de los electrodos. El conocimiento de esta anomalía puede ser de utilidad para otras especialidades que requieran el implante de catéteres vasculares permanentes a través de la vena subclavia izquierda. Abstract in english Background: Persistent left superiorvena cava (PLSVC) is a structural, asymptomatic and infrequent anomaly, present in 0.5% of the general population. Typically the diagnosis reveals itself unexpectedly at the time of pacemaker implantation, when it acquires anatomic relevancy. Several techniques are used forthetransvenous approach to enter the central venous circulation; the left subclavian vein has become a common access site for electrode implantation and, occasionally (more) , one can find an anomalous venous structure such as a PLSVC. Placement of electrodes through this anomalous venous structure can prove challenging, if not impossible. The present report tries to explore aspects of transimplantation diagnosis from a practical point of view. It also address the knowledge of anatomy, implant technique and radiographic orientation. Case presentation: Twenty-six-year-old woman with confirmed Symptomatic Sick Sinus Syndrome variety Sinus Arrest. The diagnosis of PLSVC was discovered unexpectedly at the time of the transvenous approach. The tip for the diagnosis was the "unusually medial" position of the lead, and the venogram showed the venous traject towards the coronary sinus and drainage into the right atrium. An active-fixation screw-in electrode was positioned in the antero-superior margin of the free wall of the right atrium. After 24 months of successful placement of the pa

Rodríguez-Fernández, Jairo Armando; Almazán-Soo, Arturo

2005-09-01

272

Surgical management of the left superior vena cava draining into the left atrium: a novel off-pump technique using the left atrial appendage.  

UK PubMed Central (United Kingdom)

The left superior vena cava is the most common congenital venous anomaly in the chest; however, its drainage into the left atrium is exceptional. The aim of the paper is to describe our novel technique to connect the left superior vena cava to the right cavities using the left atrial appendage, without cardiopulmonary bypass.

Boutayeb A; Marmade L; Bensouda A; Moughil S

2012-10-01

273

Leiomiosarcoma primario de mediastino que compromete el sistema de la vena cava superior: Resección quirúrgica asociada a reconstrucción venosa/ Primary leiomyosarcoma of the mediastinum involving the superior vena cava system: Surgical resection and venous reconstruction  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Los tumores del mediastino pueden tener múltiples formas de presentación y diversos orígenes anato-mopatológicos. A veces alcanzan gran tamaño y pueden comprometer por compresión o infiltración el sistema de la vena cava superior. Presentamos el caso de un hombre de 48 años que consultó por disnea, cefalea y palpitaciones en decúbito de dos meses de evolución. En la radiografía y en la tomografía computada de tórax se demostró un tumor de mediastino anterio (more) r, el estudio anatomopatológico mediante biopsia trucut concluyó leiomiosarcoma. Se realizó tratamiento quirúrgico, se resecó la masa tumoral que comprometía el sistema de la vena cava superior, se ligó y resecó el tronco venoso braquiocefálico izquierdo o innominado y se reconstruyó parte de la vena cava superior con parche de pericardio autólogo. El nervio frénico derecho se encontraba rodeado por la masa tumoral y se resecó junto con el tumor. El paciente evolucionó satisfactoriamente y fue dado de alta al décimo primer día post operado. El estudio de anatomía patológica de la pieza operatoria confirmó un leiomiosarcoma G2 de 3.100 gramos. Se completó tratamiento con radioterapia post operatoria. A 15 meses post operado el paciente se encuentra en buenas condiciones generales, sin evidencias de recidiva y sin síndrome de vena cava superior. Abstract in english Mediastinal tumors have multiple presentation forms and various pathological origins. Sometimes they reach a large size and can involve the system of superior vena cava by compression or infiltration. We present a 48 year old man admited for dyspnea, headache and palpitations in decubitus, for the last two months. The X-ray and chest computed tomography showed an anterior mediastinal tumor and the tru-cut pathological study concluded leiomyosarcoma. He underwent surgical (more) treatment; the tumor compromised the system of the superior vena cava and was resected with ligation and resection the left brachiocephalic trunk. Part of the superior vena cava was reconstructed with autologous pericardium. The right phrenic nerve was surrounded by the tumor mass and was resected in block. The patient recovered satisfactorily and was discharged on the eleventh day post surgery. The histopathologic study of the surgical specimen confirmed a leiomyosarcoma G2 (3,100 gr). Full adjuvant radiotherapy was done. At 15 months after surgery the patient is in good condition without evidence of recurrence or superior vena cava syndrome.

GONZÁLEZ L, ROBERTO; PRATS M, RAFAEL; CIFUENTES V, CLAUDIO; LAZO P, DAVID; SANTOLAYA C, RAIMUNDO; RODRÍGUEZ, PATRICIO

2011-08-01

274

Terapia de resincronización cardiaca en paciente con vena cava superior izquierda persistente: Caso clínico/ Placement of a biventricular resynchronization device in a patient with a persistent left superior vena cava: Report of one case  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english Persistent left superior vena cava is the most common venous congenital malformation and is usually asymptomatic. Its presence could increase the difficulty for transvenous lead implantation. We report a 71-year-old woman with an idiopathic dilated cardiomyopathy, atrial fibrillation and heart failure that required biventri-cular resynchronization therapy. During the placement of the device a persistent left superior vena cava was detected. The device was placed without problems and the patient had a satisfactory postoperative evolution.

Vergara S, Ismael; Frangini S, Patricia; Barrero V, Raúl

2012-01-01

275

Congenital and acquired anomalies of the inferior vena cava. Differential diagnosis by digital subtraction angiography (DSA) and computed tomography (CT). Kongenitale und erworbene Anomalien der Vena cava inferior. Differentialdiagnose durch digitale Subtraktionsangiographie (DS) und Computertomographie (CT)  

Energy Technology Data Exchange (ETDEWEB)

Segmental aplasias of the inferior vena cava, thrombosis of the vena cava, tumour infiltration (e.g. renal neoplasmas via the renal vein) and external compression (e.g. large hepatic metastases) may produce similar radiomorphologic changes in chest X-ray, DSA and CT. These radiomorphological changes are described by case reports. DSA clearly demonstrates the course of the vessels and the collaterals involved. CT may elucidate the paracaval vascular changes. It is only a synopsis of cavography (DSA) and CT with reference to embryogenesis that will lead to a reliable diagnosis and enable a definite decision on therapy and prognosis. (orig.).

Vogel, J.; Haeberle, H.J.; Friedrich, J.M.; Schumacher, K.A.; Bargon, G. (Ulm Univ. (Germany, F.R.). Radiologische Klinik)

1991-02-01

276

Long-term retrieval success rate profile for the Gunther Tulip vena cava filter.  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate the likelihood of successful retrieval of the Günther Tulip vena cava filter after various implant durations (up to 494 days). MATERIALS AND METHODS: Retrievable Günther Tulip filters were placed in 554 patients. All patients satisfied requirements for filter placement; the primary indication for placement was specified for 394 patients (71%), as follows: unspecified trauma (n = 164), bariatric procedures (n = 128), orthopedic procedures (n = 36), and other (n = 66). Filter tilt and vena cava injury were assessed at implantation. Filters were not repositioned after placement. At retrieval, filter orientation, vena cava injury, other device-related incidents, and the degree of difficulty associated with retrieval were reported. RESULTS: Filter retrieval was attempted in 275 patients and successful in 248 (90.2%). The mean filter indwell time was 58.9 days (range, 3-494 days). Unsuccessful retrievals (n = 27) were attributed primarily to improper hook orientation (n = 10) or excessive tissue in-growth at the filter legs (n = 16). Of the remaining 279 patients, 223 withdrew from the study, 41 were associated with a decision to keep the filter as a permanent device, 13 died for reasons unrelated to the study, and two had no reported endpoint data. A Kaplan-Meier product-limit survival estimate revealed that the probability of successful device retrieval remained greater than 94% at 12 weeks and greater than 67% at 26 weeks. CONCLUSIONS: This study contributes to the body of clinical data related to retrievable filters, demonstrating reliable retrieval rates at 12 weeks, with successful retrievals up to 17 months after implantation.

Smouse HB; Rosenthal D; Thuong VH; Knox MF; Dixon RG; Voorhees WD 3rd; McCann-Brown JA

2009-07-01

277

Pseudoaneurisma de aorta como causa de síndrome da veia cava superior: relato de caso/ Aortic pseudoaneurysm as cause of superior vena cava syndrome: a case report  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese A síndrome da veia cava superior representa o conjunto de sinais e sintomas decorrentes da sua obstrução. A síndrome tem como principais etiologias tumores malignos, como o carcinoma broncogênico, o linfoma e a metástase mediastinal. O câncer de pulmão é responsável por 80% dos casos, os linfomas mediastinais por 15%, e 5% correspondem às demais causas. Este relato de caso objetiva apresentar um caso incomum dessa síndrome, ocorrido em um paciente do sexo masc (more) ulino após ferimento penetrante no tórax, resultando em pseudoaneurisma de arco aórtico e a síndrome da veia cava superior. Abstract in english The superior vena cava syndrome represents the set of signs and symptoms resulting from obstruction of superior vena cava. The syndrome has as main causes malignant tumors such as bronchogenic carcinoma, lymphoma and mediastinal metastases. Lung cancer accounts for 80% of cases, mediastinal lymphomas by 15% and 5% correspond to other causes. This case report aims to present an unusual case of this syndrome, which occurred in a male patient after penetrating wound in the chest, which developed a pseudoaneurysm of the aortic arch and superior vena cava syndrome.

Harada Júnior, Katsuro; Borges, Renato Garcia Lisboa; Harada, Renata Kiyoko Borges

2012-09-01

278

[Bilateral deep venous thrombosis and vena cava aplasia treated with local thrombolysis  

DEFF Research Database (Denmark)

In this case report the treatment of a young man with bilateral iliaco-femoral DVT and vena cava aplasia is presented. The patient was treated with catheter-directed thrombolysis; the catheters were introduced in the thrombus of both legs via v. popliteae. The treatment led to almost complete thrombus resolution and no valvular incompetence at three months follow-up. In our opinion this treatment should be offered even in complex cases of acute proximal deep venous thrombosis Udgivelsesdato: 2008/5/19

Pelta, A.M.; JØrgensen, Maja

2008-01-01

279

Bilateral dyb venos trombose og vena cava-aplasi behandlet med lokal trombolyse  

DEFF Research Database (Denmark)

In this case report the treatment of a young man with bilateral iliaco-femoral DVT and vena cava aplasia is presented. The patient was treated with catheter-directed thrombolysis; the catheters were introduced in the thrombus of both legs via v. popliteae. The treatment led to almost complete thrombus resolution and no valvular incompetence at three months follow-up. In our opinion this treatment should be offered even in complex cases of acute proximal deep venous thrombosis Udgivelsesdato: 2008/5/19

Pelta, A.M.; Jorgensen, M.

2008-01-01

280

Life-threatening cerebral edema caused by acute occlusion of a superior vena cava stent.  

UK PubMed Central (United Kingdom)

A71-year-old man with advanced lung cancer developed a life-threatening cerebral edema caused by the acute occlusion of a superior vena cava (SVC) stent and was successfully treated by an additional stent placement. Although stent occlusion is a common early complication, no life-threatening situations have been reported until now. Our experience highlights the fact that acute stent occlusion can potentially lead to the complete venous shutdown of the SVC, resulting in life-threatening cerebral edema, after SVC stent placement. Immediate diagnosis and countermeasures are required.

Sofue K; Takeuchi Y; Arai Y; Sugimura K

2013-02-01

 
 
 
 
281

[Who is responsible for the removal of inferior vena cava filters?].  

UK PubMed Central (United Kingdom)

The fact that many inferior vena cava filters (IVCF) in trauma patients are not being removed has been described numerous times in the literature, but nobody really gives a reason why. This case presents a young patient who prophylactically received an optional IVCF after sustaining severe multitrauma. He had a failed retrieval 8 weeks post insertion and consequently was lost to follow-up before a second removal attempt was performed. Institutions inserting IVCF should establish guidelines for following up patients receiving prophylactic IVCF.

Baschera D; Sebunya J; Zellweger R

2012-06-01

282

Long-survival case of thymic carcinoma with superior vena cava tumor thrombus.  

Science.gov (United States)

Sarcomatoid carcinoma of the thymus is rare and responds poorly to treatment. Invasion of great vessels and metastasis are significant predictors for poor prognosis. Thymic tumors commonly cause superior vena cava (SVC) obstruction by extrinsic compression or invasion, but intraluminal permeation is the most uncommon cause. We report a rare, long-surviving case of sarcomatoid carcinoma with SVC syndrome developed by tumor thrombus. She underwent SVC replacement and extended thymectomy. The resection indicated intracaval extension without direct invasion of thymic tumor, histologically diagnosed as sarcomatoid carcinoma. After adjuvant chemotherapy, she continues to show no apparent recurrence for five years. PMID:23098957

Matsuo, Yae; Takama, Noriaki; Yasuhara, Kiyomitsu; Koyano, Tetsuya; Obayashi, Tamiyuki; Sasaki, Toyoshi; Kanesawa, Norio; Kurabayashi, Masahiko

2012-11-01

283

Long-survival case of thymic carcinoma with superior vena cava tumor thrombus.  

UK PubMed Central (United Kingdom)

Sarcomatoid carcinoma of the thymus is rare and responds poorly to treatment. Invasion of great vessels and metastasis are significant predictors for poor prognosis. Thymic tumors commonly cause superior vena cava (SVC) obstruction by extrinsic compression or invasion, but intraluminal permeation is the most uncommon cause. We report a rare, long-surviving case of sarcomatoid carcinoma with SVC syndrome developed by tumor thrombus. She underwent SVC replacement and extended thymectomy. The resection indicated intracaval extension without direct invasion of thymic tumor, histologically diagnosed as sarcomatoid carcinoma. After adjuvant chemotherapy, she continues to show no apparent recurrence for five years.

Matsuo Y; Takama N; Yasuhara K; Koyano T; Obayashi T; Sasaki T; Kanesawa N; Kurabayashi M

2012-11-01

284

Duodenocaval fistula from inferior vena cava filter penetration masquerading as lower gastrointestinal bleeding.  

UK PubMed Central (United Kingdom)

Asymptomatic penetration of the inferior vena cava (IVC) wall with retrievable filters is not uncommon. Occasionally, this can be a cause for morbidity, and rarely for mortality. We present a case of duodenocaval fistula, secondary to penetration from a strut of retrievable IVC filter that presented as lower gastrointestinal bleeding and discuss the subsequent management. Although newer generation retrievable filters provide a longer time for retrieval, they are associated with an increased incidence of IVC wall penetration, caudal migration, and occasionally symptomatic presentation, thereby necessitating surgical intervention. Close follow-up is warranted, and prompt retrieval of such devices should be done when their use is no longer indicated.

Bathla L; Panwar A; Fitzgibbons RJ Jr; Balters M

2011-11-01

285

Percutaneous permanent pacemaker implantation via the azygous vein in a patient with superior vena cava occlusion.  

UK PubMed Central (United Kingdom)

Occlusion of the superior vena cava (SVCO) makes implantation of permanent pacemakers challenging and difficult. We describe an extended application of a Medtronic Attain (Medtronic Inc., Minneapolis, MN, USA) guide catheter (a tool designed for delivery of left ventricular pacing leads into the coronary sinus) for delivery of a right ventricular pacing lead via the azygous vein in a 72-year-old woman with SVCO secondary to long-term central venous hemodialysis catheters. This approach allowed the use of an endocardial pacing lead, implantation under local anesthesia, and conventional positioning of the pacemaker generator in the pectoral region in a patient with SVCO.

Kamdar RH; Schilling RJ

2008-03-01

286

Duplication of the superior vena cava associated with atrial termination of the left hepatic vein.  

UK PubMed Central (United Kingdom)

Duplication of the superior vena cava (SVC), associated with an aberrant left hepatic vein (LHV), was found in one of the 58 dissected specimens. The right SVC virtually showed a typical appearance. The persistent left SVC, which drained into the right atrium via the enlarged coronary sinus, was formed by the persistence of the left anterior cardinal vein. The LHV opened into the right atrium, due to the persistent left hepatocardiac channel. The left common carotid artery arose from the brachiocephalic trunk as a consequence of a regression of the embryonic aortic sac. The revealed venous and arterial variations seem to be the first reported vascular combination of this type.

Milisavljevic M; Marinkovic S; Radak D; Cetkovic M; Vucurevic G; Trifunovic D

2013-01-01

287

Anomalous inferior vena cava associated with horseshoe kidney on multidetector computed tomography.  

Science.gov (United States)

We evaluated the prevalence of anomalous inferior vena cava (IVC) associated with 205 patients with horseshoe kidney (HSK) and 1990 patients without HSK on multidetector computed tomography and compared prevalence between both groups. We identified anatomical variations of the IVC in 8 patients (3.9%) with HSK (1 preisthmic IVC with retrocaval ureter, 4 double IVCs, 2 left IVCs, and 1 IVC with azygos continuation) and in 12 patients (0.6%) without HSK (8 double IVCs, 3 left IVCs, and 1 IVC with azygos continuation). Anomalous IVC was significantly more frequent in patients with HSK than those without it. PMID:23849103

Ichikawa, Tamaki; Kawada, Shuichi; Koizumi, Jun; Endo, Jun; Itou, Chihiro; Matsuura, Katsuhiko; Terachi, Toshiro; Imai, Yutaka

2013-07-10

288

Computational haemodynamic analysis of patient-specific virtual operations for total cavopulmonary connection with dual superior venae cavae.  

UK PubMed Central (United Kingdom)

OBJECTIVES: This study set out to design different types of total cavopulmonary connections (TCPC) with dual superior venae cavae (SVC), taking into account different sites for anastomosis from venae cavae to pulmonary arteries (PAs), and to compare haemodynamic features in these virtual operative designs. METHODS: The geometries of bilateral bidirectional Glenn (BBDG) connection and inferior vena cava (IVC) connected extracardiac conduit were reconstructed to three-dimensional configurations according to the magnetic resonance images (MRIs) of two patients at the same age, and virtual operations were designed to create four possible TCPC models under the guidance of paediatric cardiac surgeons. Computational fluid dynamic (CFD) simulations were performed in each model at five predetermined pulmonary flow splits, to predict postoperative blood flows. The same boundary conditions were applied on each model, in order to simplify the analysis of the influence of configurations on the flow characteristics. Control volume power losses and energy efficiency in different models were calculated and compared. Flow patterns in the models were demonstrated by streamlines corresponding to the venae cavae. RESULTS: When the flow rate of the right pulmonary artery (RPA) was 40-60% of the total pulmonary flow, control volume power loss was lower than the other three models in the model of TCPC 2 and was higher than the other three models in the model of TCPC 4. CONCLUSIONS: For this patient, anastomosing the left superior vena cava (LSVC) and right superior vena cava (RSVC) on the PAs close together will cause higher power loss and lower energy efficiency in the TCPC connection. If the LSVC and RSVC had been connected to the PAs as near as possible to stimulate growth of the central PAs when performing I-stage BBDG procedure, the extracardiac conduit from IVC would be better connected just under the anastomotic site in the following TCPC procedure to avoid high power loss.

Sun Q; Liu J; Qian Y; Zhang H; Wang Q; Sun Y; Hong H; Liu J

2013-07-01

289

In situ quantification of endothelial cell damage caused by iodinated contrast media using a rat vena cava model  

International Nuclear Information System (INIS)

Purpose: Quantification of vascular endothelial cell damage induced by iodinated contrast media using an in situ perfused rat vena cava model. Materials and methods: The institutional review board approved this study protocol prior to the commencement of all studies. A laparotomy was performed in 90 rats divided into 18 groups of five, and an 18G-catheter was inserted into the abdominal vena cava (mean length: ca 8 mm). After sacrificing, a thoracotomy was done and the outflow perfusate was emitted via a polyethylene tube inserted into the thoracic vena cava through the right atrium for an open system. Iopamidol (300 or 370 mg I/mL, 50 or 100 mL) was injected via the abdominal vena cava at a rate of 1, 4, or 8 mL/s. The abdominal vena cava was removed for histological analysis (n = 5). Physiological saline was injected as a negative control. The detachment percentage of endothelial cells was calculated by measuring the circumference and detachment section of the endothelium. The difference of the detachment percentage and circumference between each group was compared with Tukey's range test. Results: In contrast media groups, the severity of damage to the vascular endothelial cell was direct proportional to the increase of injection rate. The detachment percentage at 4 or 8 mL/s was significantly higher than that at 1 mL/s. As a result, the correlation between the injection rate and severity of cell damage was significant; however, the detachment percentage among contrast media groups was not significant at any injection rate. Conclusion: The in situ vena cava model was able to quantify contrast media injection related endothelial damage based on histopathological endpoints. Moreover, our results indicate that mechanical shear stress besides physico-chemical properties such as osmolality or viscosity cause endothelial damage.

2012-01-01

290

Abdominal wall phlebitis due to Prevotella bivia following renal transplantation in a patient with an occluded inferior vena cava.  

Science.gov (United States)

Pre-existing occlusion of the inferior vena cava may complicate renal transplantation. Suppurative abdominal wall phlebitis following renal transplantation was diagnosed in a patient with pre-existing thrombosis of the inferior vena cava of unknown cause. The phlebitis developed in the subcutaneous collateral veins of the abdominal wall contra-laterally to the renal transplant. Cultures from abdominal wall micro-abscesses yielded Prevotella bivia as the causative agent. This complication has not been described before in the context of renal transplantation. The pathogenesis and management of this serious complication are discussed in this paper. PMID:23001520

Janssen, S; van Donselaar-van der Pant, K A M I; van der Weerd, N C; Develter, W; Bemelman, F J; Grobusch, M P; Idu, M M; Ten Berge, I J M

2012-09-23

291

Abdominal wall phlebitis due to Prevotella bivia following renal transplantation in a patient with an occluded inferior vena cava.  

UK PubMed Central (United Kingdom)

Pre-existing occlusion of the inferior vena cava may complicate renal transplantation. Suppurative abdominal wall phlebitis following renal transplantation was diagnosed in a patient with pre-existing thrombosis of the inferior vena cava of unknown cause. The phlebitis developed in the subcutaneous collateral veins of the abdominal wall contra-laterally to the renal transplant. Cultures from abdominal wall micro-abscesses yielded Prevotella bivia as the causative agent. This complication has not been described before in the context of renal transplantation. The pathogenesis and management of this serious complication are discussed in this paper.

Janssen S; van Donselaar-van der Pant KA; van der Weerd NC; Develter W; Bemelman FJ; Grobusch MP; Idu MM; Ten Berge IJ

2013-02-01

292

Endovascular treatment of an iatrogenic superior vena cava perforation caused by the placement of a hemodialysis catheter: a case report  

International Nuclear Information System (INIS)

The perforation of superior vena cava during the placement of a tunneled hemodialysis catheter, via the subclavian vein, is a rare complication, and is manifested by hemothorax or hemopericardium. The treatment of this complication requires an early diagnosis and open thoracic surgery. Herein, we report a patient with hemothorax due to the perforation of the superior vena cava during the placement of a tunneled hemodialysis catheter via the right subclavian vein which was successfully treated by embolization by way of a coil and histoacryl.

2008-01-01

293

Endovascular treatment of an iatrogenic superior vena cava perforation caused by the placement of a hemodialysis catheter: a case report  

Energy Technology Data Exchange (ETDEWEB)

The perforation of superior vena cava during the placement of a tunneled hemodialysis catheter, via the subclavian vein, is a rare complication, and is manifested by hemothorax or hemopericardium. The treatment of this complication requires an early diagnosis and open thoracic surgery. Herein, we report a patient with hemothorax due to the perforation of the superior vena cava during the placement of a tunneled hemodialysis catheter via the right subclavian vein which was successfully treated by embolization by way of a coil and histoacryl.

Kim, See Hyung; Kim, Young Hwan; Keum, Dong Yoon [Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of)

2008-01-15

294

Tunneled pleural catheters in the management of chylothorax from central venous catheter-related superior vena cava obstruction.  

UK PubMed Central (United Kingdom)

Chylothorax is characterized by the accumulation of chyle in the pleural space, of which the most common cause is trauma or neoplasm. Although chylothorax accounts for a small proportion of clinical pleural effusions, prompt recognition is needed to avoid malnutrition, immunodeficiency, and fibrothorax. We report 2 patients with superior vena cava obstruction caused by tunneled venous catheters resulting in chylothorax and demonstrate the potential safety of tunneled pleural catheters for prolonged chylothorax drainage in an outpatient setting with rigorous follow-up. Changes in pleural fluid chemistries of the effusions and the possible pathophysiology were assessed with a review of the literature on pleural fluid chemistries in superior vena cava obstruction.

Luks V; Aljohaney A; Amjadi K

2013-01-01

295

[Differential diagnosis of left-sided thoracic venous catheters: case report of a persistent left superior vena cava  

UK PubMed Central (United Kingdom)

The differential diagnosis of left-sided thoracic central venous catheters is discussed in context with the cannulation of a persistent left superior vena cava. In this case the catheter tip was seen lying to the left of the spine on frontal chest X-ray. In addition to the descending aorta, differential diagnoses are a persistent left-sided superior vena cava as well as other smaller veins such as the left internal thoracic vein, the left superior intercostal vein, or the pericardiophrenic vein. The misplacement of a venous catheter in a pericardiophrenic vein may result in a fatal pericardial tamponade.

Schummer W; Schummer C; Reinhold L

2002-09-01

296

Successful use of wearable cardioverter defibrillator in a patient with dextrocardia and persistent left superior vena cava.  

Science.gov (United States)

Congenital disorders, such as dextrocardia and persistent left superior vena cava, are rare. However, their presence is often associated with other cardiac anomalies, and may lead to lethal ventricular tachyarrhythmias, which result in sudden cardiac death. Treating patients with these disorders can present a challenge to clinicians, as it may cause technical difficulties during interventional procedures, and more often, altered defibrillation techniques in a setting of prehospital sudden cardiac arrest. This report describes the first case of successful defibrillation therapy delivered by the wearable cardioverter defibrillator to a patient with dextrocardia and persistent left superior vena cava during a ventricular tachycardia arrest. PMID:24047495

Wan, Chingping; Oren, Jess W; Szymkiewicz, Steven J

2013-05-03

297

Perforation of the right ventricle during cardiac resynchronisation therapy upgrade not related to a coexisting persistent left superior vena cava.  

UK PubMed Central (United Kingdom)

Right ventricle (RV) perforation is a complication that may arise during device implants. We present the case of a patient undergoing cardiac resynchronisation therapy upgrade that was complicated with an RV perforation. The lead was successfully repositioned with a good final outcome. Despite being uncommon, persistence of the left superior vena cava is the most frequent venous cardiac anomaly and may pose challenges during the implant procedure, namely when the right superior vena cava (RSVC) is absent. Still, in this patient it was not related to the event, as the leads were advanced through the RSVC.

Providência R; Paiva LV; Cação R; Mota P

2012-01-01

298

Placement of a Retrievable Guenther Tulip Filter in the Superior Vena Cava for Upper Extremity Deep Venous Thrombosis  

International Nuclear Information System (INIS)

A retrievable Guenther Tulip caval filter(William Cook, Europe) was successfully placed and retrieved in the superior vena cava for upper extremity deep venous thrombosis in a 56-year-old woman. Bilateral subclavian and internal jugular venous thromboses thought secondary to placement of multiple central venous catheters were present. There have been reports of the use of permanent Greenfield filters and a single case report of a temporary filter in the superior vena cava. As far as we are aware this is the first reported placement and successful retrieval of a filter in these circumstances.

2002-01-01

299

Successful use of wearable cardioverter defibrillator in a patient with dextrocardia and persistent left superior vena cava.  

UK PubMed Central (United Kingdom)

Congenital disorders, such as dextrocardia and persistent left superior vena cava, are rare. However, their presence is often associated with other cardiac anomalies, and may lead to lethal ventricular tachyarrhythmias, which result in sudden cardiac death. Treating patients with these disorders can present a challenge to clinicians, as it may cause technical difficulties during interventional procedures, and more often, altered defibrillation techniques in a setting of prehospital sudden cardiac arrest. This report describes the first case of successful defibrillation therapy delivered by the wearable cardioverter defibrillator to a patient with dextrocardia and persistent left superior vena cava during a ventricular tachycardia arrest.

Wan C; Oren JW; Szymkiewicz SJ

2013-09-01

300

Transapical closure of paraprosthetic mitral leak in a patient with inferior vena cava interruption and azygos continuation.  

UK PubMed Central (United Kingdom)

Para-valvular leaks represent a relevant post-operative complication of cardiac valve replacement, often causing heart failure or severe hemolysis. We report a case of a 72 year-old woman with aortic and mitral mechanical prostheses who developed hemolytic anemia because of a para-prosthetic mitral leak. Chest tomography in such patient unexpectedly documented inferior vena cava interruption with azygos continuation into superior vena cava. Given the high surgical risk, the venous anomaly and the presence of the aortic valve prosthesis, transcatheter leak closure via antero-lateral mini-thoracotomy and transapical approach was performed.

Mega S; Patti G; Carminati M; Sedati P; D'Ambrosio A; Di Sciascio G

2013-09-01

 
 
 
 
301

Spinal Uptake Mimicking Metastasis in SPECT/CT Bone Scan in a Patient With Superior Vena Cava Obstruction.  

Science.gov (United States)

A 46-year-old female patient with a mediastinal neuroendocrine carcinoma complicated by superior vena cava syndrome was referred for a bone metastatic workup. Bone scan with SPECT/CT showed several vertebral fixations without alterations on the unenhanced CT, but a CT scan with injection of contrast media showed vertebral densities matched to the lesions described on the SPECT/CT. This pattern confirmed presence of collateral paths through vertebral veins due to superior vena cava syndrome. Lack of metastases was confirmed by MRI. PMID:24107870

Rager, Olivier; Nkoulou, René; Garibotto, Valentina; Boudabbous, Sana; Arditi, Daniel

2013-11-01

302

Spinal Uptake Mimicking Metastasis in SPECT/CT Bone Scan in a Patient With Superior Vena Cava Obstruction.  

UK PubMed Central (United Kingdom)

A 46-year-old female patient with a mediastinal neuroendocrine carcinoma complicated by superior vena cava syndrome was referred for a bone metastatic workup. Bone scan with SPECT/CT showed several vertebral fixations without alterations on the unenhanced CT, but a CT scan with injection of contrast media showed vertebral densities matched to the lesions described on the SPECT/CT. This pattern confirmed presence of collateral paths through vertebral veins due to superior vena cava syndrome. Lack of metastases was confirmed by MRI.

Rager O; Nkoulou R; Garibotto V; Boudabbous S; Arditi D

2013-11-01

303

Long-term follow-up of patients with inferior vena cava filters in the prevention of pulmonary embolism  

International Nuclear Information System (INIS)

Objective: To evaluate the long-term safety, efficacy and complications of placement vena cava filter in prevention of pulmonary embolism. Methods: Seventy-three patients with proven diagnosis of deep venous thrombosis (DVT) and (or) pulmonary embolism (PE) by Doppler ultrasonography, DSA, CT or MRI, received percutaneous inferior vena cava filters (IVCF) from January 1994 to June 2005. The clinical data and imaging findings were evaluated retrospectively. The patients underwent telephone interview or questionnaire, abdominal X-rays, Doppler ultrasonography, computed tomographic pulmonary angiography (CTPA) or indirect CT venography (CTV) after a follow-up duration of 5 months to 11 years. Results: Seventy-eight vena cava filters were used. There was 1 case of incomplete filter opening when placing filter. In follow-up, thrombi were trapped in the filter in 2 cases, filter tilting happened in 1 case, and there were no filter migration, filter disruption, filter perforation. Five of 73 cases were lost in follow-up visit, 14 patients died after implantation (5 days to 41 months, average 14.5 months). Among the 54 living patients, the identified recurrent PE was not noted. Three cases of recurrent DVT, 1 case of inferior vena caval thrombosis and 1 case of thrombosed filters were seen in follow-up. Conclusion: Inferior vena cava filter is safe and effective for the long-term prevention pulmonary embolism, and the long-term major complications after filter placement are not frequent. (authors)

2008-01-01

304

Resection of the liver and inferior vena cava for hepatic malignancy.  

UK PubMed Central (United Kingdom)

BACKGROUND: Involvement of the IVC has traditionally been considered a relative contraindication to resection for advanced tumors of the liver. Combined resection of the liver and IVC for malignancy can be performed safely and results in long-term survival in select patients. STUDY DESIGN: Sixty patients undergoing hepatic and IVC resection by the primary author from 1996 to 2012 were reviewed. Median age was 52 years. Resections were carried out for cholangiocarcinoma (n = 26), hepatocellular carcinoma (n = 16), colorectal metastases (n = 13), gastrointestinal stromal tumor (n = 2), hepatoblastoma (n = 2), and squamous cell carcinoma (n = 1). Resections performed included 27 right and 5 left trisegmentectomies and 25 right and 3 left lobectomies, including the caudate lobe. Ex vivo procedures were performed in 6 patients using veno-venous bypass and the other 54 procedures were performed using varying degrees of vascular isolation. In situ cold perfusion of the liver was used in 8 patients. The IVC was reconstructed using a tube graft (n = 38) primarily (n = 8) or with patches (n = 14). RESULTS: There were 5 perioperative deaths (8%). Three patients died of liver failure, 1 patient died of pulmonary hemorrhage, and 1 patient died of massive pulmonary embolism. Nine patients had evidence of postoperative liver failure that resolved with supportive management. Three patients required temporary dialysis. With a median follow-up of 31 months, 14 patients have died of recurrent malignancy between 22 and 44 months, and an additional 4 patients are alive with disease at 16 to 33 months. Actuarial 1- and 5-year survival rates were 89% and 35%, respectively. CONCLUSIONS: Inferior vena cava involvement by malignancy does not obviate liver resection. The procedure's increased risk is balanced by the possible benefits, given the lack of alternative curative approaches.

Hemming AW; Mekeel KL; Zendejas I; Kim RD; Sicklick JK; Reed AI

2013-07-01

305

Thrombogenesis with continuous blood flow in the inferior vena cava: A novel mouse model  

Science.gov (United States)

Summary Several rodent models have been used to study deep venous thrombosis (DVT). However, a model that generates consistent venous thrombi in the presence of continuous blood flow, to evaluate therapeutic agents for DVT, is not available. Mice used in the present study were wild-type C57BL/6 (WT), plasminogen activator inhibitor-1 (PAI-1) knock out (KO) and Delta Cytoplasmic Tail (?CT). An electrolytic inferior vena cava (IVC) model (EIM) was used. A 25G stainless-steel needle, attached to a silver coated copper wire electrode (anode), was inserted into the exposed caudal IVC. Another electrode (cathode) was placed subcutaneously. A current of 250 ?Amps over 15 minutes was applied. Ultrasound imaging was used to demonstrate the persence of IVC blood flow. Analyses included measurement of plasma soluble P-selectin (sP-Sel), thrombus weight (TW), vein wall morphometrics, P-selectin and Von Willebrand factor (vWF) staining, transmission electron microscopy (TEM), scanning electron microscopy (SEM); and the effect of enoxaparin on TW was evaluated. A current of 250 ?Amps over 15 minutes consistently promoted thrombus formation in the IVC. Plasma sP-Sel was decreased in PAI-1 KO and increased in ?CT vs. WT (WT/PAI-1: p=0.003, WT/?CT: p=0.0002). Endothelial activation was demonstrated by SEM, TEM, P-selection and vWF immunohistochemistry and confirmed by inflammatory cell counts. Ultrasound imaging demonstrated thrombus formation in the presence of blood flow. Enoxaparin significantly reduced the thrombus size by 61% in this model. This EIM closely mimics clinical venous disease and can be used to study endothelial cell activation, leukocyte migration, thrombogenesis and therapeutic applications in the presence of blood flow.

Diaz, Jose A.; Hawley, Angela E.; Alvarado, Christine M.; Berguer, Alexandra M.; Baker, Nichole K.; Wrobleski, Shirley K.; Wakefield, Thomas W.; Lucchesi, Benedict R.; Myers, Daniel D.

2011-01-01

306

Resection of sarcoma involving the intrahepatic vena cava: report of 2 cases from a specialized center.  

UK PubMed Central (United Kingdom)

BACKGROUND: Primary leiomyosarcoma (LMS) of the hepatic vena cava is a rare malignancy that has only been published in case reports. Only a few cases with successful R0 resection have been reported in the literature. METHODS: We report 2 similar cases of extended primary LMS of the intrahepatic inferior vena cava (IVC). Both patients previously underwent operations in nonspecialized centers that resulted in inadequate tumor resection. After admission to a high-volume center focusing on the treatment of patients with sarcoma, R0 resection was feasible with a multimodal therapeutic treatment approach. RESULTS: Radical complete tumor resection was achieved by means of extended right-sided hemihepatectomy (segments V-VIII and I), en bloc resection, and prosthetic replacement of the IVC and nephrectomy in 1 patient. Both patients are currently tumor-free and healthy 6 months postoperatively. CONCLUSIONS: Patients with such complex tumors should be referred to centers with specialized surgeons who can preoperatively estimate whether complete resection may be possible and who are capable of performing such delicate interventions.

Zaenkert EK; Bruns CJ; Winter H; Rentsch M; Jauch KW; Hardin G; Angele MK

2013-05-01

307

MRA of renal veins and inferior vena cava for staging of renal cell carcinoma  

International Nuclear Information System (INIS)

The staging of renal cell carcinoma (RCC) comprises exclusion of tumour expansion into the renal veins and the inferior vena cava (IVC). In 44 patients with RCC these vessels were examined using MRA on the basis of 'time-of-flight' technique (coronal/axial 2D GE-flash-sequence, MIP-algorithm). The method was evaluated against contrast-enhanced CT and DSA in normal conditions and tumour-involved IVC (n=12) and renal veins (n=32) respectively. Following analysis of projection-angiograms (PA) and individual slices the results of MRA without contrast material included an information on vascular tumour extension that was identically safe as CT and DSA. In coronal slice orientation tumour extension into the vena cava was proven in 100%, and into the renal veins in 84%. Additional axial slices were necessary to demonstrate tumour extension into the renal veins in unclear cases. Single slices showed to be superior to PA for a correct identification of the size of the tumour thrombus. (orig.)

1992-01-01

308

Abdominal compartment syndrome caused by ruptured abdominal aortic aneurysm in vena cava  

Directory of Open Access Journals (Sweden)

Full Text Available Background. Abdominal compartment syndrome (ACS) is a rapid increase in intra-abdominal pressure associated with multi-organs dysfunction. It is caused mostly by abdominal bleeding und massive volume compensation. Case report. We reported a 76-year-old patient admitted to the hospital with aortic abdominal aneurysm, 13.7 cm in diameter, ruptured in vena cava, which caused intraabdominal hypertension, the liver and kidney dysfunction, as well as circulation, respiration and metabolic disorders. Intraabdominal pressure was measured by bladder manometry. Central venous pressure and systemic arterial pressure were monitored continuously. Clinical signs were thrill and typical abdominal bruit. Aorto-caval fistula was diagnosed by the use of contrast computerized tomography. Caval endoaneurysmatic suture and aortobiiliac bypass with 18 × 9 mm Dacron prothesis were performed. Haemodynamic changes were mostly corrected during the surgery. The complete correction of haemodynamics, liver, kidney, respiration and metabolic changes was established in the next few weeks. Conclusion. The ACS was caused by rupture of abdominal aortic aneurysm in vena cava followed by edema of the abdominal organs, retroperitoneum, abdominal wall and ascites. Caval endoaneurysmatic suture and aortobiiliac bypass with 18 × 9 mm Dacron prothesis solved aortocaval fistula as well as all the organs and metabolic dysfunctions caused by ACS.

Musi? Davor; Radevi? Božina; Batri?evi? Goran; Filipovi? Aleksandar

2006-01-01

309

An alternative approach for endocardial pacemaker lead implantation in patient with persistent left superior vena cava  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction. Persistent left superior vena cava represents a congenital vascular defect of the venous system, which often makes standard 58 cm endocardial lead placement impossible. Case Outline. A right chamber approach by the left cephalic vein was tried. This was impossible because standard endocardial lead (SJM Isoflex S 1646T, bipolar lead, 58 cm in length, body diameter 7 French) was too short for this patient. A unipolar lead for coronary sinus (Medtronic ATTEIN 4193-88), 88 cm in length, body diameter 4 French, was placed in the posterior branch of the coronary sinus. With such positioning of the lead, a VVI pacemaker pacing was enabled. The operation lasted for 48 minutes, and the time of total X-ray exposure was 9.6 minutes. The values that were achieved were: threshold 0.3 V, pulse width 0.37 ms, maximum R 22.55 mV. Ten months after the implantation, the values were: thresh- old 0.3 V, maximum R 28.8 mV. Conclusion. Persistent left superior vena cava in some cases makes standard 58 cm endocardial lead placement impossible due to its joining to the right atrium over the dilated coronary sinus. Coronary sinus lead placement in the posterior or lateral coronary sinus branch represents an acceptable alternative approach for pacemaker lead placement in these patients.

Mitov Vladimir; Periši? Zoran; Kosti? Tomislav; Stojkovi? Aleksandar; Joli? Aleksandar; Aleksi? Aleksandar; Milašinovi? Goran

2010-01-01

310

Vena cava filters in cancer patients: experience with 50 patients/ Filtros de veia cava inferior em pacientes com câncer: experiência em 50 casos  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVO: Estudar os resultados imediatos e tardios obtidos com a implantação de filtros de veia cava inferior em pacientes com trombose venosa profunda concomitante a neoplasia. MÉTODOS: Avaliamos retrospectivamente 50 pacientes com câncer e trombose venosa profunda associada submetidos a interrupção de veia cava inferior com filtros intraluminais definitivos. Foram estudados aspectos referentes à indicação do procedimento, à técnica de implante dos dispositiv (more) os, complicações precoces e tardias relacionadas à operação e à evolução dos pacientes. RESULTADOS: A indicação mais freqüente para o procedimento foi a impossibilidade de anticoagulação plena (80% ) e a via de acesso preferencial foi a punção da veia femoral, realizada em 86% dos pacientes. Não houve complicações relativas ao implante dos filtros. Durante a evolução ocorreram: um episódio de tromboembolia pulmonar não fatal e dois casos de oclusão da veia cava inferior; em um paciente foi demonstrada a presença de coágulo retido no dispositivo. Vinte pacientes (40%) faleceram devido à neoplasia. CONCLUSÃO: A interrupção da veia cava inferior com filtro endoluminal é um procedimento com baixo índice de complicações e eficaz na prevenção da embolia pulmonar nos pacientes com tromobose venosa profunda de membros inferiores portadores de câncer. Abstract in english OBJECTIVE: To study the immediate and late results obtained from the implantation of vena cava filters in cancer patients with deep vein thrombosis concomitant with neoplasia. METHODS: This was a retrospective evaluation of 50 patients with an association of cancer and deep venous thrombosis who underwent interruption of the inferior vena cava and the insertion of permanent vena cava filters. The indications for the procedure, filter implantation technique, early and late (more) complications related to the operation, and the clinical evolution were evaluated. RESULTS: The most frequent indication for filter implantation was the contraindication for full anticoagulant treatment (80%). The femoral vein was the preferred access route (86% of the patients). There were no complications related to the surgical procedure. During the follow-up, the following complications were observed: 1 episode of nonfatal pulmonary thromboembolism, 2 cases of occlusion of the inferior vena cava, and 1 case of thrombus retained in the device. Twenty patients (40%) died due to progression of the neoplasm. CONCLUSIONS: Interruption of the inferior cava vein using an endoluminal filter is a procedure with a low rate of complications. It is a safe and efficient measure for preventing pulmonary embolism in cancer patients who have deep vein thrombosis of the lower limbs.

Zerati, Antonio Eduardo; Wolosker, Nelson; Yazbek, Guilherme; Langer, Marcel; Nishinari, Kenji

2005-10-01

311

The Optional VenaTech™ Convertible™ Vena Cava Filter: Experimental Study in Sheep  

International Nuclear Information System (INIS)

Purpose: Retrieval of optional caval filters may be impaired by filter tilting, migration, fracture, or embedding in the IVC wall. The goal of this experimental study was to evaluate a new optional filter, convertible by unlocking and removing the filter head. Methods: Forty-nine Pre-Alp sheep (average weight, 55 kg) were anesthetized. IVC was catheterized via the right femoral vein (n = 46) or via the internal jugular vein (n = 3) with a 12.9-F sheath. VenaTech™ Convertible™ IVC filters were inserted as either permanent filters (n = 14) or as filters to be converted. Conversion was immediately after deployment (n = 19) or delayed after 1, 3, or 6 months (n = 20). Filter delivery, deployment, and conversion with measurement of migration and tilting were evaluated by cavography. Incorporation of the filter’s stabilizers and arms in the IVC wall was assessed by gross anatomy. Results: Delivery system insertion, filter release, and immediate conversion were successful in all cases. Delayed conversion was completed in all but one sheep, due to insufficient snare tension. Complimentary balloon-catheter inflation was required in 12 of 20 delayed conversions to achieve filter opening. In all 49 sheep, no thrombosis, migration, or significant tilting occurred. Within 4 weeks of conversion, the filter’s stabilizers and arms were incorporated into the IVC wall. Upon removal, the filter head was free of intimal growth. Conclusions: The VenaTech™ Convertible™ optional IVC filter was successfully implanted in all sheep with no migration or tilting. Conversion at various dates by filter head removal was feasible in all but one case.

2012-01-01

312

[Organ-invasive carcinoma of the pararenal gland involving the inferior vena cava: successful curative and interdisciplinary surgical management].  

UK PubMed Central (United Kingdom)

HISTORY AND ADMISSION FINDINGS: A 61-year-old woman presented with a 2-month-history of progressive deterioration, increasing exertional dyspnoea and pain in the right upper abdomen (past medical history: bronchial asthma and hypertension). The physical examination showed mild generalized weakness, tenderness in the right upper abdomen, and ascites. INVESTIGATIONS: Laboratory studies did not reveal any hormonal abnormalities. A CT angiogram revealed a mass of the right adrenal gland with distinct invasion into the inferior vena cava, and tumour thrombosis that extended proximally into the right atrium. Distally, the tumour ended at the caudate lobe of the liver with an extensive peripherally engulfed thrombus from the inferior vena cava down to the common iliac veins. TREATMENT AND COURSE: An open right adrenalectomy with resection of the periadrenal tissue and extirpation of the intracaval tumour thrombus (by cavotomy under digital occlusion of the blood flow from the vena cava into the right atrium) was carried out with no significant postoperative complications. Subsequently, the patient underwent adjuvant mitotane therapy for three years. So far, no recurrence has occurred during a course of 7 years. CONCLUSION: Tumour induced thrombotic occlusion of the inferior vena cava and other veins is rare, especially with right atrium involvement. In the absence of other effective treatment options, the combination of radical resection and adjuvant mitotane therapy remains the only successful curative treatment for primary invasive adrenal gland carcinoma.

Dillner J; Meyer F; Lippert H; Huth C; Klose S; Roessner A; Halloul Z

2013-02-01

313

Obstruction of the superior vena cava due to aortic dissection: CT findings of collateral venous flow via the bronchial veins  

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Obstruction of the superior vena cava caused by acute aortic dissection can lead to collateral flow in the azygos and hemiazygos system, as well as to reversal of flow in the pleurohilar and bronchial veins. In the latter case, a small right-to-left shunt has formed. We describe the findings in such a case on a contrast enhanced spiral CT. (orig.)

Schepers-Bok, R. [Dept. of Radiology, Leyenburg Hospital, The Hague (Netherlands); Mallens, W.M.C. [Dept. of Radiology, Leyenburg Hospital, The Hague (Netherlands)

1996-10-01

314

Unusual Cause of Acute Right Ventricular Dysfunction: Rapid Progression of Superior Vena Cava Aneurysm Complicated by Thrombosis and Pulmonary Thromboembolism  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Aneurysms of the major thoracic veins are rare. They are usually asymptomatic and thus treated conservatively. We report an extremely rare case of rapidly progressing superior vena cava (SVC) aneurysm complicated by thrombosis and acute pulmonary thromboembolism (PTE) with right ventricular dysfunct...

Oh, Sang Gi; Kim, Kye Hun; Seon, Hyun Ju; Yoon, Hyun Ju; Ahn, Youngkeun; Jeong, Myung Ho; Cho, Jeong Gwan; Park, Jong Chun

315

Simultaneous pulsed Doppler velocimetry of fetal aorta and inferior vena cava. Diagnosis of fetal congenital heart block; Two case reports  

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A simple technique for the diagnosis of fetal congenital heart block by simultaneous Doppler blood-flow velocimetry of the fetal abdominal aorta and inferior vena cava is described. Furthermore, a simple method of monitoring the fetal artrial reactivity during the antenatal period; and simultaneous ...

Chan, FY; Ghosh, A; Tang, M; Lam, C

316

Azygos Vein Dialysis Catheter Placement Using the Translumbar Approach in a Patient with Inferior Vena Cava Occlusion  

International Nuclear Information System (INIS)

We describe percutaneous, translumbar placement of a 14-Fr dialysis catheter into an ascending lumbar vein to achieve tip position in an enlarged azygos vein. The patient had thrombosis of all traditional vascular sites, as well as the inferior vena cava. This catheter functioned well for 7 months before fatal catheter-related infection developed.

2008-01-01

317

Aortic penetration by temporary inferior vena cava filters: report of an interesting case and review of the literature.  

UK PubMed Central (United Kingdom)

We report a patient who received a retrievable G2 filter and developed inferior vena cava perforations in multiple locations, including penetration of one of the prongs inside the aortic lumen. Furthermore, we conducted an extensive literature review of similar cases to describe the clinical presentation, aortic pathology, radiologic findings, treatment, and outcomes related to this complication.

Caceres M; Braud R; Weiman D

2012-02-01

318

Capsular renal leiomyosarcoma with encasement of the inferior vena cava - Diagnosed by immunostaining and review of literature  

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We report and describe the presentation, pathological diagnosis with immunostaining and management of a rare case of capsular renal leiomyosarcoma encasing the inferior vena cava (IVC). We have reviewed and tabulated other such similar cases. The present case was successfully managed by radical neph...

Singh Iqbal; Joshi Mohit; Mishra Kiran

319

[The superior vena cava syndrome secondary to a benign intrathoracic goiter: a case report and review of the literature  

UK PubMed Central (United Kingdom)

The clinical case of a female patient suffering a benign retrosternal goitre which first appeared as a superior vena cava syndrome, is presented. After confirming the diagnosis with an intrathoracic CT scan, a subtotal bilateral thyroidectomy was performed resulting in a complete remission of the clinical picture. A literature review is performed commenting on some clinical, diagnostic and therapeutical aspects.

Ziad F; Lacasa J; Serrano R; Aznar R; Garrapiz J

1990-10-01

320

Polysplenia syndrome: a case associated with transhepatic portal vein, short pancreas, and left inferior vena cava with hemiazygous continuation.  

UK PubMed Central (United Kingdom)

This paper presents a 57-year-old asymptomatic patient with the polysplenia syndrome with abdominal manifestations. In addition to multiple spleens, the abdominal findings included a left inferior vena cava with hemiazygous continuation, a striking portal anomaly with the portal vein following an "intraperitoneal-left transhepatic" route to reach the porta hepatis, and a congenitally short pancreas.

Sener RN; Alper H

1994-01-01

 
 
 
 
321

Polysplenia syndrome: a case associated with transhepatic portal vein, short pancreas, and left inferior vena cava with hemiazygous continuation.  

Science.gov (United States)

This paper presents a 57-year-old asymptomatic patient with the polysplenia syndrome with abdominal manifestations. In addition to multiple spleens, the abdominal findings included a left inferior vena cava with hemiazygous continuation, a striking portal anomaly with the portal vein following an "intraperitoneal-left transhepatic" route to reach the porta hepatis, and a congenitally short pancreas. PMID:8161909

Sener, R N; Alper, H

322

Malformação de veia cava inferior e trombose venosa profunda: fator de risco de trombose venosa em jovens Inferior vena cava malformation and deep venous thrombosis: a risk factor of venous thrombosis in the young  

Directory of Open Access Journals (Sweden)

Full Text Available A ausência da veia cava inferior, alteração no processo de formação embriológica que ocorre entre a sexta e a oitava semanas de gestação, é uma rara anomalia congênita. Porém, recentemente foi confirmada como sendo um fator de risco importante para o desenvolvimento de trombose venosa profunda, especialmente em jovens. Apresentamos um caso de trombose em veias cava inferior, ilíacas, femorais e poplíteas num jovem de 16 anos com agenesia de um segmento de veia cava infra-renal e veia renal esquerda retroaórtica.Absence of inferior vena cava, caused by aberrant development within the sixth to eighth weeks of gestation, is a rare congenital anomaly. However, it has been recently confirmed as a major risk factor for the development of deep venous thrombosis, especially in young patients. We report a case of inferior vena cava, iliac, femoral and popliteal vein thrombosis in a 16-year-old patient with inferior vena cava agenesis and retroaortic left renal vein.

Renan Roque Onzi; Luiz Francisco Costa; Regis Fernando Angnes; Luciano Amaral Domingues; Paulo Moraes; Leandro Armani Scaffaro; Carolina Mancuzo Stapenhorst

2007-01-01

323

Hepatic resection through an anterior approach employing a modified liver hanging maneuver in patients with a massive liver tumor severely oppressing the inferior vena cava.  

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For a large hepatic neoplasm existing in the right hepatic lobe, hepatic resection using an anterior approach is required. We have reported an operative procedure for hepatic transection using absorbable polyglycolic acid tape. In patients with suspected tumor invasion of the inferior vena cava, on the other hand, considering the range of the residual tumor while sparing the inferior vena cava as much as possible, combined resection and reconstruction of the inferior vena cava is conducted only if operative curativity is expected. We conducted hepatic transection while maintaining the blood flow of the residual liver by applying the liver hanging maneuver method of Belghiti et al. and polyglycolic acid tape in patients with giant liver tumors of the right hepatic lobe compressing the hepatic inferior vena cava. Strong angled dissecting forceps were inserted into the ventral side of the inferior vena cava from the caudal side, and the tip was induced between hepatic veins. Two strips of polyglycolic acid tape were pinched with forceps and strongly ligated on the right and left sides of the cutoff line. Subsequently, hepatic transection was conducted using electrocautery spray coagulation and CUSA without blocking the inflow blood of the residual liver, and the right hepatic lobe was extirpated. This procedure has already been performed in 5 patients suspected of inferior vena cava invasion, and the inferior vena cava was able to be preserved in all the patients. PMID:15362776

Suzuki, Masanori; Unno, Michiaki; Katayose, Yu; Takeuchi, Heigo; Rikiyama, Toshiki; Onogawa, Tohru; Sato, Takeaki; Mizuma, Masamichi; Ohtuka, Hideo; Mastuno, Seiki

324

Filtro de veia cava: uma década de experiência em um centro de trauma nível I/ Vena cava filters: a decade of experience in a level I trauma center  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVO: Avaliar os dados relativos à utilização de filtro de veia cava na Divisão de Trauma do Centro Médico da UCSD San Diego, CA/EUA. MÉTODOS: Estudo descritivo realizado na Divisão de Trauma visando avaliar a experiência acumulada e a conduta terapêutica nos doentes atendidos pela equipe da Divisão de Trauma e submetidos à colocação de filtro de veia cava como método de prevenção ou tratamento do TEP no período de janeiro de 1999 a dezembro de 2008. (more) RESULTADOS: O estudo compreendeu 512 doentes, destacando-se o sexo masculino (73%). Quanto à causa do traumatismo predominou o acidente automobilístico, seguido por lesões provocadas por quedas. A relação homem/mulher foi 3:1. A faixa etária mais atingida foi 21 a 40 anos, representando 36% dos doentes. O percentual de filtros de cava profiláticos foi de 82% contra 18% de filtros terapêuticos. O traumatismo craniano foi a principal causa para indicação de filtros profiláticos seguido dos traumas raquimedulares. O índice de TVP pós-filtro foi 11%. CONCLUSÃO: Na presença de contraindicação ao uso de anticoagulantes em doentes vítimas de trauma grave, os filtros de veia cava inferior demonstraram ser uma opção efetiva e segura. Entretanto, deve-se aplicar rigor ao julgamento clínico para todas as indicações, mesmo após o advento de filtros "recuperáveis". Abstract in english OBJECTIVE: To evaluate the data on the use of vena cava filter in the Division of Trauma, UCSD Medical Center - San Diego, CA / USA. METHODS: A descriptive study was conducted at the Division of Trauma to evaluate the cumulated experience and the therapeutic approach in patients attended by the staff of the Division of Trauma and submitted to placement of a vena cava filter as a method of prevention or treatment of Pulmonary Thromboembolism (PTE) from January 1999 to Dece (more) mber 2008. RESULTS: The study comprised 512 patients, mostly males (73%). As to the cause, automobile accident injuries predominated, followed by injuries caused by falls. The male / female ratio was 3:1. The most affected age group was the one between 21 to 40 years, representing 36% of patients. The percentage of prophylactic vena cava filters was 82%, whilst 18% had treatment purposes. Head trauma was the main cause for the indication of prophylactic filters followed by spinal cord trauma. The rate of pos-filter deep vein thrombosis (DVT) was 11%. CONCLUSION: In the presence of contraindications to the use of anticoagulants in patients who suffered severe trauma, the inferior vena cava filters have proven to be an effective and safe optio n. However, one should apply rigorous clinical judgment to all indications, even after the advent of retrievable filters.

Reys, Luiz Guilherme Cintra Vidal; Coimbra, Raul; Fortlage, Dale

2012-01-01

325

Improvising hepatic venous outflow and inferior vena cava reconstruction for combined heart and liver and sequential liver transplantations.  

UK PubMed Central (United Kingdom)

Liver transplantation is a standard treatment for patients with familial amyloidotic polyneuropathy (FAP) with disease progression. Given the multiorgan involvement by amyloidosis, the heart is often involved. When poor cardiac function becomes prohibitive to liver transplantation, a combined heart-liver transplantation (CHLT) is the only realistic treatment. This article records a CHLT for a patient with FAP whose removed liver was immediately transplanted as an amyloidotic hepatic allograft (AHA) to a patient having hepatocellular carcinoma and cirrhosis in a sequential liver transplantation. In the CHLT, the heart and liver are donated by a deceased donor. The newly implanted heart did not tolerate cross clamping of the inferior vena cava (IVC), so a side-to-side anastomosis was performed to connect the IVC and that of the liver graft. Therefore, the AHA was devoid of an IVC. The infrarenal cava procured from the deceased donor was used for reconstruction of the AHA to match a whole graft used in routine deceased-donor liver transplantation. Venoplasty was performed using the graft right hepatic vein and the middle and left hepatic vein stump to form a single cuff. The reconstructed AHA was implanted to the recipient conveniently like a usual whole graft.

Chan SC; Cheng LC; Ho KL; Chok KS; Sharr WW; Dai WC; Lo CM

2013-04-01

326

Significance of collateral vessels on the prediction of superior vena cava syndrome on CT  

International Nuclear Information System (INIS)

Although visible collateral vessels on computed tomography (CT) has been considered as an important finding in superior vena cava (SVC) syndrome, there is no systematical analysis concerning correlation between the CT evidence of collateral vessels and clinical evidence of SVC syndrome. The purpose of this study is to evaluate how accurately we predict the clinical presence of SVC syndrome by the collateral vessels in patients with apparent SVC obstruction in CT. Forty seven patients having a CT evidence of obstruction or compression of SVC and/or its major tributaries were included in this study. Lung cancer was the most common underlying disease (n=40). The enhanced CT scans were obtained through either arm vein using a combined bolus and drip-infusion technique. Analyzing the CT scans, we particularly paid attention to the site and pattern of venous compromise, presence of collateral vessels, and if present, their location, without knowing whether symptoms and sign were present or nor, and then compared them with clinical data by a thorough review of charts, To verify the frequency of visible collateral vessels in normal subjects, we also evaluated the CT scans of 50 patients without mediastinal disease and clinical SVC syndrome as a control group. On CT, collateral vessels were found in 24 patients, among whom three patient had a single collateral and 21 patients had two or more collateral channels. There were two false positive cases, in which clinically overt SVC syndrome appeared 10 days and three months after CT examination respectively, and one false negative case. The presence of collateral vessels on CT, respectively, and one false negative case. The presence of collateral vessels on CT, regardless of the number and location of collateral vessels and pattern of venous obstruction, was a good clue for predicting the presence of clinical SVC syndrome with the sensitivity and the specificity of 95.7% and 91.7%, respectively. In control group, collateral vessels were seen in three patients (6%). We conclude that the presence of collateral vessels on CT is a highly sensitive and specific sign of clinical SVC syndrome.

1993-01-01

327

Significance of collateral vessels on the prediction of superior vena cava syndrome on CT  

Energy Technology Data Exchange (ETDEWEB)

Although visible collateral vessels on computed tomography (CT) has been considered as an important finding in superior vena cava (SVC) syndrome, there is no systematical analysis concerning correlation between the CT evidence of collateral vessels and clinical evidence of SVC syndrome. The purpose of this study is to evaluate how accurately we predict the clinical presence of SVC syndrome by the collateral vessels in patients with apparent SVC obstruction in CT. Forty seven patients having a CT evidence of obstruction or compression of SVC and/or its major tributaries were included in this study. Lung cancer was the most common underlying disease (n=40). The enhanced CT scans were obtained through either arm vein using a combined bolus and drip-infusion technique. Analyzing the CT scans, we particularly paid attention to the site and pattern of venous compromise, presence of collateral vessels, and if present, their location, without knowing whether symptoms and sign were present or nor, and then compared them with clinical data by a thorough review of charts, To verify the frequency of visible collateral vessels in normal subjects, we also evaluated the CT scans of 50 patients without mediastinal disease and clinical SVC syndrome as a control group. On CT, collateral vessels were found in 24 patients, among whom three patient had a single collateral and 21 patients had two or more collateral channels. There were two false positive cases, in which clinically overt SVC syndrome appeared 10 days and three months after CT examination respectively, and one false negative case. The presence of collateral vessels on CT, respectively, and one false negative case. The presence of collateral vessels on CT, regardless of the number and location of collateral vessels and pattern of venous obstruction, was a good clue for predicting the presence of clinical SVC syndrome with the sensitivity and the specificity of 95.7% and 91.7%, respectively. In control group, collateral vessels were seen in three patients (6%). We conclude that the presence of collateral vessels on CT is a highly sensitive and specific sign of clinical SVC syndrome.

Kim, Hyun Sook; Kim, Hyung Jin; Lee, Hyeng Gon; Ahn, In Oak; Chung, Sung Hoon [Gyeongsang National University College of Medicine, Chinju (Korea, Republic of)

1993-07-15

328

Inferior vena cava thrombosis: a rare complication of fibrocalcific pancreatic diabetes.  

Science.gov (United States)

A 42-year-old man presented with a history of recurrent loose motions for the previous 7 months. The patient also had a history of diabetes mellitus for the last 10 years and was uncontrolled on oral hypoglycaemic agents but responded to insulin. There was no history of any addiction. Examination and investigations showed the presence of malabsorption along with a calcified pancreas. The presence of a thrombus was also noted in the inferior vena cava. In the absence of alcohol intake, a diagnosis of fibrocalcific pancreatic diabetes was made and the patient was investigated for other hypercoagulable states but none was found. The patient was put on oral anticoagulants, insulin and pancreatic enzyme supplements, and currently, he is under regular follow-up for diabetes. PMID:23608838

Mishra, R; Yathish, B E; Himanshu, D; Usman, K

2013-04-22

329

Inferior vena cava thrombosis: a rare complication of fibrocalcific pancreatic diabetes.  

UK PubMed Central (United Kingdom)

A 42-year-old man presented with a history of recurrent loose motions for the previous 7 months. The patient also had a history of diabetes mellitus for the last 10 years and was uncontrolled on oral hypoglycaemic agents but responded to insulin. There was no history of any addiction. Examination and investigations showed the presence of malabsorption along with a calcified pancreas. The presence of a thrombus was also noted in the inferior vena cava. In the absence of alcohol intake, a diagnosis of fibrocalcific pancreatic diabetes was made and the patient was investigated for other hypercoagulable states but none was found. The patient was put on oral anticoagulants, insulin and pancreatic enzyme supplements, and currently, he is under regular follow-up for diabetes.

Mishra R; Yathish BE; Himanshu D; Usman K

2013-01-01

330

Anomalous right-sided pulmonary venous connection to the superior vena cava.  

UK PubMed Central (United Kingdom)

Over the years, different techniques have been introduced for the repair of sinus venosus atrial septal defect (ASD) with anomalous right-sided pulmonary venous connection to the superior vena cava. We report the case of a 9-year-old girl, who presented with dyspnea and peripheral cyanosis. Preoperative echocardiography and angiography findings suggested a partial anomalous pulmonary venous connection. On cardiopulmonary bypass, the ASD was dilated, and the anomalous pulmonary vein was anastomosed to the right atrium and redirected to the left atrium using an intraatrial baffle and a tube graft. The intraoperative and postoperative periods were uneventful, and the patient is currently in good health at 4.5 years' follow-up.

Abbasi K; Abbasi A; Tazik M; Salehiomran A; Kazemisaeed A; Sadeghian H

2009-03-01

331

Superior vena cava injury after central venous catheterization: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available "nBackground: Central venous catheters are useful instruments in monitoring of critical patients and are important roots for total parentral nutrition. The catheters are widely used in general wards and intensive care units. Their use may be associated with serious and rare complications. "n"nCase presentation: We reported a 24 years old woman that admitted to Ghaem hospital Mashhad University of Medical Science, in Mashhad, Iran, because of penetrating chest wall injury and surgical exploration indicated due to massive hemorrhage. Central vein (right jugular vein) was canulated for resuscitation and monitoring. Superior vena cava was injured after canulation and presented with delay massive mediastinal hematoma. "n"nConclusion: We aim to introduce this rare complication and its management. This management could be conservative or surgical intervention according to severity of the vein damage.

Bagheri R; Nurshafiee S

2010-01-01

332

Transfemoral approach through inferior vena cava filters for complex cardiac interventions: expanding the limits.  

UK PubMed Central (United Kingdom)

Performing complex cardiac interventions that need atrial septal crossing in patients with a previously implanted inferior vena cava filter (ICVF) has proven difficult. Accordingly, some authors have chosen accesses different from the traditional femoral vein approach. Here, we report two cases of complex cardiac procedures performed via the femoral vein and through an IVCF. In the first case, a percutaneous mitral valvuloplasty was performed in an elderly woman after crossing the IVCF with a large sheath. In the second case, simultaneous left atrial appendage and patent foramen ovale closures were performed. In both experiences, the key step was to secure the access by positioning a long sheath with its tip above the IVCF and not removing it until the procedure had finished. These cases further support the use of traditional femoral vein access in patients with IVCF and confirm the possibility of performing complex cardiac interventions in these scenarios.

Martínez G; Lindefjeld D; Martínez A

2013-03-01

333

En block resection of a large hepatocellular carcinoma involving the caudal vena cava in a dog.  

UK PubMed Central (United Kingdom)

A 13-year-old neutered female Shih Tzu was referred for investigation of a cranial abdominal mass. Investigations including conventional radiography, abdominal ultrasonography and computed tomography confirmed the mass in the caudate lobe of the liver. As a collateral vein originating from the caudal vena cava (CVC) communicated with the azygos vein, the CVC was ligated and transected cranial to the right renal vein and cranial to the mass under temporary occlusion of the thoracic descending aorta and posthepatic CVC. The mass combined with the CVC was excised. The mass was confirmed as hepatocellular carcinoma (HCC). This report describes the first case with successful en bloc resection of a large HCC involving the CVC in a dog.

Seki M; Asano K; Ishigaki K; Iida G; Teshima K; Watari T; Tanaka S

2011-05-01

334

En block resection of a large hepatocellular carcinoma involving the caudal vena cava in a dog.  

Science.gov (United States)

A 13-year-old neutered female Shih Tzu was referred for investigation of a cranial abdominal mass. Investigations including conventional radiography, abdominal ultrasonography and computed tomography confirmed the mass in the caudate lobe of the liver. As a collateral vein originating from the caudal vena cava (CVC) communicated with the azygos vein, the CVC was ligated and transected cranial to the right renal vein and cranial to the mass under temporary occlusion of the thoracic descending aorta and posthepatic CVC. The mass combined with the CVC was excised. The mass was confirmed as hepatocellular carcinoma (HCC). This report describes the first case with successful en bloc resection of a large HCC involving the CVC in a dog. PMID:21187679

Seki, Mamiko; Asano, Kazushi; Ishigaki, Kumiko; Iida, Gentoku; Teshima, Kenji; Watari, Toshihiro; Tanaka, Shigeo

2010-12-24

335

Marcapasso bi-atrial epicárdico subxifóide na obstrução da veia cava superior Bi-atrial subxiphoid epicardial pacemaker in superior vena cava syndrome  

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Full Text Available Um paciente portador de marcapasso definitivo bi-atrial-ventricular por fibrilação atrial paroxística e bradicardia sinusal, em uso crônico de anticoagulante oral, apresentou sinais clínicos da síndrome da veia cava superior. A venografia por subtração digital mostrou obstrução total do tronco braquiocefálico venoso direito e grande dificuldade de fluxo sangüíneo da veia inominada para a veia cava superior. A abordagem terapêutica constou da remoção completa do sistema transvenoso seguida de reimplante do sistema bi-atrial-ventricular por técnica epimiocárdica pela via subxifóide assistida por fluoroscopia.A patient with a bi-atrial-ventricular permanent pacemaker due to paroxystic atrial fibrillation associated to sinus bradycardia, in chronic use of oral anticoagulant, presented clinical signs of superior vena cava syndrome. Digital subtraction venography showed total obstruction of the right brachiocephalic venous trunk and severe stenosis of the connection of the left trunk to the superior vena cava. The therapeutic approach consisted of complete removal of transvenous system followed by re-implant of the bi-atrial-ventricular system using an epicardial subxiphoid access with fluoroscopic assistance

Roberto Costa; Maria Inês de Paula Leão; Kátia Regina da Silva; Paulo Roberto Camargo; Regina Valéria Costa

2006-01-01

336

Inferior vena cava filter placement for the prevention of pulmonary embolism and the complications related to the filter placement  

International Nuclear Information System (INIS)

Objective: To investigate the effects of inferior vena cava (IVC) filter placement for the prevention of fatal pulmonary embolism and to discuss the management of complications related to the filter placement. Methods: Seventy patients with proved deep vein thrombosis of lower extremity underwent inferior vena cava filter placement.A total of 72 IVC filters were implanted,which included 20 Trap Ease filters, 31 Vena Tech filters, 13 retrievable OptEaseTM filters and 8 Tempo II filters. One filter was deployed above the orifice of renal vein and the remaining 71 were deployed below the orifice of renal vein. Results: All the patients were followed up for 8-72 months after the procedure. During the follow-up period no fatal pulmonary embolism occurred except that some complications related to the filter placement occurred in 6 cases. Conclusion: Inferior vena cava filter placement can effectively prevent the occurrence of pulmonary embolism. Of course, this treatment should be strictly applied according to the indications. (authors)

2009-01-01

337

Accidental implantation of hemodialysis catheter in persistent left superior vena cava  

International Nuclear Information System (INIS)

The implantation of central catheters for hemodialysis in patients with renal failure is a common practice. The venous access to the internal jugular vein through percutaneous puncture is the most recommended procedure because it produces the lowest percentage of stenosis. The right internal jugular vein puncture is the most appropriate one because it goes directly in vertical direction into the right atrium, but in some cases its canalization is impossible making it necessary to puncture the left internal jugular vein, the one next to the innominated vein that ends in the superior cava, with the result that its path is much curved. 3 cases in which the left intern jugular catheter that was inserted to perform hemodialysis accidentally canalized the anomaly in the persistent left superior vena cava were presented. In all the cases and before proceeding with the hemodialysis it was demonstrated by the gases of the punctuated vessel, echocardiogram or contrast medium that the catheter was positioned in the venous system that drains in the right atrium.

2007-01-01

338

Superior vena cava obstruction presenting with epistaxis, haemoptysis and gastro-intestinal haemorrhage in two men receiving haemodialysis with central venous catheters: two case reports  

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Full Text Available Abstract Introduction Superior vena cava (SVC) obstruction secondary to central venous catheterization is an increasingly recognized complication. Case presentation We present two cases of superior vena cava obstruction secondary to indwelling central venous catheters used for haemodialysis access. One of the patients developed the unusual complications of torrential epistaxis and haemoptysis, which has been reported only once so far in the literature. The other patient developed melaena secondary to downhill oesophageal varices. We briefly discuss the pathophysiology, symptoms and signs, investigations and management of superior vena cava obstruction and thrombosis. Conclusion Increasing use of central venous access for haemodialysis will increase the incidence of central venous stenosis, thrombosis and exhaustion. Superior vena cava obstruction is likely to be an increasingly recognised complication of vascular access in the future.

Gopaluni Seerapani; Warwicker Paul

2009-01-01

339

Transcatheter closure of patent ductus arteriosus and interruption of inferior vena cava with azygous continuation using an Amplatzer duct occluder II  

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Full Text Available We report a case of transcatheter closure of patent ductus arteriosus using the new Amplatzer duct occluder II in an adult patient with interrupted inferior vena cava with azygous continuation via the femoral artery approach.

Koh Ghee; AI Mokthar Sharifah; Hamzah Amir; Kaur Jasvinder

2009-01-01

340

Tumor thrombus of inferior vena cava in patients with renal cell carcinoma – clinical and oncological outcome of 50 patients after surgery  

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Abstract Background To evaluate oncological and clinical outcome in patients with renal cell carcinoma (RCC) and tumor thrombus involving inferior vena cava (IVC) treated with nephrectomy and thrombectomy. Methods We identified 50 patients with a median age of 65?years...

Vergho Daniel; Loeser Andreas; Kocot Arkadius; Spahn Martin; Riedmiller Hubertus

 
 
 
 
341

[Ligation of the inferior vena cava and the Mobin-Uddin filter in the treatment of recurrent pulmonary embolism. Comparative study  

UK PubMed Central (United Kingdom)

Twenty six cases of inferior vena cava interruption for the treatment of recurrent pulmonary embolism are reviewed. Ten patients were treated with inferior vena cava ligation while in the other 16 a Mobin-Uddin umbrella was placed. The recent and late complications of both groups were analyzed. The most common complication of the inferior vena cava ligation was edema of the lower extremities in 40% of the patients. In the Mobin-Uddin group, the most frequent complication was the recurrence of thrombophlebitis in lower limbs, that appeared in 50% of the cases studied. We conclude that inferior vena cava ligation may be more beneficial to these patients because the long term complications are fewer in number and severity.

Verdejo París J; Pinto RO; Lupi Herrera E; Seoane M; Bialostozky D

1982-09-01

342

Left-sided high-flow arteriovenous hemodialysis fistula combined with a persistent left superior vena cava causing coronary sinus dilatation.  

UK PubMed Central (United Kingdom)

We present an interesting case illustrating the possible hemodynamic consequences when a left-sided arteriovenous hemodialysis fistula is combined with the congenital anomaly of a persistent left superior vena cava (PLSVC). Our case illustrates the importance of an echocardiographic examination with attention to the coronary sinus (CS) caliber-raising suspicion of a PLSVC-in the assessment for the hemodialysis access in end-stage renal disease patients. The causes and symptoms of CS dilatation, as well as the literature on PLSVC, are also discussed in detail.

Wolf M; Scott B

2013-03-01

343

Anomalías congénitas del sistema renal: agenesia renal izquierda asociada a variante arteriovenosa renal derecha y vena cava inferior  

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Full Text Available Este trabajo describe la variante anatómica en un caso incidental de disección en la Escuela de Medicina de la Universidad de Costa Rica, el cual presenta agenesia renal izquierda con variante arteriovenosa renal derecha que consta de cinco arterias renales y dos venas renales, asociado a la variante anatómica del origen de la vena cava inferior ya que es superior a la arteria mesentérica inferior.This work describes the anatomic variation from an incidental case of dissection founded at Costa Rica’s University School of Medicine, which presents left renal agenesia with a right arteriovenous variant which consists of five renal arteries and two renal veins, related to the anatomic variant from the inferior cava vein, this variation its superior to the inferior mesenteric arterie.

David Rodríguez Palomo; Patricia Chacón Castro; John Mora Chavarría

2009-01-01

344

[Anomalous connection of inferior vena cava to left atrium: infrequent entity that can be a diagnosis and surgical challenge  

UK PubMed Central (United Kingdom)

This is the diagnostic experiences as well as the surgical mode of treatment used in a 31 years old women suffering diversion of the inferior vena cava into the left atrium associated with atrial septal defect. The patient had been previously studied and operated thrice under conventional circumstances at different institutions in order to solve the septal defect. The hemodynamic solution had not been reached due to a missing pathological definition. The cineangiogram through the saphenous vein specified the left atrium form the inferior vena cava. Some considerations are made on the surgical methods used for the fourth operation, and in regard of the fact that the patient refused blood transfusion because of religious convictions (Jehova Witness).

Archundia García A; Gómez Alvarez E; Ixcamparij Rosales C; Blanco Canto M; Hernández Ruiz MA

2000-09-01

345

[Anomalous connection of inferior vena cava to left atrium: infrequent entity that can be a diagnosis and surgical challenge].  

Science.gov (United States)

This is the diagnostic experiences as well as the surgical mode of treatment used in a 31 years old women suffering diversion of the inferior vena cava into the left atrium associated with atrial septal defect. The patient had been previously studied and operated thrice under conventional circumstances at different institutions in order to solve the septal defect. The hemodynamic solution had not been reached due to a missing pathological definition. The cineangiogram through the saphenous vein specified the left atrium form the inferior vena cava. Some considerations are made on the surgical methods used for the fourth operation, and in regard of the fact that the patient refused blood transfusion because of religious convictions (Jehova Witness). PMID:11534101

Archundia García, A; Gómez Alvarez, E; Ixcamparij Rosales, C; Blanco Canto, M; Hernández Ruiz, M A

346

[Thrombosis of the superior vena cava and lateral-cervical lymphadenopathy (probably of metastatic origin). Report of a case  

UK PubMed Central (United Kingdom)

The authors describe a case of superior vena cava thrombosis with laterocervical lymphoadenopathy (probably of metastatic origin). Vascular tumors are a large neoplasm family with a wide clinical and histological spectrum. They may localize on the skin, soft tissues, liver, spleen and parotid gland. The case describes a 65 year-old male, affected by COLD and chronic hepatitis. He came to the hospital for strong gastric pain, which did not vary with meal assumption and objectivity of inflated superficial veins of arms, jugular veins, chest superficial veins and venous capillars and of the epigastric zone, accompanied with right laterocervical lymphoadenomegaly. Endoscopic ultrasonic and X-ray examinations showed a superior vena cava thrombosis determining superficial collateral, azygos and emiazygos vein inflation. The histologic examination of pathologic lymph nodes resulted as hemangioendotelioma/angiosarcoma, a rare case of lymphonodal vascular tumor with a very poor prognosis.

Pasquinelli P; Carnesecchi C; Seppia M; Leonardi R; Guglielmini R; Giuntoli S

1996-07-01

347

[Thrombosis of the superior vena cava and lateral-cervical lymphadenopathy (probably of metastatic origin). Report of a case].  

Science.gov (United States)

The authors describe a case of superior vena cava thrombosis with laterocervical lymphoadenopathy (probably of metastatic origin). Vascular tumors are a large neoplasm family with a wide clinical and histological spectrum. They may localize on the skin, soft tissues, liver, spleen and parotid gland. The case describes a 65 year-old male, affected by COLD and chronic hepatitis. He came to the hospital for strong gastric pain, which did not vary with meal assumption and objectivity of inflated superficial veins of arms, jugular veins, chest superficial veins and venous capillars and of the epigastric zone, accompanied with right laterocervical lymphoadenomegaly. Endoscopic ultrasonic and X-ray examinations showed a superior vena cava thrombosis determining superficial collateral, azygos and emiazygos vein inflation. The histologic examination of pathologic lymph nodes resulted as hemangioendotelioma/angiosarcoma, a rare case of lymphonodal vascular tumor with a very poor prognosis. PMID:8931654

Pasquinelli, P; Carnesecchi, C; Seppia, M; Leonardi, R; Guglielmini, R; Giuntoli, S

348

Angiomiolipoma renal causante de trombo en cava y síndrome de Budd-Chiari secundario/ Renal angiomyolipoma causing inferior vena cava thrombus and secondary Budd-Chiari´s syndrome  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Objetivo: Se aporta un caso de angiomiolipoma renal con tres peculiaridades: origen en seno renal, trombo en cava hasta ostium de aurícula derecha y presentación clínica en forma de síndrome de Budd-Chiari. Métodos: Se realiza una presentación y comentarios de las características del caso clínico. Resultados/Conclusiones: El angiomiolipoma renal es un tumor benigno mesenquimal, poco frecuente (2-6.4% de los tumores renales), de predominio en el sexo femenino. Habi (more) tualmente surge en el parénquima renal, siendo infrecuente su origen en el seno renal. Puede afectar a estructuras venosas formando trombo tumoral en vena renal y en vena cava inferior, llegando incluso a aurícula derecha. Habitualmente es asintomático, constituyendo un hallazgo incidental en técnicas diagnósticas de imagen, pero su presentación clínica varía desde el dolor en flanco (lo más frecuente) hasta el TEP fatal, siendo excepcional su presentación como síndrome de Budd-Chiari. Debido al riesgo de TEP y muerte, el tratamiento quirúrgico (nefrectomía radical y trombectomía) del AML con trombo en cava está indicado aún cuando sea asintomático. Abstract in english Objective: We report one case of renal angiomyolipoma with three characteristics: renal sinus origin, inferior vena cava tumor thrombus reaching the right atrium and Budd-Chiari syndrome. Methods: The characteristics of the case are presented and discussed. Results/Conclusions: Renal angiomyolipoma is a benign mesenchymal tumor. It is an uncommon tumor (2-6.4% of all kidney tumors), with a female predominance. Angiomyolipoma most often originate from the renal parenchyma (more) but they can rarely originate from the renal sinus. They can involve the renal vein, the inferior vena cava and even the right atrium as a tumor thrombus. Angiomyolipoma commonly present as an incidental finding on radiographic studies, but the clinical presentation varies from flank pain to fatal pulmonary tumor embolism. The Budd-Chiari syndrome is an extremely rare presentation. Because of the risk of potentially fatal cardiopulmonary embolism and death, surgical treatment (radical nephrectomy plus tumor thrombectomy) of these lesions is indicated even when they are asymptomatic.

Quicios Dorado, Cristina; Allona Almagro, Antonio

2008-04-01

349

Secundum atrial septal defect with interrupted inferior vena cava and azygos continuation: transfemoral closure in a 3-year old boy.  

UK PubMed Central (United Kingdom)

A secundum atrial septal defect (ASD 2) was closed percutaneously via the transfemoral approach in a 3-year-old boy with interrupted inferior vena cava and azygos continuation. The procedure was guided by transesophageal echocardiography and fluoroscopy using conscious sedation. Successful transhepatic and jugular accesses in similar patients are described. This is the first pediatric report describing a transfemoral closure of a secundum atrial septum defect via azygos continuation.

Flosdorff P; Paech C; Dähnert I

2013-02-01

350

Blocking of the hepatic vein outflow by neointima covering a wallstent across a membranous stenosis of the inferior vena cava  

International Nuclear Information System (INIS)

A 31-year-old man presented with idiopathic membranous obstruction of the suprahepatic inferior vena cava (IVC) and was treated by balloon dilation and placement of a Wallstent. The patient improved markedly. However, he developed obstruction of the hepatic vein outflow secondary to neointima formation over the stent that covered the hepatic vein ostia. The patient died of liver failure and septicemia. We believe that this is the first report of such a serious complication.

1999-01-01

351

Multislice CT of a Persistent Left Superior Vena Cava Coursing Anterior to the Right Ventricle: A Case Report  

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EKG-gated cardiac CT revealed a variant vein in a 44-year-old man that was misinterpreted as a mass on echocardiography. The variant vein was an extension of the confluence of the left internal jugular vein and left subclavian vein and coursed anterior to the right ventricle. It connected to the right atrium directly at the inferior surface of the heart. The variant vein was likely a persistent left superior vena cava, a variant that has never been reported.

Lee, You Kyung; Lee, Whal; Park, Eun Ah; Kang, Mi Jin; Chung, Jin Wook; Park, Jae Hyung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

2008-12-15

352

Obstruction of superior vena cava flow during transcatheter atrial septal defect closure with the Atriasept ASD occluder.  

UK PubMed Central (United Kingdom)

In this paper, we describe a patient with a large secundum atrial septal defect ASD (26 mm) with adequate rims that were suitable for percutaneous closure. While closing this ASD, the superior vena cava (SVC) was occluded with the right atrial disc of the Atriasept ASD occluder (Cardia) and thus the device was retrieved before its release. After retrieval of this device, an Amplatzer ASD occluder was successfully implanted without disturbing the caval flow.

Kahya Eren N; Kocaba? U; Nazl? C; Ergene O

2013-03-01

353

Multislice CT of a Persistent Left Superior Vena Cava Coursing Anterior to the Right Ventricle: A Case Report  

International Nuclear Information System (INIS)

EKG-gated cardiac CT revealed a variant vein in a 44-year-old man that was misinterpreted as a mass on echocardiography. The variant vein was an extension of the confluence of the left internal jugular vein and left subclavian vein and coursed anterior to the right ventricle. It connected to the right atrium directly at the inferior surface of the heart. The variant vein was likely a persistent left superior vena cava, a variant that has never been reported

2008-01-01

354

Superior vena cava thrombectomy with the X-SIZER catheter system in a child with Fontan palliation.  

Science.gov (United States)

A 4-year-old female with hypoplastic left heart syndrome and Fontan palliation presented with severe neurologic impairment from thrombosis of the superior vena cava (SVC). She underwent successful SVC thrombectomy with the X-SIZER Thrombectomy Catheter System, followed by balloon angioplasty. She demonstrated rapid improvement in her neurologic deficits after the procedure. This represents the first published use of the X-SIZER in a child and its first published use for SVC thrombectomy. PMID:17139678

Gossett, Jeffrey G; Rocchini, Albert P; Armstrong, Aimee K

2007-01-01

355

Importance of superior vena cava isolation in successful ablation of persistent atrial fibrillation in patient with partial anomalous pulmonary vein.  

UK PubMed Central (United Kingdom)

Ectopic foci arising from pulmonary veins (PVs) are the predominant sources for the initiation and maintenance of atrial fibrillation (AF) in a vast majority of cases. However, ectopic foci also exist in the non-PV areas like superior vena cava (SVC) in 10-20% of the cases. We report the significance of SVC isolation in a patient with persistent AF and anomalous pulmonary venous connection of the right superior pulmonary vein into the SVC.

Agarwal SC; Bittinger L; Tang AS

2013-05-01

356

Inferior vena cava thrombosis presenting as non-immune hydrops in the fetus of a woman with diabetes.  

Science.gov (United States)

We present a rare case of non-immune hydrops fetalis (NIHF) caused by a thrombus in the inferior vena cava in a neonate with low levels of anti-thrombin III. The diagnosis of (NIHF) was made in utero in a 43-year-old woman with poorly controlled gestational diabetes who subsequently developed pre-eclampsia. Cesarean section was performed due to fetal compromise and worsening pre-eclampsia. The thrombus resolved after neonatal treatment with heparin. PMID:14770403

Weissmann-Brenner, A; Ferber, A; O'Reilly-Green, C; Avila, C; Grassi, A; Divon, M Y

2004-02-01

357

OptEase and TrapEase Vena Cava Filters: A Single-Center Experience in 258 Patients  

International Nuclear Information System (INIS)

We aimed to evaluate the efficacy and safety of the OptEase and TrapEase (both from Cordis, Roden, Netherlands) vena cava filters in the prevention of pulmonary embolism (PE). Between May 2004 and December 2008, OptEase (permanent/retrievable; n = 228) or TrapEase (permanent; n = 30) vena cava filters were placed in 258 patients (160 female and 98 male; mean age 62 years [range 22 to 97]). Indications were as follows: prophylaxis for PE (n = 239), contraindication for anticoagulation in the presence of PE or DVT (n = 10), and development of PE or DVT despite anticoagulation (n = 9). Medical records were retrospectively reviewed for indications, clinical results, and procedure-related complications during placement and retrieval. Clinical PE did not develop in any of the patients. However, radiologic signs of segmental PE were seen in 6 of 66 patients with follow-up imaging data. Migration or fracture of the filter or cava perforation was not seen in any of the patients. Except for a single case of asymptomatic total cava thrombosis, no thrombotic occlusion was observed. One hundred forty-one patients were scheduled to undergo filter removal; however, 17 of them were not suitable for such based on venography evaluation. Removal was attempted in 124 patients and was successful in 115 of these (mean duration of retention 11 days [range 4 to 23]). Nine filters could not be removed. Permanent/retrievable vena cava filters are safe and effective devices for PE prophylaxis and for the management of venous thromboembolism by providing the option to be left in place.

2009-01-01

358

Experimental evaluation of a new retrievable inferior vena cava filter for protection from acute pulmonary embolism in canine  

International Nuclear Information System (INIS)

Objective: To evaluate the validity, safety and feasibility of a new retrieval inferior vena cava filter for the prevention of pulmonary embolism in an animal model. Methods: The model of deep iliofemoral venous thrombosis was established in 12 experimental dogs. In control group(6 experimental dogs), the deep venous thrombosis was made to fall off directly. In experimental group (6 experimental dogs), the deep venous thrombosis was made to fall off with an implanted filter in inferior vena cava. The filter's thrombus-trapping efficacy was evaluated by angiography of pulmonary artery, measurement of the mean pressure of pulmonary artery and arterial oxygen saturation before and after the deep venous thrombus falling off. Results: All filters implanted in the experimental dogs could successfully capture clot coming from deep venous thrombosis. There was no case of pulmonary embolism in experimental groups. On the other hand, pulmonary embolism occurred following the fall of deep venous thrombus in all dogs of control group. Conclusion: The retrievable inferior vena cava filter can effectively prevent from the pulmonary embolism due to falling off of the emboli from deep venous thrombosis. The process of implantation and retrieval is relatively simple and easy. (authors)

2007-01-01

359

Bilateral lower limb edema caused by compression of the retrohepatic inferior vena cava by a giant hepatic hemangioma.  

Science.gov (United States)

Abstract Hemangiomas are the most common benign primary tumors of the liver and their prevalence ranges from 0.4% to 20%. Approximately 85% of hemangiomas are clinically asymptomatic and are incidentally detected in imaging studies performed for other causes. In a very small minority of patients, nausea, vomiting, abdominal pain, distension, palpable mass, obstructive jaundice, bleeding, and signs and symptoms of Budd-Chiari syndrome may develop due to compression of bile duct, hepatic vein, portal vein, and adjacent organs. Occasionally, external compression of inferior vena cava may lead to edema and/or indirect symptoms such as deep vein thrombosis of the lower limbs. In this report, we present a case of giant hepatic hemangioma that completely filled the right lobe of the liver. The patient presented with bilateral lower limb edema and pain. A computed tomography scan detected a 9 × 11 × 12 cm mass indicative of a hemangioma in the right lobe of the liver that compressed the inferior vena cava. The patient refused treatment initially but returned 6 months later presenting with the same symptoms. At that time, the mass had increased in size and a hepatectomy was performed, preserving the middle hepatic vein. By postoperative month 13, the swelling in the lower extremities had decreased significantly and the inferior vena cava appeared normal. PMID:23971776

Akbulut, Sami; Yilmaz, Mehmet; Kahraman, Aysegul; Yilmaz, Sezai

360

Superior vena cava thrombosis and paradoxical embolic stroke due to collateral drainage from the brachiocephalic vein to the left atrium.  

Science.gov (United States)

Thrombosis involving a permanent infusion catheter in the subclavian vein and superior vena cava is relatively common, especially in cancer patients. Edema of the arms and head is a well-known clinical consequence of this thrombosis, with an intrinsic risk of pulmonary embolism; however, systemic embolization into the cerebral circulation has not been reported as a sequela. Herein, we describe the case of a 56-year-old man with metastatic prostate cancer who developed superior vena cava syndrome due to extensive thrombosis in the presence of a central venous catheter that was used for long-term chemotherapy. The patient's case was complicated by a cerebrovascular accident that was most likely caused by a paradoxical air embolism. A clear mechanism for the embolism was provided by a network of collateral veins, which developed between the brachiocephalic vein and the left atrium due to the superior vena cava obstruction and resulted in a right-to-left shunt. We discuss diagnosis and treatment of the condition in our patient and in general terms. PMID:21494530

Nascimbene, Angelo; Angelini, Paolo

2011-01-01

 
 
 
 
361

Superior vena cava thrombosis and paradoxical embolic stroke due to collateral drainage from the brachiocephalic vein to the left atrium.  

UK PubMed Central (United Kingdom)

Thrombosis involving a permanent infusion catheter in the subclavian vein and superior vena cava is relatively common, especially in cancer patients. Edema of the arms and head is a well-known clinical consequence of this thrombosis, with an intrinsic risk of pulmonary embolism; however, systemic embolization into the cerebral circulation has not been reported as a sequela. Herein, we describe the case of a 56-year-old man with metastatic prostate cancer who developed superior vena cava syndrome due to extensive thrombosis in the presence of a central venous catheter that was used for long-term chemotherapy. The patient's case was complicated by a cerebrovascular accident that was most likely caused by a paradoxical air embolism. A clear mechanism for the embolism was provided by a network of collateral veins, which developed between the brachiocephalic vein and the left atrium due to the superior vena cava obstruction and resulted in a right-to-left shunt. We discuss diagnosis and treatment of the condition in our patient and in general terms.

Nascimbene A; Angelini P

2011-01-01

362

Avaliação in vitro de um novo filtro de veia cava In vitro evaluation of a new vena cava filter  

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Full Text Available OBJETIVO: O objetivo do estudo foi avaliar a eficácia de um novo filtro de veia cava, de baixo perfil, na retenção de coágulos em modelo in vitro. MÉTODO: O filtro consiste em dois cones opostos pelo ápice. O cone distal é formado por oito hastes de aço inoxidável, que têm a função de retenção dos êmbolos. O cone proximal é constituído de quatro hastes, cuja função é ancorar e centralizar. Os filtros foram introduzidos e fixados no interior de um tubo de PVC transparente de 25, 30 e 35 mm de diâmetro interno, em posição vertical, e conectados com um sistema pulsátil de fluxo (bomba peristáltica). Foi utilizado, para veículo, um reservatório com solução salina (0,9%) com 40% de glicerina, mantido em temperatura ambiente. Confeccionaram-se trombos com sangue bovino em tubos plásticos de 3, 4,5 e 6 mm de diâmetro e, posteriormente, foram segmentados nas medidas de 10, 15, 20 e 30 mm de comprimento, totalizando 12 diferentes tamanhos. Realizaram-se 100 liberações para cada tipo de êmbolo e tamanho das cânulas, totalizando 3.600 eventos. Foram feitos lançamentos seqüenciais com cinco êmbolos, sendo 10 para cada tamanho de êmbolo e cânulas, totalizando 360 eventos. Fez-se avaliação da capacidade de retenção dinâmica utilizando os três diferentes tamanhos de cânulas com 100 eventos cada, totalizando 300 eventos. RESULTADOS: Detectou-se que o diâmetro e comprimento dos êmbolos, assim como diâmetros da cânula, podem comprometer a eficácia do filtro. A média de captura de êmbolos pelos filtros foi de 80,5% nas cânulas de 35 mm, 88,7% para cânulas de 30 mm e 86,6% para cânulas de 25 mm. CONCLUSÃO: Conclui-se que a eficácia desse filtro sofre interferência relacionada ao tamanho dos êmbolos e diâmetro da cânula.OBJECTIVE: The objective of the current study was to evaluate the efficacy of a new low-profile vena cava filter in the retention of emboli in an in vitro model. METHOD: The filter consists of two cones connected at the apexes. The distal cone is comprised of eight stainless steel arms with a purpose of retaining emboli and the proximal cone, made of four arms, acts as an anchor to centralize the filter. Filters were installed and fixed inside three systems using transparent PVC tubes of different sizes (internal diameters of 25, 30 and 35 mm) that were held in a vertical position and connected to a pulsating flow system (peristaltic pump). A reservoir of 0.9% saline solution with 40% glycerin at room temperature was used as the vehicle. Thrombi were made from bovine blood in 3-mm, 4-mm, 5-mm and 6-mm plastic tubes and later the thrombi were sectioned into 10-mm, 15-mm, 20-mm and 30-mm lengths. Each of the 12 sizes of thrombi was assessed 100 times in each of the three systems, with a total of 3,600 events. Five emboli were sequentially released, 10 for each size of embolus and tube, with a total of 360 events. An evaluation of the capacity of the three systems - 100 events each, total of 300 events - to dynamically retain the emboli was made. MRESULTS: The diameter and length of the emboli, as well as tubes greater than 35 mm in diameter can negatively affect the efficacy of the filter. The average of emboli capture for the filters was 80.5% in 35-mm tubes, 88.7% for 30-mm tubes and 86.6% for 25-mm tubes. CONCLUSION: We conclude that the efficacy of this filter is influenced by the size of the emboli and the diameter of the PVC tubes.

Domingo Marcolino Braile; José Maria Pereira de Godoy; Marco Centola

2005-01-01

363

Avaliação in vitro de um novo filtro de veia cava/ In vitro evaluation of a new vena cava filter  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVO: O objetivo do estudo foi avaliar a eficácia de um novo filtro de veia cava, de baixo perfil, na retenção de coágulos em modelo in vitro. MÉTODO: O filtro consiste em dois cones opostos pelo ápice. O cone distal é formado por oito hastes de aço inoxidável, que têm a função de retenção dos êmbolos. O cone proximal é constituído de quatro hastes, cuja função é ancorar e centralizar. Os filtros foram introduzidos e fixados no interior de um tubo (more) de PVC transparente de 25, 30 e 35 mm de diâmetro interno, em posição vertical, e conectados com um sistema pulsátil de fluxo (bomba peristáltica). Foi utilizado, para veículo, um reservatório com solução salina (0,9%) com 40% de glicerina, mantido em temperatura ambiente. Confeccionaram-se trombos com sangue bovino em tubos plásticos de 3, 4,5 e 6 mm de diâmetro e, posteriormente, foram segmentados nas medidas de 10, 15, 20 e 30 mm de comprimento, totalizando 12 diferentes tamanhos. Realizaram-se 100 liberações para cada tipo de êmbolo e tamanho das cânulas, totalizando 3.600 eventos. Foram feitos lançamentos seqüenciais com cinco êmbolos, sendo 10 para cada tamanho de êmbolo e cânulas, totalizando 360 eventos. Fez-se avaliação da capacidade de retenção dinâmica utilizando os três diferentes tamanhos de cânulas com 100 eventos cada, totalizando 300 eventos. RESULTADOS: Detectou-se que o diâmetro e comprimento dos êmbolos, assim como diâmetros da cânula, podem comprometer a eficácia do filtro. A média de captura de êmbolos pelos filtros foi de 80,5% nas cânulas de 35 mm, 88,7% para cânulas de 30 mm e 86,6% para cânulas de 25 mm. CONCLUSÃO: Conclui-se que a eficácia desse filtro sofre interferência relacionada ao tamanho dos êmbolos e diâmetro da cânula. Abstract in english OBJECTIVE: The objective of the current study was to evaluate the efficacy of a new low-profile vena cava filter in the retention of emboli in an in vitro model. METHOD: The filter consists of two cones connected at the apexes. The distal cone is comprised of eight stainless steel arms with a purpose of retaining emboli and the proximal cone, made of four arms, acts as an anchor to centralize the filter. Filters were installed and fixed inside three systems using transpar (more) ent PVC tubes of different sizes (internal diameters of 25, 30 and 35 mm) that were held in a vertical position and connected to a pulsating flow system (peristaltic pump). A reservoir of 0.9% saline solution with 40% glycerin at room temperature was used as the vehicle. Thrombi were made from bovine blood in 3-mm, 4-mm, 5-mm and 6-mm plastic tubes and later the thrombi were sectioned into 10-mm, 15-mm, 20-mm and 30-mm lengths. Each of the 12 sizes of thrombi was assessed 100 times in each of the three systems, with a total of 3,600 events. Five emboli were sequentially released, 10 for each size of embolus and tube, with a total of 360 events. An evaluation of the capacity of the three systems - 100 events each, total of 300 events - to dynamically retain the emboli was made. MRESULTS: The diameter and length of the emboli, as well as tubes greater than 35 mm in diameter can negatively affect the efficacy of the filter. The average of emboli capture for the filters was 80.5% in 35-mm tubes, 88.7% for 30-mm tubes and 86.6% for 25-mm tubes. CONCLUSION: We conclude that the efficacy of this filter is influenced by the size of the emboli and the diameter of the PVC tubes.

Braile, Domingo Marcolino; Godoy, José Maria Pereira de; Centola, Marco

2005-01-01

364

Experiência preliminar com novo filtro de veia cava: resultados de 15 implantes Preliminary experience with a new vena cava filter: results of 15 implantations  

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Full Text Available Este estudo apresenta resultados preliminares obtidos com um novo filtro permanente de veia cava, baseado no desenho de Greenfield, com três hastes prolongadas de um total de seis, para dar estabilidade central ao filtro na luz da veia cava. Neste artigo, relatamos sua avaliação clínica preliminar quanto à aplicabilidade, eficácia e segurança. De agosto de 2004 a dezembro de 2006, 15 filtros foram implantados em nove homens e seis mulheres, com idades variando de 38 a 79 anos (média de 57,8 anos). O acesso foi feito sempre por via transjugular. As indicações foram: trombose venosa proximal, com contra-indicação de anticoagulação em 12 pacientes; complicações hemorrágicas com anticoagulação em dois pacientes; e embolia pulmonar, apesar de anticoagulação adequada, em um paciente. Os filtros foram avaliados quanto à liberação, inclinação, mau posicionamento e perfuração de cava. No seguimento, avaliou-se trombose no local de acesso, tromboembolismo venoso recorrente, migração do filtro e trombose de cava pelo ultra-som. Nenhum paciente recebeu anticoagulantes no seguimento. O filtro foi liberado com sucesso em todos os casos sem mau posicionamento, inclinação, perfuração ou trombose de acesso. Os pacientes foram seguidos entre 3 e 23 meses (média de 11 meses). Nenhum paciente teve recorrência de tromboembolismo venoso. Não houve casos de trombose de veia cava ou migração do filtro. Óbito ocorreu em sete casos, todos relacionados com a moléstia de base. Os resultados preliminares indicam potencial eficácia e segurança do uso do novo filtro no período estudado.This study presents preliminary results obtained from a new permanent filter, based on Greenfield's filter design, with prolongations on three of six struts to stabilize it centrally in the vena caval lumen. The preliminary clinical evaluation of the filter with regard to feasibility, efficacy and safety is reported. From August 2004 to December 2006, 15 vena cava filters were deployed in nine men and six women, who ranged in age from 38 to 79 years (mean, 57.8 years). The approach used was always transjugular. Indications for filter placement were proximal deep venous thrombosis with a contraindication to anticoagulation in 12 patients; hemorrhagic complications with anticoagulation in two patients; and pulmonary embolism, despite adequate anticoagulation in one patient. New vena cava filters were evaluated for releasing, tilting, malpositioning and caval perforation. Follow-up included assessment of access site thrombosis and filter migration, recurrent venous thromboembolism, and caval thrombosis by duplex ultrasound. No patient received anticoagulants in the follow-up. In all patients the filter was successfully released, with no malpositioning, tilting, perforation or access thrombosis. The patients were followed for 3 to 23 months (mean = 11 months). No patient developed recurrent venous thromboembolism. No other patients developed inferior vena cava thrombosis or filter migration. Death occurred in seven patients, all related to baseline illness. This preliminary study suggests good feasibility and safety of the new filter up to the observation period.

Winston B. Yoshida; Hamilton A. Rollo; Mariângela Giannini; Marcone L. Sobreira; Regina Moura

2008-01-01

365

Implante profilático e temporário de filtro de veia cava inferior no trauma Prophylactic and temporary inferior vena cava filter implant in trauma  

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Full Text Available O tromboembolismo pulmonar (TEP) é importante causa de óbito no trauma e esse, na maioria das vezes, contraindica a principal farmacoterapia na prevenção e no tratamento do TEP: a anticoagulação. Relatamos um caso de paciente politraumatizado, com risco elevado de embolia pulmonar, submetido ao implante preventivo e temporário de filtro de veia cava inferior (FVC).Pulmonary embolism (PE) is a major cause of death in trauma and that, on most cases, the main contraindication for pharmacotherapy in the prevention and treatment of PE: the anticoagulation. We report a case of multiple trauma patient at high risk of pulmonary embolism, preventive and implant subjected to temporary inferior vena cava filter (VCF).

Fábio Augusto Cypreste Oliveira; Carlos Eduardo de Sousa Amorelli; Fábio Lemos Campedelli; Juliana Caetano Barreto; Mariana Caetano Barreto; Philippe Moreira da Silva; Fernanda Lauar Sampaio Meirelles

2013-01-01

366

Experiência preliminar com novo filtro de veia cava: resultados de 15 implantes/ Preliminary experience with a new vena cava filter: results of 15 implantations  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Este estudo apresenta resultados preliminares obtidos com um novo filtro permanente de veia cava, baseado no desenho de Greenfield, com três hastes prolongadas de um total de seis, para dar estabilidade central ao filtro na luz da veia cava. Neste artigo, relatamos sua avaliação clínica preliminar quanto à aplicabilidade, eficácia e segurança. De agosto de 2004 a dezembro de 2006, 15 filtros foram implantados em nove homens e seis mulheres, com idades variando de 3 (more) 8 a 79 anos (média de 57,8 anos). O acesso foi feito sempre por via transjugular. As indicações foram: trombose venosa proximal, com contra-indicação de anticoagulação em 12 pacientes; complicações hemorrágicas com anticoagulação em dois pacientes; e embolia pulmonar, apesar de anticoagulação adequada, em um paciente. Os filtros foram avaliados quanto à liberação, inclinação, mau posicionamento e perfuração de cava. No seguimento, avaliou-se trombose no local de acesso, tromboembolismo venoso recorrente, migração do filtro e trombose de cava pelo ultra-som. Nenhum paciente recebeu anticoagulantes no seguimento. O filtro foi liberado com sucesso em todos os casos sem mau posicionamento, inclinação, perfuração ou trombose de acesso. Os pacientes foram seguidos entre 3 e 23 meses (média de 11 meses). Nenhum paciente teve recorrência de tromboembolismo venoso. Não houve casos de trombose de veia cava ou migração do filtro. Óbito ocorreu em sete casos, todos relacionados com a moléstia de base. Os resultados preliminares indicam potencial eficácia e segurança do uso do novo filtro no período estudado. Abstract in english This study presents preliminary results obtained from a new permanent filter, based on Greenfield's filter design, with prolongations on three of six struts to stabilize it centrally in the vena caval lumen. The preliminary clinical evaluation of the filter with regard to feasibility, efficacy and safety is reported. From August 2004 to December 2006, 15 vena cava filters were deployed in nine men and six women, who ranged in age from 38 to 79 years (mean, 57.8 years). Th (more) e approach used was always transjugular. Indications for filter placement were proximal deep venous thrombosis with a contraindication to anticoagulation in 12 patients; hemorrhagic complications with anticoagulation in two patients; and pulmonary embolism, despite adequate anticoagulation in one patient. New vena cava filters were evaluated for releasing, tilting, malpositioning and caval perforation. Follow-up included assessment of access site thrombosis and filter migration, recurrent venous thromboembolism, and caval thrombosis by duplex ultrasound. No patient received anticoagulants in the follow-up. In all patients the filter was successfully released, with no malpositioning, tilting, perforation or access thrombosis. The patients were followed for 3 to 23 months (mean = 11 months). No patient developed recurrent venous thromboembolism. No other patients developed inferior vena cava thrombosis or filter migration. Death occurred in seven patients, all related to baseline illness. This preliminary study suggests good feasibility and safety of the new filter up to the observation period.

Yoshida, Winston B.; Rollo, Hamilton A.; Giannini, Mariângela; Sobreira, Marcone L.; Moura, Regina

2008-09-01

367

Implante profilático e temporário de filtro de veia cava inferior no trauma/ Prophylactic and temporary inferior vena cava filter implant in trauma  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese O tromboembolismo pulmonar (TEP) é importante causa de óbito no trauma e esse, na maioria das vezes, contraindica a principal farmacoterapia na prevenção e no tratamento do TEP: a anticoagulação. Relatamos um caso de paciente politraumatizado, com risco elevado de embolia pulmonar, submetido ao implante preventivo e temporário de filtro de veia cava inferior (FVC). Abstract in english Pulmonary embolism (PE) is a major cause of death in trauma and that, on most cases, the main contraindication for pharmacotherapy in the prevention and treatment of PE: the anticoagulation. We report a case of multiple trauma patient at high risk of pulmonary embolism, preventive and implant subjected to temporary inferior vena cava filter (VCF).

Oliveira, Fábio Augusto Cypreste; Amorelli, Carlos Eduardo de Sousa; Campedelli, Fábio Lemos; Barreto, Juliana Caetano; Barreto, Mariana Caetano; Silva, Philippe Moreira da; Meirelles, Fernanda Lauar Sampaio

2013-03-01

368

Tratamento cirúrgico da síndrome da veia cava superior causado por timoma invasivo/ Surgical treatment of superior vena cava syndrome caused by invasive thymoma  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Paciente do sexo masculino, branco, 57 anos, portador de síndrome da veia cava superior havia 3 meses, devido a timoma invasivo em mediastino médio e anterior, levando a comprometimento da veia cava superior intrínseca e extrinsecamente. Após avaliação por tomografia computadorizada e angiorressonância magnética de tórax, o paciente foi submetido à ressecção radical do timoma - derivação venosa da veia subclávia esquerda para átrio direito, com tubo de PTF (more) E (politetrafluoroetileno). Relevante caso de timoma invasivo ocasionando a oclusão da veia cava superior. A evolução clínica, após 7 meses, foi considerada satisfatória. Abstract in english We report on a case of a 57 years-old white male, patient, who presented superior vena cava syndrome (SVC) for 3 months, derived from an invasive thymoma in the medium and anterior mediastinum, compromising intrinsic and extrinsic to the SVC. After evaluation by computed tomography and magnetic angioresonance of the thorax, the patient underwent radical resection of the thymoma - bypass from left subclavian vein to right atrium, using polytetrafluoroethylene tube. Relevan (more) t case of invasive thymoma causing the occlusion of SVC. The clinic evolution of the patient after 7 months was considered satisfactory.

Rosa, George Ronald Soncini da; Takizawa, Ney; Schimidt, Douglas; Sugita, Mitur

2010-06-01

369

Endovascular treatment of stenoses in the superior vena cava syndrome caused by non-tumoral lesions  

Energy Technology Data Exchange (ETDEWEB)

We report our experience in percutaneous treatment of non-tumoral superior vena cava syndrome (SVCS) between December 1998 and July 2001. During a period of 2.5 years, 9 patients (age range 27-84 years, mean age 50 years) were treated percutaneously for significant non-tumoral SVCS. Symptomatic SVCS were due to dialysis catheters (7), central line (1) and radiation therapy (1). In thrombotic occlusions and severe stenosis, a preliminary in situ thrombolysis was achieved before angioplasty. Patients were followed by echo-Doppler, computed tomography angiography (CTA), magnetic resonance angiography (MRA), or phlebography. Complete recanalization of the veins and immediate resolution of symptomatic SVCS were obtained in all patients, with no procedure-related complication. Thirteen stents were placed in 9 patients with a mean clinical follow-up of 9.1 months (range 2-23 months). One hundred percent patency at 6 months was obtained. Two patients recurred twice and were treated with new stent placement. At 12 months the patency was 67% and assisted patency was 100%. Stent placement in benign symptomatic SVCS is a safe and minimally invasive procedure, with no technical and clinical complications in our experience. It allowed immediate relief of symptoms, and in dialysed patients could provide continued use of hemodialysis access. Close clinical surveillance is mandatory to assess stent patency. (orig.)

Bornak, A.; Ris, H.-B.; Probst, H.; Corpataux, J.-M. [Department of Thoracic and Vascular Surgery, Centre Hospitalier Universitaire Vaudois, Bugnon 46, 1011 Lausanne (Switzerland); Wicky, S. [Department of Radiodiagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, Bugnon 46, 1011 Lausanne (Switzerland); Milesi, I. [Department of Angiology, Centre Hospitalier Universitaire Vaudois, Bugnon 46, 1011 Lausanne (Switzerland)

2003-05-01

370

Primary Stent Angioplasty of the Inferior Vena Cava After Liver Transplantation and Liver Resection.  

UK PubMed Central (United Kingdom)

PURPOSE: This study evaluated technical efficacy and safety of stent angioplasty of the inferior vena cava (IVC) after liver transplantation or liver resection and analysis of changes in creatinine levels and patients' weight. METHODS: Between October 2004 and February 2011, 16 patients (mean age, 52.6 years) with symptomatic IVC stenoses after liver transplantation (n = 10) or liver resection (n = 6) were subjected to stent angioplasty. Enrollment criteria included edema and/or ascites. The smallest diameter of the IVC, serum creatinine values, and patients' weight were assessed before and after stent placement and respective values were compared. Technical and clinical success, patency rates, related complications, and patients' survival were analyzed. RESULTS: Stent placement was technically successful in 16 patients (100 %). Clinical success was achieved in 13 patients (81.25 %), reflecting two patients with early restenosis and one patient suffering from thrombosis distal to the stent. Mean follow-up was 372 days. Primary patencies were 75 % (n = 12). Primary assisted patencies were 93.75 % (n = 15). Serum creatinine levels decreased significantly (p = 0.01) from 1.68 mg/dl before to 1.08 mg/dl after stent placement. Patients' weight decreased (mean 2.1 %). No angioplasty-related complications occurred. CONCLUSIONS: Stent angioplasty of the IVC is an effective and safe treatment of stenoses after liver transplantation and resection and has a positive effect on creatinine levels.

Huber TJ; Hammer S; Loss M; Müller-Wille R; Schreyer AG; Stroszczynski C; Wohlgemuth WA; Uller W

2013-10-01

371

Histology of Tissue Adherent to OptEase Inferior Vena Cava Filters Regarding Indwelling Time  

International Nuclear Information System (INIS)

The purpose of this paper is to report on the histology of tissues found on retrieved filters with regard to indwelling time. Between February 2006 and January 2007, 28 Optease inferior vena cava filters (Cordis Europa, Roden, The Netherlands) were retrieved from 27 patients. Twenty-two filters were inserted prophylactically for trauma patients and six for patients with venous thromboembolism. Cavography was performed both before and after filter removal to evaluate the presence of thrombi or wall damage. Filters were retrieved with the snare and sheath method. All material adherents to the filters were examined histologically.The mean indwelling time of the filters was 24.9 days (range, 6-69 days). Red tissue fragments were seen on all the filters, consistent microscopically with clots and fibrin. On five filters (18%; mean indwelling time, 45.4 days) white tissue consistent with vascular intima was found. All postprocedure cavographies were normal. We conclude that most material adherent to the retrieved filters is thrombi, while vascular intima can be found in the minority of filters with a longer indwelling time.

2009-01-01

372

Leiomyosarcomas of the inferior vena cava: diagnostic features on cross-sectional imaging  

International Nuclear Information System (INIS)

Aim: To evaluate the cross-sectional radiological appearances and to review the clinical presentation and outcome of patients with leiomyosarcomas of the inferior vena cava (IVC LMS). These are rare aggressive tumours that present late with non-specific symptoms and have a poor prognosis. Materials and Methods: From January 2002 to December 2008, the radiological images of 23 sequential patients with pathologically proven IVC LMS were independently reviewed by two experienced radiologists. The clinical presentation, treatment including surgical details, and outcome were recorded. Results: There were 19 females and four males with a mean age of 53 years. CT typically demonstrated a large, lobulate, non-calcified heterogeneous mass with peripheral enhancement. T1-weighted magnetic resonance imaging (MRI) images demonstrated a mass with a low signal intensity and T2-weighted MRI images demonstrated a mass with a high signal intensity. Clinical presentation included leg oedema, back and abdominal pain with almost 50% of patients presenting with metastases. Eleven patients underwent ablative surgery. The mean survival time of all patients in the study was 34 months and that of the 11 post-surgical patients was 56 months. Conclusion: There are a variety of diagnostic features on both computed tomography (CT) and MRI which aid the diagnosis of this unusual vascular neoplasm. CT is vital in determining the location of the tumour within the IVC and MRI accurately depicts its extent and the potential for surgical resectability, which offers the only chance of survival.

2011-01-01

373

[Superior vena cava syndrome: cause of secondary raise of intracranial pressure after traumatic brain injury].  

Science.gov (United States)

A 41-year-old male is admitted for cranial trauma, having fallen from his own height. His state of extreme agitation imposes sedation, intubation and mechanical ventilation. A CT-scan reveals acute right hemispheric subdural haematoma, with discrete midline shift, and diffuse cerebral oedema. ICP-monitoring reveals severely increased intracranial pressure, which is responsive to routine medical neuroprotective treatment. Ten days after admission, sedation and neuroprotective treatment is gradually withdrawn. At the end of the second week, a secondary ascent in ICP is observed. The presence of a right subclavian central venous line, in combination with the strong inflammatory response and septic state of the patient, has caused bilateral thrombosis of subclavian and internal jugular veins. This superior vena cava syndrome (SVCS) impedes cerebral venous drainage, thus raising ICP. Within a few days of anticoagulant therapy, SVCS resolved. Impeded cerebral venous drainage is often forgotten or ignored as a cause of secondary elevated ICP. In face of persisting or recurring raised ICP and cerebral oedema, or apparition of communicant hydrocephalus, cerebral venous drainage should be investigated. PMID:18835126

Piteaud, I; Abdennour, L; Icke, C; Stany, I; Lescot, T; Puybasset, L

2008-10-02

374

[A right common iliac aneurysm perforating into the inferior vena cava with resultant congestive heart failure].  

UK PubMed Central (United Kingdom)

A 69 year-old male with a right common iliac aneurysm perforating into the inferior vena cava was admitted with severe cardiomegaly and dyspnea. He had been suffering from recurrent congestive heart failure for the last 8 years prior to surgery. At operation, the fistula of 15mm diameter was closed with interrupted sutures of 3-0 nylon with pledgets within the aneurysm by controlling bleeding from the fistula by digital compression. The right common iliac aneurysm was resected and replaced with a double velour knitted dacron graft of 10mm diameter. The postoperative course was uneventful. The CTR was reduced to 57% from 70%, and the cardiac index was normalized from 6.10 to 3.39 l/min/m2. This complication is rare with only 4 previous reports in Japan. Hemodynamic improvements were dramatic after surgery in spite of poor response to medical treatments. This complication should be surgically managed as soon as the diagnosis is confirmed.

Inoue K; Kitamura S; Oyama C; Kawachi K; Morita R; Nishii T; Kameda Y

1989-01-01

375

Thrombosis caused by polyurethane double-lumen subclavian superior vena cava catheter and hemodialysis  

DEFF Research Database (Denmark)

During an 18-month period, 82 consecutive patients (37 women and 45 men), with a mean age of 50 yr (range 15 to 74), underwent hemodialysis with 91 polyurethane double-lumen subclavian superior vena cava catheters inserted via the right subclavian vein. Upon catheter removal, venograms were performed in 53 which revealed thrombosis in 13. Autopsy performed in 13 other patients revealed thrombosis in three. Mean catheter duration was 27 days (range 1 to 138). Catheter duration was significantly (p less than .01) longer in the 16 cases complicated by thrombosis. There was no significant difference in the frequency of thrombosis between men and women. Two patients developed symptoms of subclavian vein occlusion after the creation of an arteriovenous fistula on the same side as a previous hemodialysis catheter. Overall, thrombosis was found in 23% and increased with longer catheter duration. We recommend phlebography to exclude thrombosis before creating an arteriovenous fistula on the same side as the previous hemodialysis catheter. There was no case of clinical discernible pulmonary embolism.

Wanscher, Maria RØrbæk; Frifelt, J J

1988-01-01

376

Initial experience in humans with a new retrievable inferior vena cava filter.  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate preliminary clinical experience in humans with the Recovery nitinol filter (RNF) for the inferior vena cava, especially the efficacy of the device and safety of its retrieval. MATERIALS AND METHODS: Thirty-two patients were followed up to assess for filter efficacy and for ability to remove the filter. RESULTS: Sixteen men and 16 women aged 18-83 years (mean, 53 years) underwent treatment with the RNF. Indications for placement were recent pulmonary embolism (n = 16), recent deep venous thrombosis (n = 20), and/or prophylaxis (n = 2). Four patients had contraindications to anticoagulant therapy, and four had complications from anticoagulant therapy. The filter was successfully placed in 32 patients. In 24 (100%) of 24 patients, the filter was successfully retrieved with a jugular approach. The mean implantation period was 53 days (range, 5-134 days). Trapped thrombus was seen within the filter in seven cases. In one patient with a large trapped thrombus, the filter was noted to have migrated 4 cm cephalad. There were no episodes of pulmonary embolism or insertion-site thrombosis. CONCLUSION: This preliminary experience in humans confirms the efficacy of the RNF. It also demonstrates the feasibility and safety of retrieval up to 134 days after implantation.

Asch MR

2002-12-01

377

Persistent left superior vena cava mistaken for nodal metastasis: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Evaluation of the mediastinum is crucial for patients with lung cancer. Mediastinal lymph node metastases play a dramatic role in the process of staging. Physicians should be aware of the potential pitfalls regarding mediastinal evaluation. This case report provides an example. Case presentation We report the case of a 57-year-old Caucasian man who presented with a four-month history of non-productive cough. He was diagnosed with non-small cell lung cancer. Initially, it was thought to be inoperable due to the presence of a para-aortic lymph node. A more careful examination of the mediastinum revealed that the "lymph node" was in fact a persistent left superior vena cava. Conclusions This study highlights the difficulties in mediastinal staging, especially when intravenous contrast is not used. The recognition of this vascular malformation dramatically changed the therapeutic decisions, giving our patient the opportunity of surgical resection. To the best of our knowledge, such correlation has not been described in English literature.

Tzilas Vasilios; Bastas Antonios; Koti Aspasia; Papandrinopoulou Dimitra; Tsoukalas Georgios

2010-01-01

378

Braile vena cava filter and greenfield filter in terms of centralization.  

UK PubMed Central (United Kingdom)

The aim of this study was to evaluate complications experienced during implantation of the Braile Vena Cava filter (VCF) and the efficacy of the centralization mechanism of the filter. This retrospective cohort study evaluated all Braile Biomédica VCFs implanted from 2004 to 2009 in Hospital de Base Medicine School in São José do Rio Preto, Brazil. Of particular concern was the filter's symmetry during implantation and complications experienced during the procedure. All the angiographic examinations performed during the implantation of the filters were analyzed in respect to the following parameters: migration of the filter, non-opening or difficulties in the implantation and centralization of the filter. A total of 112 Braile CVFs were implanted and there were no reports of filter opening difficulties or in respect to migration. Asymmetry was observed in 1/112 (0.9%) cases. A statistically significant difference was seen on comparing historical data on decentralization of the Greenfield filter with the data of this study. The Braile Biomédico filter is an evolution of the Greenfield filter providing improved embolus capture and better implantation symmetry.

de Godoy JM; Menezes da Silva AA; Reis LF; Miquelin D; Torati JL

2013-01-01

379

The Guenther temporary inferior vena cava filter for short-term protection against pulmonary embolism  

International Nuclear Information System (INIS)

Purpose. To evaluate clinically the Guenther temporary inferior vena cava (IVC) filter. Methods. Eleven IVC filters were placed in 10 patients. Indications for filter placement were surgical pulmonary embolectomy in seven patients, pulmonary embolism in two patients, and free-floating iliofemoral thrombus in one patient. Eight filters were inserted from the right femoral approach, three filters from the left. Follow-up was by plain abdominal radiographs, cavography, and duplex ultrasound (US). Eight patients received systemic heparinization. Follow-up, during 4-60 months after filter removal was by clinical assessment, and imaging of the lungs was performed when pulmonary embolism (PE) was suspected. Patients received anticoagulation therapy for at least 6 months. Results. Ten filters were removed without complications 7-14 days (mean 10 days) after placement. One restless patient pulled the filter back into the common femoral vein, and a permanent filter was placed. In two patients a permanent filter was placed prior to removal. One patient developed sepsis, and one an infection at the insertion site. Clinically no recurrent PE developed with the filter in place or during removal. One patient had recurrent PE 7 months after filter removal. Conclusion. The Guenther temporary IVC filter can be safely placed for short-term protection against PE. The use of this filter is not appropriate in agitated or immunocompromised patients.

1997-01-01

380

Braile vena cava filter and greenfield filter in terms of centralization.  

Science.gov (United States)

The aim of this study was to evaluate complications experienced during implantation of the Braile Vena Cava filter (VCF) and the efficacy of the centralization mechanism of the filter. This retrospective cohort study evaluated all Braile Biomédica VCFs implanted from 2004 to 2009 in Hospital de Base Medicine School in São José do Rio Preto, Brazil. Of particular concern was the filter's symmetry during implantation and complications experienced during the procedure. All the angiographic examinations performed during the implantation of the filters were analyzed in respect to the following parameters: migration of the filter, non-opening or difficulties in the implantation and centralization of the filter. A total of 112 Braile CVFs were implanted and there were no reports of filter opening difficulties or in respect to migration. Asymmetry was observed in 1/112 (0.9%) cases. A statistically significant difference was seen on comparing historical data on decentralization of the Greenfield filter with the data of this study. The Braile Biomédico filter is an evolution of the Greenfield filter providing improved embolus capture and better implantation symmetry. PMID:23459189

de Godoy, José Maria Pereira; Menezes da Silva, Adinaldo A; Reis, Luis Fernando; Miquelin, Daniel; Torati, José Luis Simon

2013-01-31

 
 
 
 
381

A young testicular cancer case presenting with an inferior vena cava thrombosis and bilateral pulmonary embolisms  

Directory of Open Access Journals (Sweden)

Full Text Available The increased risk of thromboembolic events is well known in patients with cancer. We aimed to highlight this relationship in a case of testicular cancer. A 25-year-old young man was admitted to our hospital with complaints of sudden onset chest pain and dyspnea. Physical examination revealed a respiratory rate of 30/min and a blood pressure of 110/70 mmHg. A partial reduction of breath sounds in the basal posterior of the right lung was present on lung auscultation. Posteroanterior chest radiography was interpreted as normal. Echocardiographic evaluation revealed severe dilatation and hypertrophy of the right heart, and the pulmonary arterial pressure was 75 mmHg. Multi-detector computed tomography showed a submassive pulmonary embolism and inferior vena cava thrombosis. The level of serum alpha-fetoprotein was slightly higher than normal. A right testicular mass was found upon physical examination. A right orchiectomy operation was performed. Pathological investigation revealed a malignant mixed germinal tumor of the testicle. In conclusion, in cases of thromboembolism in young males, physicians should consider the possibility of testicular cancer.

Bünyamin Serto?ullar?ndan; Bülent Özbay; Kadir Ceylan; ?rfan Bayram; Serhat Avcu

2012-01-01

382

The importance of superior vena cava isolation in ablation strategy for atrial fibrillation.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: Superior vena cava (SVC) is one of the most important nonpulmonary vein origins of atrial fibrillation, and SVC should be carefully treated in order to decrease the recurrence of atrial fibrillation after ablation. Despite the fact that pulmonary vein isolation (PVI) should be performed prophylactically for all pulmonary veins, prophylactic SVC isolation (SVCI) is still controversial. This review describes recent data on treatments for SVC focus during atrial fibrillation ablation. RECENT FINDINGS: There are two different major approaches to treat SVC focus during atrial fibrillation ablation. One is the conventional approach, in which SVCI is performed only if atrial fibrillation from SVC origin is recognized using pacing maneuvers and/or isoproterenol infusions. Another approach is performing SVCI in all cases prophylactically in addition to PVI. The rate of atrial fibrillation freedom 1 year after initial atrial fibrillation ablation by prophylactic PVI along with SVCI was almost the same as with the conventional method (85-90% atrial fibrillation freedom). In addition, the conventional method also had a good result even 5 years after ablation (73.3%). SUMMARY: Because of the good result after using the conventional approach and possible complications during SVCI, SVCI should be performed only if SVC focus is recognized, not prophylactically.

Higuchi K; Yamauchi Y; Hirao K; Marrouche NF

2013-01-01

383

Inferior vena cava obstruction: long-term results of endovascular management.  

UK PubMed Central (United Kingdom)

BACKGROUND: Hepatic venous outflow obstruction (HVOO) can have acute or chronic presentation. In the chronic variety of inferior vena cava (IVC) obstruction, endovascular management with balloon angioplasty and stent implantation has emerged as a feasible, safe alternative to surgery which has high incidence of mortality and morbidity. AIMS AND OBJECTIVES: To study the feasibility and long-term follow-up of endovascular management of chronic IVC obstruction. METHODS: We studied 12 cases of HVOO who underwent endovascular management (balloon dilatation ± stenting). In most of the cases, the cause of obstruction was not obvious, but one case had metastatic hepatic nodules compressing on IVC. Diagnosis was established by clinical examination, venous Doppler and was confirmed by venography and/or computed tomography (CT) angiography. Cases underwent balloon dilatation and/or stenting. RESULTS: Out of 12 cases, six had membranous obstruction (four complete and two incomplete), five cases had segmental stenosis and one case had tumour compression. The lesion was crossed with either guide wire or Brockenbrough needle with Mullins sheath assembly and balloon dilatation was done with Inoue or Mansfield balloon. Seven cases underwent balloon dilatation alone while five cases underwent stenting. There was procedural success in all cases with reduction of gradient by 84%, disappearance of collaterals and clinical improvement. During the follow-up of 13 years, one case had restenosis, which was managed by stenting. CONCLUSION: Endovascular management of IVC obstruction is safe with good long-term patency rates.

Srinivas BC; Dattatreya PV; Srinivasa KH; Prabhavathi; Manjunath CN

2012-03-01

384

Bird's nest versus the Kimray-Greenfield inferior vena cava filter: Randomized clinical study  

International Nuclear Information System (INIS)

[en] A randomized clinical study was conducted comparing the percutaneously introduced bird's nest inferior vena cava (IVC) filter and the Kimray-Greenfield IVC filter. Study end points included recurrent pulmonary embolism, new or worse leg venous stasis symptoms, IVC thrombosis, and ease of filter introduction. Of the 109 patients in the study, 58 were randomly assigned to the BN and 51 to the KG filter. Demographic factors were comparable between the two groups. Follow-up entailed cavography, noninvasive assessment of the femoral veins, and standardized telephone interviews. The follow-up period was extended to 1 year after filter insertion. Results for the bird's nest versus the Kimray-Greenfield filter respectively were as follows: death due to massive pulmonary embolism, 3% versus 5%; recurrent pulmonary embolism, 1.5% versus 7.5%; filter migration, 1.1% versus 0.0%; IVC thrombosis, 6% versus 2.5%; new or worse leg edema, 28.5% versus 22%; ease of introduction (qualitative), maximal versus minimal; patient discomfort (qualitative), minimal versus maximal. The authors conclude the bird's nest filter is better than the Kimray-Greenfield filter in terms of prevention of recurrent pulmonary embolism and ease of introduction. In terms of venous stasis, the bird's nest filter is not better and may be worse than the Kimray-Greenfield filter. Filter migration is a problem with the bird's nest filter

1987-12-04

385

Failed Retrieval of an Inferior Vena Cava Filter During Pregnancy Because of Filter Tilt: Report of Two Cases  

International Nuclear Information System (INIS)

Thromboembolic disease during pregnancy is an important cause of obstetric morbidity and mortality. Pregnant patients with venous thromboembolism are usually managed by conventional anticoagulation. However, this must be discontinued during vaginal or caesarian delivery to avoid haemorrhage and to reduce the risk of possible epidural haematoma. Retrievable inferior vena cava filters (IVCFs) offer protection against pulmonary embolism during this high-risk period, when anticoagulation is discontinued, while avoiding potential long-term sequelae of a permanent IVCF. Here we report two patients who presented in the third trimester of pregnancy with floating ileofemoral deep vein thrombosis. Both patients were initially treated with standard anticoagulation; however, shortly before delivery both patients had a retrievable IVCF placed in a suprarenal position. In both patients, retrieval failed at 28 days after insertion because of filter tilt. The timing and mechanism of filter tilt remains uncertain. We believe that a number of factors could have been involved, including change in the anatomic configuration with lateral displacement of the IVCF as a result of the gravid uterus as well as forceful uterine contractions during labour, which modified the shape and diameter of the IVC. We showed that failure to retrieve the IVCF has had considerable implications for the two young patients regarding long-term anticoagulation and have highlighted the need for further clinical trials regarding the safe use of retrievable IVCFs during pregnancy.

2009-01-01

386

Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging/ Anomalias congênitas da veia cava inferior: revisão dos achados na tomografia computadorizada multidetectores e ressonância magnética  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Anomalias da veia cava inferior são incomuns, ocorrendo em até 8,7% da população, quando consideradas as anomalias da veia renal esquerda. A veia cava inferior se desenvolve da sexta à oitava semanas de gestação, originada de três veias embrionárias pareadas: veias subcardinais, supracardinais e pós-cardinais. A complexidade da ontogenia da veia cava inferior, com numerosas anastomoses entre essas três veias embrion&# (more) 225;rias, pode levar a uma grande variedade do retorno venoso do abdome e membros inferiores. Algumas dessas anomalias têm implicações clínicas e cirúrgicas significativas, associadas a outras anomalias congênitas, e em alguns casos, associadas a trombose venosa de membros inferiores, principalmente em pacientes adultos jovens. Foram revistos os exames de dez pacientes com anomalias da veia cava inferior, três deles com trombose venosa profunda de membros inferiores. Foram salientados os principais aspectos das anomalias da veia cava inferior, nos exames de tomografia computadorizada multidetectores e ressonância magnética, correlacionados com a embriologia e demonstrando as principais vias alternativas de drenagem venosa. O conhecimento das anomalias da veia cava inferior é fundamental na avaliação dos exames de imagem do abdome, evitando erros de interpretação e indicando a possibilidade de anomalias associadas, implicações clínicas e cirúrgicas. Abstract in english Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in (more) the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications.

Yang, Catherine; Trad, Henrique Simao; Mendonca, Silvana Machado; Trad, Clovis Simao

2013-07-01

387

The application of GxA8xB9nther Tulip retrievable inferior vena cava filter in interventional treatment for acute deep venous thrombosis of lower extremity  

International Nuclear Information System (INIS)

Objective: To discuss the therapeutic efficacy and manipulation skill of Gunther Tulip retrievable inferior vena cava filter in interventional treatment for acute deep venous thrombosis of lower extremity. Methods: From September 2007 to April 2008, a total of 36 patients with acute deep venous thrombosis of lower extremity were treated in our hospital. The time of the onset of disease ranged from 1 day to 12 days. The precipitation causes included prolonged lying in bed due to surgery or bone fracture (n = 18) and postpartum (n = 5), while no obvious precipitation causes could be found in 13 patients. Pulmonary embolism was coexisted in 12 cases. Clinically, the affected limb was swelling and painful, the skin was cyan-purple or pale in color with higher skin temperature. The circumferential length of the affected thigh was 3-10 cm longer than that of normal side. Patients with coexisted pulmonary embolism had the clinical presentation of dyspnea, chest pain, hemoptysis, etc. Gunther Tulip retrievable inferior vena cava filter was implanted via femoral venous access or via right internal jugular venous access, which was followed by intravenous transcatheter thrombolysis. Vascular ultrasonography and angiography were performed 45-75 days after the treatment to confirm that there was no fresh or free thrombus in the veins of lower limb or in the pulmonary arteries. When it was confirmed, Gunther Tulip retrievable inferior vena cava filter was taken out via right internal jugular venous access, which was followed by inferior venacavography. After the procedure anticoagulation and antibiotic medication were employed for 3-5 days. A follow-up for 4-10 months was made. Results: A total of 36 Gunther Tulip retrievable inferior vena cava filters were successfully implanted by one procedure, the average time cost for the filter delivery was 1.5 minutes (0.5-5 minutes). During the delivery procedure, the amplitude of elastic displacement of filter was less than 2 mm. One filter was implanted with a tilt of 25 degrees, and no newly-developed clinical manifestations of pulmonary embolism appeared after filter implant. In twelve patients Gunther Tulip filters were successfully retrieved by single manipulation in 45-75 days after filter delivery, and the retrieval procedure took the mean time of 4.4 minutes (2-15 minutes). Inferior venacavography confirmed that no vascular perforation or rupture occurred. In the remaining 24 patients the filters were kept in inferior vena cava and no clinical symptoms related to pulmonary embolism or inferior vena cava occlusion were observed during the follow-up period. Conclusion: Gunther Tulip retrievable inferior vena cava filter has many advantages in clinical use. The filter can be accurately placed to the scheduled position, it is very powerful in capturing the thrombus, it can be hold in the inferior vena cava for long time (long time window for thrombolysis therapy) before it is planed to be retrieved, and its retrieval success is very high. Moreover, with high technical successful rate the implantation of Gunther Tulip retrievable inferior vena cava filter is very safe and effective for the interventional treatment of acute deep venous thrombosis of lower extremity. (authors)

2010-01-01

388

Hand-assisted laparoscopic radical nephrectomy in the treatment of a renal cell carcinoma with a level ii vena cava thrombus  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english Excision of renal cell carcinoma (RCC) with corresponding vena cava thrombus is a technical challenge requiring open resection and vascular clamping. A 58 year old male with a right kidney tumor presented with a thrombus extending 1 cm into the vena cava. Using a hand-assisted transperitoneal approach through a 7 cm gel-port, the right kidney was dissected and the multiple vascular collaterals supplying the tumor were identified and isolated. The inferior vena cava was mo (more) bilized 4 cm cephalad and 4 cm caudal to the right renal vein. Lateral manual traction was applied to the right kidney allowing the tumor thrombus to be retracted into the renal vein, clear of the vena cava. After laparoscopic ultrasonographic confirmation of the location of the tip of the tumor thrombus, an articulating laparoscopic vascular stapler was used to staple the vena cava at the ostium of the right renal vein. This allowed removal of the tumor thrombus without the need for a Satinsky clamp. The surgery was completed in 243 minutes with no intra-operative complications. The entire kidney and tumor thrombus was removed with negative surgical margins. Estimated blood loss was 300 cc. We present a laparoscopic resection of a renal mass with associated level II thrombus using a hand-assisted approach. In patients with minimal caval involvement, our surgical approach presents an option to the traditional open resection of a renal mass.

Kovac, Jason R.; Luke, Patrick P.

2010-06-01

389

Hand-assisted laparoscopic radical nephrectomy in the treatment of a renal cell carcinoma with a level ii vena cava thrombus  

Directory of Open Access Journals (Sweden)

Full Text Available Excision of renal cell carcinoma (RCC) with corresponding vena cava thrombus is a technical challenge requiring open resection and vascular clamping. A 58 year old male with a right kidney tumor presented with a thrombus extending 1 cm into the vena cava. Using a hand-assisted transperitoneal approach through a 7 cm gel-port, the right kidney was dissected and the multiple vascular collaterals supplying the tumor were identified and isolated. The inferior vena cava was mobilized 4 cm cephalad and 4 cm caudal to the right renal vein. Lateral manual traction was applied to the right kidney allowing the tumor thrombus to be retracted into the renal vein, clear of the vena cava. After laparoscopic ultrasonographic confirmation of the location of the tip of the tumor thrombus, an articulating laparoscopic vascular stapler was used to staple the vena cava at the ostium of the right renal vein. This allowed removal of the tumor thrombus without the need for a Satinsky clamp. The surgery was completed in 243 minutes with no intra-operative complications. The entire kidney and tumor thrombus was removed with negative surgical margins. Estimated blood loss was 300 cc. We present a laparoscopic resection of a renal mass with associated level II thrombus using a hand-assisted approach. In patients with minimal caval involvement, our surgical approach presents an option to the traditional open resection of a renal mass.

Jason R. Kovac; Patrick P. Luke

2010-01-01

390

Congenital anomalies of the inferior vena cava: importance of multiplanar imaging methods: an iconographic essay; Anomalias congenitas da veia cava inferior: valor dos metodos multiplanares em seu diagnostico - ensaio iconografico  

Energy Technology Data Exchange (ETDEWEB)

The inferior vena cava is the result of a complex embryologic process which takes place between 6 and 8 weeks of intra-uterine life. Several variations can occur during this process, and a defective embryogenesis of this vessel may lead to the development of anatomic variants. Although many of these variants are asymptomatic, the radiologist should be aware of them and of the potential medico-legal issues involved, especially in cases in which abdominal surgery or hemodynamic procedures are contemplated. In this paper, the major congenital anomalies involving the inferior vena cava are reviewed under the form of a pictorial essay, highlighting the role of the multiplanar imaging methods (volumetric computed tomography and magnetic resonance imaging) in their diagnosis. Keywords: Congenital variations; Inferior vena cava; Renal veins; Computed tomography; Magnetic resonance imaging. author)

Viana, Sergio Lopes; Mendonca, Jose Luiz Furtado de; Freitas, Flavia Mendes Oliveira [Clinica Radiologica Vila Rica, Brasilia, DF (Brazil)] (and others). E-mail: radiolog@uol.com.br

2006-10-15

391

Subacute and chronic benign superior vena cava obstructions: endovascular treatment with self-expanding metallic stents.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Our purpose is to report our clinical experience with patients who underwent endovascular treatment with Wallstents for subacute or chronic benign obstruction of the superior vena cava (SVC). SUBJECTS AND METHODS: Twelve patients who were an average of 54 +/- 12 years old were referred for treatment of severe SVC syndrome related to implanted central venous catheters (n = 8), postradiation fibrosis (n = 2), a permanent pacemaker (n = 1), or a benign tumor (n = 1). Symptoms were present for an average of 16 weeks (range, 4-48 weeks) before treatment. Diagnosis of SVC obstruction was confirmed with helical CT and pretherapeutic phlebography. Four patients had Stanford's type II ste