WorldWideScience

Sample records for vena cava disease

  1. The superior vena cava syndrome caused by malignant disease

    International Nuclear Information System (INIS)

    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 truction 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

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

    International Nuclear Information System (INIS)

    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)

  3. Anomalies of the vena cava inferior

    International Nuclear Information System (INIS)

    Two cases of anomalous inferior vena cava are presented, with the emphasis on embryology. The firts patient was investigated by venography for a clinically proven varicocele as a probable cause of infertility. A double inferior vena cava was found during venography, and was confirmed by computed tomography (CT). In the second case a left-sided inferior vena cava was an incidental finding when a CT scan was done as a diagnostic procedure in a case of Hodgkin's disease. A short summary of the embryology and the significance of the variants is presented

  4. Superior vena cava obstruction

    International Nuclear Information System (INIS)

    This exhibit demonstrates the capability of MR imaging in the evaluation of obstruction of the superior vena cava (SVC) or brachiocephalic veins. All images were obtained with a 0.3-T permanent magnet system using spin-echo technique. Of 267 patients evaluated for intrathoracic pathology, 22 patients had evidence of narrowing or obstruction of the SVC or thoracic inlet veins demonstrated by MR. MR images were compared with contrast-enhanced CT scans when available. MR imaging demonstrated the extent and site of venous compromise in all cases and provided information comparable to that provided by CT regarding collateral venous circulation. Although venography, radionuclide scintigraphy, and contrast-enhanced CT have been used to evaluate venous compromise, MR imaging can provide similar information without the use of intravenous contrast material or ionizing radiation

  5. 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

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

    Scientific Electronic Library Online (English)

    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.

    2006-03-01

    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. 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 ora [...] l 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.

  7. Vena cava superior izquierda persistente / Persistent left superior vena cava

    Scientific Electronic Library Online (English)

    Gustavo, Restrepo; Erik, Trespalacios; Salim, Ahumada; Nancy, Toro.

    2014-04-01

    Full Text Available La vena cava superior izquierda persistente es la anomalía más común del drenaje venoso del tórax y con frecuencia acompaña a otras anomalías congénitas. Generalmente, su hallazgo es incidental durante la inserción de catéteres venosos centrales. Su diagnóstico puede hacerse por medio de múltiples t [...] écnicas de imagen. El principal hallazgo ecocardiográfico es un seno coronario dilatado que sugiere la presencia de vena cava superior izquierda persistente. Cuando ésta drena en la aurícula izquierda, urge la corrección del defecto. Aunque habitualmente tiene un curso benigno, siempre que se documente vena cava superior izquierda conviene buscar otras anomalías congénitas. Abstract in english Persistent left superior vena cava (PLSVC) is the most common variation of the thoracic venous system and it is frequently associated with other congenital defects. Its presence is usually detected during the central venous catheter insertion. An echocardiographic finding of a dilated coronary sinus [...] is the most frequent indirect sign of PLSV presence. When this abnormal vessel drains into the left atria, a repair procedure is indicated. PLSVC course is usually benign, but when found, a search for an associated congenital cardiovascular defect is mandatory.

  8. [Traumatic thrombosis of the inferior vena cava].

    Science.gov (United States)

    Mouaffak, Y; Mikou, M M; Benyacob, A; Mosaddek, A; Faroudy, M; Ababou, A; Lazreq, C; Sbihi, A

    2004-07-01

    Traumatic thrombosis of vena cava is rare. Thrombosis of the inferior vena cava diagnosed by uroscanner after blunt abdominal trauma involving the kidney is reported. The Doppler exam confirmed the floating character of the clot. Three days after the initiation of anticoagulant therapy, the thrombus disappeared without any clinical or radiological signs of pulmonary embolism. Fifteen cases of traumatic thrombosis of the inferior vena cava have been described in the literature. Mechanisms, clinical pictures and the management are discussed. PMID:15324965

  9. Veia cava superior esquerda anômala com ausência de veia cava superior direita: achados de imagem Persistent left superior vena cava with absent right superior vena cava: image findings

    Directory of Open Access Journals (Sweden)

    Cyrillo Rodrigues de Araújo Júnior

    2003-10-01

    Full Text Available A persistência da veia cava superior esquerda com ausência da veia cava superior direita é uma anomalia rara, com menos de 150 casos descritos na literatura. A não-obliteração e regressão da veia cardinal anterior esquerda durante o desenvolvimento embriológico promove uma variação sistêmica de retorno venoso ao coração, com persistência da veia cava superior esquerda. Sua incidência varia de 0,3% em pacientes sem alterações cardíacas congênitas concomitantes a 4,3% naqueles com cardiopatias. Na maioria das vezes coexiste a veia cava superior direita, porém se houver regressão e degeneração da veia cardinal anterior direita, implicará a sua ausência e a drenagem venosa para o coração será feita pela veia cava superior esquerda ao átrio direito, através do seio coronariano. Mostramos um caso de um paciente submetido a radiografia de tórax e tomografia computadorizada para avaliação de doença pulmonar obstrutiva crônica, tendo como achado a persistência da veia cava superior esquerda com ausência da direita, sem qualquer cardiopatia associada e com a drenagem cardíaca sendo feita, através do seio coronariano, para o átrio direito.Persistent left superior vena cava with 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.

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

    Scientific Electronic Library Online (English)

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

    2012-08-01

    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 enf [...] ermedad. 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. 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, comp [...] lications 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.

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

    Directory of Open Access Journals (Sweden)

    Haghighi Mahshid

    2006-12-01

    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.

  12. Liver cirrhosis in hepatic vena cava syndrome (or membranous obstruction of inferior vena cava)

    Science.gov (United States)

    Shrestha, Santosh Man

    2015-01-01

    Hepatic vena cava syndrome (HVCS) also known as membranous obstruction of inferior vena cava reported mainly from Asia and Africa is an important cause of hepatic venous outflow obstruction (HVOO) that is complicated by high incidence of liver cirrhosis (LC) and moderate to high incidence of hepatocellular carcinoma (HCC). In the past the disease was considered congenital and was included under Budd-Chiari syndrome (BCS). HVCS is a chronic disease common in developing countries, the onset of which is related to poor hygienic living condition. The initial lesion in the disease is a bacterial infection induced localized thrombophlebitis in hepatic portion of inferior vena cava at the site where hepatic veins open which on resolution transforms into stenosis, membrane or thick obstruction, and is followed by development of cavo-caval collateral anastomosis. The disease is characterized by long asymptomatic period and recurrent acute exacerbations (AE) precipitated by clinical or subclinical bacterial infection. AE is managed with prolonged oral antibiotic. Development of LC and HCC in HVCS is related to the severity and frequency of AEs and not to the duration of the disease or the type or severity of the caval obstruction. HVOO that develops during severe acute stage or AE is a pre-cirrhotic condition. Primary BCS on the other hand is a rare disease related to prothrombotic disorders reported mainly among Caucasians that clinically manifest as acute, subacute disease or as fulminant hepatic failure; and is managed with life-long anticoagulation, porto-systemic shunt/endovascular angioplasty and stent or liver transplantation. As epidemiology, etiology and natural history of HVCS are different from classical BCS, it is here, recognized as a separate disease entity, a third primary cause of HVOO after sinusoidal obstruction syndrome and BCS. Understanding of the natural history has made early diagnosis of HVCS possible. This paper describes epidemiology, natural history and diagnosis of HVCS and discusses the pathogenesis of LC in the disease and mentions distinctive clinical features of HVCS related LC.

  13. Superior vena cava syndrome in hemodialysis patient

    Directory of Open Access Journals (Sweden)

    Molhem Azeb

    2011-01-01

    Full Text Available Obstruction of blood flow in the superior vena cava (SVC results in symptoms and signs of SVC syndrome. SVC obstruction can be caused either by invasion or external compression of the SVC by contagious pathologic processes involving the right lung, lymph nodes, and other mediastinal structures, or by thrombosis of blood within the SVC. Occasionally, both mechanisms co-exist. We hereby report a case of a 28-year-old male, Saudi patient who was diagnosed with end-stage renal disease and was maintained on regular hemodiaysis via right jugular vein dual lumen catheter for ten months. Three years later, the patient presented with signs and symptoms suggestive of SVC obstruction that was successfully managed with SVC stenting.

  14. Prenatal diagnosis of isolated interrupted inferior vena cava with azygos continuation to superior vena cava

    OpenAIRE

    Giang, Do Thi Cam; Rajeesh, Gayatri; Vaidyanathan, Balu

    2014-01-01

    Absence of inferior vena cava is an uncommon congenital abnormality. It is usually associated with other structural anomalies, typically left isomerism. We report a case of interrupted inferior vena cava with azygos continuation diagnosed as an isolated finding during routine prenatal ultrasound scan, confirmed by post-natal echocardiography. Detailed ultrasound examination of the fetal anatomy failed to demonstrate other anomalies. The neonatal course of this fetus was uneventful.

  15. Experience with three percutaneous vena cava filters

    International Nuclear Information System (INIS)

    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

  16. Endovascular treatment of superior vena cava syndrome

    DEFF Research Database (Denmark)

    Duvnjak, Stevo; Andersen, Poul Erik

    2011-01-01

    Abstract AIM: The aim of this study was to report our experience with palliative stent treatment of superior vena cava syndrome. METHODS: Between January 2008 and December 2009, 30 patients (mean age 60.7 years) were treated with stents because of stenosed superior vena cava. All patients presented clinically with superior vena cava syndrome and according caval stenosis confirmed by computed tomography. The causes of stenoses were non-small cell carcinoma in 22 patients and small cell carcinoma in 8 patients. RESULTS: In all patients the stents were placed as intended in all patients there was an immediate clinical improvement with considerable reduction in the edema of upper extremities and head. There was, however, continous dyspnea in five patients (17%) and two patients (7%) had persistent visible collateral venous circulations on the upper chest. There were no stent associated complications. All patients were followed clinically till death and the median follow-up period was 2.8 months (15-420 days). During follow-up three cases of stent thrombosis (one complete and two partial thrombosis) were observed. CONCLUSION: Palliative care with stent implantation for superior vena cava syndrome is a minimal invasive and safe procedure with good clinical effect giving the patients a significant better quality of their residual life.

  17. CONDUCTA EN EL SÍNDROME DE VENA CAVA SUPERIOR (SVCS) / Management in superior vena cava syndrome

    Scientific Electronic Library Online (English)

    Eduardo, Arribalzaga F; Marcos, Aguirre V; Cristian, Corchuelo P.

    2014-02-01

    Full Text Available Objetivos: Mostrar la conducta realizada en este síndrome. Material y Métodos: Serie retrospectiva de 5 casos tratados entre el 1 de abril de 1995 y el 31 de marzo de 2013. Diagnóstico por imágenes y toma de biopsia con tratamiento específico posterior. Resultados: Todos se debieron a causas tumoral [...] es: 2 timomas (uno irresecable), 1 linfoma Hodgkin, 1 leiomiosarcoma de vena cava y 1 caso de cáncer pulmonar a pequeñas células. Fallecieron por progresión de enfermedad 2 casos, 2 están libres de enfermedad a 12 y 11 meses de tratamiento y 1 enfermo se perdió en el seguimiento. Conclusiones: Se define la necesidad de seguir un algoritmo que determine los pasos a seguir ante la presencia de este síndrome. Abstract in english Objectives: Management in this syndrome. Material and Methods: Retrospective series of 5 cases treated between April 1, 1995 to March 31, 2013. Diagnostic imaging and taking biopsy with subsequent specific treatment. Results: All patients were due to tumor causes: 2 thymomas (one unresectable), 1 ly [...] mphoma Hodgkin, 1 Leiomyosarcoma of vena cava and 1 case of small cell lung cancer. Died of disease progression 2 cases, 2 are free of disease to 12 and 11 months of treatment and 1 patient was lost to follow-up. Conclusions: The need to follow an algorithm which determines the steps to follow in the presence of this syndrome is defined.

  18. Radiographic evaluation of caudal vena cava size as a useful parameter for the diagnosis of heart disease in dairy cattle

    International Nuclear Information System (INIS)

    To quantify the radiographic parameters of the caudal vena cava (CVC) in healthy cattle and demonstrate their clinical usefulness, the present study compared the ratios of the diameter of the thoracic CVC to the diameter of the aorta (Ao) and length of the thoracic vertebrae (VL), which are all positioned in the same intercostal space, in 81 healthy control cattle (43 growing, 38 adult) and 10 cattle with heart disease. The average diameter of the CVC (CVCave) was correlated with the size of the Ao and VL in the control cows. Although the diameter and pulsation index of the CVC differed significantly between the growing and adult cows, the ratios of CVC/Ao and CVC/VL were fixed values for both the growing and mature cattle. However, in the cattle with heart disease, the pulsation index of the CVC was significantly lower or there was absence of pulsation due to a dilated CVC, and the ratio of CVCave/Ao and CVCave/VL were significantly higher than those in the healthy cattle

  19. Ultrasound Detection of Superior Vena Cava Thrombus

    OpenAIRE

    Aaron Birch; David Um; Brooks Laselle

    2014-01-01

    Superior vena cava (SVC) syndrome is most commonly the insidious result of decreased vascular flow through the SVC due to malignancy, spontaneous thrombus, infections, and iatrogenic etiologies. Clinical suspicion usually leads to computed tomography to confirm the diagnosis. However, when a patient in respiratory distress requires emergent airway management, travel outside the emergency department is not ideal. With the growing implementation of point-of-care ultrasound (POCUS...

  20. Percutaneous insertion of the inferior vena cava filter

    International Nuclear Information System (INIS)

    Objective: To evaluate the effect of inferior vena cava filter for prevention of pulmonary embolus (PE) formation. Methods: Twenty-eight cases of deep venous thrombosis (DVT) were treated with insertion of the inferior vena cava filter. Results: The filter was implanted into inferior vena cava below the rena vein. There were no severe complications occurred in the group. Twenty-seven cases were followed up to 2-34 months, and no migration of the filters were found. And no pulmonary embolism were revealed in fifteen cases without pulmonary thromboembolism. Conclusions: The inferior vena cava filter implantation is a safe and effective method to prevent pulmonary thromboembolism

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

    Scientific Electronic Library Online (English)

    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.

    2006-07-01

    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 endo [...] vascular 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

  2. Clinical application and advancement of inferior vena cava filter

    International Nuclear Information System (INIS)

    Deep venous thrombosis is a common disorder, with a considerably high incidence and mortality. Inferior vena cava filter provides fruitful means in decrease and prevention of fatal pulmonary embolism. The authors reviewed the history, indications and applications of inferior vena cava filter for different types of deep venous thrombosis, with outlook of future trends. (authors)

  3. [Renal angiomyolipoma with inferior vena cava thrombosis during pregnancy].

    Science.gov (United States)

    Bidault, V; Pignot, G; Rocher, L; Glas, L; Patard, J-J

    2015-04-01

    The diagnosis of angiomyolipoma with tumor thrombus from the renal vein into the inferior vena cava is rare, especially during pregnancy. We report the case of a 31-year-old pregnant woman who was diagnosed with a 9cm angiomyolipoma of the right kidney with inferior vena cava thrombosis, managed by active surveillance during pregnancy and delayed surgery after childbirth. PMID:25638747

  4. Surgical management of leiomyosarcoma of the inferior vena cava.

    Science.gov (United States)

    Jiang, Hua; Wang, You-Xin; Li, Bing; Jiang, Yan-Yong; Miao, Cheng-Li; Liao, Dai-Xiang; Zhao, Rong-Hua; Luo, Cheng-Hua

    2015-06-01

    The optimal surgical management of patients with leiomyosarcoma of inferior vena cava remains a controversy. From 1975 and 2009, five patients with leiomyosarcoma of inferior vena cava were treated at the Chinese PLA General Hospital and Beijing Shijitan Hospital. The age ranged 39-61 years and the duration of symptoms ranged from 18 to 36 months. Abdominal and back pain are the most common complaints. A combination of various imaging modalities is essential for treatment planning. R0, R1, R2, and biopsy only were accomplished in 2, 1, 1, and 1 case, respectively. Combined resections included inferior vena cava, right kidney, adrenal gland, psoas, colon, duodenal, gallbladder, liver, and/or aorta, without inferior vena cava reconstruction. No inferior vena cava-related postoperative complication was seen in our series. PMID:25171923

  5. Radiological evaluation of inferior vena cava obstruction: pictorial essay

    Energy Technology Data Exchange (ETDEWEB)

    Pittman, C. [Memorial Univ. of Newfoundland, Health Sciences Centre, Dept. of Diagnostic Imaging, St. John' s, Newfoundland (Canada); Reddy, M. [Memorial Univ. of Newfoundland, Health Sciences Centre, Dept. of Medicine, St. John' s, Newfoundland (Canada); Reddy, E.R. [Memorial Univ. of Newfoundland, Health Sciences Centre, Dept. of Diagnostic Imaging, St. John' s, Newfoundland (Canada)

    1999-12-01

    The clinical diagnosis of inferior vena cava (IVC) obstruction is often difficult, since patients may present with a multitude of signs and symptoms. The clinical manifestations depend on several factors: the underlying cause, the level of obstruction, the adequacy of collateral circulation, the presence of intercurrent disease, and the organ system involved. Although the most common clinical manifestations are deep venous thrombosis in the legs, abdominal pain, low back pain, loin pain and hematuria, patients may present with unusual and varied pathologic conditions. IVC obstruction may resemble or be associated with such conditions as congestive cardiac failure, cirrhosis of the liver or renal disease. (author)

  6. Infra hepatic interruption of inferior vena cava

    International Nuclear Information System (INIS)

    Congenital anomaly of IVC is rare, but understanding of this anomaly is important in radiological diagnosis angiographic procedures and major retroperitoneal and thoracic surgery. We analysed 23 cases of IVC interruption diagnosed by cardiac angiography at Seoul National University Hospital. The results were as follows: 1. The incidence of intrahepatic interruption of IVC was 0.45% of the patients having cardiac angiography and most patients showed cyanosis (91%). 2. The most common associated cardiac anomaly was right ventricular outflow tract obstruction (60%). Other associated cardiac defects were VSD, ASD, valvular anomalies in 9 cases (39%) respectively; double outlet right ventricle, bilateral superior vena cava, single ventricle in 6 cases (26%) respectively; single atrium, PDA in 5 cases (22%) respectively. 6 cases of situs inverses, 3 cases if sutus ambiguous, 2 cases of visceral heterotaxia and one case of asplenia were observed also. 7 cases of left-sided IVC were associated with IVC interruption in normal situs.

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

    Directory of Open Access Journals (Sweden)

    Camilo Boza W

    2001-04-01

    Full Text Available 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 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

  8. Multicentric pheochromocytoma and involvement of the inferior vena cava

    Scientific Electronic Library Online (English)

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

    2001-03-01

    Full Text Available 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, sem 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 a [...] drenal pheochromocytoma with extension to the supra-diaphragmatic vena cava, which underwent surgical excision through thoracophrenic laparotomy without the need for cardiopulmonary 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.

  9. Persistent Left Superior Vena Cava with Absence of Right Superior Vena Cava.

    Directory of Open Access Journals (Sweden)

    Nicolas Ernesto Ottone

    2010-06-01

    Full Text Available The variations on the venous system’s conformation are closely related with the embryological development, due to atrophy or persistency of embryological connections that this system establishes for its final formation. During a routine dissection of a heart-lung block of a male Caucasian cadaver (40 % formolized, at the Dissection Team of the Second Chair of Anatomy, School of Medicine, University of Buenos Aires, our team found a persistent left superior vena cava (PLSVC, with its right superior vena cava (RSVC missing. In addition, the PLSVC was draining to a dilated coronary sinus. Before the PLSVC drains, it receives the corresponding Acygos vein, which describes its journey above the left pulmonary root. It is essential for the specialist physician to be aware of the existence of this variation in order to address and resolve safely the procedure and the existing pathology of the patient, since, most of the time, this vascular anomaly is found incidentally in the context of a CT, echocardiogram, or during the placement of endocavitary catheters.

  10. Vena cava as autologous tissue for pulmonary valve substitute.

    Science.gov (United States)

    Scharfschwerdt, Michael; Sievers, Hans-H; von Heinz, Marie; Schmidtke, Claudia

    2008-12-01

    In this study, we report on our first experience with the construction of a valve using autologous vena cava tissue for right ventricular outflow tract reconstruction. Simulating the clinical situation valves were built from tubular pieces of porcine inferior vena cava placed in a PTFE tube and investigated in a pulsatile flow simulator. Based on the given vena cava dimensions, conduits were constructed with diameters of 19 mm in bicuspid or tricuspid and 22 mm and 24 mm in bicuspid configuration. The lowest pressure gradients were observed in the 22 mm vena cava valves in bicuspid configuration (8.6+/-0.5 mmHg) compared to 24 mm valves (10.6+/-0.9 mmHg, P=0.0004) and 19 mm valves (13.4+/-1.5 mmHg, P=0.005). No differences could be found between 19 mm bicuspid and tricuspid valves. Concerning valve opening movements, a complete opening in the 19 mm and a nearly unhindered opening in 22 mm valves were registered. In 24 mm valves opening was incomplete. Leakage was increased in 19 mm bicuspid valves due to leaflet prolapse. In conclusion, construction of a valve mechanism from vena cava tissue is feasible. The in-vitro hemodynamic results are encouraging, animal experiments are ongoing to investigate the midterm function of these valves. PMID:18718954

  11. New percutaneous and retrieval vena cava catheter filter

    International Nuclear Information System (INIS)

    This paper reports a new percutaneous and retrievable vena cava filter assessed. The authors used the Seldinger technique for percutaneous insertion of the 10-F catheter filter through the right internal jugular vein with fluoroscopic guidance. The authors used fibrinolytic agents (streptokinase) by direct infusion through the catheter filter. Venocavography and pulmonary angiography were performed at day 5 and day 10 before removal of the catheter filter at the patient's bed. This vena cava percutaneous filter was made for use by radiologists, interventional cardiologists, and staff of intensive care units. The compilation rate for this technique was low

  12. Fatal Pericardial Tamponade After Superior Vena Cava Stenting

    International Nuclear Information System (INIS)

    We discuss a fatal complication of percutaneous superior vena cava (SVC) self-expandable stent placement in a patient with superior vena cava syndrome (SVCS). The SVCS was caused by a malignant mediastinal mass with total occlusion of the SVC. Twenty-four hours after the procedure, the patient died of a hemopericardial tamponade. In the literature, only seven cases have been described with this life-threatening complication. Patients with a necrotic tumor mass are more likely to develop this complication. Knowledge of this complication may increase patient survival.

  13. Pediatric child abuse victim with posttraumatic inferior vena cava thrombosis.

    Science.gov (United States)

    Goodpasture, Meggan L; Zeller, Kristen A; Petty, John K

    2014-05-01

    Posttraumatic inferior vena cava thrombosis (IVCT) is very rare, with only a few cases reported in the literature. While thromboembolism as a result of trauma is common in adult patients, it is very rare in young children and seldom involves the inferior vena cava. We report the youngest patient to date with IVCT and the only child reported whose findings are the result of child physical abuse. The diagnosis can be challenging both clinically and radiographically. Additionally, the risks of morbidity and even mortality associated with an IVCT if untreated are significant. PMID:24578163

  14. Bilateral inferior vena cava filter insertion in a patient with duplication of the infrarenal vena cava.

    LENUS (Irish Health Repository)

    Leong, S

    2010-06-19

    BACKGROUND: Inferior vena cava (IVC) filter insertion is a commonly performed procedure for indications such as recurrent pulmonary emboli or contraindication to anticoagulation. Symptomatic duplication of the IVC is exceedingly rare with only a handful of cases being described in the literature. AIM: We report an unusual case of a patient with symptomatic duplication of the IVC. RESULT: A 53-year-old woman presented at our hospital for resection of a cerebral metastasis from a non-small cell lung cancer following a recent diagnosis of bilateral lower limb deep venous thrombosis. This required perioperative reversal of anticoagulation and IVC filter insertion. Conventional venography performed during filter insertion documented the existence of a duplicated IVC. CONCLUSION: We present a case of a symptomatic duplication of the IVC requiring filter insertion. We review the developmental anatomy of the IVC along with the diagnostic findings and management strategies available.

  15. 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)

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

    2010-12-01

    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 dife [...] rencia 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. 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 i [...] n 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.

  16. 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)

    Julia Janet Rojas Estrada

    2010-12-01

    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.

  17. Superior vena cava obstruction associated with nephrogenic systemic fibrosis.

    Science.gov (United States)

    Holzem, Kassandra E; Nardone, Beatrice; Lomasney, Jon W; Yazdan, Pedram; Gerami, Pedram; West, Dennis P; Laumann, Anne E

    2014-05-01

    A 56-year-old woman with hypertension-induced end stage renal disease presented with skin thickening and mottled discoloration. Cutaneous biopsy showed increased dermal fibroblasts embedded in fibromyxoid stroma with scattered perivascular and interstitial mononuclear cells. Immunohistochemistry revealed prominent CD34+ dendritic cells in septal spaces, consistent with Nephrogenic Systemic Fibrosis (NSF). Seven years and two years prior she had received a gadolinium-based contrast agent (GBCA). She died due to NSF. Gross autopsy revealed a thickened and stenotic superior vena cava (SVC). Extensive fibrosis of the SVC, dermis, and subcutaneous tissue was noted, together with hyalinized collagen fibers within the muscular wall of the intestines and dura mater. These findings support the importance of skin changes in the recognition of life threatening extracutaneous tissue involvement in NSF. PMID:24809889

  18. Síndrome de veia cava superior / Superior vena cava syndrome

    Scientific Electronic Library Online (English)

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

    2002-09-01

    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 síndro [...] me 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. 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 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.

  19. Síndrome de veia cava superior Superior vena cava syndrome

    Directory of Open Access Journals (Sweden)

    SAMUEL ZUÍNGLIO DE BIASI CORDEIRO

    2002-09-01

    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.

  20. Renal Angiomyolipoma Associated with Inferior Vena Cava Thrombus

    OpenAIRE

    Francois Richard; Raphaelle Renard-Penna; Marc-Olivier Bitker; Eva Comperat; Xavier Durand

    2009-01-01

    A 57-year-old woman was found to have an inferior vena cava involvement of a known sinusal angiomyolipoma incompletely resected three years beforehand. Intravascular extension into the IVC of angiomyolipoma has rarely been reported. We present a new case and reconsider the literature about this uncommon complication of a benign renal tumor.

  1. 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)

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

    2012-08-01

    Full Text Available 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 const [...] ituyen 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 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 management of sepsis. The importance of early diagnosis and treatment is highlighted. We also report the successful management with stenting for superior vena cava syndrome.

  2. Detection by means of CT of inferior vena cava filters

    International Nuclear Information System (INIS)

    Vena cava filters are an excellent tool for the prevention of pulmonary embolism (PE) in patients with deep vein thrombosis (DVT) of the lower limbs. However, these devices are not entirely free of complications as thrombi can develop inside them, threatening to occlude them completely. The objective of this report is to study the incidence of thrombosis in vena cava filters, as well as their impact on prognosis. We also mention the importance of CT as an imaging technique in the study of this complication. We present 30 patients in whom different filters were implanted and their prospective follow-up by means of CT over a mean follow-up period of 36 months. Chi-square analysis was used to determine whether there was a significant relationship among the complications encountered (p<0,05), and their course over time was studied by means of Kaplan-Meyer curves. Five cases (16%) of complete thrombosis of the filter were observed among patients in whom the Gunther model had been implanted, yielding an index of probability of complete permeability of the inferior vena cava at 13 months of 82%. Thrombi of different degrees (between 5% and 60%) were also observed inside the filter in ten patients (33%) with Gunther, Simon-Nitional and LGM models. Filter thrombosis was not significantly associated with the onset of recurrent PE or of venous disorders involving lower limbs, the relationship between PE and preimplantation presence of inferior vena cava thrombosis was significanferior vena cava thrombosis was significant (p<0.01). It was also observed that post implantation anti coagulation did not significantly prevent later onset of filter thrombosis. (Author)

  3. Vena cava superior izquierda persistente asociada con cardiopatías congénitas / Persistent Left Superior Vena Cava Associated with Congenital Heart Defects

    Scientific Electronic Library Online (English)

    Florentino J., Vargas.

    2008-06-01

    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. Abstract in english Persistent left superior vena cava associated with congenital heart defects is generally a benign finding without hemodynamic impact which does not need surgery. Nevertheless, in some circumstances, it may result a condition needing a treatment, or it may be necessary to perform certain modification [...] s in surgical techniques used for other congenital heart defects. The present article deals with a review of those situations in which a persistent left superior vena cava needs a specific surgical approach. In addition, an original surgical procedure used in these patients, which has been recently reported by our team, is commented in relationship with each of the different anatomic presentations.

  4. Computed Tomography-Guided Central Venous Catheter Placement in a Patient with Superior Vena Cava and Inferior Vena Cava Occlusion

    International Nuclear Information System (INIS)

    An 18-year-old man with a gastrointestinal hypomotility syndrome required lifelong parenteral nutrition. Both the superior and inferior vena cava were occluded. Computed tomography guidance was used to place a long-term central venous catheter via a large tributary to the azygos vein

  5. Radiographic evaluation of caudal vena cava size in dogs

    International Nuclear Information System (INIS)

    Dilation of the caudal vena cava (CVC) on lateral thoracic radiographs is often interpreted as suggestive of right-sided congestive heart failure, To quantitate the clinical utility of evaluating CVC size as an indicator of right-sided heart disease, we compared the ratio of the diameter of the CVC as measured on a left lateral thoracic radiograph to the descending aorta (Ao), length of the thoracic vertebra above the tracheal bifurcation (VL), and width of the right fourth rib (R4) in 35 dogs with right heart disease and 35 control dogs, Each CVC ratio(CVC/Ao, CVC/VL, CVC/R4) was statistically larger in dogs with right heart disease, Response operating characteristic curves and likelihood ratios were used to determine ratios helpful in identifying dogs with right heart disease. A CVC/Ao > 1.50, CVC/VL > 1.30, or CVC/R4 > 3.50 are strongly suggestive of a right-sided heart abnormality in a patient

  6. 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)

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

    2005-10-01

    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 lin [...] foma. 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 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 wi [...] th 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

  7. Síndrome da veia cava superior: caso clínico / Superior vena cava syndrome: Case report

    Scientific Electronic Library Online (English)

    Sandrina Figueiredo, Braga; Daniel, Brandão; Pedro Pinto, Sousa; Jacinta, Campos; Alexandra, Canedo; Pedro, Brandão; João Carlos, Mota; Luís, Vouga.

    2014-03-01

    Full Text Available A Síndrome da Veia Cava Superior (SVCS) surge quando há diminuição ou obstrução do ?uxo de sangue através da veia cava superior (VCS) e pode cursar com muito debilitantes. Embora classicamente associada a etiologias malignas, o aumento do número de procedimentos endovenosos (cateteres venosos centra [...] is, pacemakers, cardio-desfibriladores) fez aumentar a percentagem de casos de etiologia benigna, que manifestações clínicas actualmente correspondem a 40%. O tratamento endovascular tem ganho crescente popularidade, mas nem sempre é exequível ou conduz a melhoria clínica a longo prazo, pelo que por vezes o tratamento cirúrgico é necessário. Os autores descrevem o caso clínico de um doente com SVCS, relacionado com colacação prévia de pacemaker. Após tentativa infrutífera de tratamento endovascular, o doente foi submetido a reconstrução cirúrgica, com resolução da sintomatologia. Abstract in english Superior Vena Cava Syndrome (SVCS) occurs when there is a reduction or blockage of blood ?ow through the superior vena cava (SVC) and may be associated with debilitating clinical manifestations. Although classically associated with malignant etiologies, increasing number of intravenous procedures (c [...] entral venous catheters, pacemakers) have raised the percentage of cases of benign etiology, which currently account for 40%. Endovascular management of SVCS has gained increasing popularity, although it is not always feasible or leads to long-term clinical improvement, so sometimes surgical treatment is necessary. The authors present a patient with superior vena cava syndrome due to pacemaker leads. After unsuccessful attempt of endovascular treatment, the patient underwent surgical reconstruction with resolution of symptoms.

  8. Modeling Flow Past a Tilted Vena Cava Filter

    Energy Technology Data Exchange (ETDEWEB)

    Singer, M A; Wang, S L

    2009-06-29

    Inferior vena cava filters are medical devices used to prevent pulmonary embolism (PE) from deep vein thrombosis. In particular, retrievable filters are well-suited for patients who are unresponsive to anticoagulation therapy and whose risk of PE decreased with time. The goal of this work is to use computational fluid dynamics to evaluate the flow past an unoccluded and partially occluded Celect inferior vena cava filter. In particular, the hemodynamic response to thrombus volume and filter tilt is examined, and the results are compared with flow conditions that are known to be thrombogenic. A computer model of the filter inside a model vena cava is constructed using high resolution digital photographs and methods of computer aided design. The models are parameterized using the Overture software framework, and a collection of overlapping grids is constructed to discretize the flow domain. The incompressible Navier-Stokes equations are solved, and the characteristics of the flow (i.e., velocity contours and wall shear stresses) are computed. The volume of stagnant and recirculating flow increases with thrombus volume. In addition, as the filter increases tilt, the cava wall adjacent to the tilted filter is subjected to low velocity flow that gives rise to regions of low wall shear stress. The results demonstrate the ease of IVC filter modeling with the Overture software framework. Flow conditions caused by the tilted Celect filter may elevate the risk of intrafilter thrombosis and facilitate vascular remodeling. This latter condition also increases the risk of penetration and potential incorporation of the hook of the filter into the vena caval wall, thereby complicating filter retrieval. Consequently, severe tilt at the time of filter deployment may warrant early clinical intervention.

  9. Modeling Flow Past a Tilted Vena Cava Filter

    International Nuclear Information System (INIS)

    Inferior vena cava filters are medical devices used to prevent pulmonary embolism (PE) from deep vein thrombosis. In particular, retrievable filters are well-suited for patients who are unresponsive to anticoagulation therapy and whose risk of PE decreased with time. The goal of this work is to use computational fluid dynamics to evaluate the flow past an unoccluded and partially occluded Celect inferior vena cava filter. In particular, the hemodynamic response to thrombus volume and filter tilt is examined, and the results are compared with flow conditions that are known to be thrombogenic. A computer model of the filter inside a model vena cava is constructed using high resolution digital photographs and methods of computer aided design. The models are parameterized using the Overture software framework, and a collection of overlapping grids is constructed to discretize the flow domain. The incompressible Navier-Stokes equations are solved, and the characteristics of the flow (i.e., velocity contours and wall shear stresses) are computed. The volume of stagnant and recirculating flow increases with thrombus volume. In addition, as the filter increases tilt, the cava wall adjacent to the tilted filter is subjected to low velocity flow that gives rise to regions of low wall shear stress. The results demonstrate the ease of IVC filter modeling with the Overture software framework. Flow conditions caused by the tilted Celect filter may elevate the risk of intrafilter thter may elevate the risk of intrafilter thrombosis and facilitate vascular remodeling. This latter condition also increases the risk of penetration and potential incorporation of the hook of the filter into the vena caval wall, thereby complicating filter retrieval. Consequently, severe tilt at the time of filter deployment may warrant early clinical intervention.

  10. Decompression of superior vena cava during bidirectional Glenn shunt

    OpenAIRE

    Kulkarni Venugopal; Mudunuri Ravikiran; Mulavisala Krishnaprasad; Byalal R

    2009-01-01

    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 probl...

  11. Radiation-induced superior vena cava syndrome.

    OpenAIRE

    Lee, Y.; Doering, R.; Jihayel, A.

    1995-01-01

    A 59-year-old man developed superior vena caval obstruction 20 years after receiving a radiation treatment for primary germinal cell tumor of the mediastinum. Venous decompression was achieved by anastomosing a 10-mm ringed polytetrafluoroethylene graft from the left internal jugular vein to the right atrium, which yielded immediate relief of symptoms. A left internal jugular venogram demonstrated graft patency 11 months post-operatively, and the patient remained free of symptoms of superior ...

  12. 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)

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

    2008-07-01

    Full Text Available 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 ven [...] oso 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 raramente 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 o [...] bvious. 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.

  13. Relationship between Microscopic Hematuria and Inferior Vena Cava Reflux on Color Doppler Ultrasonography

    OpenAIRE

    Kimio Sugaya; Saori Nishijima; Katsumi Kadekawa; Katsuhiro Ashitomi

    2013-01-01

    We examined the relationship between microscopic hematuria and inferior vena cava (IVC) reflux. Transabdominal color Doppler ultrasonography of the IVC was performed in the supine position with the convex probe positioned perpendicular to the upper abdominal wall, and the extent of reflux into the IVC with each heart beat was examined near the diaphragm. A total of 171 patients were studied who had no diseases that could cause hematuria, and no symptomatic gross hematuria. The relationsh...

  14. 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

  15. 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

  16. 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

  17. Preliminary experimental study of retrievable nitinol inferior vena cava filter

    International Nuclear Information System (INIS)

    Objective: To evaluate, in vitro and in an animal model together with the placement, stability, clot capturing efficacy, retrieval and safety of a new non-invasive retrievable nitinol inferior vena cava filter (RNIVCF) for temporary or permanent use. Methods: RNIVCF were made by wrapping nitinol monofilament wire on a steel mandrill to form a steric configuration. A 5-F Teflon sheath/dilator was taken for placement and retrieval. In vitro clots' trapping was assessed with size of 2.5/3/4-mm-diameter clots. Twenty adult mongrel dogs were used in this study. 2.5-mm-diameter homologous radiopaque clots (2.5-mm-HRC) were injected into IVC until the experimental animals die of acute pulmonary embolism (PE) and then to determine the minimum fatal quantity of clots in 8 dogs. RNIVCFs were introduced into the inferior vena cava in 12 dogs. For 10 animals, 10-ml 2.5-mm-HRC were injected below the filter to test its thrombus-trapping efficacy. The retrieval of filter was attempted on the 7th day after placement in two other dogs. Plain films of the abdomen and chest were made to document the effectiveness of the filter. Results: Initial experimental study showed that the RNIVCF functioned as intended. In vitro all 3 and 4-mm-diameter clots injected in the device simulating IVC flow was trapped by the filter. However, 95%-100% 2.5-mm-diameter clots were also captured by it. More than 10-ml 2.5-mm-HRC with once injection into IVC could cause the death of experimental animals due use the death of experimental animals due to acute PE in per-experiment. RNIVCF could be easily and successfully placed percutaneously in the inferior vena cava of the dogs through a 5-F sheath. The filter was accurately positioned in the inferior vena cava by moving the retrieval wire. All 13 RNIVCFs were placed in 12 dogs, one of those has double inferior vena cava and two filters were implanted. The filters trapped these 2.5-mm-diameter clots in the iliac veins of 8 dogs and none of them died of acute PE. But the initial two dogs with two original RNIVCF died of acute PE due to hypertension of the inferior vena cava below the filters caused by injecting too much clots to force the trapped clots passing through the filters. Therefore, only 10-ml clots was necessary for injection into each the IVC of the dogs and thus the stabilized portion of the original RNIVCF can change into three-petals-quincunx shape. Two filters were retrieved successfully through the sheath/dilator in the 7th day after placement without difficulty. Conclusion: RNIVCF is a kind of sophisticated device for retracting emboli. It can be sited percutaneously with 5F delivery permanently or temporarily in stable condition. The smooth contours cause no traumatic effect especially for retrieving small emboli

  18. Right nutcracker syndrome associated with left-sided inferior vena cava, hemiazygos continuation and persistant left superior vena cava: a rare combination.

    Science.gov (United States)

    Yildiz, Adalet Elcin; Cayci, Fatma Semsa; Genc, Sinan; Cakar, Nilgun; Fitoz, Suat

    2014-01-01

    The term nutcracker syndrome refers to compression of left renal vein between aorta and superior mesenteric artery causing renal venous hypertension. Right nutcracker syndrome associated with a left-sided inferior vena cava is an extremely rare anomaly. Reported two cases in English literature were diagnosed by ultrasonography and computed tomography angiography in adulthood. Herein, we present a case of right nutcracker syndrome with left-sided inferior vena cava and hemiazygos continuation in a 12-year-old girl. PMID:24461470

  19. Agenesia da veia cava inferior / Agenesis of the inferior vena cava

    Scientific Electronic Library Online (English)

    Caroline Saltz, Gensas; Leonardo Martins, Pires; Marcelo Lapa, Kruse; Tiago Luiz Luz, Leiria; Daniel Garcia, Gomes; Gustavo Glotz de, Lima.

    2012-12-01

    Full Text Available Agenesia da veia cava inferior é uma malformação rara. Sua causa mais comum é a disgenesia durante a embriogênese, mas também pode estar relacionada a trombose intrauterina ou perinatal. Normalmente é assintomática, em associação, ou não, com outras malformações congênitas, e pode cursar com maior r [...] isco de insuficiência venosa crônica e trombose venosa profunda, especialmente em jovens. Seu diagnóstico frequentemente é acidental, durante cirurgias abdominais ou procedimentos radiológicos. Relatamos cinco casos de agenesia da veia cava inferior detectada durante procedimentos eletrofisiológicos. Abstract in english Agenesis of the inferior vena cava is a rare malformation. Its most common cause is dysgenesis during embryogenesis, but it may also be related to intrauterine or perinatal thrombosis. It is usually asymptomatic, associated or not with other congenital malformations and may be related to increased r [...] isk of chronic venous insufficiency and deep vein thrombosis, especially in young individuals. Diagnosis is often incidental, during abdominal surgery or radiological procedures. We reported five cases of agenesis of the inferior vena cava detected during electrophysiological procedures.

  20. Symptomatic caval penetration by a Celect inferior vena cava filter

    International Nuclear Information System (INIS)

    We report a case of penetration of the inferior vena cava (IVC) by all four primary struts of a Celect caval filter in a 17-year-old girl with Klippel-Trenaunay syndrome. The girl presented with acute lower abdominal and right leg pain 17 days after filter insertion. An abdominal radiograph demonstrated that the filter had moved caudally and that the primary struts had splayed considerably since insertion. Contrast-enhanced CT confirmed that all four primary struts had penetrated the IVC wall. There was a small amount of retroperitoneal hemorrhage. The surrounding vessels and viscera were intact. The filter was subsequently retrieved without complication. (orig.)

  1. Symptomatic caval penetration by a Celect inferior vena cava filter

    Energy Technology Data Exchange (ETDEWEB)

    Bogue, Conor O.; John, Philip R.; Connolly, Bairbre L.; Rea, David J.; Amaral, Joao G. [Hospital for Sick Children and University of Toronto, Division of Image Guided Therapy, Department of Diagnostic Imaging, Toronto, ON (Canada)

    2009-10-15

    We report a case of penetration of the inferior vena cava (IVC) by all four primary struts of a Celect caval filter in a 17-year-old girl with Klippel-Trenaunay syndrome. The girl presented with acute lower abdominal and right leg pain 17 days after filter insertion. An abdominal radiograph demonstrated that the filter had moved caudally and that the primary struts had splayed considerably since insertion. Contrast-enhanced CT confirmed that all four primary struts had penetrated the IVC wall. There was a small amount of retroperitoneal hemorrhage. The surrounding vessels and viscera were intact. The filter was subsequently retrieved without complication. (orig.)

  2. Decompression of superior vena cava during bidirectional Glenn shunt

    Directory of Open Access Journals (Sweden)

    Kulkarni Venugopal

    2009-01-01

    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.

  3. A Novel Technique for Inferior Vena Cava Filter Extraction

    International Nuclear Information System (INIS)

    Inferior vena cava (IVC) filters are used to protect against pulmonary embolism in high-risk patients. Whilst the insertion of retrievable IVC filters is gaining popularity, a proportion of such devices cannot be removed using standard techniques. We describe a novel approach for IVC filter removal that involves snaring the filter superiorly along with the use of flexible forceps or laser devices to dissect the filter struts from the caval wall. This technique has used to successfully treat three patients without complications in whom standard techniques failed

  4. Perforation of inferior vena cava during filter placement.

    Science.gov (United States)

    Piecuch, J; Wiewiora, M; Nowowiejska-Wiewiora, A; Szkodzinski, J; Polonski, L

    2011-03-01

    The placement of an inferior vena cava (IVC) filter is a therapeutic method for selected patients with deep venous thrombosis and pulmonary embolism. However, insertion and placement of the filter may be associated with certain complications. For instance, retroperitoneal hematoma resulting from perforation of the wall by the filter is such a very rare but serious complication. We report the case of a 64-year-old woman with perforation of the IVC wall and consecutive hematoma caused by the filter who was treated surgically. PMID:21500182

  5. 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)

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

    Energy Technology Data Exchange (ETDEWEB)

    Hoffer, Eric K., E-mail: eric.k.hoffer@hitchcock.org; Mueller, Rebecca J.; Luciano, Marcus R.; Lee, Nicole N.; Michaels, Anne T.; Gemery, John M. [Dartmouth-Hitchcock Medical Center, Department of Radiology, Section of Vascular and Interventional Radiology (United States)

    2013-08-01

    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.

  7. 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

  8. Right lung upper lobe carcinoma radical excision plus superior vena cava angioplasty

    OpenAIRE

    Peng, Gui-lin; Yin, Wei-qiang; Zhang, Xin; He, Jian-xing

    2013-01-01

    An elderly male patient was found to be with “nodule in upper lobe of right lung” during his health examination, although without any symptom. Chest CT at admission showed that the nodules were close to the superior vena cava, and CT reconstruction displayed an adipose space between the nodules and the superior vena cava. However, bronchoscopy showed negative results. Pre-operative exploration showed that the right upper lung nodules were tightly attached to the surface of superior vena c...

  9. 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 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.)

  10. Three cases of amoebic liver abscess causing inferior vena cava obstruction, with a review of the literature

    OpenAIRE

    Sarda, Anil K.; Mittal, Rakesh; Basra, Baljeet K.; Mishra, Anurag; Talwar, Nikhil

    2011-01-01

    Amoebic liver abscess is a common disease, especially in endemic areas, but it is a rare cause of inferior vena cava (IVC) obstruction, with only a few cases appearing in the literature. We report three cases of amoebic liver abscess complicated with obstruction of the IVC and which responded to conservative treatment or radiological intervention.

  11. Trombosis de vena cava inferior y endocarditis en un paciente prematuro: Caso clínico / Inferior vena cava thrombosis and endocarditis in a premature patient: Case report

    Scientific Electronic Library Online (English)

    Andrea, Parra Buitrago; Natalia Andrea, Valencia Zuluaga; Andrés Felipe, Uribe Murillo.

    2014-12-01

    Full Text Available La trombosis de la vena cava inferior corresponde a un porcentaje importante de las trombosis venosas en la etapa neonatal, generalmente asociado a factores de riesgo como el uso de catéter venoso central. La incidencia de endocarditis bacteriana en recién nacidos prematuros es baja. Objetivos: Cara [...] cterizar el caso de un neonato pretérmino en que se asociaron ambas patologías y detallar el espectro cambiante de esta enfermedad en la población neonatal y sus posibilidades terapéuticas. Caso clínico: Recién nacido prematuro de 31 + 5 semanas de gestación, que presentó bacteriemia por Enterococo faecalis, evolucionó con trombosis progresiva de la vena cava inferior y aurícula derecha secundaria al uso de catéter venoso umbilical, con posterior diagnóstico de endocarditis. Se manejó con anticoagulación con heparina de bajo peso molecular en forma subcutánea, dada evolución favorable, se decidió continuar manejo médico con terapia anticoagulante por 4-6 semanas, y al alta manejo con aspirina. Conclusiones: El neonato pretérmino con endocarditis infecciosa y trombo intracardiaco presentan un dilema interesante de manejo, por lo cual se debe individualizar el tratamiento según la evolución clínica y el perfil de seguridad de los agentes trombolíticos y/o anticoagulantes. La disponibilidad y las ventajas de la heparina de bajo peso molecular ha dado lugar a su uso como una alternativa de tratamiento en neonatos y niños con trombosis venosa profunda. Abstract in english Thrombosis of the inferior vena cava represents a significant percentage of all venous thrombosis that take place during the neonatal period, generally associated with risk factors such as the use of central venous catheter. The incidence of bacterial endocarditis in preterm infants is low. Objectiv [...] es: To characterize the case of a preterm neonate with both conditions and to detail the disease changing spectrum in the neonatal population and its therapeutic possibilities. Case report: Premature newborn, 31 + 5 weeks of gestation who presented Enterococcus faecalis bacteremia, developed progressive thrombosis of the inferior vena cava and right atrium secondary to the use of umbilical venous catheter, with subsequent diagnosis of endocarditis. He was treated with anticoagulation with subcutaneous low molecular weight heparin. Given a favorable evolution, it was decided to continue the anticoagulation therapy for 4-6 weeks, and at the time of discharge, aspirin treatment was given. Conclusions: The preterm infant with infective endocarditis and intracardiac thrombus presents an interesting management dilemma. Treatment should be individualized according to the clinical evolution and safety profile of thrombolytic and/or anticoagulant agents. Availability and advantages of low molecular weight heparin have led to its use as an alternative treatment in neonates and infants with deep venous thrombosis.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-06-15

    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.)

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

    Directory of Open Access Journals (Sweden)

    Dante Antonelli

    2007-10-01

    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.

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

    OpenAIRE

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

    2005-01-01

    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 complications relate...

  15. Ausência de veia cava inferior: relato de caso / Absence of the inferior vena cava: case report

    Scientific Electronic Library Online (English)

    Elton Correia, Alves; Gabriela Bóia Rocha, Ferro; Luciana Karla Lira, França; Mabel Batista, Jacó; Guilherme Benjamin Brandão, Pitta.

    2010-12-01

    Full Text Available A ausência congênita de veia cava inferior é achado incomum e ocasional durante exames complementares ou cirurgias do abdome. Em razão de a maioria dos pacientes sem outras malformações serem assintomáticos, há dificuldade em estimar a prevalência dessas anomalias. O objetivo deste trabalho foi rela [...] tar o caso de um paciente de 28 anos, sexo masculino, referido para radiografia de tórax devido a quadro de febre alta (39ºC) não-responsiva à medicação. Radiografia de tórax sugeriu dilatação de veia ázigos. Em inquérito dirigido para sintomas cardiovasculares, referiu dor torácica (durante atividade física e em repouso) e dispneia ocasionais durante o sono associada ao período em que intensificou a prática de exercícios. Realizada tomografia computadorizada sem contraste e, posteriormente, contrastada. As mesmas não esclareceram o caso, fazendo-se necessário angiotomografia, a qual evidenciou ausência de veia cava inferior torácica. Abstract in english The congenital absence of the inferior vena cava is a rare and occasional finding at complementary exams or abdominal surgeries. As the majority of patients without other malformations are asymptomatic, it is hard to estimate the prevalence of these anomalies. Our goal was to report a case of a 28-y [...] ear-old patient, male, referred to thorax X-ray due to high fever state (39ºC), nonresponder to medication. The X-ray suggested azygos vein dilatation. The interview about cardiovascular symptoms revealed thoracic pain during both physical exercises and at rest, and occasional dyspnea during sleep related to the period of intensification of physical exercises. Computadorized tomography with and without contrast did not solve the case, what explain the request of an angiotomography, that showed absence of thoracic inferior vena cava.

  16. CT diagnosis of tumor thrombus of the renal vein and inferior vena cava

    International Nuclear Information System (INIS)

    We used computed tomography (CT) for diagnosis in 4 cases of renal tumor associated with tumor thrombus of the renal vein and inferior vana cava. The results obtained are described below: A total of 4 cases consisting of 3 cases of renal cell carcinoma and one case of squamous cell carcinoma of the renal pelvis, treated at the Jikei University Hospital during the six months period from January to June of 1979, were studied. The affected side was right in 3 cases and left in one case. In all of the former cases the tumor thrombus was extending from the renal vein to the inferior vena cava, while in the latter case it was confined in the renal vein. All these 4 cases received CT together with renal arteriography and inferior venacavography, followed by nephrectomy, and were confirmed of the presence of tumor thrombus in the renal vein and inferior vena cava operatively. CT findings revealed a pronounced enlargement of the renal vein, and tumor thrombus of the renal vein was diagnosed in all of the 4 cases. In 2 of 3 cases in which tumor thrombus extended to the inferior vena cava, the dilated renal vein was found to be connected to the slightly dilated inferior vena cava, while in the remaining one case the outline of the inferior vena cava was obscure, showing no clear dilatation. After contrast enhancement, a filling defect was seen in the inferior vena cava. CT findings of tumor thrombus in the vein indicated a dilatation of the renal vein and inferior vena cava. In the renal vein and inferior vena cava. In addition, a filling defect was found after contrast enhancement, suggesting that CT is helpful as a diagnostic aid. (author)

  17. 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

  18. A case report of superior vena cava obstruction.

    Science.gov (United States)

    Tepe, Sava?; Uluca, Yavuz; Timurkaynak, Timur

    2013-12-01

    We report herein an 83-year-old gentleman with lung cancer who presented with nausea, complete atrioventricular (AV) block and presyncope. Despite a present temporary pacemaker, which had been inserted through the femoral vein 5 days previously, the patient had asystole attacks that resolved with atropine administration. Coronary angiography demonstrated no critical stenosis. Sick sinus syndrome was diagnosed, and permanent pacemaker implantation was decided. However, the guidewire could not be advanced into the superior vena cava (SVC). Right jugular venogram showed complete obstruction of the SVC. Subsequent computerized tomography also revealed its obstruction by a large lung tumor. Special attention should be given to patients with benign or malignant SVC syndrome before permanent pacemaker implantation. PMID:24351947

  19. Catheter-induced thrombosis of the superior vena cava.

    Science.gov (United States)

    Venturini, Elio; Becuzzi, Lucia; Magni, Lucia

    2012-01-01

    There has been an increase in the use of central venous catheters (CVCs) in clinical practice. One of the most dangerous complications associated with their use is symptomatic or asymptomatic thrombosis (T), sometimes associated with superior vena cava (SVC) syndrome, resulting from impaired venous drainage. The right heart clots can induce an increased risk of mortality due the potential pulmonary embolism (PE). We report a case of asymptomatic 83-year-old woman in whom the thrombosis was detected after an echocardiogram. Echocardiography demonstrated a cardiac mass, and the T was confirmed by (magnetic resonance imaging) MRI. The clinical scenario, a high index of suspicion and routine use of echocardiogram in patients with CVC, can lead to a correct diagnosis, preventing dangerous complications. PMID:23198269

  20. Clinical Sequelae of Thrombus in an Inferior Vena Cava Filter

    International Nuclear Information System (INIS)

    The purpose of this study was to assess the long-term clinical sequelae of inferior vena cava (IVC) filter thrombus and the effect of anticoagulation on filter thrombus. Of 1,718 patients who had IVC filters placed during 2001-2008, 598 (34.8%) had follow-up abdominal CT. Filter thrombus was seen in 111 of the 598 (18.6%). There were 44 men (39.6%). The mean age at filter placement was 64 years. The medical diseases included cancer in 64, trauma in 15, stroke in 12, and others in 20. The frequency of filter thrombus on CT and asymptomatic filter thrombus on CT was calculated. The frequency of pulmonary embolism (PE) in patients with filter thrombus was calculated. The frequency of thrombus progression or regression (on CT, available in 56) was calculated. The effect of anticoagulation on filter thrombus regression/progression was evaluated using the Fisher exact test by comparing the group of patients who received anticoagulants versus those who did not. A P-value of <0.05 was considered significant. The overall frequency of filter thrombus was 18.6%. Total occlusion of the IVC filter was seen in 12 of 598 (2%). The filter thrombus was asymptomatic in 110 (18.3%). Filter thrombus was detected after a median of 35 days (range, 0-2082) following filter placement. Thrombus extended above the filter in 4 (3.6%); IVC thrombus below the filter was seen in 35(31.5%). Thrombus in the filter occluded <25% of the filter volume in 58 (52.3%), 25-50% in 21 (18.9%), and 50-75% in .3%), 25-50% in 21 (18.9%), and 50-75% in 20 (18%). Total IVC occlusion was seen in 12 (10.8%). Eighty-three patients received anticoagulation. Sixteen patients developed symptoms of PE. PE was confirmed on CT in 3 of 15 (2.7%). On follow-up, filter thrombus regressed completely in 19 (33.9%) after a median of 6 months. Filter thrombus decreased in size in 13 (23.2%) and it progressed without IVC occlusion in 7 (12.6%). In one (1.7%), filter thrombus progressed to IVC occlusion. Filter thrombus remained stable in 16 (28.6%). There was no significant difference in thrombus regression or progression rates whether or not the patients received anticoagulation for filter thrombus. In conclusion, asymptomatic thrombus in the filter is common and it rarely progresses to complete caval occlusion. Anticoagulation has little effect on the resolution of filter thrombosis and future occurrence of PE.

  1. Venous Thromboembolism After Removal of Retrievable Inferior Vena Cava Filters

    International Nuclear Information System (INIS)

    The purpose of this study was to examine the incidence of new or recurrent venous thromboembolism (VTE) after retrieval of inferior vena cava (IVC) filters and risk factors associated with such recurrence. Between March 2001 and September 2008, at our institution, implanted retrievable vena cava filters were retrieved in 76 patients. The incidence of new or recurrent VTE after retrieval was reviewed and numerous variables were analyzed to assess risk factors for redevelopment of VTE after filter retrieval. In 5 (6.6%) of the 76 patients, redevelopment or worsening of VTE was seen after retrieval of the filter. Three patients (4.0%) had recurrent deep venous thrombosis (DVT) in the lower extremities and 2 (2.6%) had development of pulmonary embolism, resulting in death. Although there was no significant difference in the incidence of new or recurrent VTE related to any risk factor investigated, a tendency for development of VTE after filter retrieval was higher in patients in whom DVT in the lower extremities had been so severe during filter implantation that interventional radiological therapies in addition to traditional anticoagulation therapies were required (40% in patients with recurrent VTE vs. 23% in those without VTE; p = 0.5866 according to Fisher's exact probability test) and in patients in whom DVT remained at the time of filter retrieval (60% in patients with recurrent VTE vs. 37% in those without VTE; p = 0.3637). In conclusion, new or recurrent VTE was r In conclusion, new or recurrent VTE was rare after retrieval of IVC filters but was most likely to occur in patients who had severe DVT during filter implantation and/or in patients with a DVT that remained at the time of filter retrieval. We must point out that the fatality rate from PE after filter removal was high (2.6%).

  2. Simon nitinol vena cava filters: effectiveness and complications

    International Nuclear Information System (INIS)

    Purpose: The aim of this retrospective analysis was to evaluate the clinical safety and effectiveness of the simon nitinol inferior vena cava filter (SNF) for prevention of pulmonary embolism. Patients and Methods: 117 patients (63 male, 54 female; aged 58.38 ± 14.59 years) underwent percutaneous implantation of an SNF from 1993 through 1999. Patient reports were retrospectively analysed for complications during and after implantation and deep venous thrombosis (DVT) and pulmonary embolism before and after implantation. Helical-CT with contrast media and plain abdominal radiography were performed on 35 patients, helical-CT alone on two patients. We checked the position and configuration of the SNF and looked for a perforation of the filter legs through the wall of the inferior vena cava (IVC). The IVC and deep pelvic veins were analysed for patency. Results: During implantation 10 of 117 (9%) patients had minor complications, major complications were reported in 0.9% (1/117). There was no significant increase in thrombosis of the deep pelvic veins and the IVC after implantation. Pulmonary re-embolism (PE) was documented in 9 out of 117 patients (7.7%). One out of the 35 examined patients (2.9%) showed a single strut fracture of the SNF. Tilting more than 15 was seen in 7 out of 37 patients (19%). Dislocation of the SNF more than 10 mm occurred in one out of 35 patients (2.9%), perforation through the wall of the IVC in all 37 patients. We found no occlusion of the IVpatients. We found no occlusion of the IVC. (orig.)

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

    Science.gov (United States)

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

    1996-07-01

    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

  4. Fractured Inferior Vena Cava Filter Strut Presenting with ST-Segment Elevation and Cardiac Tamponade.

    Science.gov (United States)

    Khurana, Dheeraj; Raza, Jaffar; Abrol, Sunil; Coplan, Neil L

    2015-04-01

    The fracture of an inferior vena cava filter strut and its migration to the heart is a rare sequela of implanted inferior vena cava filters. Perforation through the right ventricle into the pericardium with resultant cardiopulmonary compromise is even less frequent. We report the case of a 53-year-old man who presented with chest pain and hypotension consequent to cardiac tamponade. A fractured inferior vena cava filter strut had migrated and perforated his right ventricle. The fractured strut was successfully removed by means of cardiac surgery. Inferior vena cava filters should be placed when necessary to minimize the risk of pulmonary embolism, and regular radiologic monitoring should be performed; however, the eventual extraction of retrievable filters should be considered. In addition to discussing the patient's case, we briefly review the relevant medical literature. PMID:25873837

  5. Inferior vena cava aneurysm in an infant presenting with a renal mass.

    Science.gov (United States)

    Unzueta-Roch, José L; García-Abós, Miriam; Sirvent-Cerdá, Sara; de Prada, Inmaculada; Martínez de Azagra, Amelia; Ollero, Jose M; Madero-López, Luis

    2014-10-01

    Aneurysm of the inferior vena cava is a rare finding in the pediatric population. We report the case of a 5-month-old infant presenting with anemia, hypertension, and dehydration in the emergency room. A renal mass was found with ultrasound and MRI and a renal tumor was first considered. Histopathologic review of the surgical specimen led to the diagnosis of aneurysmal dilatation of the vena cava. PMID:24390451

  6. Radiological evidence of double inferior vena cava in a young adult male.

    OpenAIRE

    Oral Nevruz; Yalcin Kirici; Cenk Kilic; Ugur Bozlar; Ugur Ural

    2007-01-01

    ABSTRACT The development of the inferior vena cava IVC is a complex process comprising the formation and regression of some anastomoses, so various anomalies may occur during embryogenesis. These variations can increase the difficulty of aneurysm resection as well as the risk of venous injury and subsequent excessive bleeding during retroperitoneal and thoracic surgical interventions. Here, we report a patient with double inferior vena cava by radiographically during his investigation for ...

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

    Scientific Electronic Library Online (English)

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

    2010-09-01

    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 apr [...] esentou 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. Abstract in english 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.

  8. 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)

    Clovis Luis Konopka

    2010-09-01

    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.

  9. Leiomiossarcoma da veia cava inferior: relato de caso / Leiomyosarcoma of the inferior vena cava: a case report

    Scientific Electronic Library Online (English)

    Rafael Lemos, Nascif; Ana Graziela Santana, Antón; Gabriel Lacerda, Fernandes; George Caldas, Dantas; Vinícius de Araújo, Gomes; Marcelo Ricardo Canuto, Natal.

    2014-12-01

    Full Text Available Relatamos um caso de paciente do sexo feminino, 48 anos, com quadro clínico de dor abdominal de moderada intensidade e abaulamento do abdome. Ao exame físico constatou-se massa abdominal palpável. A tomografia computadorizada mostrou volumosa massa retroperitoneal, com realce heterogêneo e íntima re [...] lação com a veia cava inferior. Realizou-se ressecção em bloco da massa e do segmento invadido da veia cava. A histologia revelou leiomiossarcoma. Abstract in english The authors report a case of a 48 year-old female patient with moderate abdominal pain and bulging in the abdomen. Physical examination demonstrated the presence of a palpable abdominal mass. Computed tomography showed a heterogeneously enhancing retroperitoneal mass in close contact with the inferi [...] or vena cava. En bloc resection of the mass and of the attached vena cava segment was performed. Histological analysis revealed leiomyosarcoma.

  10. Filtros de vena cava inferior en posición suprarrenal / Suprarenal inferior vena cava filters. Retrospective review of 30 cases

    Scientific Electronic Library Online (English)

    Leopoldo, Mariné M; Renato, Mertens M; Albrecht, Krämer Sch; Francisco, Valdés E; Michel, Bergoeing R; Ivette, Arriagada J; Jeanette, Vergara G; Claudia, Carvajal N.

    2008-12-01

    Full Text Available [...] Abstract in english Background: Inferior vena cava (IVC) filters are used to prevent massive pulmonary embolism in cases where anticoagulation is contraindicated or has failed. It is usually implanted below the renal veins. In a few cases it is necessary to deploy the filter above them, with theoretical rísk of seconda [...] ry renal failure. Aim: To report the experience with filters located above the renal veins. Patients and Methods: Medical records of all patients with percutaneous suprarenal filters are reviewed. Results: Between May 1993 and May 2007, 361 percutaneous IVC filter procedures were performed. In thirty patients aged 19 to 77 years (average 48years, 50% males), they were placed in suprarenalposition (8,3%). Suprarenal IVC filters were implanted in patients with extensive caval thrombosis, renal vein thrombosis extending to cava, displacement of previous IVC filters and double IVC system. Jugular vein approach was the access of choice. Technical success was 100%, no death or pulmonary embolism occurred. Patients were followed from 1 to 165 months (average 57 months). Eight deaths were recorded, five in patients with cáncer No patient had renal failure on follow up (average creatinine 0.90+0,26 mg/dL). Three patients developed a new deep vein thrombosis (10%), without pulmonary embolism. Conclusions: In this retrospective analysis of patients, suprarenal placement of IVC filters was not associated to secondary renal failure, and showed good short and long term results.

  11. Stenting of the Superior Vena Cava and Left Brachiocephalic Vein with Preserving the Central Venous Catheter in Situ

    International Nuclear Information System (INIS)

    Stenting of the central veins is well established for treating localized venous stenosis. The techniques regarding catheter preservation for central venous catheters in the superior vena cava have been described. We describe here a method for stent implantation in the superior vena cava and the left brachiocephalic vein, and principally via a single jugular venous puncture, while saving a left sided jugular central venous catheter in a patient suffering from central venous stenosis of the superior vena cava and the left brachiocephalic vein.

  12. Stenting of the Superior Vena Cava and Left Brachiocephalic Vein with Preserving the Central Venous Catheter in Situ

    Energy Technology Data Exchange (ETDEWEB)

    Isfort, Peter; Penzkofer, Tobias; Goerg, Fabian; Mahnken, Andreas H. [University Hospital RWTH Aachen, Aachen(Korea, Republic of)

    2011-10-15

    Stenting of the central veins is well established for treating localized venous stenosis. The techniques regarding catheter preservation for central venous catheters in the superior vena cava have been described. We describe here a method for stent implantation in the superior vena cava and the left brachiocephalic vein, and principally via a single jugular venous puncture, while saving a left sided jugular central venous catheter in a patient suffering from central venous stenosis of the superior vena cava and the left brachiocephalic vein.

  13. A rare case of a complete left inferior vena cava associated with the symptoms of Dunbar syndrome.

    Science.gov (United States)

    Wartmann, Christopher T; Kinsella, Christopher R; Tubbs, R Shane; Loukas, Marios

    2011-03-01

    We report a case of an 82-year-old female with an anomalous left inferior vena cava. The left inferior vena cava ascends parallel and to the left of the descending abdominal aorta. At the level of the celiac trunk, the inferior vena cava courses anteriorly and to the right to reach the posterior surface of the liver. The patient also suffers from chronic mild postprandial abdominal pain. It is possible that position of inferior vena cava anterior to the aorta, at the level of the celiac trunk, may lead to intermittent celiac artery compression syndrome (Dunbar syndrome). PMID:21322050

  14. 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 impwas 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  16. Implante de un cardiodesfibrilador bicameral vía vena cava superior izquierda persistente / Implant of a Dual-chamber Implantable Cardioverter Defibrillator through a Persistent Left Superior Vena Cava

    Scientific Electronic Library Online (English)

    Atilio, Abud; Oscar, Didio; Adrián, Carlessi; Bruno, Strada; Daniel, Bagattin; Raúl, Goyeneche.

    2009-06-01

    Full Text Available La vena cava superior izquierda persistente (VCSIP) es la anomalía congénita venosa del tórax más frecuente. Se encuentra en el 0,3% de la población general y en el 5-10% de los pacientes con cardiopatías congénitas. Generalmente evoluciona en forma asintomática y no genera trastornos hemodinámicos, [...] pero su reconocimiento es importante, ya que puede dificultar la introducción de catéteres para mediciones hemodinámicas, los implantes de marcapasos cardíacos (MCP) y de cardiodesfibriladores automáticos implantables (CDAI), especialmente cuando se utiliza la vía cefálica o la subclavia izquierda. En el caso clínico que se presenta se efectuó el implante de un CDAI bicameral vía VCSIP, descubierta durante el procedimiento. Asimismo, se muestran las características de esta variedad anatómica mediante tomografía cardíaca computarizada de 64 cortes (TCC64). Abstract in english Persistent left superior vena cava (PLSVC) is the most common congenital defect in the thoracic venous system, with an incidence of 0.3% in the general population and of 5-10% in patients with congenital heart disease. This asymptomatic condition does not produce hemodynamic impairment; however, it [...] should be recognized as its presence poses technical challenges in the introduction of catheters for hemodynamic measurements and for placement of pacemakers (PMs) and implantable cardioverter defibrillators (ICD) via the cephalic vein or the left suclavian vein. In the present case report we describe the implantation of a dual-chamber ICD through a PLSVC discovered during the procedure. In addition, images from cardiac 64-row multidetector computed tomography (64-row CT) show the anatomic features of this variety.

  17. 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 impnsciousness of responsibility are most important.(authors)

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

    Scientific Electronic Library Online (English)

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

    2007-01-01

    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 e [...] n 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. Abstract in english 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.

  19. Inferior vena cava filters: What radiologists need to know

    International Nuclear Information System (INIS)

    Inferior vena cava (IVC) filters are a controversial mechanical adjunct in the prevention of pulmonary embolism, the most serious result of venous thromboembolism. Despite modern IVC filters being in clinical use for more than 45 years, there is still uncertainty amongst many radiologists about the indications for IVC filter placement and their removal, particularly the more recent prophylactic use in patients without confirmed deep vein thrombosis (DVT) or pulmonary embolism (PE). Recently published guidelines on filter use from the National Institute of Health and Clinical Excellence (NICE) and other professional bodies are discussed. The vast majority of IVC filters in the UK are inserted by interventional radiologists, so radiologists may be the first point of contact for information requested by other clinicians. The increasing use of filters means that radiologists will encounter filters increasingly often during abdominal cross-sectional imaging. Awareness of common filter-related complications, such as tilting, thrombosis, and caval perforation, is useful to reassure or alert other clinicians. The potential role of filters in upper extremity DVT and requirement for concomitant anticoagulation is discussed

  20. Mesoaortic entrapment of a left inferior vena cava

    Directory of Open Access Journals (Sweden)

    Gupta Ashish

    2010-01-01

    Full Text Available A persistent left inferior vena cava (IVC is a rare anomaly, with a reported incidence of only 0.2-0.5%. When present, it courses between the superior mesenteric artery and the aorta to continue as the right IVC, similar to the course of a left renal vein (LRV. This anomaly is usually asymptomatic, but there may be vague abdominal complaints if the IVC is compressed in the mesoaortic angle. Although symptomatic compression of the LRV (anterior nutcracker syndrome is well recognized, there has been only one report in the literature of a similar compression of a persistent left IVC. Because of its rarity, this anomaly may be missed or mistaken for other conditions on imaging. An accurate diagnosis is crucial as the presence of this anomaly may have implications for surgical treatment of aortic lesions or placement of an IVC filter. Magnetic resonance angiography and, more recently, multidetector computed tomography scan, can provide an exquisite three-dimensional demonstration of vascular abnormalities.

  1. 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

    Directory of Open Access Journals (Sweden)

    Adelmar Afonso de Amorim Júnior

    2002-01-01

    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.

  2. 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

    Scientific Electronic Library Online (English)

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

    2013-07-01

    Full Text Available 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 r [...] elevance of knowledge on mammographic signs of systemic diseases.

  3. Superior vena cava syndrome in a patient with previous cardiac surgery: what else should we suspect?

    Directory of Open Access Journals (Sweden)

    Dolou Paraskevi

    2010-06-01

    Full Text Available Abstract Background Although mediastinal tumors compressing or invading the superior vena cava represent the major causes of the superior vena cava syndrome, benign processes may also be involved in the pathogenesis of this medical emergency. One of the rarest benign causes is a pseudoaneurysm developing in patients previously having heart surgery. Case report We present the case of a large pseudoaneurysm of the ascending aorta, five years after primary surgery, with a significant compression of the right mediastinal venous system causing superior vena cava syndrome, detected at chest CT angiography. Perioperative findings showed two rush out points both coming from the distal aortic suture line which was performed five years ago. The patient underwent reoperation under circulatory arrest facilitating safe exploration and repair of the distal anastomotic leaks Conclusion Enhanced chest CT should be always undertaken in all patients with superior vena cava syndrome, especially in those previously having cardiac or aortic surgery to correctly evaluate the presence of a pseudoaneurysm. Mass effect to the superior vena cava makes necessary an open surgical treatment of the pseudoaneurysm so as to concurrently resolve the right mediastinal venous system's compression. Surgery should be performed in terms of safe approach to avoid exsanguination and cerebral malperfusion.

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

    International Nuclear Information System (INIS)

    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

  5. Temporary and permanent inferior vena cava filter combination in a young patient: to implant or not to implant?

    Science.gov (United States)

    Kutlu, Ramazan; Alkan, Alpay; Sigirci, Ahmet; Altinok, Tayfun; Yildirim, Zeki

    2003-01-01

    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. PMID:14753313

  6. Leiomyosarcoma of the superior vena cava: Resection with vascular reconstruction – case report and review of the literature

    OpenAIRE

    Katz, Michael G.; Dekel, Hagi; Elias, Sorin; Kravtsov, Vladimir; Didkovsky, Elena; Sasson, Lior

    2007-01-01

    The present report describes a case of pedunculated intraluminal leiomyosarcoma of the superior vena cava, extending to the right atrium, that was successfully resected surgically. Superior vena cava reconstruction was performed using bovine pericardial graft, saving the sinus node. The pathological variants of this neoplasm according to the anatomical site of the tumour are described.

  7. Extension of adrenal tumors into the vena cava: results of magnetic resonance angiography

    International Nuclear Information System (INIS)

    In rare cases, large adrenal masses with a suspicion of malignancy exhibit tumor extension into the adrenal vein and inferior vena cava. When planning surgery, the relationship of the extension to the inferior vena cava is of decisive improtance. We describe in two cases on the detection of a tumor thrombus in the inferior vena cava arising from a malignant adrenal mass by means of MR angiography (TOF, coronary 2D GRE images [FLASH], 3 slices acquired during 15 second apnea). The angiograms correlated well with the results of DSA venacavography and with the intraoperative findings. Thus, MRA has been demonstrated to be suitable for the certain proof of a venous tumor thrombus not only in cases of renal cell carcinomas but also in cases of malignant adrenal masses. The method should be applied whenever there is evidence of a venous involvement in the adrenal MR images. (orig.)

  8. Approach on implantation of inferior vena cava filters for deep vein thrombosis of lower limb

    International Nuclear Information System (INIS)

    Objective: To sum up the application experience of embolectomy thrombolytic therapy after implantation of inferior vena cava filters (IVCF) for deep vein thrombosis. Methods: Data of 14 cases confirmed deep vein thrombosis (DVT) of lower limb by deep vein venography was analyzed. After inferior vena cava filters implantation, transcatheter embolectomy or thrombolytic therapy was performed under the guidance of fluoroscopy. Results: Inferior vena cava filters implantation were succeeded in all cases. 12 cases with embolectomy or thrombolysis got excellent effects, and 2 cases got improved, Without pulmonary embolism (PTE) and serious bleeding. The symptoms of lower limb disappeared. Conclusion: Curative effect is notable for DVT after implantation of caval vein filter before embolectomy or thrombolysis. (authors)

  9. Evaluation of the superior vena cava system in children with digital subtraction angiography

    International Nuclear Information System (INIS)

    The authors report a new pediatric application of digital subtraction angiography (DSA) that is the evaluation of the superior vena cava system. 22 children have been explored. All of them had a history of previous central venous catheter placement for parenteral nutrition (13), hemodialysis (5), chemotherapy or antibiotic therapy (4). The aim of the examination was to obtain a venous mapping before a new catheter placement (14 cases) or to look for a venous thrombosis origin of superior vena cava syndrom or septicemia (8 cases). Except failure of two examinations because of absence of venous injection site, DSA showed thrombosis of one vein in 7 cases and of multiple veins in 11 cases. A pulmonary embolus was also discovered. The authors conclude that this non invasive method yields very valuable information on superior vena cava system

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

    International Nuclear Information System (INIS)

    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. (orig.)

  11. Retrievable Inferior Vena Cava Filters: Factors that Affect Retrieval Success

    International Nuclear Information System (INIS)

    Purpose: To report and analyze the indications, procedural success, and complications of retrievable inferior vena cava filters (rIVCF) placement and to identify parameters that influence retrieval attempt and failure. Methods: Between January 2005 and December 2010, a total of 200 patients (80 men, median age 67 years, range 11–95 years) received a rIVCF with the clinical possibility that it could be removed. All patients with rIVCF were prospectively entered into a database and followed until retrieval or a decision not to retrieve the filter was made. A retrospective analysis of this database was performed. Results: Sixty-one percent of patients had an accepted indication for filter placement; 39% of patients had a relative indication. There was a tendency toward a higher retrieval rate in patients with relative indications (40% vs. 55%, P = 0.076). Filter placement was technically successful in all patients, with no procedure-related mortality. The retrieval rate was 53%. Patient age of >80 years (odds ratio [OR] 0.056, P > 0.0001) and presence of malignancy (OR 0.303, P = 0.003) was associated with a significantly reduced probability for attempted retrieval. Retrieval failure occurred in 7% (6 of 91) of all retrieval attempts. A time interval of > 90 days between implantation and attempted retrieval was associated with retrieval failure (OR 19.8, P = 0.009). Conclusions: Patient age >80 years and a history of malignancy are predictors of a reduced probability fre predictors of a reduced probability for retrieval attempt. The rate of retrieval failure is low and seems to be associated with a time interval of >90 days between filter placement and retrieval.

  12. Adjunctive Inferior Vena Cava Filter Placement for Acute Pulmonary Embolism

    International Nuclear Information System (INIS)

    Inferior vena cava (IVC) filters are sometimes placed as an adjunct to full anticoagulation in patients with significant pulmonary embolism (PE). We aimed to determine the prevalence of adjunctive IVC filter placement in individuals diagnosed with PE, as well as the effect of adjunctive filter placement on mortality in patients with right heart strain associated with PE. This was a retrospective study of patients with acute PE treated with full anticoagulation admitted to a single academic medical center. Information abstracted from patient charts included presence or absence of right heart strain and of deep-vein thrombosis, and whether or not an IVC filter was placed. The endpoint was in-hospital mortality. Over 2.75 years, we found that 248 patients were diagnosed with acute PE, with an in-hospital mortality rate of 4.4%. The prevalence of adjunctive IVC filter placement was 13.3% (33 of 248), and the prevalence of documented right heart strain was 27.0% (67 of 248). In-hospital mortality was 10.2% in the non-filter-treated group (5 of 49), whereas there were no deaths in the filter-treated group (0 of 18); however, the difference was not statistically significant (P = 0.37). Both the presence of deep-vein thrombosis and of right heart strain increased the likelihood that an adjunctive IVC filter was placed (P < 0.0001 and P < 0.001, respectively). At our institution, patients were treated with IVC filters in addition to anticoagulation in 13.3% of cases of acute Pticoagulation in 13.3% of cases of acute PE. Prospective studies or large clinical registries should be conducted to clarify whether this practice improves outcomes.

  13. Left Retrocaval Ureter around the Ipsilateral Limb of a Double Caudal Vena Cava in a Cat.

    Science.gov (United States)

    Casteleyn, C; Cornillie, P; Van Cruchten, S; Van Ginneken, C

    2015-05-01

    Necropsy examination of an adult neutered male cat, which was humanely destroyed as it had feline immunodeficiency virus (FIV) infection, demonstrated the presence of a left retrocaval ureter that was entrapped around the left limb of a double caudal vena cava. These associated anomalies originate from the complex embryofetal development of the caudal vena cava. Since no clinical signs had been reported and no gross lesions related to this anomaly were observed, this manifestation should be simply considered as an anatomical variation. PMID:25798957

  14. Large adrenocortical carcinoma extending into the inferior vena cava and right atrium.

    Science.gov (United States)

    Hisham, A N; Sarojah, A; Zanariah, H

    2003-01-01

    A case of large adrenocortical carcinoma extending into the inferior vena cava and right atrium is reported. Computed tomography showed a large mass displacing the left kidney inferiorly with an intravascular tumour thrombus extending into the inferior vena cava and right atrium. Radical surgery under hypothermia and cardiopulmonary bypass was performed and the tumour mass, together with the tumour thrombus, was successfully removed. The presence of intravascular tumour extension alone should not be a contraindication to radical surgical therapy, as it is the best hope for prolonged survival. PMID:12527494

  15. Testicular tumors with tumor thrombosis within the inferior vena cava: Two case reports

    International Nuclear Information System (INIS)

    Testicular tumors are almost all malignant tumors and can develop in younger age groups. Testicular tumors are mostly curable, with reported cases of tumor thrombosis within the inferior vena cava being rare. Two patients, aged 35 years and 37 years old complaining of testicular pain and lower abdominal pain were diagnosed with testicular tumors by ultrasound. In addition, tumor thrombus of the inferior vena cava was diagnosed concomitantly at the time of the diagnosis by computed tomography and magnetic resonance imaging. Here, we report testicular tumors accompanied by tumor thrombus, which is an extremely rare finding, with limited reports available. Pathologic diagnoses were seminoma and mixed germ cell tumors, respectively

  16. 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

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

    International Nuclear Information System (INIS)

    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. (orig.)

  18. Inferior vena cava filter strut perforation discovered during right robotic-assisted laparoscopic partial nephrectomy.

    Science.gov (United States)

    Kappa, Stephen F; Morgan, Todd M; Keegan, Kirk A; Cookson, Michael S

    2012-04-01

    Inferior vena cava (IVC) filters are a relatively safe and effective treatment designed to prevent pulmonary emboli. Late complications of IVC filters include filter migration, tilting, strut fracture, strut perforation, and IVC thrombosis. We present a case of a 67-year-old male undergoing a right robotic-assisted laparoscopic partial nephrectomy whose IVC filter strut had perforated the vena caval wall. PMID:22014963

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-12-03

    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.

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

    Directory of Open Access Journals (Sweden)

    Marcos Filgueiras

    2008-08-01

    Full Text Available 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 management 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.

  1. 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)

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

    2008-08-01

    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 c [...] omplained 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 management 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.

  2. 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)

    M. Subirana Domènech

    2011-06-01

    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.

  3. Cranial vena cava syndrome secondary to cryptococcal mediastinal granuloma in a cat.

    Science.gov (United States)

    Letendre, Jo-Annie; Boysen, Søren

    2015-04-01

    The successful management of cranial vena cava syndrome with suspected secondary chylothorax due to mediastinal cryptococcal granuloma in a 4-year-old male domestic shorthair cat is described. Treatment included long-term antifungal medication, short-term corticosteroids, intermittent thoracocentesis, rutin, octreotide, and enalapril. PMID:25829555

  4. The clinical application of the implantation of retrievable filters in superior vena cava

    International Nuclear Information System (INIS)

    Objective: To investigate the safety of the placement of Tulip retrievable filter in superior vena cava and to discuss the prevention of pulmonary embolism (PE). Methods: Implantation of Tulip retrievable filter in superior vena cava was performed in ten patients (6 males and 4 females, aged 42-60 years) with acute or subacute deep venous thrombosis in upper extremity or cephalo-cervical region. After the placement of filter, the local via-catheter thrombolysis was conducted. The clinical results, such as the improvement of venous obstructed symptoms at upper extremity or cephalo-cervical region, were recorded. The filter's shape and location were checked. The possible occurrence of pulmonary embolism was observed. Results: The filter was successfully implanted in supper vena cava in all patients, and the deep venous thrombosis at upper extremity and cephalo-cervical region responded well to the local via-catheter thrombolysis. The filters showed no displacement or tilting. The swelling at upper extremity and cephalo-cervical region was markedly faded away. No symptomatic pulmonary embolism occurred. the filter was successfully retrieved via the femoral vein in four patients. Conclusion: Tulip filter can be safety implanted in superior vena cava and can be smoothly retrieved. The occurrence of pulmonary embolism can be effectively prevented if corresponding local via-catheter thrombolysis is carried out. (authors)

  5. Right lung upper lobe carcinoma radical excision plus superior vena cava angioplasty.

    Science.gov (United States)

    Peng, Gui-Lin; Yin, Wei-Qiang; Zhang, Xin; He, Jian-Xing

    2013-12-01

    An elderly male patient was found to be with "nodule in upper lobe of right lung" during his health examination, although without any symptom. Chest CT at admission showed that the nodules were close to the superior vena cava, and CT reconstruction displayed an adipose space between the nodules and the superior vena cava. However, bronchoscopy showed negative results. Pre-operative exploration showed that the right upper lung nodules were tightly attached to the surface of superior vena cava and could not be effectively divided; an invasion could not be ruled out. The surgery was performed in a distal-proximal manner. The pulmonary fissure, bronchi, and arteries were divided firstly, followed by veins and the surrounding tissues of the lung. After the surrounding spaces of the tumor were sufficiently disassociated, superior vena cava angioplasty was performed using a stapler. The surgery was performed completely under thoracoscopy, during which the surgical incision was not enlarged. The main operation port was about 4 cm in diameter. Two axillary operation ports (about 1.2 and 0.6 cm in diameter, respectively) were also used. All the surgical equipment were used smoothly, and thus the surgery was completed with lowest invasion. PMID:24409370

  6. [Translumbar cannulation of vena cava inferior as an alternative method of vascular access for hemodialysis].

    Science.gov (United States)

    Le?, Jaros?aw; Grzesiak, Joanna; ?abu?, Ma?gorzata; Kade, Grzegorz; Zelichowski, Grzegorz; Brzozowski, Krzysztof; Zukowski, Pawe?; Wa?kowicz, Zofia; Rybicki, Zbigniew

    2008-04-01

    The aim of our report is description of the first in Poland translumbar cannulation of vena cava inferior used as an alternative vascular access for hemodialysis in 62 years old patient without further access for hemodialysis and no access for peritoneal dialysis. PMID:18634367

  7. Treatment of pacemaker-induced superior vena cava syndrome by balloon angioplasty and stenting.

    LENUS (Irish Health Repository)

    Klop, B

    2011-01-01

    Superior vena cava (SVC) syndrome is a rare but serious complication after pacemaker implantation. This report describes three cases of SVC syndrome treated with venoplasty and venous stenting, with an average follow-up of 30.7 (±3.1)?months. These cases illustrate that the definitive diagnosis, and the extent and location of venous obstruction, can only be determined by venography.

  8. Superior vena cava syndrome caused by a pseudoaneurysm of the ascending aorta

    OpenAIRE

    Vydt, T.; Coddens, J.; Wellens, F.

    2005-01-01

    Pseudoaneurysm of the ascending aorta is a well known complication after aortic root surgery. A case of a large pseudoaneurysm is reported, seen as a superior vena cava syndrome, a very rare clinical presentation. Perioperative transoesophageal echocardiography showed the presence of a large pseudoaneurysm starting from the left coronary ostium implantation.

  9. Delayed Spontaneous Superior Vena Cava Perforation Associated with a SVC Wallstent

    International Nuclear Information System (INIS)

    A patient was referred for superior vena cava (SVC) stenting prior to surgical biopsy of a mediastinal mass. A technically satisfactory insertion was followed 6 months later by cardiac tamponade with two legs of the Wallstent having perforated the wall of the SVC

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

    International Nuclear Information System (INIS)

    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.)

  11. 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)

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

    2003-08-01

    Full Text Available 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 me [...] tastásica, en cuyo caso si parece justificada una actitud quirúrgica agresiva con finalidad curativa. Presentamos nuestra experiencia con 25 pacientes con carcinoma renal 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 approa [...] ch 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 thrombectomy. 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.

  12. 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)

    Jairo Cruz

    2007-12-01

    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.

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

    Scientific Electronic Library Online (English)

    Jairo, Cruz; César A, Restrepo V.

    2007-12-01

    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 derec [...] ha 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. Abstract in english 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.

  14. Three-Dimensional Rotational Angiography of the Inferior Vena Cava as an Adjunct to Inferior Vena Cava Filter Retrieval

    International Nuclear Information System (INIS)

    The objective of this study was to explore the role of three-dimensional (3-D) rotational angiography (RA) of the inferior vena cava (IVC; 3-D CV) before filter retrieval and its impact on treatment planning compared with standard anteroposterior cavography (sCV). Thirty patients underwent sCV and 3-D CV before IVC filter retrieval. Parameters assessed were: projection of filter arms or legs beyond the caval lumen, thrombus burden within the filter and IVC, and orientation of the filter within IVC. Skin and effective radiation doses were calculated. Statistical analysis was performed using paired Student t test and nonparametric McNemar's test. Standard anteroposterior cavography detected 49 filter arms or legs projecting beyond the caval lumen in 25 patients. Three-dimensional CV demonstrated 89 filter arms or legs projecting beyond the caval lumen in 28 patients. Twenty-two patients had additional filter arms or legs projecting beyond the caval lumen detected on 3-D CV that were not detected on sCV (p < 0.001). Filter apex tilt detection differed significantly (p < 0.001) between sCV and 3-D CV, with 3-D CV being more accurate. The filter apex abutted the IVC wall in 10 patients (33%) on 3-D CV, but this was diagnosed in only 3 patients (10%) with sCV. Thrombus was detected in 8 patients (27%), 1 thrombus of which was seen only on 3-D CV, and treatment was changed in this patient because of thrombus size. Mean effective radiation doses for 3-D CV were approximately ation doses for 3-D CV were approximately two times higher than for sCV (1.68 vs. 0.86 mSv), whereas skin doses were three times lower (12.87 vs. 35.86 mGy). Compared with sCV, performing 3-D CV before optional IVC filter retrieval has the potential to improve assessment of filter arms or legs projecting beyond the caval lumen, filter orientation, and thrombus burden.

  15. 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)

    Gustavo J. Ventura Couto

    2008-03-01

    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.

  16. Tomographic anatomy of the vena cava and renal veins: features relevant to vena cava filter placement / Anatomia tomográfica da veia cava e das veias renais: aspectos relevantes para implante de filtro de veia cava

    Scientific Electronic Library Online (English)

    Thiago Melo do, Espírito Santo; Fernando, Bacalhau; Adilson Ferraz, Paschôa; Bonno, van Bellen; Igor, Austin; Douglas, Raci.

    2015-03-01

    Full Text Available CONTEXTO: Há uma demanda crescente por procedimentos invasivos que abordam a veia cava inferior, especialmente o implante de filtros de veia cava. A identificação da veia renal mais caudal para a liberação segura do filtro nem sempre é fácil durante a cavografia. OBJETIVOS: Estabelecer parâmetros d [...] a relação das veias renais e da cava infrarrenal com o corpo vertebral correspondente, sua relação com a biotipologia, presença de variações anatômicas, relação dos corpos vertebrais com a bifurcação das veias ilíacas comuns para a veia cava e distância desta bifurcação até a desembocadura da veia renal mais caudal, visando à implantação de filtro de veia cava. MÉTODOS: Foram analisadas 150 tomografias computadorizadas de abdome no período entre outubro e novembro de 2011, tendo sido agrupadas de acordo com o biotipo apresentado (ângulo de Charpy). As tomografias forem realizadas na MEDIMAGEM e analisadas no Serviço de Cirurgia Vascular Integrada, ambas da Beneficência Portuguesa de São Paulo. RESULTADOS: Dos 150 exames analisados, 127 (84,66%) apresentaram a emergência da veia renal mais caudal desde a projeção do primeiro espaço intervertebral lombar (L1-L2) até o corpo de L2, independentemente do biotipo do paciente. Somente 23 pacientes (15,33%) apresentaram a desembocadura da veia renal mais caudal abaixo do corpo de L2, ou seja, na projeção do espaço entre L2 e L3. CONCLUSÕES: A correlação radiológica da confluência da veia renal mais distal em relação aos corpos vertebrais apresenta pouca variação, independentemente do biotipo do paciente. Abstract in english BACKGROUND: There is a growing demand for invasive procedures involving the inferior vena cava, in particular for placement of vena cava filters. It is not always easy to identify the more distal renal vein with cavography, for safe release of filters. OBJECTIVES: To determine parameters for the re [...] lationships between the renal veins and the infrarenal vena cava and their corresponding vertebral bodies, their relationships with biotype and the occurrence of anatomic variations, the relationships between vertebral bodies and the bifurcation of the common iliac veins and the distance from this bifurcation to the outflow of the more distal renal vein, with reference to placement of vena cava filters. METHODS: A total of 150 abdominal computed tomography scans conducted from October to November 2011 were analyzed and classified according to the biotype exhibited (using Charpy's angle). Scans were performed at MEDIMAGEM and analyzed at the Integrated Vascular Surgery Service, both part of Hospital da Beneficência Portuguesa in São Paulo, Brazil. RESULTS: In 127 of the 150 scans analyzed (84.66%), the more distal renal vein emerged between the first lumbar intervertebral space (L1-L2) and the body of L2, irrespective of patient biotype. Just 23 patients (15.33%) exhibited a more distal renal vein with outflow below the body of L2, i.e. in the projection of the space between L2 and L3. CONCLUSIONS: The radiological correlation between the confluence of the more distal renal vein and vertebral bodies exhibits little variation, irrespective of the biotype of the patient.

  17. 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

    Directory of Open Access Journals (Sweden)

    Ismael Vergara S

    2012-01-01

    Full Text Available 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.

  18. Atypical leiomyoma arising in a hepatic vein with extension into the inferior vena cava and right atrium

    International Nuclear Information System (INIS)

    We report an atypical leiomyoma arising in a hepatic vein and extending into the inferior vena cava and right atrium in a fourteen year old boy. US, CT and MRI facilitated diagnosis and removal of this tumor. (orig.)

  19. Adrenocortical carcinoma with extension into inferior vena cava and right atrium: Report of 3 cases in children

    International Nuclear Information System (INIS)

    We present three caases of adrenocortical carcinoma, a rare tumor in children, with extension into the inferior vena cava and the right atrium. The diagnosis is facilitated by use of ultrasonography, computed tomography and magnetic resonance imaging. (orig.)

  20. Anomalous connection of superior vena cava to the left atrium masquerading as epilepsy: A case report with review of literature

    OpenAIRE

    Singh Sandeep; Geelani Muhammed; Modi Pranav; Niwaria Yogesh; Shahi Sudhir; Banerjee Amit

    2008-01-01

    An 11-year-old girl who presented with recurrent epileptic fits was eventually found to have a superior vena cava draining into the left atrium. There was no atrial septal defect. The patient underwent a successful surgical correction.

  1. 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)

  2. In Vitro Evaluation of a Rheolytic Thrombectomy System for Clot Removal from Five Different Temporary Vena Cava Filters

    International Nuclear Information System (INIS)

    Purpose: To evaluate the feasibility of thrombus removal from temporary vena cava filters using a rheolytic thrombectomy device and to assess the embolization rate of this procedure. Methods: Five temporary vena cava filters together with porcine thrombi were placed in a vena cava flow model (semitranslucent silicone tube of 23 mm diameter, pulsatile flow at a mean flow rate of 4 L/min). A rheolytic thrombectomy system (Hydrolyser) was used with a 9 Fr guiding catheter to remove the clots. The effluent was passed through filters of different size and the amount of embolized particles as well as the remaining thrombus were measured. Results: Thrombus removal rates ranged from 85% to 100%. Embolization rates between 47% and 60% were calculated for the different filters. Conclusion: The Hydrolyser is able to remove sufficiently high amounts of thrombus from temporary vena cava filters. However, the amount of embolized particles makes it impossible to utilize this method without special precautions against embolization

  3. Thrombosis of the ileo-caval sector: puerperal thrombosis and agenesia thrombosis of the inferior vena cava

    International Nuclear Information System (INIS)

    The thrombosis of the inferior vena cava account for around the 15% of the cases of deep venous thrombosis. This is the case of a puerperal primigravida with a cesarean section labor presenting with a thrombosis initially in the right ovarian vein and then extension to the inferior vena cava. Treatment included low molecular weight heparin in anticoagulant doses; rest with elevation of the extremities and elastic bandage. After a satisfactory process evolution with partial lysis of the thrombus, the oral anticoagulation with Acenocumarol for 6 months was started. The second patient, a man aged 73 with backgrounds of an operated hepatic hydatidosis, had a thrombosis of the infrarenal inferior vena cava and agenesia of retrohepatic segment of the inferior vena cava. The patient remains with anticoagulant treatment including Acenocumarol, elastic bandage and hygienic care. As sequela he had a postphlebitic syndrome and reworsening of the edema leading to its admission in two occasions.(author)

  4. 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)

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

    2011-06-01

    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. 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 ven [...] a cava appeared as an incidental finding in a forensic autopsy.

  5. Superior Vena Cava Thrombosis and Paradoxical Embolic Stroke due to Collateral Drainage from the Brachiocephalic Vein to the Left Atrium

    OpenAIRE

    Nascimbene, Angelo; Angelini, Paolo

    2011-01-01

    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 syndr...

  6. Removal of a Guenther Tulip retrievable inferior vena cava filter after 147 days in a pediatric patient

    Energy Technology Data Exchange (ETDEWEB)

    Mody, Rekha N.; Stokes, LeAnn S.; Bream, Peter R.; Spottswood, Stephanie E. [Vanderbilt University Medical Center, Department of Radiology, Nashville, TN (United States)

    2006-05-15

    A Guenther Tulip retrievable inferior vena cava filter was placed in a 9-year-old boy with T-cell ALL who had both iliofemoral deep vein thrombosis (DVT) and acute intracranial hemorrhage. The filter was removed 147 days after placement, when the patient was no longer at increased risk for DVT or pulmonary embolus. Removal of the filter did not compromise flow through the vena cava. (orig.)

  7. Right renal vein elongation with the inferior vena cava for cadaveric kidney transplants: an old neglected surgical approach

    OpenAIRE

    Jose C. Baptista-Silva; Jose O. Medina-Pestana; Marcos J.M. Verissimo; Marcos J. Castro; Maris S. Demuner; Marcio F. Signorelli

    2005-01-01

    INTRODUCTION: Short right renal vein is a frequent and well-known technical inconvenience that is commonly observed during transplantation of the right kidney. We present our experience with the elongation of short cadaveric right renal veins using the contiguous vena cava during cadaveric renal transplants. METHODS: We performed 34 kidney transplantations with a short right renal vein requiring elongation using the inferior vena cava, to make the venous anastomosis technically feasible. The ...

  8. You see what you know … gas bubbles in the inferior vena cava, an unusual presentation of necrotizing soft tissue infection.

    Science.gov (United States)

    Winter, Thomas C; Rudolf, Lou; Sommers, Daniel N

    2015-06-01

    Gas detected within the systemic circulation as an unexpected finding is a very rare phenomenon. A case of multiple bubbles within the inferior vena cava detected incidentally during a sonogram requested to assess for portal vein thrombosis is presented. These were eventually determined to be sequelae of a fatal, clinically silent necrotizing soft tissue infection. The differential diagnosis for gas within the inferior vena cava is reviewed, and teaching points that may help future patients are presented. PMID:25364965

  9. Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Catherine; Trad, Clovis Simao [Central de Diagnostico Ribeirao Preto (CEDIRP), SP (Brazil); Trad, Henrique Simao, E-mail: hstrad@terra.com.br [Central de Diagnostico Ribeirao Preto (CEDIRP), SP (Brazil); Universidade de Sao Paulo (HC-FMRPUSP), Ribeirao Preto, SP (Brazil). Fac. de Medicina. Hospital das Clinicas; Mendonca, Silvana Machado [Clinica de Diagnostico por Imagem (CDPI), Rio de Janeiro, RJ (Brazil)

    2013-06-15

    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 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. (author)

  10. Dialysis catheter-related superior vena cava syndrome with patent vena cava: Long term efficacy of unilateral viatorr stent-graft avoiding catheter manipulation

    Energy Technology Data Exchange (ETDEWEB)

    Quaretti, Pietro; Galli, Franco; Maramarco, Lorenzo Paplo; Corti, Riccardo; Leati, Giovanni; Fiorina, Ilaria; Maestri, Marcello [IRCCS Policlinico San Matteo Foundation, Pavia (Italy)

    2014-06-15

    Central venous catheters are the most frequent causes of benign central vein stenosis. We report the case of a 79-year-old woman on hemodialysis through a twin catheter in the right internal jugular vein, presenting with superior vena cava (SVC) syndrome with patent SVC. The clinically driven endovascular therapy was conducted to treat the venous syndrome with a unilateral left brachiocephalic stent-graft without manipulation of the well-functioning catheter. The follow-up was uneventful until death 94 months later.

  11. Dialysis catheter-related superior vena cava syndrome with patent vena cava: Long term efficacy of unilateral viatorr stent-graft avoiding catheter manipulation

    International Nuclear Information System (INIS)

    Central venous catheters are the most frequent causes of benign central vein stenosis. We report the case of a 79-year-old woman on hemodialysis through a twin catheter in the right internal jugular vein, presenting with superior vena cava (SVC) syndrome with patent SVC. The clinically driven endovascular therapy was conducted to treat the venous syndrome with a unilateral left brachiocephalic stent-graft without manipulation of the well-functioning catheter. The follow-up was uneventful until death 94 months later.

  12. A conventional multimodality imaging cascade to detect a superior vena cava obstruction.

    Science.gov (United States)

    Grimaldi, Antonio; Cammalleri, Valeria; Maisano, Francesco; Ferrarello, Santo; Colombo, Antonio; Alfieri, Ottavio; La Canna, Giovanni

    2011-03-01

    Iatrogenic injuries of the superior vena cava (SVC) following surgical or endovascular treatments are rare but challenging complications and require prompt diagnosis and appropriate treatment. The additional diagnostic value of venography, contrast-enhanced computed tomography, and magnetic resonance imaging has been widely assessed in the clinical setting of the SVC obstruction, whereas the role of conventional transoesophageal echocardiography (TEE) is still uncertain. A 43-year-old female patient was admitted to the echocardiography laboratory because of a superior vena cava syndrome (SVCS) following a balloon SVC venoplasty with stent implantation. A standard transoesophageal echocardiography examination clearly detected the SVC obstruction on previously implanted stents. We found that fundamental steps of early diagnosis of SVCS would benefit from standard TEE. PMID:21186200

  13. [MR angiography of pelvic veins and the inferior vena cava using 0.5 tesla].

    Science.gov (United States)

    Haubold-Reuter, B; Nicolas, V

    1994-10-01

    The pelvic veins and/or the inferior vena cava were examined in 15 patients with pelvic vein thrombosis or retroperitoneal tumours, using phlebography or cavography and MR angiography. The latter was carried out using 0.5 Tesla with an inflow technique TR/TE 30/8 ms, flip angle 70 degrees). 3-D projection angiograms were obtained from the 2-D angiograms in the coronary plane. Image quality was generally satisfactory and the veins up to the internal iliac could be demonstrated in all cases; below this, the examination was unreliable. Comparison of the methods with reference to information of therapeutic relevance has shown that in two-thirds of all examinations (8/13) MR angiography and phlebography were of equal diagnostic value. In the presence of a renal cell carcinoma, MR angiography was unable to distinguish between thrombosis and infiltration of the vena cava. PMID:7948977

  14. Entrapment of Guide Wire in an Inferior Vena Cava Filter: A Technique for Removal

    Energy Technology Data Exchange (ETDEWEB)

    Abdel-Aal, Ahmed Kamel, E-mail: akamel@uabmc.edu; Saddekni, Souheil [University of Alabama at Birmingham, Department of Radiology (United States); Hamed, Maysoon Farouk [University of Alabama at Birmingham, Department of Anesthesia (United States); Fitzpatrick, Farley [Radiology Specialists of Louisville (United States)

    2013-04-15

    Entrapment of a central venous catheter (CVC) guide wire in an inferior vena cava (IVC) filter is a rare, but reported complication during CVC placement. With the increasing use of vena cava filters (VCFs), this number will most likely continue to grow. The consequences of this complication can be serious, as continued traction upon the guide wire may result in filter dislodgement and migration, filter fracture, or injury to the IVC. We describe a case in which a J-tipped guide wire introduced through a left subclavian access without fluoroscopic guidance during CVC placement was entrapped at the apex of an IVC filter. We describe a technique that we used successfully in removing the entrapped wire through the left subclavian access site. We also present simple useful recommendations to prevent this complication.

  15. Entrapment of Guide Wire in an Inferior Vena Cava Filter: A Technique for Removal

    International Nuclear Information System (INIS)

    Entrapment of a central venous catheter (CVC) guide wire in an inferior vena cava (IVC) filter is a rare, but reported complication during CVC placement. With the increasing use of vena cava filters (VCFs), this number will most likely continue to grow. The consequences of this complication can be serious, as continued traction upon the guide wire may result in filter dislodgement and migration, filter fracture, or injury to the IVC. We describe a case in which a J-tipped guide wire introduced through a left subclavian access without fluoroscopic guidance during CVC placement was entrapped at the apex of an IVC filter. We describe a technique that we used successfully in removing the entrapped wire through the left subclavian access site. We also present simple useful recommendations to prevent this complication.

  16. MR angiography of pelvic veins and of the inferior vena cava using 0,5 Tesla

    International Nuclear Information System (INIS)

    The pelvic veins and/or the inferior vena cava were examined in 15 patients with pelvic vein thrombosis or retroperitoneal tumours, using phlebography or cavography and MR angiography. The latter was carried out using 0.5 Tesla with an inflow technique (TR/TE 30/8 ms, flip angle 70 ). 3-D projection angiograms were obtained from the 2-D angiograms in the coronary plane. Image quality was generally satisfactory and the veins up to the internal iliacs could be demonstrated in all cases; below this, the examination was unreliable. Comparison of the methods with reference to information of therapeutic relevance has shown that in two-thirds of all examinations (8/13) MR angiography and phlebography were of equal diagnostic value. In the presence of a renal cell carcinoma, MR angiography was unable to distinguish between thrombosis and infiltration of the vena cava. (orig.)

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

    OpenAIRE

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

    2013-01-01

    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 thromb...

  18. Serial repositioning of a Guenther tulip retrievable inferior vena cava filter in a pediatric patient

    Energy Technology Data Exchange (ETDEWEB)

    Haider, Ehsan A.; Rosen, J. Choi; Torres, Carlos; Valenti, David A. [McGill University Health Center, Department of Radiology, Montreal, QC (Canada)

    2005-11-01

    We report an 11-year-old boy who required inferior vena cava (IVC) filtration for a prolonged period of time. A retrievable IVC filter was placed and repositioned three times, providing a total of 60 days of IVC filtration. The filter was removed when his risk of pulmonary embolus had decreased substantially. This is a relatively uncommon practice in the pediatric population. The technique is presented, and the available literature is reviewed. (orig.)

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

    Science.gov (United States)

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

    2013-04-26

    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. PMID:23675558

  20. Inferior vena cava filters in cancer patients: to filter or not to filter

    OpenAIRE

    Hikmat Abdel-Razeq; Asem Mansour; Yousef Ismael; et al.

    2011-01-01

    Hikmat Abdel-Razeq1, Asem Mansour2, Yousef Ismael1, Hazem Abdulelah11Department of Internal Medicine, 2Department of Radiology, King Hussein Cancer Center, Amman, JordanPurpose: Cancer and its treatment are recognized risk factors for venous thromboembolism (VTE); active cancer accounts for almost 20% of all newly diagnosed VTE. Inferior vena cava (IVC) filters are utilized to provide mechanical thromboprophylaxis to prevent pulmonary embolism (PE) or to avoid bleeding from systemic anticoagu...

  1. Placement of vena cava filter via percutaneous puncture of the great saphenous vein

    OpenAIRE

    JIN, YIQI; ZHOU, DAYONG; Chen, Lei; HUANG, XIANCHEN; Xu, Guoxiong; Huang,Jian; Shen, Liming

    2013-01-01

    The aim of this study was to investigate the feasibility and safety of vena cava filter (VCF) placement via percutaneous puncture of the great saphenous vein (GSV) in the prevention of pulmonary embolisms. Using ultrasound positioning, VCF placement via percutaneous puncture of the GSV was performed on 12 patients with deep vein thrombosis (DVT) in the lower extremities. Transcatheter thrombolysis was conducted simultaneously. The postoperative filter position, puncture wound recovery and flu...

  2. Nephron Sparing Surgery for Renal Angiomyolipoma with Inferior Vena Cava Thrombus in Tuberous Sclerosis

    OpenAIRE

    Adrien Riviere; Thomas Bessede; Jean-Jacques Patard

    2014-01-01

    Introduction. Angiomyolipoma is a common benign renal tumor. It is associated with Tuberous Sclerosis Complex (TSC) in 20% of patients. Angiomyolipomas are classically multiple, bilateral, and growing; they may lead to complications such as Wunderlich syndrome or, in rare cases, to venous extension. Observation. a 74-year-old woman with TSC presented with an angiomyolipoma of the right kidney with inferior vena cava (IVC) fatty thrombus. She underwent partial nephrectomy and thrombectomy. Aft...

  3. Aggressive renal angiomyolipoma extending into the renal vein and inferior vena cava — an uncommon entity

    OpenAIRE

    Bakshi, S. S.; Vishal, K.; Kalia, V.; Gill, J. S.

    2011-01-01

    Renal angiomyolipoma is recognised as a benign hamartomatous lesion with no obvious malignant potential. However, the tumour may show extrarenal/perinephric extension at times. Rarely, the lesion may extend into the renal vein and inferior vena cava (IVC) indicating aggressive behaviour. We present a case of an angiomyolipoma of the kidney with sonographic, CT and MRI evidence of extension into the renal vein and IVC.

  4. Association of Superior Vena Cava Syndrome with Sleep Apnea: Investigation Using an Impulse Oscillometry System

    OpenAIRE

    Masato Katagiri; Noriyuki Masuda; Masaru Kubota; Mayuko Wada; Hisashi Mitsufuji; Tsuyoshi Ichikawa; Naohito Ishii; Masanori Yokoba

    2012-01-01

    Superior vena cava syndrome (SVCS) patients sometimes show signs of obstructive sleep apnea (OSA). However, the mechanism causing hypoxia during sleep in SVCS patients is still uncertain. The aim of this study was to elucidate 1) the changes in central and peripheral respiratory resistance with SVCS, and 2) interpret the mechanism underlying the development of hypoxia during sleep in patients with SVCS related to OSA. Ten SVCS patients related to a neoplasm were recruited for this study. The ...

  5. Compensatory dilatation of the Azygos Venous system Secondary To Superior Vena Cava Occlusion

    OpenAIRE

    Paoletti, Francesco; Pellegrino, Valeria; Antonelli, Melissa; Ripani, Umberto; Mosca, Stefano; Duri?, Davide; Galzerano, Antonio

    2009-01-01

    Superior vena cava (SVC) occlusion can be clinically recognized in the acute setting when the stenosing process does not allow the development of collateral venous channels, which guarantee the venous drainage to the right heart. On the contrary, when the obstruction develops progressively, the diagnosis of SVC obstruction may remain undiagnosed. In the present case, the presence of SVC thrombosis was purely coincidental. In fact, the obstruction was first noticed on diagnostic tests performe...

  6. Vena cava bypass with stented polytetrafluoroethylene bifurcated grafts. A report of 2 cases.

    OpenAIRE

    Del Campo, C; Casey, M.T.

    1993-01-01

    Severe stenosis or occlusion of either the superior or the inferior vena cava requires surgical bypass grafting in a selected group of patients. When the obstruction extends into the major tributaries, a bifurcated graft becomes necessary. We present the cases of 2 surgically treated patients, each of whom received a stented polytetrafluoroethylene bifurcated graft constructed at the time of the operation. Symptoms disappeared post-operatively in 1 patient and abated in the other. Both grafts...

  7. An unusual clinical presentation resembling superior vena cava syndrome post heart surgery

    OpenAIRE

    Pellegrini Ronald; Kaczorowski David; López-Candales Angel

    2005-01-01

    Abstract Background An unusual sequence of post operative events heralded by hemodynamic deterioration followed by dyspnea and rapidly progressive dilatation of superficial neck and facial veins, resembling a superior vena cava syndrome, two days post surgical resection of filamentous aortic valve masses, closure of a patent foramen ovale, and performance of a modified Maze procedure for atrial fibrillation in a patient that presented with transient neurologic findings is presented. Case Pres...

  8. Lymphangiomatosis Involving the Inferior Vena Cava, Heart, Pulmonary Artery and Pelvic Cavity

    International Nuclear Information System (INIS)

    A 38-year-old woman who had undergone pelvic lymphangioma resection two months previously presented with cough and dyspnea. Transthoracic echocardiography and CT demonstrated the presence of a mixed cystic/solid component tumor involving the inferior vena cava, heart and pulmonary artery. Complete resection of the cardiac tumor was performed and lymphangioma was confirmed based on histopathologic examination. To the best of our knowledge, this is the first report of lymphangiomatosis with cardiac and pelvic involvement in the published clinical literature

  9. Lymphangiomatosis Involving the Inferior Vena Cava, Heart, Pulmonary Artery and Pelvic Cavity

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hun; Seo, Hye Sun; Seo, Jon; Kim, Hee Kyung; Her, Keun [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Suk, Eun Ha [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2010-02-15

    A 38-year-old woman who had undergone pelvic lymphangioma resection two months previously presented with cough and dyspnea. Transthoracic echocardiography and CT demonstrated the presence of a mixed cystic/solid component tumor involving the inferior vena cava, heart and pulmonary artery. Complete resection of the cardiac tumor was performed and lymphangioma was confirmed based on histopathologic examination. To the best of our knowledge, this is the first report of lymphangiomatosis with cardiac and pelvic involvement in the published clinical literature.

  10. Superior vena cava syndrome: A rare complication of percutaneous nephrolithotripsy laser lithotripsy

    OpenAIRE

    Qing Ji; Jianjun Yang; Hongbin Jia; Lidong Zhang

    2010-01-01

    Purpose: To describe a case of acute superior vena cava syndrome during percutaneous nephrolithotomy (PCNL), and to review the associated clinical features, management and complications. Clinical features: A 34-year-old man, diagnosed as right renal calculi and nodal tachycardia, was admitted to receive percutaneous nephroscope laser lithotripsy. Shortly after stone disintegration, he suffered acute hypoxic and hypotension, and showed cyanoderma of face and chest skin, ocular proptosis, ju...

  11. Superior vena cava syndrome due to metastasis from urothelial cancer: A case report and literature review

    OpenAIRE

    Wakeda, Hironobu; Hamasuna, Ryoichi; Asada, Yujiro; Kamoto, Toshiyuki

    2013-01-01

    Superior vena cava (SVC) syndrome is caused by compression or obstruction of the SVC. We report here in a case of SVC syndrome due to lymph node metastasis from urothelial cancer to the mediastinum and lung. The origin of metastasis was determined by computed tomography (CT)-guided biopsy of metastases. After radiotherapy to the mediastinum with glucocorticoid failed, anticancer pharmacotherapy including paclitaxel, gemicitabine, and cisplatin proved effective and SVC syndrome resolved. But p...

  12. Dilated coronary sinus in a dog with persistent left cranial vena cava

    International Nuclear Information System (INIS)

    This paper describes the electrocardiographic, echocardiographic (two-dimensional, M-mode, contrast and Doppler) and non-selective angiocardiographic features in a 3 year old female Beagle with dilated coronary sinus due to persistent left cranial vena cava. Negative P waves in leads III and aVR and a positive P wave in lead aVL were seen, Echocardiographically, a hipoechoic circular structure was seen between the left atrium and the pericardium in the area where the coronary sinus islocated, A velocity pattern with two peaks was obtained, one systolicwith velocity = 0.44 +/- 0.05 m/sec and the other diastolic with velocity = 0.27 +/- 0.01 m/sec, By M-mode echocardiography, at level of the aorta and the left atrium, a linear structure was identified betweenthe left atrium and the pericardium; this structure was characterizedby phasic movements of the anterior wall during the cardiac cycle, Following a left cephalic vein injection of saline, bubbles were seen within the coronary sinus; when saline was injected into the right cephalic vein, bubbles were also seen within the coronary sinus and right atrium and ventricle, Non-selective angiocardiography confirmed a dilated coronary sinus with persistent left cranial vena cava, The right cranial vena cava was absent, The dog was clinically normal and the unusual vessel was an incidental finding

  13. Interventional therapy of lower extremity deep vein thrombosis under protection of temporary vena cava filter

    International Nuclear Information System (INIS)

    Objective: To determine the usefulness and complication of interventional therapy of deep venous thrombosis (DVT) with local thrombolysis or a combination of mechanical thrombectomy and local thrombolysis under the protection of temporary vena cava filter, and to assess the efficacy of temporary vena cava filter. Methods: Thirty-two patients with DVT were treated with catheter-directed local thrombolysis (n=20) or a combination of hydrodynamic thrombectomy and local thrombolysis (n=12) after insertion of a temporary caval filter. 34 temporary caval filters were inserted and two cases received 2 filters. Results: Successful recanalization was achieved in 75% of patients. A complete lysis was achieved in 17 cases (53%), and thrombolysis of 50%-100% in 7 cases (22%). The mean durations for local thrombolysis alone were 61.7 hours and for the combination of thrombolysis with hydrodynamic thrombectomy were 30.3 hours. There was a statistically significant difference between the two methods (t=3.08, P<0.01). No clinical relevant pulmonary embolism occurred during the therapy procedure. Conclusion: A combination of mechanical thrombectomy and local thrombolysis with the use of temporary vena cava filter provides a more safe method in the therapy of DVT. The insertion of a temporary caval filter is promising in the reduction of pulmonary embolism

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

    Directory of Open Access Journals (Sweden)

    Wang Quan

    2012-06-01

    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.

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

    International Nuclear Information System (INIS)

    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)

  16. Catéter en vena cava superior para hemodiálisis entre los últimos recursos en hemitórax superior / Catheter in the superior vena cava for hemodialysis as a last resort in superior hemithorax

    Scientific Electronic Library Online (English)

    César Augusto, Restrepo Valencia; C.M., Buritica Barragán; A., Arango.

    Full Text Available Se presentan 4 pacientes con enfermedad renal crónica en terapia hemodialítica en quienes se habían agotado los accesos venosos clásicos (yugular interno, subclavio) y no clásicos (axilar e innominado) en el hemitórax superior para hemodiálisis, debido principalmente a trombosis de los mismos por ca [...] teterismos anteriores, y que no eran candidatos a diálisis peritoneal. En ellos, con la técnica recomendada por Archundia et al., se implantaron 4 catéteres permanentes directamente en la vena cava superior, con posterior tunelización subcutánea. Los catéteres funcionaron adecuadamente y están permeables actualmente después de un período de utilización promedio de 19 meses. Abstract in english We report four patients with chronic kidney disease undergoing haemodialysis therapy, which had exhausted conventional venous access (internal jugular, subclavian) and non-conventional access (axillary, innominate) in the upper hemithorax for haemodialysis. This was primarily due to thrombosis of th [...] ese veins caused by previous catheterisation. These patients did not qualify for peritoneal dialysis. Using the technique recommended by Archundia et al., 4 indwelling catheters were implanted directly in the superior vena cava in each of the patients with subsequent subcutaneous tunneling. The catheters operated correctly and are currently permeable after being used for an average of 19 months.

  17. Trombosis bilateral de venas renales e insuficiencia renal aguda secundaria a trombosis de un filtro en vena cava inferior / Bilateral renal vein thrombosis and acute renal failure due to inferior vena cava filter thrombosis. Report of one case

    Scientific Electronic Library Online (English)

    Jorge, Vega; Rienzi, Díaz.

    1473-14-01

    Full Text Available [...] Abstract in english Bilateral renal vein thrombosis is an unusual etiology of acute renal failure and usually is associated with nephrotic syndrome. We report a 77-year-old man, consulting in the emergency room for anuria that appeared 24 hours after a syncope. The patient was carrier of an inferior vena cava filter pr [...] ophylactically installed 17 months earlier and was not receiving anticoagulation. Serum creatinine on admission was 5.45 mg/dl and blood urea nitrogen was 54 mg/dl. Computed tomography and Doppler ultrasonography showed an extensive thrombosis of inferior vena cava and both renal veins. Heparin therapy was started with a rapid recovery of renal function and diuresis.

  18. Tratamento cirúrgico da conexão anômala parcial das veias pulmonares em veia cava superior / Surgical treatment of partial anomalous pulmonary venous connection to the superior vena cava

    Scientific Electronic Library Online (English)

    Marcelo Dagola, Paulista; Paulo Henrique Dagola, Paulista; Ana Luiza Paulista, Guerra; Paulo Paredes, Paulista.

    2009-06-01

    Full Text Available OBJETIVO: O tratamento cirúrgico da conexão anômala das veias pulmonares em veia cava superior, associada ao defeito septal atrial tipo seio venoso, é bem estabelecido e transcorre com baixa mortalidade e morbidade. Com a finalidade de diminuir a incidência de estenose ou oclusão da veia cava superi [...] or direita, especialmente quando associada à presença de veia cava superior esquerda, o apêndice atrial direito foi utilizado para ampliar a veia cava superior direita, após o desvio das veias pulmonares para o átrio esquerdo. MÉTODOS: No período entre junho de 1986 e setembro de 2008, foram operados 95 pacientes, consecutivos, portadores desta anomalia com drenagem em veia cava superior direita e porção alta do átrio direito. A idade variou de 6 meses a 68 anos e o sexo feminino predominou com 50 casos. RESULTADOS: No material apresentado, não ocorreu nenhum óbito na fase de pós-operatório imediato ou tardio. O ritmo cardíaco permaneceu sempre sinusal e não ocorreram complicações na evolução. CONCLUSÃO: O presente trabalho demonstra a aplicabilidade da técnica descrita, com resultados favoráveis em relação a mortalidade, distúrbios de ritmo e complicações na região da veia cava superior direita. Abstract in english OBJECTIVE: Surgical treatment of anomalous pulmonary venous connection to the superior vena cava, associated with sinus venous atrial septal defect, is well established and correlates with low mortality and morbidity. In order to reduce the incidence of stenosis or occlusion of the right superior ve [...] na cava, especially when associated with the presence of left superior vena cava, the right atrial appendage was used to enlarge the right superior vena cava, after the diversion of the anomalous pulmonary veins for the left atrium. METHODS: Between June 1986 and September 2008, 95 consecutive patients were operated with anomalous drainage in the superior right vena cava and high right atrium. Ages ranged from 6 months to 68 years and females predominated with 50 cases. RESULTS: There was no death in the immediate or late post operative care. The sinus cardiac rhythm was preserved in all cases and there was no complications in the late follow up. CONCLUSION: This paper demonstrates the applicability of the technique described, with favorable results on mortality, rhythm disturbances and complications in the right superior vena cava.

  19. Role of inferior vena cava filter implantation in preventing pulmonary embolism

    International Nuclear Information System (INIS)

    A retrospective review of all patients undergoing IVC filter implantation at Shifa International Hospital, Islamabad, from June 2004 to June 2006 was conducted to study the indications of inferior vena cava (IVC) filter use and impact on short-term morbidity/mortality. A total of 17 patients received IVC filters. Five patients were excluded due to data loss. One month clinical followup was available for 12 patients and 6 months follow-up was also available for 4 of 12 patients. The underlying disease was deep venous thrombosis (DVT) with pulmonary embolism (PE) in 6 (50%), DVT without PE in 4 (33.3%) and PE with negative duplex scan for DVT in 2 (16.6%) patients, respectively. Indications for IVC filter implantation were DVT and/or PE with contraindication to anticoagulation in 8 (66.7%) and DVT and/or PE with complications of anticoagulation in 4 (33.3%) patients. No procedure-related complications were noted in all 17 patients. Three patients (25%) died of non-PE related causes during the 1st month. There were no PE related mortalities at 6 months. This data set indicates that IVC filter implantation is a safe procedure with no short-term morbidity/mortality and potential long-term mortality benefit. (author)

  20. Implante de filtro em veia cava inferior dupla: relato de caso e revisão da literatura / Filter placement in duplicated inferior vena cava: case report and review of the literature

    Scientific Electronic Library Online (English)

    Rafael Demarchi, Malgor; Marcone Lima, Sobreira; Priscila Nunes, Boaventura; Regina, Moura; Winston Bonetti, Yoshida.

    2008-06-01

    Full Text Available Veia cava inferior dupla é uma variação anatômica rara cuja prevalência é de 0,2-3%. O implante de filtro de veia cava, quando indicado em casos com duplicidade da veia cava inferior, pode ser realizado de diferentes formas: em ambas as veias cavas; em uma delas, embolizando a anastomose entre ambas [...] ; em somente uma delas; ou por implante supra-renal. Relatamos um caso de trombose venosa profunda no pós-operatório de implante de prótese de quadril com contra-indicação para tratamento anticoagulante e cuja cavografia evidenciou duplicidade de veia cava inferior. O implante de filtro de veia cava inferior realizado em posição supra-renal mostrou-se opção adequada e segura. Abstract in english Double inferior vena cava is a rare anatomic variation with prevalence ranging between 0.2-3.0%. In cases of duplication, inferior vena cava filter placement options include placing it in both vena cava, coil-embolization of the intervenous segment plus placing a filter in the right inferior vena ca [...] va, or suprarenal filter placement. We report a case of deep venous thrombosis after unilateral primary total hip replacement, presenting with contraindications for anticoagulant therapy, in which cavography showed inferior vena cava duplication. Inferior vena cava filter placement was performed in the supra-renal portion and was proved to be an adequate and safe procedure.

  1. Renal carcinoma infiltrating inferior vena cava and combined valvular heart disease - one-stage uro-cardiological procedure: a case report

    OpenAIRE

    Zapala Lukasz; Biederman Andrzej; Poletajew Slawomir; Antoniewicz Artur A; Borowka Andrzej

    2010-01-01

    Abstract Standard treatment of patients with coexisting cardiac and non-cardiac diseases includes two separate operations. We report a case of 55-year-old man with combined valvular heart disease and renal carcinoma infiltrating inferior caval vein, who underwent one-stage cardio-urologic procedure. In the first step, mitral and tricuspid valvuloplasty were performed by cardiac surgeons. Then, urologists performed radical nephrectomy and thrombectomy. The postoperative course was uneventful. ...

  2. Trombosis del sector ilio-cava: trombosis puerperal y trombosis en agenesia de la cava inferior / Thrombosis of the ileo-caval sector: puerperal thrombosis and agenesia thrombosis of the inferior vena cava

    Scientific Electronic Library Online (English)

    Jorge, García Egea; Isabel, Lara Guerrero; José Miguel, Fustero Aznar; Vicente, Hermoso Cuenca; Abel, Vélez Lomana.

    2011-03-01

    Full Text Available La trombosis de la vena cava inferior supone alrededor del 15 % del total de los casos de trombosis venosa profunda. Se presenta un caso de una puérpera primigesta con parto por cesárea que presentó una trombosis con inicio en la vena ovárica derecha y extensión hasta la cava inferior. Fue tratada c [...] on heparina de bajo peso molecular en dosis anticoagulantes, reposo con extremidades elevadas y elastocompresión. Tras la evolución satisfactoria del proceso, con lisis parcial del trombo, se comenzó anticoagulación oral con acenocumarol durante 6 meses. El segundo paciente, un varón de 73 años, con antecedentes de hidatidosis hepática intervenida, presentó una trombosis de la cava inferior infrarrenal y agenesia del segmento retrohepático de la cava inferior. El enfermo sigue con tratamiento anticoagulante con acenocumarol, elastocompresión y cuidados higiénicos. Como secuela presentó un síndrome posflebítico con episodios de úlceras flebostásicas y reagudizaciones del edema, que han obligado a su hospitalización en dos ocasiones. Abstract in english The thrombosis of the inferior vena cava account for around the 15% of the cases of deep venous thrombosis. This is the case of a puerperal primigravida with a cesarean section labor presenting with a thrombosis initially in the right ovarian vein and then extension to the inferior vena cava. Treatm [...] ent included low molecular weight heparin in anticoagulant doses; rest with elevation of the extremities and elastic bandage. After a satisfactory process evolution with partial lysis of the thrombus, the oral anticoagulation with Acenocumarol for 6 months was started. The second patient, a man aged 73 with backgrounds of an operated hepatic hydatidosis, had a thrombosis of the infrarenal inferior vena cava and agenesia of retrohepatic segment of the inferior vena cava. The patient remains with anticoagulant treatment including Acenocumarol, elastic bandage and hygienic care. As sequela he had a postphlebitic syndrome and reworsening of the edema leading to its admission in two occasions.

  3. 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)

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

    2005-09-01

    Full Text Available 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 imposibilita 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 ar [...] e used forthetransvenous approach to enter the central venous circulation; the left subclavian vein has become a common access site for electrode implantation and, occasionally, 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 pacemaker, the patient is

  4. 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)

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

    2011-08-01

    Full Text Available 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 anterior, 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 l [...] ast 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 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.

  5. 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)

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

    2012-01-01

    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 failu [...] re 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.

  6. 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

    Directory of Open Access Journals (Sweden)

    Katsuro Harada Júnior

    2012-09-01

    Full Text Available 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 masculino após ferimento penetrante no tórax, resultando em pseudoaneurisma de arco aórtico e a síndrome da veia cava superior.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.

  7. 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)

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

    2012-09-01

    Full Text Available 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 me [...] diastinais 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 masculino 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 lymphoma [...] s 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.

  8. Long-term results of the Simon nitinol inferior vena cava filter

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the clinical efficacy, mechanical stability, and safety of the Simon nitinol inferior vena cava filter (SNF). The SNF was inserted in 114 consecutive patients at two institutions for prophylaxis of pulmonary embolism (PE). Clinical follow-up data were obtained retrospectively on all patients, and 38 patients underwent a dedicated radiologic follow-up protocol consisting of abdominal radiography, Doppler sonography, and CT. There was no immediate complication following filter insertion. Fifty patients died, on average, 5.6 (1-23) months after filter insertion, and 64 patients were alive, on average, 27 (3-62) months after filter insertion. Recurrent pulmonary embolism was documented in 5 patients (4.4 %) but originated distal to the filter in 1 patient. Deep venous thrombosis (DVT) was documented in 5.3 %, thrombosis at the access site in 3.5 %, and thrombosis of the inferior vena cava in 3.5 %. The rate of thromboembolic complications was similar in patients who did receive long-term anticoagulation and in those who did not. Radiologic follow-up showed no filter migration after, on average, 32 (5-62) months. A CT examination showed that struts of the SNF had penetrated the vena cava in 95 %, and were in contact with adjacent organs in 76 %; however, there were no clinical symptoms attributable to the filter. Filters were in an eccentric position in 63 % and partial filter disruption was found in 16 %; however, this did not affect und in 16 %; however, this did not affect filter function. The rate of recurrent pulmonary embolism after insertion of the SNF is 2.4 % per patient per year. Regardless of long-term anticoagulation, the rate of caval thrombosis is acceptably low. Except for occasional access-site thrombosis, no other filter-related morbidity was observed. (orig.)

  9. Ruptured Angiomyolipoma with Fatty Tumor Thrombus of the Renal Vein and Inferior Vena Cava

    Directory of Open Access Journals (Sweden)

    Ching-Hwa Yang

    2006-08-01

    Full Text Available Renal angiomyolipoma is a benign clonal neoplasm that consists of three constituents,namely, blood vessels, adipose tissue and smooth muscle. Although renal angiomyolipomahas a benign nature and grows slowly, extrarenal occurrences have been reported in the hilarlymph nodes, retroperitoneum, liver, colon and direct extension to the renal vein and inferiorvena cava as a tumor thrombus. Such a tumor thrombus is not an uncommon preoperativefinding in renal cell carcinoma but is a rare presentation in renal angiomyolipoma. We presenta case and review the literature, noting that tumor thrombus occur in sizable angiomyolipoma(> 4 cm, right kidneys and, predominantly, in females. The potentially lethal natureof a vena cava thrombus prompted radical surgery.

  10. Ecocardiografia transesofágica e diagnóstico intraoperatório de veia cava superior esquerda persistente / Transesophageal echocardiography and intraoperative diagnosis of persistent left superior vena cava / Ecocardiografía transesofágica y diagnóstico intraoperatorio de vena cava superior izquierda persistente

    Scientific Electronic Library Online (English)

    Alexander Alves da, Silva; Enis Donizetti, Silva; Arthur Vitor Rosenti, Segurado; Pedro Paulo, Kimachi; Claudia Marquez, Simões.

    2009-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A persistência da veia cava superior esquerda ocorre isoladamente em 0,5% da população normal, porém nos pacientes com cardiopatia congênita chega a estar presente em 3% a 10% dos casos. O objetivo deste relato foi apresentar um caso de diagnóstico intraoperatório com o au [...] xílio da ecocardiografia transesofágica e ressaltar a importância da sua utilização rotineira em intervenções cirúrgicas para correção de cardiopatia congênita. RELATO DO CASO: Paciente do sexo masculino, 16 anos, ASA II, com diagnóstico prévio de comunicação interatrial (CIA) tipo seio venoso superior com drenagem anômala parcial de veias pulmonares em programação para correção cirúrgica da cardiopatia. Após indução da anestesia geral foi realizado ecocardiograma transesofágico (ETE). O exame inicial mostrou dilatação das câmaras cardíacas direitas, CIA tipo seio venoso superior de 17 milímetros, drenagem anômala da veia pulmonar superior direita desembocando na veia cava superior (VCS) direita e dilatação do seio coronário, o que aventou a possibilidade da persistência da veia cava superior esquerda. Para a confirmação da suspeita foram injetados no acesso venoso do braço esquerdo 10 mL de solução fisiológica a 0,9% (faz o papel de "contraste" no exame ecocardiográfico) e imediatamente após foram visualizadas as microbolhas passando pelo seio coronário, teste positivo para o diagnóstico de VCS superior esquerda persistente. CONCLUSÕES: A ecocardiografia transesofágica rotineira no intraoperatório de pacientes com cardiopatia congênita tem fundamental importância como método auxiliar não só ao cirurgião, muitas vezes influenciando diretamente na técnica cirúrgica empregada, como também para o anestesiologista, que pode extrair do exame uma série de informações úteis no manuseio hemodinâmico do paciente. Abstract in spanish JUSTIFICATIVA Y OBJETIVOS: La persistencia de la vena cava superior izquierda ocurre de forma aislada en 0,5% de la población normal, sin embargo, en los pacientes con cardiopatía congénita llega a estar presente de un 3% a un 10% de los casos. El objetivo de este relato, fue presentar un caso de di [...] agnóstico intraoperatorio con la ayuda de la ecocardiografía transesofágica y resaltar la importancia de su utilización de rutina en intervenciones quirúrgicas para la corrección de cardiopatía congénita. RELATO DEL CASO: Paciente del sexo masculino, 16 años, ASA II, con diagnóstico previo de comunicación interatrial (CIA), tipo seno venoso superior, con drenaje anómalo parcial de venas pulmonares, programado para la corrección quirúrgica de la cardiopatía. Después de la inducción de la anestesia general, se realizó el ecocardiograma transesofágico (ETE). El examen inicial mostró lo siguiente: dilatación de las cámaras cardiacas derechas, CIA tipo seno venoso superior de 17 milímetros, drenaje anómalo de la vena pulmonar superior derecha desembocando en la vena cava superior (VCS) derecha, y dilatación del seno coronario, vislumbrándose así la posibilidad de la persistencia de la vena cava superior izquierda. Para la confirmación de la sospecha, se inyectaron en el acceso venoso del brazo izquierdo, 10 mL de solución fisiológica a 0,9% (haciendo el papel de "contraste" en el examen ecocardiográfico), e inmediatamente después, se visualizaron las micro burbujas pasando por el seno coronario, test positivo para el diagnóstico de VCS superior izquierda persistente. CONCLUSIONES: La ecocardiografía transesofágica de rutina en el intraoperatorio de pacientes con cardiopatía congénita, tiene una fundamental importancia como método auxiliar no solo para el cirujano, que muchas veces está influenciando directamente la técnica quirúrgica usada, sino también para el anestesiólogo, que puede extraer del examen una serie de informaciones útiles en el manejo hemodinámico del paciente. Abstract in english BACKGROUND AND OBJECTIVES: Isolated persistent left superior vena cava has

  11. Ecocardiografia transesofágica e diagnóstico intraoperatório de veia cava superior esquerda persistente Ecocardiografía transesofágica y diagnóstico intraoperatorio de vena cava superior izquierda persistente Transesophageal echocardiography and intraoperative diagnosis of persistent left superior vena cava

    Directory of Open Access Journals (Sweden)

    Alexander Alves da Silva

    2009-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A persistência da veia cava superior esquerda ocorre isoladamente em 0,5% da população normal, porém nos pacientes com cardiopatia congênita chega a estar presente em 3% a 10% dos casos. O objetivo deste relato foi apresentar um caso de diagnóstico intraoperatório com o auxílio da ecocardiografia transesofágica e ressaltar a importância da sua utilização rotineira em intervenções cirúrgicas para correção de cardiopatia congênita. RELATO DO CASO: Paciente do sexo masculino, 16 anos, ASA II, com diagnóstico prévio de comunicação interatrial (CIA tipo seio venoso superior com drenagem anômala parcial de veias pulmonares em programação para correção cirúrgica da cardiopatia. Após indução da anestesia geral foi realizado ecocardiograma transesofágico (ETE. O exame inicial mostrou dilatação das câmaras cardíacas direitas, CIA tipo seio venoso superior de 17 milímetros, drenagem anômala da veia pulmonar superior direita desembocando na veia cava superior (VCS direita e dilatação do seio coronário, o que aventou a possibilidade da persistência da veia cava superior esquerda. Para a confirmação da suspeita foram injetados no acesso venoso do braço esquerdo 10 mL de solução fisiológica a 0,9% (faz o papel de "contraste" no exame ecocardiográfico e imediatamente após foram visualizadas as microbolhas passando pelo seio coronário, teste positivo para o diagnóstico de VCS superior esquerda persistente. CONCLUSÕES: A ecocardiografia transesofágica rotineira no intraoperatório de pacientes com cardiopatia congênita tem fundamental importância como método auxiliar não só ao cirurgião, muitas vezes influenciando diretamente na técnica cirúrgica empregada, como também para o anestesiologista, que pode extrair do exame uma série de informações úteis no manuseio hemodinâmico do paciente.JUSTIFICATIVA Y OBJETIVOS: La persistencia de la vena cava superior izquierda ocurre de forma aislada en 0,5% de la población normal, sin embargo, en los pacientes con cardiopatía congénita llega a estar presente de un 3% a un 10% de los casos. El objetivo de este relato, fue presentar un caso de diagnóstico intraoperatorio con la ayuda de la ecocardiografía transesofágica y resaltar la importancia de su utilización de rutina en intervenciones quirúrgicas para la corrección de cardiopatía congénita. RELATO DEL CASO: Paciente del sexo masculino, 16 años, ASA II, con diagnóstico previo de comunicación interatrial (CIA, tipo seno venoso superior, con drenaje anómalo parcial de venas pulmonares, programado para la corrección quirúrgica de la cardiopatía. Después de la inducción de la anestesia general, se realizó el ecocardiograma transesofágico (ETE. El examen inicial mostró lo siguiente: dilatación de las cámaras cardiacas derechas, CIA tipo seno venoso superior de 17 milímetros, drenaje anómalo de la vena pulmonar superior derecha desembocando en la vena cava superior (VCS derecha, y dilatación del seno coronario, vislumbrándose así la posibilidad de la persistencia de la vena cava superior izquierda. Para la confirmación de la sospecha, se inyectaron en el acceso venoso del brazo izquierdo, 10 mL de solución fisiológica a 0,9% (haciendo el papel de "contraste" en el examen ecocardiográfico, e inmediatamente después, se visualizaron las micro burbujas pasando por el seno coronario, test positivo para el diagnóstico de VCS superior izquierda persistente. CONCLUSIONES: La ecocardiografía transesofágica de rutina en el intraoperatorio de pacientes con cardiopatía congénita, tiene una fundamental importancia como método auxiliar no solo para el cirujano, que muchas veces está influenciando directamente la técnica quirúrgica usada, sino también para el anestesiólogo, que puede extraer del examen una serie de informaciones útiles en el manejo hemodinámico del paciente.BACKGROUND AND OBJECTIVES: Isolated persistent left superior vena cava has an incidence of 0.5% in the normal population, but in patients

  12. 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 contever, 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.

  13. Cement embolus trapped in the inferior vena cava filter during percutaneous vertebroplasty

    International Nuclear Information System (INIS)

    A 58-year-old female patient, diagnosed with adenocarcinoma of the lung, underwent percutaneous vertebroplasty at the L4 vertebral body due to painful spinal metastases. Because of deep venous thrombosis of the left femoral and iliac veins, an inferior vena cava filter had been placed before vertebroplasty. Bone cement migrated into the venous bloodstream and then was being trapped within the previously placed filter. This case illustrates that caval filter could capture the bone cement and prevent it from migrating to the pulmonary circulation.

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

    DEFF Research Database (Denmark)

    Pelta, A.M.; Jorgensen, M.

    2008-01-01

    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

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

    DEFF Research Database (Denmark)

    Pelta, A.M.; JØrgensen, Maja

    2008-01-01

    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

  16. Cement embolus trapped in the inferior vena cava filter during percutaneous vertebroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Li, Zhi; Ni, Rui Fang; Zhao, Xin; Yang, Chao; Li, Ming Ming [First Affiliated Hospital of Soochow University, Suzhou (China)

    2013-06-15

    A 58-year-old female patient, diagnosed with adenocarcinoma of the lung, underwent percutaneous vertebroplasty at the L4 vertebral body due to painful spinal metastases. Because of deep venous thrombosis of the left femoral and iliac veins, an inferior vena cava filter had been placed before vertebroplasty. Bone cement migrated into the venous bloodstream and then was being trapped within the previously placed filter. This case illustrates that caval filter could capture the bone cement and prevent it from migrating to the pulmonary circulation.

  17. Life-threatening Cerebral Edema Caused by Acute Occlusion of a Superior Vena Cava Stent

    International Nuclear Information System (INIS)

    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.

  18. Radiotherapy in patients with vena cava superior compression due to lung cancer

    International Nuclear Information System (INIS)

    Radiotherapy is carried out in 51 patients presenting vena cava superior compression due to lung cancer by two methods: telegammatherapy and deep X-ray therapy with a lead lattice. In 19 patients cyclophosphamide is injected 24 hours before irradiation. Insofar as prompt control of the compression phenomena is mandatory, it is recommended to undertake radiotherapy immediately after diagnosing. The choice of treatment method depends on the patient's general condition, age and histological pattern of the neoplastic process. Following improvement of the condition, resorting to chemo- or immunotherapy should be by all means considered. 9 refs. (orig.)

  19. Treatment of pulmonary embolism and prevention of recurrence by placement of vena cava filters in prevention of deep venous thrombosis: Case report

    Directory of Open Access Journals (Sweden)

    Vu?i?evi?-Trobok Jadranka

    2002-01-01

    Full Text Available Introduction In patients with pulmonary thromboembolism it is clinical to suspect the disease, establish the diagnosis and initiate anticoagulation treatment as early as possible in order to prevent relapses, which may be fatal. Deep venous thrombosis of lower extremities is the most common site of origin, which initially may remain obscure. Case report Two weeks prior to admission the patient had right-sided chest pain accompanied with dyspnea, interpreted and treated as pleuropneumonia. Pulmonary thromboembolism was suspected due to clinical symptoms, chest X-ray, elevated enzyme levels findings, blood gas analysis with hypoxemia and ECG with right heart overload. The diagnosis of pulmonary thromboembolism confirmed by lung scintigraphy presented with perfusion defects. After twenty days of heparin therapy, the patient developed left leg edema. Ultrasound screening confirmed bilateral iliac-femoral popliteal vein thrombosis of iliacofemoropopliteal veins bilaterally. Phlebography performed via jugular vein disclosed thrombotic material in the right common iliac vein, as well as in the vena cava inferior. In the course of the procedure vena cava filter has been placed. Discussion Although the patient was receiving anticoagulation heparin therapy, he developed pulmonary thromboembolism relapse and deep venous thrombosis. In our patient, vena cava filter placement was aimed at preventing pulmonary thromboembolism relapse. Since a deficit of S protein was also established, the patient is unfortunately likely to develop thrombosis at other sites as well. Conclusion In our patient pulmonary thromboembolism was a consequence of deep venous thrombosis, and the diagnosis was established by ultrasound screening of the lower extremities and confirmed by phlebography. During phlebography vena cava filter was placed in order to prevent pulmonary thromboembolism.

  20. Persistencia de la vena cava superior izquierda: Diagnóstico e importancia prenatal Persistency of the left superior caval vein: Diagnosis and its prenatal importance

    Directory of Open Access Journals (Sweden)

    Juan F Jaramillo

    2010-04-01

    Full Text Available Durante un ultrasonido obstétrico de rutina se deben realizar ciertos planos del corazón en los cuales no es complejo identificar un grupo de anomalías como la persistencia de la vena cava superior izquierda. Cuando se identifica una vena cava superior izquierda aislada, sin otras anomalías del corazón fetal, no existe ninguna repercusión perinatal. Su importancia radica en que un grupo considerable de estos casos se acompaña de cardiopatías congénitas y anomalías anatómicas y cromosómicas. En este artículo se describen nueve casos de vena cava superior izquierda persistente, al igual que las anomalías del corazón asociadas, como también las alteraciones extracardiacas encontradas.Certain heart fetal planes must be realized during a routine obstetric ultrasound in order to identify a group of anomalies such as the persistency of the left superior caval vein. When an isolated left superior venal vein is identified without any other anomaly of the fetal heart, it does not have any perinatal repercussion. Its importance lies in the fact that a considerable number of these cases are associated with a high incidence of congenital heart diseases and anatomic and chromosomal abnormalities. This article reports nine cases of persistency of the left superior caval vein as well as the associated heart abnormalities and the extra-cardiac alterations found.

  1. Further characterization of the 5-HT receptor mediating vascular relaxation and elevation of cyclic AMP in porcine isolated vena cava.

    OpenAIRE

    Sumner, M. J.; Feniuk, W.; Humphrey, P. P.

    1989-01-01

    1. 5-Hydroxytryptamine (5-HT) and 5-carboxamidotryptamine (5-CT) produce both smooth muscle relaxation and elevation of tissue adenosine 3':5'-cyclic monophosphate (cyclic AMP) levels in isolated rings of neonatal porcine vena cava. We now present studies attempting to characterize in more detail the 5-HT receptor mediating these responses. 2. Both 5-HT and 5-CT relaxed porcine isolated vena cava rings (EC50 values 200 nM and 4 nM respectively) and elevated tissue cyclic AMP levels (EC50 valu...

  2. Spinal uptake mimicking metastasis in SPECT/CT bone scan in a patient with superior vena cava obstruction.

    Science.gov (United States)

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

    2013-11-01

    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

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

    Science.gov (United States)

    Mega, Simona; Patti, Giuseppe; Carminati, Mario; Sedati, Pietro; D'Ambrosio, Andrea; Di Sciascio, Germano

    2015-01-01

    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. PMID:24048023

  4. 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 ncomplications after filter placement are not frequent. (authors)

  5. Inferior vena cava filters in cancer patients: to filter or not to filter

    Directory of Open Access Journals (Sweden)

    Hikmat Abdel-Razeq

    2011-03-01

    Full Text Available Hikmat Abdel-Razeq1, Asem Mansour2, Yousef Ismael1, Hazem Abdulelah11Department of Internal Medicine, 2Department of Radiology, King Hussein Cancer Center, Amman, JordanPurpose: Cancer and its treatment are recognized risk factors for venous thromboembolism (VTE; active cancer accounts for almost 20% of all newly diagnosed VTE. Inferior vena cava (IVC filters are utilized to provide mechanical thromboprophylaxis to prevent pulmonary embolism (PE or to avoid bleeding from systemic anticoagulation in high-risk situations. In this report, and utilizing a case study, we will address the appropriate utilization of such filters in cancer patients.Methods: The case of a 43-year-old female patient with rectal cancer, who developed deep vein thrombosis following a complicated medical course, will be presented. The patient was anticoagulated with a low molecular weight heparin, but a few months later and following an episode of bleeding, an IVC filter was planned. Using the PubMed database, articles published in English language addressing issues related to IVC filters in cancer patients were accessed and will be presented.Results: Many recent studies questioned the need to insert IVC filters in advanced-stage cancer patients, particularly those whose anticipated survival is short and prevention of PE may be of little clinical benefit and could be a poor utilization of resources.Conclusion: Systemic anticoagulation can be safely offered for the majority of cancer patients. When the risk of bleeding or pulmonary embolism is high, IVC filters can be utilized. However, placement of such filters should take into consideration the stage of disease and life expectancy of such patients.Keywords: anticoagulation, bleeding, chemotherapy

  6. Behçet Hastal??? Ve Vena Kava Superior Sendromu

    OpenAIRE

    DANACI,, M.; Akpolat, T.; S?ahan, C.; Yu?cel, I?; Turanli, A. Y.; I?ncesu, L.

    2010-01-01

    Behcet's Disease and Vena Cava Superior Syndrome Vascular lesions are common in Behcet's disease. A patient with Behcet's disease and vena cava superior syndrome is presented. Magnetic resonance imaging findings of the patient are discussed. Behçet hastal???nda vasküler lezyonlar s?kür. Behçet hastal??? ve vena kava superior sendromu olan bir hasta sunulmu?tur. Bu hastadaki manyetik rezonans görüntüleme bulgular? tart???lm??t?r.

  7. Mayer-rokitansky-kuster-hauser syndrome associated with severe inferior vena cava stenosis.

    Science.gov (United States)

    Londra, Laura; Tobler, Kyle; Wu, John; Kolp, Lisa

    2014-01-01

    Precis. The postoperative course of a neovagina creation procedure in a young woman with Meyer-Rokitansky-Kuster-Hauser syndrome was complicated, despite prophylaxis, by extensive pelvic deep venous thrombosis secondary to unsuspected severe inferior vena cava stenosis. Background. Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is characterized by congenital vaginal agenesis and an absent or rudimentary uterus in genotypical females. Malformations of the inferior vena cava (IVC) are not commonly associated with MRKH syndrome. We report a case of a patient with MRKH syndrome with severe IVC stenosis that was diagnosed when the patient presented with extensive pelvic deep venous thrombosis (DVT) during the postoperative course of a neovagina creation. Case. A 19-year-old female underwent a McIndoe procedure. Despite DVT prophylaxis, extensive pelvic DVT of the femoral vein was diagnosed on postoperative day 7. Therapeutic anticoagulation was initiated, and pharmacological and mechanical thrombolysis were performed. During these procedures, a hypoplastic IVC was noted. Conclusion. MRKH syndrome can be associated with IVC malformations, which constitute an anatomical risk factor for postoperative DVT. PMID:25136466

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

    Directory of Open Access Journals (Sweden)

    Filipovi? Aleksandar

    2006-01-01

    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.

  9. The clinical implications of variants of vena cava inferior and aorta on retroperitoneal surgery

    Directory of Open Access Journals (Sweden)

    S. V. Mukhtarulina

    2014-12-01

    Full Text Available Objective: to study variants of retroperitoneal vascular structure and its clinical implications on retroperitoneal surgery in patients with cervical cancer IA–IIB stage.Materials and methods. 101 patients who underwent paraaortic and bilateral pelvic lymphadenectomy were included in this study. 10 patients of the first group with anomalies of inferior vena cava, renal arteries and veins, common iliac vein and ovarian vessels were compared with 91 patients of the second group without anomalies.Results. Variants of major retroperitoneal vascular structure were present in 10 (9.9 % patients. Supernumerary renal arteries and veins observed in 5 (4.9 % patients; retroaortic left renal vein type I and II – in 3 (3.0 % patients. Double vena cava inferior detected in 1 (1.0 % patient. Patients with variants of retroperitoneal vascular structures hadn’t vessel injury. There was no difference in intraoperative hemorrhage, transfusion red blood cell, rate of intraoperative hemoglobin and removed paraaortic lymph nodes between the groups. Risk factors for intraoperative bleeding in patients with cervical cancer, depending on the presence or absence of anomalies of retroperitoneal vessels had no significant difference.Conclusion. Despite the fact that the variants of retroperitoneal vascular structures are rare (9.9 %, the success of retroperitoneal surgery is associated with the knowledge of vascular variations which decrease serious, life-threatening complications.

  10. 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)

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

    2005-10-01

    Full Text Available 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 interrupç [...] ão de veia cava inferior com filtros intraluminais definitivos. Foram estudados aspectos referentes à indicação do procedimento, à técnica de implante dos dispositivos, 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 und [...] erwent 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 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.

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

    Directory of Open Access Journals (Sweden)

    Antonio Eduardo Zerati

    2005-10-01

    Full Text Available 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 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.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 dispositivos, 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.

  12. 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)

    Renan Roque Onzi

    2007-06-01

    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.

  13. Right renal vein elongation with the inferior vena cava for cadaveric kidney transplants: an old neglected surgical approach

    Scientific Electronic Library Online (English)

    Jose C., Baptista-Silva; Jose O., Medina-Pestana; Marcos J.M., Verissimo; Marcos J., Castro; Maris S., Demuner; Marcio F., Signorelli.

    2005-12-01

    Full Text Available INTRODUCTION: Short right renal vein is a frequent and well-known technical inconvenience that is commonly observed during transplantation of the right kidney. We present our experience with the elongation of short cadaveric right renal veins using the contiguous vena cava during cadaveric renal tra [...] nsplants. METHODS: We performed 34 kidney transplantations with a short right renal vein requiring elongation using the inferior vena cava, to make the venous anastomosis technically feasible. The elongated right renal vein was anastomosed end to side to the external iliac vein in 24 patients, to the common iliac vein in 8 patients and to the inferior vena cava in 2 patients. The right renal artery with an aortic patch was implanted end to side in 33 patients, and end to end without aortic patch to the internal iliac artery in one patient. RESULTS: In all cases, the vascular anastomoses were easily performed in the recipient and no thrombosis was observed. CONCLUSION: Elongation of a short right renal vein with the inferior vena cava is a feasible mean to overcome technical problems that may compromise the results of cadaveric renal transplantation.

  14. Right renal vein elongation with the inferior vena cava for cadaveric kidney transplants: an old neglected surgical approach

    Directory of Open Access Journals (Sweden)

    Jose C. Baptista-Silva

    2005-12-01

    Full Text Available INTRODUCTION: Short right renal vein is a frequent and well-known technical inconvenience that is commonly observed during transplantation of the right kidney. We present our experience with the elongation of short cadaveric right renal veins using the contiguous vena cava during cadaveric renal transplants. METHODS: We performed 34 kidney transplantations with a short right renal vein requiring elongation using the inferior vena cava, to make the venous anastomosis technically feasible. The elongated right renal vein was anastomosed end to side to the external iliac vein in 24 patients, to the common iliac vein in 8 patients and to the inferior vena cava in 2 patients. The right renal artery with an aortic patch was implanted end to side in 33 patients, and end to end without aortic patch to the internal iliac artery in one patient. RESULTS: In all cases, the vascular anastomoses were easily performed in the recipient and no thrombosis was observed. CONCLUSION: Elongation of a short right renal vein with the inferior vena cava is a feasible mean to overcome technical problems that may compromise the results of cadaveric renal transplantation.

  15. Echocardiographic detection of left circumflex coronary artery to left superior vena cava fistula by use of Doppler color flow mapping.

    Science.gov (United States)

    Marcus, B; Sivazlian, K; Gordon, L S

    1991-01-01

    We report the two-dimensional and Doppler color flow mapping echocardiographic findings in a neonate with left circumflex coronary arteriovenous fistula to a left superior vena cava. Doppler color flow mapping, in concert with detailed imaging, was essential to identify this rare fistula and to prepare for therapeutic intervention at initial cardiac catheterization. PMID:1910840

  16. Use of noncontrast computed tomography of the inferior vena cava for real-time imaging guidance for the placement of inferior vena cava filters.

    Science.gov (United States)

    Winkler, Michael A; Majmudar, Palak M; Landwehr, Kevin P; Hobbs, Stephen B; Saha, Sibu P

    2015-03-01

    Appropriate placement of an inferior vena cava (IVC) filter necessitates imaging of the renal veins because when an IVC filter is deployed its tip should be at or below the inferior aspect of the inferiormost renal vein. Traditionally, imaging during placement of IVC filters has been with conventional cavography and fluoroscopy. Recently, intravascular ultrasound has been used for the same purpose but with additional expense. Morbidly obese patients often exceed the weight limit of fluoroscopy tables. In addition, short obese patients are at risk of falling from narrow fluoroscopy tables. For such patients, computed tomography (CT) guidance is a viable alternative to conventional fluoroscopic guidance. IVC placement was performed in the CT suite for two obese patients who exceeded the weight limits of the available fluoroscopy tables. In one case, a Vena-Tech filter (Braun Medical, Melsungen, Germany) was placed using CT fluoroscopy. In the second case, a Recovery (Bard, Murray Hill, NJ) filter was placed using intermittent limited z-axis scanning. In the first case, the filter was placed below the level of the renal veins and above the confluence of the iliac veins, which is acceptable placement. In the second case, with refinement of technique, the filter tip was placed less than 1 cm below the inferiormost renal vein, which is considered optimal placement. CT of the IVC precisely images the renal veins and can characterize their number and their confluence with the IVC. CT guidance is a viable alternative to fluoroscopic guidance for the placement of IVC filters in morbidly obese patients. PMID:25780332

  17. 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)

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

    Full Text Available 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 Div [...] isão 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. 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 staf [...] f 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 December 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.

  18. 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

    Directory of Open Access Journals (Sweden)

    Luiz Guilherme Cintra Vidal Reys

    2012-01-01

    Full Text Available 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. 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".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 December 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.

  19. Implanted central venous catheter-related acute superior vena cava syndrome: management by metallic stent and endovascular repositioning of the catheter tip

    International Nuclear Information System (INIS)

    We describe a case of a 49-year-old woman with stage-IIIB lung adenocarcinoma who experienced an acute superior vena cava syndrome related to an implanted central venous catheter without associated venous thrombosis. The catheter was surgically implanted for chemotherapy. Superior vena cava syndrome appeared after the procedure and was due to insertion of the catheter through a subclinical stenosis of the superior vena cava. Complete resolution of the patient's symptoms was obtained using stent placement and endovascular repositioning of the catheter tip. (orig.)

  20. Long-term success of endovascular treatment of benign superior vena cava occlusion with chylothorax and chylopericardium

    International Nuclear Information System (INIS)

    The most likely etiology of benign obstruction of the superior vena cava (SVC) include fibrosing mediastinitis and iatrogenic etiologies such as sclerosis and obstruction caused by pacemakers and central venous catheter. Percutaneous stenting of SVC has been used with success both in malignant and benign superior vena cava syndrome; however, long-term follow-up of endovascular procedures is not well known. We present a case of a patient with complete occlusion of SVC of benign etiology, presenting dramatically with bilateral chylothorax and chylopericardium with cardiac tamponade, who underwent successful vena caval revascularization with thrombolytic therapy and placement of self-expanding metallic stent. The 42-month follow-up could encourage endovascular procedures even in SVC syndrome of benign etiology. (orig.)

  1. La saturación venosa de oxigeno en la vena cava superior versus arteria pulmonar en pacientes pediátricos / The oxygen venous saturation in the superior vena cava versus the pulmonary artery in children

    Scientific Electronic Library Online (English)

    Junior M., Lima Aguiar; Antolín, Romero Suárez; Abel, Facenda Mederos; Néstor, Sánchez Nogueira.

    2010-12-01

    Full Text Available Introducción: La monitorización continua de la saturación venosa de oxígeno alerta precozmente sobre serios disturbios en el balance de oxígeno y facilitan las intervenciones terapéuticas oportunas. Objetivo: Identificar la relación entre la saturación de oxígeno de la sangre extraída de la vena cav [...] a superior y la de la arteria pulmonar. Método: Se incluyeron en un estudio prospectivo, analítico, descriptivo y observacional 72 pacientes pediátricos, programados para cirugía cardiaca electiva previo consentimiento informado y aprobación del Comité de Ética. Posterior a la inducción de la anestesia general se introdujo un catéter en la vena cava superior. Al finalizar la corrección quirúrgica se determinaron las saturaciones venosas de oxigeno de la vena cava superior y por punción directa de la arteria pulmonar. Los datos fueron procesados estadísticamente y se determinaron las medias y las desviaciones estándar de ambas muestras. Se aplicó la prueba t de Student. Se consideró que existía diferencia o asociación significativa si la probabilidad asociada al test era menor que 0,05 (p0.05). Conclusiones: La monitorización continua de la saturación venosa de oxigeno en la vena cava superior se correlaciona con la de la arteria pulmonar en esta serie. Abstract in english The continuous monitoring of the oxygen venous saturation is an early alert on serious disorders in oxygen balance and allows timely therapeutical interventions. Objective: To identify the relation between oxygen saturation of the blood extracted from the superior vena cava and from the pulmonary ar [...] tery. Method: An observational, descriptive, analytical and prospective study was conducted in 72 children, programmed for elective cardiac surgery and the written informed consent and the approval of Ethics Committee. After induction of general anesthesia a catheter was passed into the superior vena cava. At the end of surgical correction of the oxygen venous saturations in the above vein were determined and by direct puncture of the pulmonary artery. Data were statistically processed determining the means and the standard deviations (SD) of both samples. The Student t test was applied. Authors considered the existence of a difference or association if the associated likelihood to test was lower than 0,05 (p 0.05). Conclusions: The continuous monitoring of the oxygen venous saturation in the superior vena cava is correlated with that of the pulmonary artery in this series.

  2. Optease Vena Cava Filter Optimal Indwelling Time and Retrievability

    International Nuclear Information System (INIS)

    The purpose of this study was to assess the indwelling time and retrievability of the Optease IVC filter. Between 2002 and 2009, a total of 811 Optease filters were inserted: 382 for prophylaxis in multitrauma patients and 429 for patients with venous thromboembolic (VTE) disease. In 139 patients [97 men and 42 women; mean age, 36 (range, 17–82) years], filter retrieval was attempted. They were divided into two groups to compare change in retrieval policy during the years: group A, 60 patients with filter retrievals performed before December 31 2006; and group B, 79 patients with filter retrievals from January 2007 to October 2009. A total of 128 filters were successfully removed (57 in group A, and 71 in group B). The mean filter indwelling time in the study group was 25 (range, 3–122) days. In group A the mean indwelling time was 18 (range, 7–55) days and in group B 31 days (range, 8–122). There were 11 retrieval failures: 4 for inability to engage the filter hook and 7 for inability to sheathe the filter due to intimal overgrowth. The mean indwelling time of group A retrieval failures was 16 (range, 15–18) days and in group B 54 (range, 17–122) days. Mean fluoroscopy time for successful retrieval was 3.5 (range, 1–16.6) min and for retrieval failures 25.2 (range, 7.2–62) min. Attempts to retrieve the Optease filter can be performed up to 60 days, but more failures will be encountered with this approach.

  3. Aggressive renal angiomyolipoma with vena cava extension: A case report and literature review.

    Science.gov (United States)

    Shen, Gang; Mao, Qiqi; Yang, Hanjin; Wang, Chaojun

    2014-11-01

    Renal angiomyolipoma (AML) is the most common type of benign mesenchymal tumor of the kidney. AMLs typically present as benign lesions without local invasion. However, the tumor may exhibit aggressive behavior. Intravascular extension into the inferior vena cava (IVC) and hemorrhagic aneurysm formation associated with AML has rarely been reported in the past. In the current study, the novel case of a 77-year-old female is described who presented with a tumor thrombus extending to the IVC. The patient subsequently underwent a radical nephrectomy and an IVC tumor thrombectomy. In addition, the available literature regarding this unusual complication of a common renal neoplasm has been reviewed. It is essential for radiologists and clinicians to be aware that AMLs may exhibit these types of aggressive behaviors. PMID:25295081

  4. Acute wiiitis representing as thrombosis of the inferior vena cava and left pelvic veins.

    Science.gov (United States)

    Brodmann, M; Gary, T; Hafner, F; Eller, P; Deutschmann, H; Pilger, E; Seinost, G

    2015-08-01

    Deep venous thrombosis as a result of venous wall injury provoked by trauma is a common finding. It often occurs in patients with sportive overstraining, caused by over fatigue of the body structures. In 2007, the entity of "acute wiiitis" was first described in a letter to the New England Journal of Medicine. Acute wiiitis sums up all affections, mainly skeletal and muscle affections, provoked by playing Nintendo Wii, a very common and loved video-game system. Deep venous thrombosis as a consequence of Nintendo Wii has not been described so far. We present a patient with a massive free floating thrombus of the left pelvic veins originating from the gluteal veins and reaching into the inferior vena cava after playing Nintendo Wii. PMID:24681523

  5. Superior vena cava syndrome after pulsatile bidirectional Glenn shunt procedure: Perioperative implications

    Directory of Open Access Journals (Sweden)

    Neema Praveen

    2009-01-01

    Full Text Available Bidirectional superior cavopulmonary shunt (bidirectional Glenn shunt is generally performed in many congenital cardiac anomalies where complete two ventricle circulations cannot be easily achieved. The advantages of BDG shunt are achieved by partially separating the pulmonary and systemic venous circuits, and include reduced ventricular preload and long-term preservation of myocardium. The benefits of additional pulsatile pulmonary blood flow include the potential growth of pulmonary arteries, possible improvement in arterial oxygen saturation, and possible prevention of development of pulmonary arteriovenous malformations. However, increase in the systemic venous pressure after BDG with additional pulsatile blood flow is known. We describe the peri-operative implications of severe flow reversal in the superior vena cava after pulsatile BDG shunt construction in a child who presented for surgical interruption of the main pulmonary artery.

  6. Renal Failure Secondary to Thrombotic Complications of Suprarenal Inferior Vena Cava Filter in Cancer Patients

    International Nuclear Information System (INIS)

    Purpose: To evaluate renal function before and after suprarenal inferior vena cava (IVC) filter placement.Methods: We describe, in a personal series of 13 consecutive cases (all of them stage IV cancer patients, one LGM filter, one Antheor filter, 11 Greenfield filters) in our institution, two cases of fatal renal vein thrombosis after placement of a suprarenal filter. Evaluation of renal function was based on serum urea (in mmol/L; normal 3.30-6.60), serum creatinine (in ?mol/L; normal <115.1), and calculation of serum creatinine clearance. Results and conclusion: This study suggests that in advanced-stage cancer patients who have a single functional kidney, renal functional insufficiency, or previous renal vein thrombosis, IVC filter placement above the renal veins may not be appropriate. Suprarenal filter placement should be performed only after analysis of predicted survival, after detailed discussions with the patient, and most importantly after renal function evaluation

  7. Brachytherapy for the prevention of neointimal hyperplasia in the canine inferior vena cava after stent placement

    Energy Technology Data Exchange (ETDEWEB)

    Isota, Masayuki; Kaminou, Toshio; Sakai, Yukimasa; Nakamura, Kenji; Yamada, Ryusaku [Osaka City Univ. (Japan). Medical School

    2002-06-01

    The aim of this study was to evaluate the efficacy of brachytherapy for preventing neointimal hyperplasia in the inferior vena cava (IVC) after stent placement. Sixteen beagles underwent Z-stent placement in the IVC and the aorta. For 8 of 16 beagles, irradiation (15 Gy) was delivered endoluminally to the stented segments of each vessel immediately after stent placement using the {sup 192}Ir. All animals were sacrificed after 6 weeks for morphometric and histopathologic examination. Morphometrically, neointimal thickness in the IVC of the radiation group was significantly decreased compared with the control group as well as that in the aorta (p<0.05). Histopathologic findings showed the neointima in the IVC of the control group contained markedly organization of thrombus and neovascularization though that in the IVC of the radiation group consisted mainly of smooth muscle cells without organization of thrombus and neovascularization. From these data intravenous irradiation may prevent clinical restenosis after stent placement. (author)

  8. Cine MR evaluation of the inferior vena cava in patients with Simon Nitinol filters

    International Nuclear Information System (INIS)

    This study evaluated the ability of cine MR imaging to detect thrombus in the inferior vena cava (IVC) of seven patients after percutaneous implantation of Simon-Nitinol filters. Cine MR imagine was performed at 0.6 T. Sixteen phases of the cardiac cycle were obtained in sagittal or coronal projection with echo time equal to 15 msec, repetition time equal to 40 msec, and flip angle of 400. The section thickness was 7.5 mm. Blood flow in the IVC had high signal intensity that varied with the cardiac cycle. Thrombus had a range of signal intensities, but there was no variation of signal intensity during the cardiac cycle. The Simon-Nitinol filter caused no detectable image degradation. Cine MR imaging had the ability to detect thrombosis of the IVC below the filter and thrombus above the filter, and localize the position of the filter

  9. Patency of the inferior vena cava after placement of Simon nitinol filter

    International Nuclear Information System (INIS)

    This paper reports on Simon nitinol filters (SNFs) placed in 33 patients (11 male, 22 female; mean age, 67 years; range, 38-88 years) since February 1988. MR imaging and US were performed in 18 of these patients to evaluate patency of the inferior vena cava (IVC) 2-9 months after SNF placement. Six patients were imaged twice with MR and US, for a total of 24 studies. Duplex Doppler US was used. For MR imaging, spin-echo sequences were used for six examinations in five patients, and fast low-angle shot sequences in the remaining 18. The results were as follows for MR imaging versus US: adequate visualization of the IVC, 23 versus 10 studies; partial visualization, one versus five; nonvisualization, zero versus nine; normal IVC, 16 versus 10; occlusions of IVC, five (three patients) versus zero; partial occlusion, two (asymptomatic patients) versus zero; and nondiagnostic findings, one versus 14

  10. Superior vena cava syndrome: A rare complication of percutaneous nephrolithotripsy laser lithotripsy

    Directory of Open Access Journals (Sweden)

    Qing Ji

    2010-01-01

    Full Text Available Purpose: To describe a case of acute superior vena cava syndrome during percutaneous nephrolithotomy (PCNL, and to review the associated clinical features, management and complications. Clinical features: A 34-year-old man, diagnosed as right renal calculi and nodal tachycardia, was admitted to receive percutaneous nephroscope laser lithotripsy. Shortly after stone disintegration, he suffered acute hypoxic and hypotension, and showed cyanoderma of face and chest skin, ocular proptosis, jugular filling and ventricular fibrillation. Dopamine and adrenaline was intravenously injected. The patient was turned over to supine position and external cardiac massage and electric defibrillation were carried out immediately. The patient finally cardioverted. His vital signs subsequently became stable and cyanoderma faded. The patient was eventually discharged from the intensive care unit three days following the event. Conclusion: Severe complications such as cardiac arrest could happen during PCNL. Close monitoring the vital signs is essential for early finding and quick response to rescue.

  11. Marcapasso bi-atrial epicárdico subxifóide na obstrução da veia cava superior Bi-atrial subxiphoid epicardial pacemaker in superior vena cava syndrome

    Directory of Open Access Journals (Sweden)

    Roberto Costa

    2006-10-01

    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

  12. Endovascular Treatment of Malignant Superior Vena Cava Syndrome: Results and Predictive Factors of Clinical Efficacy

    International Nuclear Information System (INIS)

    To demonstrate the effectiveness of endovascular treatment (EVT) with self-expandable bare stents for malignant superior vena cava syndrome (SVCS) and to analyze predictive factors of EVT efficacy. Retrospective review of the 164 patients with malignant SVCS treated with EVT in our hospital from August 1992 to December 2007 and followed until February 2009. Endovascular treatment includes angioplasty before and after stent placement. We used self-expandable bare stents. We studied results of this treatment and looked for predictive factors of clinical efficacy, recurrence, and complications by statistical analysis. Endovascular treatment was clinically successful in 95% of cases, with an acceptable rate of early mortality (2.4%). Thrombosis of the superior vena cava was the only independent factor for EVT failure. The use of stents over 16 mm in diameter was a predictive factor for complications (P = 0.008). Twenty-one complications (12.8%) occurred during the follow-up period. Relapse occurred in 36 patients (21.9%), with effective restenting in 75% of cases. Recurrence of SVCS was significantly increased in cases of occlusion (P = 0.01), initial associated thrombosis (P = 0.006), or use of steel stents (P = 0.004). Long-term anticoagulant therapy did not influence the risk of recurrence or complications. In malignancy, EVT with self-expandable bare stents is an effective SVCS therapy. These results prompt us to propose treatment with stents earlier in the clinical cment with stents earlier in the clinical course of patients with SVCS and to avoid dilatation greater than 16 mm.

  13. Congenital absence of inferior vena cava and thrombosis: a case report

    Directory of Open Access Journals (Sweden)

    Iqbal Javaid

    2008-02-01

    Full Text Available Abstract Introduction A congenitally absent Inferior Vena Cava (IVC is a rare anomaly that is recognised to be associated with idiopathic Deep Venous Thrombosis (DVT, particularly in the young. It may not be apparent until later in life. Retrospectively, as discussed in this case, there can be clues indicating the presence of such an anomaly from a young age. However, it is not clear whether early recognition of this condition would affect the prognosis and treatment. Case presentation A 54 year old gentleman was admitted with 3 weeks of abdominal pain and localised swelling over the right flank. Examination revealed palpable 'snake-like' tortuous, tender lumps on the abdominal wall. Past history revealed chronic non-healing venous leg ulcers, and varicose veins necessitating varicose vein ligation at a very young age. The ulcers eventually needed skin grafting. During this, current admission he was investigated and diagnosed with Deep Vein Thrombosis (DVT. CT scan, performed to search for intra-abdominal cancer, revealed absence of the Inferior Vena Cava with extensive thrombosed collaterals of the superficial abdominal and azygous veins and a congenitally atrophic left kidney. Conclusion This is a case of one of the oldest patient described in the literature to be diagnosed with absence of the IVC. It is thought that IVC anomalies are under-diagnosed, and may be commoner than once believed. However there were vital clues in his previous medical history suspicious for an underlying venous anomaly. Idiopathic DVT in a relatively young person with a past history of chronic leg ulceration or varicose veins should be investigated for congenital anomalies of the IVC. This is best achieved by CT scan of the abdomen.

  14. 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)

  15. Phakomatosis pigmentovascularis IIb with hypoplasia of the inferior vena cava and the right iliac and femoral veins causing recalcitrant stasis leg ulcers.

    Science.gov (United States)

    Park, Jong-Gap; Roh, Kee-Young; Lee, Hyun-Jeong; Ha, Seog-Jun; Lee, Jun-Young; Yun, Sang Seob; Lim, Keun Woo; Song, Kyung Sup; Kim, Jin-Wou

    2003-08-01

    We present a patient with phakomatosis pigmentovascularis (PPV) type IIb accompanied with venous hypoplasia, from the inferior vena cava to the superficial femoral vein. Although it is not obvious whether this vascular anomaly, which is probably congenital, is coincidental or not, it is possible that the 2 diseases have some relationship each other, because PPV is thought to result from abnormal vasomotor activity during the embryonic period. In the diagnosis of type II PPV, careful examination and several studies are required to determine systemic involvement that may include large vessel changes. PMID:12894112

  16. 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.

  17. Titanium greenfield inferior vena cava filter; effectiveness of percutaneous placement for prevention of pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Bong Gak; Hahn, Seong Tai; Jung, Jung Im; Lee, Sang Hoon; Koh, Ki Young; Park, Seog Hee; Shinn, Kyung Sub [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2000-11-01

    To evaluate the effectiveness of percutaneous placement of a Greenfield titanium filter in the inferior vena cava (IVC) for the prevention of pulmonary embolism (PE) in patients with deep vein thrombosis (DVT). Twelve patients with DVT underwent percutaneous Greenfield titanium filter placement. The indications included recurrent pulmonary embolism or failed anticoagulation therapy in six patients, extensive PE in three, and prophylaxis for high risk of PE in the remaining three. In all cases the filter was positioned after confirming the anatomy, patency, and presence of thrombosis of the IVC and renal veins by inferior vena cavography. Long-term follow-up study involved clinical evaluation, plain radiography, Doppler ultrasonography and CT scanning. Filter placement [infrarenal in ten patients (83%) and suprarenal in two (17%)] was technically successful in all cases (100%). The venous approach involved the right femoral vein in eight patients (67%) and the right internal jugular vein in four (33%). Complications included overlapping of the filter legs in three patients (25%), and misplacement in one (8%). After filter placement, no further PE developed. In all of five patients followed up for two years, the IVC maintained patency without evidence of caval perforation or occlusion. In patients with DVT, percutaneous placement of a Greenfield titanium filter is a safe and effective method for the prevention of PE.

  18. Titanium greenfield inferior vena cava filter; effectiveness of percutaneous placement for prevention of pulmonary embolism

    International Nuclear Information System (INIS)

    To evaluate the effectiveness of percutaneous placement of a Greenfield titanium filter in the inferior vena cava (IVC) for the prevention of pulmonary embolism (PE) in patients with deep vein thrombosis (DVT). Twelve patients with DVT underwent percutaneous Greenfield titanium filter placement. The indications included recurrent pulmonary embolism or failed anticoagulation therapy in six patients, extensive PE in three, and prophylaxis for high risk of PE in the remaining three. In all cases the filter was positioned after confirming the anatomy, patency, and presence of thrombosis of the IVC and renal veins by inferior vena cavography. Long-term follow-up study involved clinical evaluation, plain radiography, Doppler ultrasonography and CT scanning. Filter placement [infrarenal in ten patients (83%) and suprarenal in two (17%)] was technically successful in all cases (100%). The venous approach involved the right femoral vein in eight patients (67%) and the right internal jugular vein in four (33%). Complications included overlapping of the filter legs in three patients (25%), and misplacement in one (8%). After filter placement, no further PE developed. In all of five patients followed up for two years, the IVC maintained patency without evidence of caval perforation or occlusion. In patients with DVT, percutaneous placement of a Greenfield titanium filter is a safe and effective method for the prevention of PE

  19. Computational Modeling of Blood Flow in the TrapEase Inferior Vena Cava Filter

    Energy Technology Data Exchange (ETDEWEB)

    Singer, M A; Henshaw, W D; Wang, S L

    2008-02-04

    To evaluate the flow hemodynamics of the TrapEase vena cava filter using three dimensional computational fluid dynamics, including simulated thrombi of multiple shapes, sizes, and trapping positions. The study was performed to identify potential areas of recirculation and stagnation and areas in which trapped thrombi may influence intrafilter thrombosis. Computer models of the TrapEase filter, thrombi (volumes ranging from 0.25mL to 2mL, 3 different shapes), and a 23mm diameter cava were constructed. The hemodynamics of steady-state flow at Reynolds number 600 was examined for the unoccluded and partially occluded filter. Axial velocity contours and wall shear stresses were computed. Flow in the unoccluded TrapEase filter experienced minimal disruption, except near the superior and inferior tips where low velocity flow was observed. For spherical thrombi in the superior trapping position, stagnant and recirculating flow was observed downstream of the thrombus; the volume of stagnant flow and the peak wall shear stress increased monotonically with thrombus volume. For inferiorly trapped spherical thrombi, marked disruption to the flow was observed along the cava wall ipsilateral to the thrombus and in the interior of the filter. Spherically shaped thrombus produced a lower peak wall shear stress than conically shaped thrombus and a larger peak stress than ellipsoidal thrombus. We have designed and constructed a computer model of the flow hemodynamics of the TrapEase IVC filter with varying shapes, sizes, and positions of thrombi. The computer model offers several advantages over in vitro techniques including: improved resolution, ease of evaluating different thrombus sizes and shapes, and easy adaptation for new filter designs and flow parameters. Results from the model also support a previously reported finding from photochromic experiments that suggest the inferior trapping position of the TrapEase IVC filter leads to an intra-filter region of recirculating/stagnant flow with very low shear stress that may be thrombogenic.

  20. Iliac vein thrombosis: a case report of treatment with inferior vena cava filter, urokinase and vascular stent

    International Nuclear Information System (INIS)

    Thrombolytic therapy and placement of vascular metallic stent can be used for the treatment of iliac venous stenosis and thrombosis, but these treatments increase the risk of pulmonary thromboembolism. Inferior vena cava filter was developed for the prevention of recurrent pulmonary thromboembolism due to lower extremity deep vein thrombosis and has been regarded as relatively safe and effective treatment modality. We experienced good result of combined treatment of inferior vena filter, thrombolytic therapy and placement of right iliac venous metallic stent in a patient with severe stenosis and thrombosis at both common iliac veins

  1. Therapeutic effect and prognostic analysis of intensity-modulated radiotherapy for primary hepatocellular carcinoma with portal vein and/or inferior vena cava tumor thrombus

    Directory of Open Access Journals (Sweden)

    HUANG Long

    2015-06-01

    Full Text Available ObjectiveTo determine the efficacy and prognostic factors of intensity-modulated radiotherapy (IMRT for primary hepatocellular carcinoma (HCC with portal vein and/or inferior vena cava tumor thrombus. MethodsTwenty-three HCC patients with portal vein and/or inferior vena cava tumor thrombus received IMRT with an 8 MV linear accelerator at the Cancer Center of General Hospital of Armed Police Forces, Anhui Medical University, from April 2008 to August 2011. A single dose of 3 to 6 Gy was delivered at five fractions per week, with a total dose of 56 to 96 Gy and a median dose of 60 Gy. Survival time was recorded, and adverse reactions were evaluated. Survival rate calculation and survival analysis were performed using the Kaplan-Meier method. Comparison of categorical between two groups was made by chi-square test. ResultsOne patient did not complete radiotherapy due to upper gastrointestinal bleeding. Of 22 patients who completed IMRT, 4 achieved complete remission and 10 achieved partial remission, with an overall response rate of 63.7%. Our analysis showed that the type of tumor thrombus and tumor size were associated with tumor response rate and were significant prognostic factors (P?0.05. The median survival time was 13.4 months. The 1-, 2-, and 3-year survival rates were 59%, 27%, and 18%, respectively. The 22 patients who completed radiotherapy did not experience acute radiation injury or late adverse outcomes such as radiation-induced liver disease. ConclusionThis study suggests IMRT is a safe and effective treatment option for HCC patients with portal vein and/or inferior vena cava tumor thrombus.

  2. Scimitar syndrome of atypical, rare drainage of venous vessel to the superior vena cava. A case report

    OpenAIRE

    Sybilski, Adam J.; Michalczuk, Ma?gorzata; Chudoba, Anna; Tolak-omernik, Katarzyna; Bulski, Tomasz; Walecki, Jerzy

    2013-01-01

    Scimitar syndrome is a rare and complex congenital anomaly characterized by partial or complete anomalous pulmonary venous return from the right or left lung into the inferior vena cava, through drainage into the hepatic vein, right atrium or left atrium. The syndrome is commonly associated with hypoplasia of the right lung and right pulmonary artery. We present an 11-year-old female with atypical and rare type of scimitar syndrome. The girl has had cough for 2 months before admission, withou...

  3. Surgical lead extraction for total occlusion of the superior vena cava by chronic lead infection after mustard procedure.

    Science.gov (United States)

    Steinberg, Christian; Calvaruso, Davide; Guimond, Jean; Bédard, Elisabeth; Perron, Jean

    2014-05-01

    We present a case of total occlusion of the superior vena cava (SVC) with extensive thrombosis of the adjacent large veins secondary to multiple abandoned pacemaker leads with a superimposed chronic lead infection by Corynebacterium jeikeium. A surgical lead extraction was performed with an extensive en-bloc resection of the SVC together with the right subclavian vein and the right innomate vein. No venous reconstruction was required because of an unobstructed runoff via a well-developed azygos system. PMID:24438576

  4. Persistent left superior vena cava: A possible contraindication to chemotherapy and total parenteral nutrition in cancer patients

    OpenAIRE

    Iovino, Francesco; Auriemma, Pasquale Pio; Viscovo, Luca Del; Scagliarini, Sara; Di Napoli, Marilena; Vita, Ferdinando

    2012-01-01

    Persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly. Awareness of this condition may be useful when placement of left-side transvenous subclavian or internal jugular catheters is required. This anomaly may be detected only by chest radiograph following placement of the catheter. The primary endpoints of this study were to analyze the prevalence of PLSVC, measurement of its diameters and the outcome of cancer patients with this anomaly undergoing placement of ...

  5. Posterior Nutcracker Syndrome Associated with Interrupted Left Inferior Vena Cava with Azygos Continuation and Retroaortic Right Renal Vein

    OpenAIRE

    Luo, Xiao-li; Qian, Gen-nian; Xiao, Hui; Zhao, Chun-lei; Zhou, Xiao-dong

    2012-01-01

    Various anatomic anomalies have been considered the causes of nutcracker syndrome (NCS). Posterior NCS refers to the condition, in which vascular narrowing was secondary to the compression of the retroaortic left renal vein while it is crossing between the aorta and the vertebral column. Here, we report an unusual case of posterior NCS associated with a complicated malformation of the interrupted left inferior vena cava with azygos continuation and retroaortic right renal vein, diagnosed by b...

  6. Posterior Nutcracker Syndrome Associated with Interrupted Left Inferior Vena Cava with Azygos Continuation and Retroaortic Right Renal Vein

    International Nuclear Information System (INIS)

    Various anatomic anomalies have been considered the causes of nutcracker syndrome (NCS). Posterior NCS refers to the condition, in which vascular narrowing was secondary to the compression of the retroaortic left renal vein while it is crossing between the aorta and the vertebral column. Here, we report an unusual case of posterior NCS associated with a complicated malformation of the interrupted left inferior vena cava with azygos continuation and retroaortic right renal vein, diagnosed by both color Doppler ultrasonography and CT angiography.

  7. Posterior Nutcracker Syndrome Associated with Interrupted Left Inferior Vena Cava with Azygos Continuation and Retroaortic Right Renal Vein

    Energy Technology Data Exchange (ETDEWEB)

    Luo, Xiao Li; Zhou, Xiao Dong [Xijing Hospital, Fourth Military Medical University, Shaanxi (China); Qian, Gen Nian; Xiao, Hui; Zhao, Chun Lei [Fuzhou General Hospital, Fujian (China)

    2012-06-15

    Various anatomic anomalies have been considered the causes of nutcracker syndrome (NCS). Posterior NCS refers to the condition, in which vascular narrowing was secondary to the compression of the retroaortic left renal vein while it is crossing between the aorta and the vertebral column. Here, we report an unusual case of posterior NCS associated with a complicated malformation of the interrupted left inferior vena cava with azygos continuation and retroaortic right renal vein, diagnosed by both color Doppler ultrasonography and CT angiography.

  8. Bilhemia: a fatal complication following percutaneous placement of a transhepatic inferior vena cava catheter in a child

    Energy Technology Data Exchange (ETDEWEB)

    Sierre, Sergio; Lipsich, Jose; Questa, Horacio [Hospital de Pediatria Prof JP Garrahan, Department of Interventional Radiology, Buenos Aires (Argentina)

    2007-05-15

    A transhepatic central venous catheter was implanted in a 2-year-old child with a history of multiple venous access procedures and superior and inferior vena cava thrombosis. After 2 weeks, inadvertent dislodgement of the catheter was complicated by a biloma. The biloma was percutaneously drained, but a biliary-venous fistula led to a rapidly progressive and fatal bilhemia. We report this case as an infrequent complication of transhepatic catheterization. (orig.)

  9. Multislice CT of a Persistent Left Superior Vena Cava Coursing Anterior to the Right Ventricle: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  10. Incidental right Bochdalek hernia with interruption of the inferior vena cava and hepatic venous collateral continuation: A case report

    Scientific Electronic Library Online (English)

    Farzanah I., Ismail; Rule, Human; Anith, Chacko; Parmanand, Naran; Samia, Ahmad; Siraj, Ellemdin.

    2014-10-01

    Full Text Available A 36-year-old asymptomatic female had a routine chest radiograph to exclude pulmonary tuberculosis, as part of an employee wellness programme. There was opacification of the right lower thorax. Computed tomography and venography demonstrated an incidental right Bochdalek hernia with interruption of [...] the inferior vena cava (IVC) and hepatic venous collateral continuation. The association of a Bochdalek hernia with an anomaly of the IVC is rare, with only one case described in the literature.

  11. 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)

    Cristina, Quicios Dorado; Antonio, Allona Almagro.

    2008-04-01

    Full Text Available 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. R [...] esultados/Conclusiones: El angiomiolipoma renal es un tumor benigno mesenquimal, poco frecuente (2-6.4% de los tumores renales), de predominio en el sexo femenino. Habitualmente 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 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.

  12. 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)

  13. Quiste hidatídico hepático complicado con invasión a vena cava inferior y embolización de membranas hidatídicas a aurícula derecha: Caso clínico Hepatic hydatid cyst invading inferior vena cava with embolic membranes to right atrium: Report of one case

    Directory of Open Access Journals (Sweden)

    JUAN C BAHAMONDES S

    2010-04-01

    Full Text Available La hidatidosis es una zoonosis parasitaria, de mayor incidencia en el sur de Chile. Su localización más frecuente es hepática y pulmonar. Sus complicaciones derivan de su crecimiento y afección de estructuras adyacentes o de su ruptura a cavidades. Presentamos un caso de quiste hidatídico hepático complicado, en una paciente que debutó con cuadro de dolor abdominal localizado en hipocondrio derecho producto de una lesión quística hepática con comunicación a vena cava inferior, siendo intervenida en su hospital de origen. Posteriormente AngioTAC y ecocardiografía transesofágica confirmaron masa intra auricular. Se realizó extracción de la masa bajo paro circulatorio con hipotermia profunda, correspondía a membranas hidatídicas y trombos adheridos a ella. La paciente evolucionó satisfactoriamente.We report a 30 year old female admitted with a story of right upper quadrant pain and previous hepatic surgery for hydatid disease. A thoracoabdominal angio CAT sean and transesophageal echocardiogram revealed a mass located in the right atrium. The patient was operated and the right atrial mass was excised. Pathological study of the surgical piece confirmed a hydatid cyst. Post operative recovery was uneventful.

  14. Quiste hidatídico hepático complicado con invasión a vena cava inferior y embolización de membranas hidatídicas a aurícula derecha: Caso clínico / Hepatic hydatid cyst invading inferior vena cava with embolic membranes to right atrium: Report of one case

    Scientific Electronic Library Online (English)

    JUAN C, BAHAMONDES S; PABLO, SANDOVAL M; HÉCTOR, LOSADA M; GUSTAVO, MERIÑO S; JUAN, SALMAN A; ABELARDO, SILVA V; JAVIER, MORA P.

    2010-04-01

    Full Text Available La hidatidosis es una zoonosis parasitaria, de mayor incidencia en el sur de Chile. Su localización más frecuente es hepática y pulmonar. Sus complicaciones derivan de su crecimiento y afección de estructuras adyacentes o de su ruptura a cavidades. Presentamos un caso de quiste hidatídico hepático c [...] omplicado, en una paciente que debutó con cuadro de dolor abdominal localizado en hipocondrio derecho producto de una lesión quística hepática con comunicación a vena cava inferior, siendo intervenida en su hospital de origen. Posteriormente AngioTAC y ecocardiografía transesofágica confirmaron masa intra auricular. Se realizó extracción de la masa bajo paro circulatorio con hipotermia profunda, correspondía a membranas hidatídicas y trombos adheridos a ella. La paciente evolucionó satisfactoriamente. Abstract in english We report a 30 year old female admitted with a story of right upper quadrant pain and previous hepatic surgery for hydatid disease. A thoracoabdominal angio CAT sean and transesophageal echocardiogram revealed a mass located in the right atrium. The patient was operated and the right atrial mass was [...] excised. Pathological study of the surgical piece confirmed a hydatid cyst. Post operative recovery was uneventful.

  15. Long-Term Safety and Effectiveness of the “OptEase” Vena Cava Filter

    International Nuclear Information System (INIS)

    Purpose: To assess the long-term safety and effectiveness of the OptEase inferior vena cava (IVC) filter. Materials and Methods: In this Institutional Review Board-approved, retrospective study, we reviewed data of 71 patients who received an OptEase filter at our institution from 2002 to 2007. Thirty-nine (55%) patients had symptoms of venous thromboembolism before filter placement. The indications for filter included contraindication to anticoagulation in 31 (44%) patients, prophylaxis against pulmonary embolism (PE) in 29 (41%) patients, and failure of anticoagulation in 11 (15%) patients. Procedure-related complications, such as symptomatic post-filter PE, deep venous thrombosis (DVT), IVC occlusion, and incidental imaging-evident filter-related complications, were recorded. Safety was assessed by the occurrence of filter-related complications during placement and follow-up. Effectiveness was assessed by the occurrence of post-filter PE. Results: Sixty-five (92%) filters were placed under fluoroscopy, and 6 (8%) were placed using intravascular ultrasound guidance. Seventy (99%) filters were placed successfully. Seven (10%) filters were placed in the suprarenal cava. Retrieval was attempted in 14 (20%) patients, and 12 filters were successfully retrieved. Clinical follow-up was available for 20 ± 21 months. Symptoms of postfilter PE and DVT occurred in 15% (n = 11) and 10% (n = 7) patients, respectively. None of these patients had computed tomography (CT)-proven Pnts had computed tomography (CT)-proven PE, and only one had ultrasound-proven new DVT. One patient had symptomatic IVC occlusion. Follow-up abdominal CT in 20 patients showed thrombus in the filter in two of them. There were no instances of filter migration, filter tilt, or caval wall penetration. Conclusion: The OptEase filter appears to have an acceptable long-term safety profile. The filter was effective against PE.

  16. Percutaneous placement of bird's nest inferior vena cava filter

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Hoon; Sung, Kyu Bo; Yoon, Hyun Ki [Asan Medical Center, Ulsan Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-04-01

    To describe clinical experiences of the use of Bird's Nest inferior vena cava(IVC) filter. Between August 1991 and August 1997, IVC filter was percutaneously inserted in 51 patients with pulmonary embolism(PE) and deep vein thrombosis of the lower extremities. Indications for the placement of this filter were contraindication to anticoagulation in 17 patients, prophylaxis of PE in 17, failed anticoagulation in 11, massive PE with residual floating thrombus in three and complications involving anticoagulation in 3. In order to delineate the location of renal vein and extension of deep vein thrombosis into the IVC, all patients under went inferior vena cavography before filter placement. Thirty filters were inserted through the right femoral vein, 19 through the right internal jugular vein and three through the left femoral vein. The patients involved were followed up for periods ranging from one week to six years (mean 10 months). A Bird's Nest IVC filter was placed in the infrarenal IVC in 44 patients and in the suprarenal IVC in 7. Certain complicatioins ensued. IVC penetration occurred in three patients(5.9%), and in seven(1.37%) the filter wire prolapsed. Except for transient pain, however, there were no serious IVC penetration-related complications and no evidence of recurrence of PE in the cases involving prolapse of the filter wire. During follow up, clinically suspected recurrent PE was noted in two patients(3.9%), but there was no evidence of newly developed occlusion of the IVC. In patients who under went follow up, Bird's Nest IVC filter effectively prevented the development and recurrence of PE, and there were no complications. To prevent of penetration of the IVC and prolapse of the filter, however, technical skill was needed.

  17. Avaliação in vitro de um novo filtro de veia cava In vitro evaluation of a new vena cava filter

    Directory of Open Access Journals (Sweden)

    Domingo Marcolino Braile

    2005-01-01

    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.

  18. Avaliação in vitro de um novo filtro de veia cava / In vitro evaluation of a new vena cava filter

    Scientific Electronic Library Online (English)

    Domingo Marcolino, Braile; José Maria Pereira de, Godoy; Marco, Centola.

    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 ê [...] mbolos. 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. 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 purpos [...] e 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.

  19. 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)

    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.

    2013-03-01

    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 impl [...] ante 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 subjec [...] ted to temporary inferior vena cava filter (VCF).

  20. Tratamento cirúrgico da síndrome da veia cava superior causado por timoma invasivo Surgical treatment of superior vena cava syndrome caused by invasive thymoma

    Directory of Open Access Journals (Sweden)

    George Ronald Soncini da Rosa

    2010-06-01

    Full Text Available 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 PTFE (politetrafluoroetileno. Relevante caso de timoma invasivo ocasionando a oclusão da veia cava superior. A evolução clínica, após 7 meses, foi considerada satisfatória.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. Relevant case of invasive thymoma causing the occlusion of SVC. The clinic evolution of the patient after 7 months was considered satisfactory.

  1. 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)

    George Ronald Soncini da, Rosa; Ney, Takizawa; Douglas, Schimidt; Mitur, Sugita.

    2010-06-01

    Full Text Available 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 angiorressonân [...] cia magnética de tórax, o paciente foi submetido à ressecção radical do timoma - derivação venosa da veia subclávia esquerda para átrio direito, com tubo de PTFE (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 angi [...] oresonance of the thorax, the patient underwent radical resection of the thymoma - bypass from left subclavian vein to right atrium, using polytetrafluoroethylene tube. Relevant case of invasive thymoma causing the occlusion of SVC. The clinic evolution of the patient after 7 months was considered satisfactory.

  2. Clinical evaluation of stenting for different types of malignant inferior vena cava obstruction

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical outcome of stenting for different types of malignant inferior vena cava (IVC)obstruction. Methods: Eighty-four liver cancer patients complicated with IVC obstruction were divided into external compression type and embolic type by magnetic resonance angiography (MRA)and/or digital subtraction angiography (DSA). Of the 47 cases with external compression type, 26 patients were undergone interventional stent placement (group A)and the other 21 patients were served as control group(group B). Of the 37 cases with embolis type, 20 patients were stented (group C)and remaining 17 patients were in control group (group D). Transarterial chemo-embolization (TACE)were performed for those patients without contraindications. Results: Within one week remission rates of clinical symptoms were 96.2% and 90.0% in group A and group C (P>0.05), after six weeks remission rates were 84.6% and 30.0%, respectively (P0.05). Conclusions: Interventional stent placement is recommended for patients with external compression IVC obstruction, with significant relief of the clinical symptoms and prolongation of the survival term. For embolic type of IVC obstruction patients, stenting is only a short-term palliative mstenting is only a short-term palliative modality because of higher re-obstruction rate and shorter survival term. (authors)

  3. Hydrodynamic gene delivery to the pig liver via an isolated segment of the inferior vena cava.

    Science.gov (United States)

    Fabre, J W; Grehan, A; Whitehorne, M; Sawyer, G J; Dong, X; Salehi, S; Eckley, L; Zhang, X; Seddon, M; Shah, A M; Davenport, M; Rela, M

    2008-03-01

    Hydrodynamic gene delivery is an attractive option for non-viral liver gene therapy, but requires evaluation of efficacy, safety and clinically applicable techniques in large animal models. We have evaluated retrograde delivery of DNA to the whole liver via the isolated segment of inferior vena cava (IVC) draining the hepatic veins. Pigs (18-20 kg weight) were given the pGL3 plasmid via two programmable syringe pumps in parallel. Volumes corresponding to 2% of body weight (360-400 ml) were delivered at 100 ml s(-1) via a Y connector. The IVC segment pressure, portal venous pressure, arterial pressure, electrocardiogram (ECG) and pulse were monitored. Concurrent studies were performed in rats for interspecies comparisons. The hydrodynamic procedure generated intrahepatic vascular pressures of 101-126 mm Hg, which is approximately 4 times higher than in rodents, but levels of gene delivery were approximately 200-fold lower. Suprahepatic IVC clamping caused a fall in arterial pressure, with the development of ECG signs of myocardial ischaemia, but these abnormalities resolved rapidly. The IVC segment approach is a clinically acceptable approach to liver gene therapy. However, it is less effective in pigs than in rodents, possibly because of larger liver size or a less compliant connective tissue framework. PMID:18004400

  4. Malignant inferior vena cava obstruction involving right atrium. Palliative treatment with self expandable metallic stent

    International Nuclear Information System (INIS)

    Objective: To investigate the safety and efficacy of placement of self-expandable metallic stent within right atrium and inferior vena cava (ICV) in patients with malignant ICV obstruction involving right atrium. Methods: There were 5 male patients with advanced hepatocellular carcinoma, aged from 42 to 65 years (mean 56.3 years). The malignancies invaded right atrium and ICV simultaneously, and caused obstruction of ICV. These patients presented symptoms and signs of obstruction of ICV such as hepatomegaly, ascites, edema of lower extremities. 'Z' type stainless steel stents (7.5-10.0 cm in length and 2.5 cm in diameter) were selected for these patients. Part (1.0-3.0 cm in length) of stent was placed in right atrium and the rest was in ICV. Results: All of stents were placed successfully and obstructed ICV reopened. The symptoms of obstruction of ICV relieved or disappeared. There were no recurrence of symptoms of obstruction of ICV and any cardiac complication related to placement of stents in follow-up period (67-188 days). Conclusion: Placement of self-expandable metallic stent within right atrium and ICV in treatment of patients with malignant ICV obstruction involving right atrium is one of the safe and effective methods

  5. Leiomyosarcomas of the inferior vena cava: diagnostic features on cross-sectional imaging

    Energy Technology Data Exchange (ETDEWEB)

    Ganeshalingam, S., E-mail: skandadas.ganeshalingam@nhs.ne [Department of Clinical Radiology, The Royal Marsden NHS Foundation Trust, London (United Kingdom); Rajeswaran, G. [Department of Clinical Radiology, The Royal Marsden NHS Foundation Trust, London (United Kingdom); Jones, R.L. [Department of Clinical Oncology, University of Washington and Hutchinson Cancer Research Center, Seattle, WA (United States); Thway, K. [Department of Histopathology, The Royal Marsden NHS Foundation Trust, London (United Kingdom); Moskovic, E. [Department of Clinical Radiology, The Royal Marsden NHS Foundation Trust, London (United Kingdom)

    2011-01-15

    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.

  6. Association of Superior Vena Cava Syndrome with Sleep Apnea: Investigation Using an Impulse Oscillometry System

    Directory of Open Access Journals (Sweden)

    Masato Katagiri

    2012-07-01

    Full Text Available Superior vena cava syndrome (SVCS patients sometimes show signs of obstructive sleep apnea (OSA. However, the mechanism causing hypoxia during sleep in SVCS patients is still uncertain. The aim of this study was to elucidate 1 the changes in central and peripheral respiratory resistance with SVCS, and 2 interpret the mechanism underlying the development of hypoxia during sleep in patients with SVCS related to OSA. Ten SVCS patients related to a neoplasm were recruited for this study. The degree of apnea hypopnea index (AHI for OSA was evaluated by portable diagnosing device before and after SVCS treatment. We also analyzed the airway resistance and reactance quantitatively in the supine position by Master Screen impulse oscillometry system (MS-IOS®. After SVCS treatment, mean values of AHI were significantly decreased from 30.9 to 16.9 (/hour (p = 0.001. Central respiratory resistance (R20 also decreased significantly from 0.40 to 0.33 kPa/L/s (p = 0.025 in the supine position. In contrast, peripheral respiratory resistance (R5-R20 and distal capacitive reactance (X5 did not change significantly. It is thought that the exacerbation of OSA due to SVCS is caused by increasing upper airway resistance related to reversible edema of the upper airway mucous or tissue. In contrast, SVCS may not cause peripheral respiratory tract and lung parenchyma edema.

  7. Congenital Agenesis of Inferior Vena Cava: A Rare Cause of Unprovoked Deep Venous Thrombosis.

    Science.gov (United States)

    Parsa, Pouria; Lane, John S; Barleben, Andrew R; Owens, Erik L; Bandyk, Dennis

    2015-07-01

    Congenital anomalies of the inferior vena cava (IVC), although rare, are a risk factor for lower limb deep venous thrombosis (DVT). A 19-year-old male presented with a left flank and groin pain caused by iliofemoral venous thrombosis. Vascular imaging by computed tomography (CT) scanning and venography demonstrated agenesis of the IVC. Catheter-directed thrombolysis via a popliteal vein was attempted but did not alter the patency of the common femoral vein outflow collaterals into the retroperitoneal azygous venous system. The patient was anticoagulated using systemic heparin infusion and clinical symptoms resolved within 5 days. He was transitioned to oral Coumadin anticoagulation, and follow-up venous duplex testing demonstrated no infrainguinal DVT and phasic venous flow with respiration in the femoral vein indicating patent collateral veins. Anomalies of the IVC are present in 0.3-0.5% of otherwise healthy individuals. Agenesis of the IVC has an incidence of 0.0005-1% in the general population but is found in almost 5% of patients DVT. In adults, IVC agenesis anomaly can cause diagnostic problems in the paravertebral area because of the tumor-like appearance of the azygous venous collaterals on noncontrast CT imaging. In young adults presenting with unprovoked lower limb DVT, the presence of an IVC anomaly should be considered and evaluated for by venous duplex testing and if necessary CT venography. PMID:25747887

  8. Interventional therapy of stenosis or occlusion in superior vena cava and its major branches

    International Nuclear Information System (INIS)

    Objective: To assess the different methods and their outcomes of interventional therapy for stenosis or occlusion in superior vena cava and its branches. Methods: Sixty patients with stenosis or occlusion of SVC and its branches were retrospectively analyzed after interventional therapy. Among them, 38 were males and 22 were females, with age range from 15 to 72 years old (mean age 58). Seventeen patients were treated by thrombolysis, and the rest 43 patients accepted percutaneous angioplasty and stenting. Before and after that, the pressures within the vein were measured at the inflow side. The paired-t test was used for statistical analysis. Results: After treatment, the pressure at the inflow side dropped from (24.8±2.3) mm Hg to (7.1±1.5) mm Hg (1 mm Hg =0.133 kPa), with a significant difference (t= 3.232, P<0.01 ). The clinical outcomes included complete relief in 27 patients, partial relief in 28 patients and non-relief in 5 patients. No major complications occurred. During 6 months follow up, restenosis occurred in 10 patients, among whom 6 received repeat intervention with good results. The other 4 patients turned to surgery. Conclusion: Interventional therapy for stenosis or occlusion in SVC and its branches could recanalize the vessels, restore the blood flow and relief the clinical symptoms. (authors)

  9. The relationship between superior vena cava diameter and collapsibility and central venous pressure.

    Science.gov (United States)

    Cowie, B S; Kluger, R; Rex, S; Missant, C

    2015-05-01

    The aim of this study was to assess the relationship between superior vena cava (SVC) diameter, collapsibility and central venous pressure (CVP) in cardiac surgical patients. SVC maximum and minimum diameters, plus collapsibility with ventilation, were measured with transoesophageal echocardiography in the mid-oesophageal bicaval view with M-mode. Simultaneously, CVP was measured via the right atrial port of a pulmonary artery catheter. Measurements were possible in 91 out of 92 patients. The median CVP was 10 mmHg with a range of 2 to 19 mmHg. There was a weak, but statistically significant, correlation between CVP and SVC collapsibility index (r=-0.21, P=0.049). There was no statistically significant correlation between maximum SVC diameter and CVP. Maximum SVC diameter was statistically significantly correlated with weight (Pearson's r=0.28, P=0.008). There was no statistically significant correlation between CVP and age or body dimensions. Our findings indicate that SVC diameter and collapsibility are easily measured with transoesophageal echocardiography but do not reliably reflect CVP in anaesthetised cardiac surgical patients. PMID:25943610

  10. Thrombosis caused by polyurethane double-lumen subclavian superior vena cava catheter and hemodialysis

    DEFF Research Database (Denmark)

    Wanscher, Maria RØrbæk; Frifelt, J J

    1988-01-01

    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.

  11. Braile vena cava filter and greenfield filter in terms of centralization.

    Science.gov (United States)

    de Godoy, José Maria Pereira; Menezes da Silva, Adinaldo A; Reis, Luis Fernando; Miquelin, Daniel; Torati, José Luis Simon

    2013-01-01

    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

  12. Cardiac tamponade following liver transplantation after intrapericardial control of the suprahepatic vena cava.

    Science.gov (United States)

    Xu, Junming; Hong, Johnny C; Busuttil, Ronald W

    2015-03-01

    Transabdominal intrapericardial control of the suprahepatic inferior vena cava (SIVC) is a rather uncommon procedure occasionally required in conjunction with complicated liver transplantation (LT) and hepatobiliary surgery. Experience with this technique is limited. Here we report 6 cases of LT in which transabdominal intrapericardial control of the SIVC was necessary. After institutional review board approval was obtained, a single-center, retrospective review was conducted from January 1991 to December 2013 to identify adult cases (age?>?18 years) of LT in which transabdominal intrapericardial isolation of the SIVC was necessary. Among 4102 adult LT cases in the study period, 6 such cases were identified. To gain access to the pericardial space, a 6- to 9-cm vertical incision was made above the SIVC. After reperfusion, the diaphragmatic incision was partially closed and selectively drained. Pericardial tamponade developed in 1 patient, and it necessitated emergent reoperation and widespread drainage. In conclusion, transabdominal intrapericardial isolation of the SIVC is easily achieved without the need for a separate thoracic incision. However, to be effective, the pericardial incision should be only partially closed, and the pericardial sac should be drained liberally. Such patients should be carefully monitored for signs and symptoms of pericardial tamponade, the development of which should prompt an immediate return to the operating room for emergent decompression and widespread drainage. PMID:25408472

  13. Stenting in malignant obstruction of inferior vena cava caused by hepatic carcinoma

    International Nuclear Information System (INIS)

    Objective: To evaluate the effectiveness of endovascular deployment of metallic Z-type self- expandable stents in treating the patients with inferior vena cava (IVC)obstruction caused by hepatic malignant tumour. Methods: One hundred and fifty six patients with IVC obstruction due to malignant compression were enrolled. Venography was performed via femoral vein before and after metallic Z-type self-expandable stent deployment across the stenotic segment of IVC. The diameter of stenotic segment, collateral vessels, venous pressures and the scores of patients IVC syndrome were compared before and alter stent placement. Results: One hundred and seventy nine stents were implanted in 156 patients successfully. The average obstructive length of IVC was (6.1±2.2) cm. The pressure gradient of stenotic segments of IVC declined from (2.1±0.5) kPa to (0.5±0.11) kPa. The diameters of stenotic segment of IVC increased from (0.33±0.11) cm to (1.6±0.4) cm. After operations, the main clinical symptoms and physical signs relieved quickly. During 2-24 month follow-up, the patency of IVC stents reached 86.7%. Conclusion: Endovascular deployment of metallic Z-type self-expandable stent is an effective palliative treatment for patients with malignant obstruction of IVC. (authors)

  14. 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)

    Catherine, Yang; Henrique Simao, Trad; Silvana Machado, Mendonca; Clovis Simao, Trad.

    2013-07-01

    Full Text Available 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 embrionárias, 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 post [...] cardinal 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 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.

  15. 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)

    Jason R. Kovac

    2010-06-01

    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.

  16. 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)

    Jason R., Kovac; Patrick P., Luke.

    2010-06-01

    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 approa [...] ch 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.

  17. Tratamento endovascular da síndrome da veia cava superior: relato de caso e revisão da literatura / Endovascular treatment of superior vena cava syndrome: case report and review of the literature

    Scientific Electronic Library Online (English)

    Marco Aurélio, Cardozo; Eduardo, Lichtenfels; Nilon, Erling Jr.; Dorvaldo P., Tarasconi.

    2006-12-01

    Full Text Available Relatamos o caso de uma paciente portadora de síndrome da veia cava superior sintomática de origem benigna tratada pela técnica endovascular. A angiorressonância magnética pré-angioplastia evidenciou extensa trombose do tronco braquiocefálico esquerdo, da veia subclávia esquerda e obstrução da veia [...] cava superior junto ao tronco braquiocefálico direito. A paciente realizou mastectomia radical 2 anos antes, associada à quimioterapia e radioterapia do tórax. Foram realizados angioplastia venosa e implante de stent expansível por balão. O resultado foi satisfatório, com alívio imediato dos sintomas devido à recanalização da veia cava superior e do tronco braquiocefálico direito. Foi instituída anticoagulação oral. A paciente permanece sem recidiva dos sintomas após 8 meses de acompanhamento. O tratamento endovascular é uma alternativa terapêutica com baixa morbidade e resultado satisfatório a médio prazo que pode ser oferecida aos pacientes portadores de síndrome da veia cava superior. Abstract in english We report a case of a patient with symptomatic benign superior vena cava syndrome treated by the endovascular technique. The angiographic resonance before angioplasty showed extensive thrombosis of the left brachiocephalic trunk, left subclavian vein and superior vena cava obstruction close to the r [...] ight brachiocephalic trunk. The patient underwent radical mastectomy 2 years ago with adjuvant chemotherapy and chest radiotherapy. Venous angioplasty and balloon-expandable stenting were performed. Satisfactory result was obtained with immediate relief of symptoms due to recanalization of the right brachiocephalic trunk and superior vena cava. Oral anticoagulation was initiated. The patient is still asymptomatic after 8 months of follow-up. The endovascular treatment is a therapeutic alternative with low morbidity and satisfactory mid-term results that can be offered to patients with superior vena cava syndrome.

  18. Tratamento endovascular da síndrome da veia cava superior: relato de caso e revisão da literatura Endovascular treatment of superior vena cava syndrome: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Marco Aurélio Cardozo

    2006-12-01

    Full Text Available Relatamos o caso de uma paciente portadora de síndrome da veia cava superior sintomática de origem benigna tratada pela técnica endovascular. A angiorressonância magnética pré-angioplastia evidenciou extensa trombose do tronco braquiocefálico esquerdo, da veia subclávia esquerda e obstrução da veia cava superior junto ao tronco braquiocefálico direito. A paciente realizou mastectomia radical 2 anos antes, associada à quimioterapia e radioterapia do tórax. Foram realizados angioplastia venosa e implante de stent expansível por balão. O resultado foi satisfatório, com alívio imediato dos sintomas devido à recanalização da veia cava superior e do tronco braquiocefálico direito. Foi instituída anticoagulação oral. A paciente permanece sem recidiva dos sintomas após 8 meses de acompanhamento. O tratamento endovascular é uma alternativa terapêutica com baixa morbidade e resultado satisfatório a médio prazo que pode ser oferecida aos pacientes portadores de síndrome da veia cava superior.We report a case of a patient with symptomatic benign superior vena cava syndrome treated by the endovascular technique. The angiographic resonance before angioplasty showed extensive thrombosis of the left brachiocephalic trunk, left subclavian vein and superior vena cava obstruction close to the right brachiocephalic trunk. The patient underwent radical mastectomy 2 years ago with adjuvant chemotherapy and chest radiotherapy. Venous angioplasty and balloon-expandable stenting were performed. Satisfactory result was obtained with immediate relief of symptoms due to recanalization of the right brachiocephalic trunk and superior vena cava. Oral anticoagulation was initiated. The patient is still asymptomatic after 8 months of follow-up. The endovascular treatment is a therapeutic alternative with low morbidity and satisfactory mid-term results that can be offered to patients with superior vena cava syndrome.

  19. Interruption or congenital stenosis of the inferior vena cava: Prevalence, imaging, and clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Koc, Zafer [Baskent University, School of Medicine, Department of Radiology, Adana (Turkey)]. E-mail: koczafer@gmail.com; Oguzkurt, Levent [Baskent University, School of Medicine, Department of Radiology, Adana (Turkey)

    2007-05-15

    Objective: To present the prevalence, clinical, and imaging findings of interruption or congenital stenotic lesions of the inferior vena cava (IVC), associated malformations, and their clinical relevance. Materials and methods: Between March 2004 and March 2006, 7972 patients who had undergone consecutive routine abdominal multidetector row computed tomography were analyzed for interruption or stenotic lesion of the IVC. Results: Prevalence of interruption (n = 8) or congenital stenosis (n = 4) of the IVC occurred in 12 (0.15%) of 7972 patients. Four patients with interruption and four patients with congenital stenosis of the IVC were symptomatic with DVT (n = 4), leg swelling (n = 4), leg pain (n = 2), lower extremity varices (n = 2), hepatic vein thrombosis (n = 1), and hematochezia (n = 1). All four of the asymptomatic patients were from the interruption group, and these patients had interrupted IVC with well-developed azygos/hemiazygos continuation. Eight symptomatic patients did not have a well-developed azygos/hemiazygos continuation, and drainage of lower extremity was mainly from collateral veins. Additional findings in eight symptomatic patients were abdominal venous collaterals (n = 8), venous aneurysm (n = 2), lower extremity varices (n = 2), varicocele (n = 2), and pelvic varices (n = 1). Conclusion: Interruption or stenosis of the IVC are rare on routine abdominal CT examinations and may cause different clinical findings depending on the variant drainage patterns or collaterals. Interrupted IVC is commonly asymptomatic if associated with well-developed azygos/hemiazygos continuation, whereas commonly symptomatic if well-developed azygos/hemiazygos continuation is not present.

  20. The implantation of retrievable superior vena cava filter: report of 6 cases

    International Nuclear Information System (INIS)

    Objective: To discuss the techniques and clinical value of the placement of retrievable superior vena cava (SVC) filter. Methods: Under DSA guidance, the placement of retrievable SVC filter was performed in 6 patients with jugular vein thrombosis or upper extremity deep vein thrombosis. The diagnoses were proved by colour Doppler ultrasound and venography. All patients were affected with malignancy. The venous thrombosis was caused by the insertion of PICC (n=3) or by the compression or invasion of tumor (n=3). Catheterization was carried out via the right femoral vein. After venography of SVC, the delivery system of SVC filter was inserted into SVC, and the filter was placed at the site slightly below the confluence of brachiocephalic veins. The retrieval of the filter was performed through the femoral vein route. Results: The retrievable filter was successfully placed in SVC in all cases. No dislodgement or migration of the filters occurred during the procedure. The filter was successfully retrieved via the femoral vein in two cases at 15 days and 28 days after the placement respectively as color Dopper ultrasound showed that the venous thrombus disappeared. The remaining 4 patients were unwilling to take the procedure of filter retrieval. All the patients were followed up periodically. During the follow-up course, five patients died of some causes (deterioration of the tumor, etc.) unrelated to filter placement in 2-16 months after the procedure. No serious complications such as SVC thrombosis, pulmonary embolism, migration of filter, vascular perforation, etc. occurred. Conclusion: The placement of retrievable SVC filter is technically simple, clinically feasible and safe, and the filter can be retrieved easily. This technique is very useful for preventing both the pulmonary embolism caused by jugular vein or upper extremity deep vein thrombosis and the complications related to long-term retention of the filter within SVC. (authors)

  1. British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry

    International Nuclear Information System (INIS)

    Purpose: The British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry was produced to provide an audit of current United Kingdom (UK) practice regarding placement and retrieval of IVC filters to address concerns regarding their safety. Methods: The IVC filter registry is a web-based registry, launched by the BSIR on behalf of its membership in October 2007. This report is based on prospectively collected data from October 2007 to March 2011. This report contains analysis of data on 1,434 IVC filter placements and 400 attempted retrievals performed at 68 UK centers. Data collected included patient demographics, insertion and retrieval data, and patient follow-up. Results: IVC filter use in the majority of patients in the UK follows accepted CIRSE guidelines. Filter placement is usually a low-risk procedure, with a low major complication rate (9 weeks versus those with a shorter dwell time. New lower limb deep vein thrombosis (DVT) and/or IVC thrombosis was reported in 88 patients following filter placement, there was no significant difference of incidence between filter types. Conclusions: This registry report provides interventional radiologists and clinicians with an improved understanding of the technical aspects of IVC filter placement to help improve practice, and the potential consequences of IVC filter placement so that we are better able to advise patients. There is a significant learning curve associated with IVC filter insertion, and when a filter is placed with the intention of removal, procedures should be in place to avoid the patient being lost to follow-up

  2. Follow-Up of 6 Patients with Permanent ; Vena Cava Filters in the Prevention of Pulmonary Embolism

    Directory of Open Access Journals (Sweden)

    M. Vahedian

    2011-10-01

    Full Text Available Introduction & Objective: Venous thromboembolic disease is a significant cause of morbidity and mortality in the United States. Deep venous thrombosis (DVT and pulmonary embolism (PE are a spectrum of a single disease entity. In most clinical situations, anticoagulation is the preferred form of therapy .IVC filter placement when using anticoagulation therapy is contraindicated or proves ineffective. The placement of an IVC filter is considered standard preventive treatment for PE. The aim of this study was follow up of patients with permanent vena cava filters in the prevention of pulmonary embolism after six months. Materials & Methods: In this cross sectional study 6 patients with IVC filter were followed up after 6 months. They were examined about having emboli, reccurent DVT, edema, varicosis, bleeding, misplacement, and fracture of filter. Data were analyzed with SPSSV17. Results: 6 patients having a mean age of 58.6 years were evaluated. There was no difference in sex . The reason of admission in all cases was DVT. Doppler sonography was done for all the patients. In 66.66% anticoagulation therapy was done before surgery. The filter was placed percutaneously in all cases. After 6 months in 5 cases there were no signs of DVT, PE, edema, and varicosis. In addition one patient died because of respiratory arrest due to encephalopathy. No complications were seen during admission period. Conclusion: Although IVC filter increases the risk of recurrent DVT in the long term ,it remarkablely decreases the risk of PE.IVC filter is a useful and effective treatment in patients with contraindication of using anticoagulation therapy especially in patients with cancer. (Sci J Hamadan Univ Med Sci 2011;18(2:29-32

  3. CT Findings of Intrarenal Yolk Sac Tumor with Tumor Thrombus Extending into the Inferior Vena Cava: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Shao Chun; Li, Xue Hua; Sun, Can Hui; Feng, Shi Ting; Peng, Zhen Peng; Huang, Si Yun; Li, Zi Ping [Dept. of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou (China)

    2014-10-15

    Yolk sac tumor (YST) is a rare germ cell neoplasm of childhood that usually arises from the testis or ovary. The rare cases of YST in various extragonadal locations have been reported, but the primary intrarenal YST is even more uncommon. Here, we report a case of a primary intrarenal YST with tumor thrombus of the inferior vena cava and left renal vein in a 2-year-old boy, with an emphasis on the CT features. To our knowledge, this is the first reported case of an intrarenal YST with intravascular involvement.

  4. Trapping of massive thrombus in an inferior vena cava filter: treatment with additional filter placement and aspiration thrombectomy

    International Nuclear Information System (INIS)

    For the patients suffering from extensive deep vein thrombosis (DVT), the placement of an inferior vena cava (IVC) filter in conjunction with anticoagulant therapy has been used to prevent pulmonary embolisms. However, for the patients who anticoagulant is contraindicated or if this is complicated, the use of an IVC filter without concurrent anticoagulation may become the sole treatment for pulmonary embolisms. In this situation, the thrombi trapped in the IVC filter may cause significant clinical problems. We report here on a case of IVC filter thrombosis that was successfully treated by aspiration thrombectomy after placing another filter proximal to the previous filter

  5. Trapping of massive thrombus in an inferior vena cava filter: treatment with additional filter placement and aspiration thrombectomy

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin Soo; Kim, Young Whan; Cho, Won Hyun; Kim, Hyong Tae; Koo, Ja Hyun; Woo, Seong Ku [Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2006-08-15

    For the patients suffering from extensive deep vein thrombosis (DVT), the placement of an inferior vena cava (IVC) filter in conjunction with anticoagulant therapy has been used to prevent pulmonary embolisms. However, for the patients who anticoagulant is contraindicated or if this is complicated, the use of an IVC filter without concurrent anticoagulation may become the sole treatment for pulmonary embolisms. In this situation, the thrombi trapped in the IVC filter may cause significant clinical problems. We report here on a case of IVC filter thrombosis that was successfully treated by aspiration thrombectomy after placing another filter proximal to the previous filter.

  6. CT Findings of Intrarenal Yolk Sac Tumor with Tumor Thrombus Extending into the Inferior Vena Cava: A Case Report

    International Nuclear Information System (INIS)

    Yolk sac tumor (YST) is a rare germ cell neoplasm of childhood that usually arises from the testis or ovary. The rare cases of YST in various extragonadal locations have been reported, but the primary intrarenal YST is even more uncommon. Here, we report a case of a primary intrarenal YST with tumor thrombus of the inferior vena cava and left renal vein in a 2-year-old boy, with an emphasis on the CT features. To our knowledge, this is the first reported case of an intrarenal YST with intravascular involvement.

  7. Idiopathic Thrombosis of the Inferior Vena Cava and Bilateral Femoral Veins in an Otherwise Healthy Male Soldier

    Science.gov (United States)

    Gordon, Sarah; Kerns, Tamie; Londeree, William; Ching, Brian

    2013-01-01

    Thrombosis of the inferior vena cava is less common than deep venous thrombosis of the lower extremities, particularly in the absence of an obvious congenital caval abnormality or hypercoagulable state. We present a case of IVC thrombosis in an otherwise healthy and active 28-year-old male soldier secondary to dehydration and venous webbing. IVC thrombosis is an uncommon and underrecognized condition; in this case, the patient's caval thrombosis was initially mistaken for acute back strain. Prompt recognition is necessary to minimize long-term sequelae. PMID:24187556

  8. Posterior Nutcracker Syndrome Associated with Interrupted Left Inferior Vena Cava with Azygos Continuation and Retroaortic Right Renal Vein

    Science.gov (United States)

    Luo, Xiao-Li; Qian, Gen-Nian; Xiao, Hui; Zhao, Chun-Lei

    2012-01-01

    Various anatomic anomalies have been considered the causes of nutcracker syndrome (NCS). Posterior NCS refers to the condition, in which vascular narrowing was secondary to the compression of the retroaortic left renal vein while it is crossing between the aorta and the vertebral column. Here, we report an unusual case of posterior NCS associated with a complicated malformation of the interrupted left inferior vena cava with azygos continuation and retroaortic right renal vein, diagnosed by both color Doppler ultrasonography and CT angiography. PMID:22563273

  9. Limitations of using synthetic blood clots for measuring in vitro clot capture efficiency of inferior vena cava filters

    Directory of Open Access Journals (Sweden)

    Robinson RA

    2013-05-01

    Full Text Available Ronald A Robinson, Luke H Herbertson, Srilekha Sarkar Das, Richard A Malinauskas, William F Pritchard, Laurence W GrossmanOffice of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, MD, USAAbstract: The purpose of this study was first to evaluate the clot capture efficiency and capture location of six currently-marketed vena cava filters in a physiological venous flow loop, using synthetic polyacrylamide hydrogel clots, which were intended to simulate actual blood clots. After observing a measured anomaly for one of the test filters, we redirected the focus of the study to identify the cause of poor clot capture performance for large synthetic hydrogel clots. We hypothesized that the uncharacteristic low clot capture efficiency observed when testing the outlying filter can be attributed to the inadvertent use of dense, stiff synthetic hydrogel clots, and not as a result of the filter design or filter orientation. To study this issue, sheep blood clots and polyacrylamide (PA synthetic clots were injected into a mock venous flow loop containing a clinical inferior vena cava (IVC filter, and their captures were observed. Testing was performed with clots of various diameters (3.2, 4.8, and 6.4 mm, length-to-diameter ratios (1:1, 3:1, 10:1, and stiffness. By adjusting the chemical formulation, PA clots were fabricated to be soft, moderately stiff, or stiff with elastic moduli of 805 ± 2, 1696 ± 10 and 3295 ± 37 Pa, respectively. In comparison, the elastic moduli for freshly prepared sheep blood clots were 1690 ± 360 Pa. The outlying filter had a design that was characterized by peripheral gaps (up to 14 mm between its wire struts. While a low clot capture rate was observed using large, stiff synthetic clots, the filter effectively captured similarly sized sheep blood clots and soft PA clots. Because the stiffer synthetic clots remained straight when approaching the filter in the IVC model flow loop, they were more likely to pass between the peripheral filter struts, while the softer, physiological clots tended to fold and were captured by the filter. These experiments demonstrated that if synthetic clots are used as a surrogate for animal or human blood clots for in vitro evaluation of vena cava filters, the material properties (eg, elastic modulus and dynamic behavior of the surrogate should first be assessed to ensure that they accurately mimic an actual blood clot within the body.Keywords: blood clot, elastic modulus, polyacrylamide hydrogel, in vitro testing of vena cava filters

  10. Use of a Trellis Device for Endovascular Treatment of Venous Thrombosis Involving a Duplicated Inferior Vena Cava

    Energy Technology Data Exchange (ETDEWEB)

    Saettele, Megan R., E-mail: SaetteleM@umkc.edu [University of Missouri, Kansas City, Department of Radiology, Saint Luke' s Hospital (United States); Morelli, John N., E-mail: dr.john.morelli@gmail.com [Texas A and M University Health Science Center, Department of Radiology, Scott and White Clinic and Hospital (United States); Chesis, Paul; Wible, Brandt C. [University of Missouri, Kansas City, Department of Interventional Radiology, Saint Luke' s Hospital (United States)

    2013-12-15

    Congenital anomalies of the inferior vena cava (IVC) are increasingly recognized with CT and venography techniques. Although many patients with IVC anomalies are asymptomatic, recent studies have suggested an association with venous thromboembolism. We report the case of a 62-year-old woman with extensive venous clot involving the infrarenal segment of a duplicated left IVC who underwent pharmacomechanical thrombectomy and tissue plasminogen activator catheter-directed thrombolysis with complete deep venous thrombosis resolution. To our knowledge this is the first reported case in the English literature of the use of a Trellis thrombectomy catheter in the setting of duplicated IVC.

  11. Superior vena cava syndrome associated with right-to left shunt through systemic-to-pulmonary venous collaterals

    Energy Technology Data Exchange (ETDEWEB)

    Juan, Yu Hsiang; Saboo, Sachin S.; Anand, Vishal; Chatzizisis, Yiannis S.; Steigner, Michael L. [Brigham and Women' s Hospital, Harvard Medical School, Boston (United States); Lin, Yu Ching [Chang Gung Memorial Hospital, Keelung and Chang Gung University, Keelung (China)

    2014-04-15

    Superior vena cava (SVC) obstruction is associated with the gradual development of venous collaterals. We present a rare form of systemic-to-pulmonary subpleural collateral pathway that developed in the bridging subpleural pulmonary veins in a 54-year-old woman with complete SVC obstruction. This uncommon collateral pathway represents a rare form of acquired right-to-left shunt due to previous pleural adhesions with an increased risk of stroke due to right-to-left venous shunting, which requires lifelong anticoagulation.

  12. Catheter-Directed Thrombolysis of Inferior Vena Cava Thrombosis in a 13-Day-Old Neonate and Review of Literature

    International Nuclear Information System (INIS)

    Complete inferior vena cava thrombosis (IVC) in neonates is uncommon, but may cause significant morbidity. A 13-day-old neonate suffered IVC thrombosis secondary to antithrombin III deficiency, possibly contributed to by a mutation in the methyl tetrahydrofolate reductase gene. Catheter-directed thrombolysis (CDT) with recombinant tissue plasminogen activator (rt-PA, Alteplase) was used successfully to treat extensive venous thrombosis in this neonate without complications. We also review the literature on CDT for treatment of IVC thrombosis in critically ill neonates and infants.

  13. Use of a Trellis Device for Endovascular Treatment of Venous Thrombosis Involving a Duplicated Inferior Vena Cava

    International Nuclear Information System (INIS)

    Congenital anomalies of the inferior vena cava (IVC) are increasingly recognized with CT and venography techniques. Although many patients with IVC anomalies are asymptomatic, recent studies have suggested an association with venous thromboembolism. We report the case of a 62-year-old woman with extensive venous clot involving the infrarenal segment of a duplicated left IVC who underwent pharmacomechanical thrombectomy and tissue plasminogen activator catheter-directed thrombolysis with complete deep venous thrombosis resolution. To our knowledge this is the first reported case in the English literature of the use of a Trellis thrombectomy catheter in the setting of duplicated IVC

  14. Use of a Trellis device for endovascular treatment of venous thrombosis involving a duplicated inferior vena cava.

    Science.gov (United States)

    Saettele, Megan R; Morelli, John N; Chesis, Paul; Wible, Brandt C

    2013-12-01

    Congenital anomalies of the inferior vena cava (IVC) are increasingly recognized with CT and venography techniques. Although many patients with IVC anomalies are asymptomatic, recent studies have suggested an association with venous thromboembolism. We report the case of a 62-year-old woman with extensive venous clot involving the infrarenal segment of a duplicated left IVC who underwent pharmacomechanical thrombectomy and tissue plasminogen activator catheter-directed thrombolysis with complete deep venous thrombosis resolution. To our knowledge this is the first reported case in the English literature of the use of a Trellis thrombectomy catheter in the setting of duplicated IVC. PMID:23370490

  15. Two Stage Complex Embolization of an Arteriovenous Fistula between the Right Common Iliac Artery and the Inferior Vena Cava

    Directory of Open Access Journals (Sweden)

    Marc Gingell Littlejohn

    2009-01-01

    Full Text Available

    We  present an interesting case of a symptomatic high flow AV fistula between the right common iliac artery (CIA and the inferior vena cava (IVC, successfully treated by endovascular coil embolization. The patient was found to have a right lower polar renal artery crossing the ipsilateral ureter arising from the CIA, causing pelvi-ureteric junction (PUJ obstruction and recurrent pyelonephritis.  It is hypothesized that this fistula arising from the lower polar renal artery and entering the IVC, may have occurred as a result of trauma during a previous pyeloplasty, or a pathologically induced process of angiogenesis stemming from recurrent pyelonephritis.

  16. Internal jugular and common femoral venous access for the removal of a long-term embedded vena cava filter

    Science.gov (United States)

    Salati, Umer; Govender, Pradeep; Torreggiani, William; Browne, Ronan

    2014-01-01

    We describe an inferior vena cava filter retrieval technique requiring triple venous access performed in a 35-year-old male who was referred for filter removal 16 months after its insertion. The filter showed a right-sided tilt with endothelialization of the distal filter struts into the caval wall. Access was required via both internal jugular veins to straighten the filter using a snared-loop technique. Further 18 F right common femoral vein access was required to snare and remove the filter, which could not be completely collapsed distally due to endothelialized tissue, precluding normal removal via the jugular venous route. PMID:24509181

  17. 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

    Scientific Electronic Library Online (English)

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

    2007-06-01

    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, espe [...] cialmente 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. Abstract in english 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 i [...] nferior vena cava, iliac, femoral and popliteal vein thrombosis in a 16-year-old patient with inferior vena cava agenesis and retroaortic left renal vein.

  18. Atresia of the Coronary Sinus Ostium to the Right Atrium with a Persistent Left Superior Vena Cava Atresia del Ostium del Seno Coronario en el Atrio Derecho con una Vena Cava Superior Izquierda Persistente

    Directory of Open Access Journals (Sweden)

    Abadio Gonçalves Caetano

    2009-09-01

    Full Text Available The coronary sinus has lately assumed an important role in the cardiologic clinic once it has been widely used in invasive procedures of the heart. Commonly, it is used during the electrodes implants for the epimiocardic monitoring of the cardiac rhythm, through a biventricular pace maker. These invasive procedures are not possible in hearts with an atresic coronary sinus ostium. In the presence of this anomaly, another may occur: the development of the "Marchal" vein which is a remaining of the left superior vena cava (LSVC. This happens so that the venous blood from the heart can drain into the right atrium, by a communication between the LSVC and the left brachiocephalic vein. The presence of a LSVC brings difficulties when performing an invasive procedure in order to access the right atrium through the superior vena cava, usually done in the cardiologic clinic. Moreover, the LSVC crossing over the left atrium is vulnerable to cardiovascular surgical interventions, confirmed by clinical reports. In the present study, 400 formalin fixed hearts from male cadavers, aged between 35 and 80 years, were investigated, particularly for the anatomy of the coronary sinus. The obliterated ostium of the coronary sinus to the right atrium associated with a persistent LSVC was present in only one (0.25%. We performed a diameter study of these structures since they were dilated due to the venous blood from the heart draining into the right atrium, by a communication between the LSVC and the left brachiocephalic vein. We also perform a literature review of these cases and discuss our finding in relation to its clinical importance.El seno coronario recientemente ha asumido un papel importante en la clínica cardiológico, siendo ampliamente utilizado en procedimientos invasivos del corazón. Comúnmente, se utiliza en los implantes de los electrodos para el monitoreo epimiocárdico del ritmo cardiaco, a través de un ritmo biventricular establecido. Estos procedimientos invasivos no son posibles en los corazones con una atresia del ostium del seno coronario. En presencia de esta condición, se puede producir otra anomalía: el desarrollo de la vena de "Marchal" la cual es un vestigio de la vena cava superior izquierda (VCSI. Esto provoca que la sangre venosa del corazón pueda drenar en el atrio derecho, por una comunicación entre la VCSI y la vena braquicefálica izquierda. La presencia de una VCSI trae dificultades a la hora de realizar un procedimiento invasivo con el fin de acceder al atrio derecho a través de la vena cava superior, usualmente hecho en la clínica cardiológica. Por otra parte, el cruzamiento de la VCSI sobre el atrio izquierdo es vulnerable en las intervenciones quirúrgicas cardiovasculares, confirmado por informes clínicos. En el presente estudio, 400 corazones fijados en formalina provenientes a cadáveres de sexo masculino, con edades comprendidas entre los 35 y 80 años, fueron investigados, en particular por la anatomía del seno coronario. El ostium obliterado del seno coronario al atrio derecho asociado con una VCSI persistente estuvo presente en sólo una muestra (0,25%. Se realizó un estudio del diámetro de estas estructuras dilatadas debido a que la sangre venosa drena desde el corazón hacia el atrio derecho, por una comunicación entre la VCSI y la vena braquicefálica izquierda. También se realiza una revisión de la literatura de estos casos y se discuten nuestros hallazgos en relación con su importancia clínica.

  19. Atresia of the Coronary Sinus Ostium to the Right Atrium with a Persistent Left Superior Vena Cava / Atresia del Ostium del Seno Coronario en el Atrio Derecho con una Vena Cava Superior Izquierda Persistente

    Scientific Electronic Library Online (English)

    Abadio Gonçalves, Caetano; Tiago Coelho, Ribeiro; Omar Andrade Rodrigues, Filho; Valéria Paula Sassoli, Fazan.

    2009-09-01

    Full Text Available El seno coronario recientemente ha asumido un papel importante en la clínica cardiológico, siendo ampliamente utilizado en procedimientos invasivos del corazón. Comúnmente, se utiliza en los implantes de los electrodos para el monitoreo epimiocárdico del ritmo cardiaco, a través de un ritmo biventri [...] cular establecido. Estos procedimientos invasivos no son posibles en los corazones con una atresia del ostium del seno coronario. En presencia de esta condición, se puede producir otra anomalía: el desarrollo de la vena de "Marchal" la cual es un vestigio de la vena cava superior izquierda (VCSI). Esto provoca que la sangre venosa del corazón pueda drenar en el atrio derecho, por una comunicación entre la VCSI y la vena braquicefálica izquierda. La presencia de una VCSI trae dificultades a la hora de realizar un procedimiento invasivo con el fin de acceder al atrio derecho a través de la vena cava superior, usualmente hecho en la clínica cardiológica. Por otra parte, el cruzamiento de la VCSI sobre el atrio izquierdo es vulnerable en las intervenciones quirúrgicas cardiovasculares, confirmado por informes clínicos. En el presente estudio, 400 corazones fijados en formalina provenientes a cadáveres de sexo masculino, con edades comprendidas entre los 35 y 80 años, fueron investigados, en particular por la anatomía del seno coronario. El ostium obliterado del seno coronario al atrio derecho asociado con una VCSI persistente estuvo presente en sólo una muestra (0,25%). Se realizó un estudio del diámetro de estas estructuras dilatadas debido a que la sangre venosa drena desde el corazón hacia el atrio derecho, por una comunicación entre la VCSI y la vena braquicefálica izquierda. También se realiza una revisión de la literatura de estos casos y se discuten nuestros hallazgos en relación con su importancia clínica. Abstract in english The coronary sinus has lately assumed an important role in the cardiologic clinic once it has been widely used in invasive procedures of the heart. Commonly, it is used during the electrodes implants for the epimiocardic monitoring of the cardiac rhythm, through a biventricular pace maker. These inv [...] asive procedures are not possible in hearts with an atresic coronary sinus ostium. In the presence of this anomaly, another may occur: the development of the "Marchal" vein which is a remaining of the left superior vena cava (LSVC). This happens so that the venous blood from the heart can drain into the right atrium, by a communication between the LSVC and the left brachiocephalic vein. The presence of a LSVC brings difficulties when performing an invasive procedure in order to access the right atrium through the superior vena cava, usually done in the cardiologic clinic. Moreover, the LSVC crossing over the left atrium is vulnerable to cardiovascular surgical interventions, confirmed by clinical reports. In the present study, 400 formalin fixed hearts from male cadavers, aged between 35 and 80 years, were investigated, particularly for the anatomy of the coronary sinus. The obliterated ostium of the coronary sinus to the right atrium associated with a persistent LSVC was present in only one (0.25%). We performed a diameter study of these structures since they were dilated due to the venous blood from the heart draining into the right atrium, by a communication between the LSVC and the left brachiocephalic vein. We also perform a literature review of these cases and discuss our finding in relation to its clinical importance.

  20. Computer tomographic demonstration of so-called azygos continuation in the absence of the hepatic segment of the inferior vena cava

    International Nuclear Information System (INIS)

    Dilatation of the azygos vein is usually due to increased pressure or flow, rarely is it diopathic. Another cause is so-called continuation of the azygos in cases of absence of the hepatic segment of the inferior vena cava. The method of choice for the investigation of azygos dilatation nowadays is computer tomotgraphy. Anomalies of the inferior vena cava can be recognised in this way unequivocally by a non-invasive method. Computer tomography frequently shows important additional abnormalities (e.g. situs inversus, polysplenia), since it demonstrates all organs situated in the plane of section. (orig.)

  1. Transient right-sided heart failure after percutaneous transluminal angioplasty (PTA) of Membranous obstruction of inferior vena cava: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sung Bin [College of Medicine, University of Ulsan, Ulsan (Korea, Republic of); Lee, Deok hee; Kim, Yeon Suk; Jung, Seung Mun; Ryu, Dae Sik; Park, Man Soo [Kangnung Hospital, Kangnung (Korea, Republic of)

    2000-09-01

    We experienced a case of transient right-sided heart failure after angioplasty of membranous obstruction of the inferior vena cava confirmed by sonography and an inferior vena cavogram. Angioplasty involved the use of a self-expandable metallic stent, but after successful recanalization of the obstruction, the patient became dyspneic. Chest radiography revealed mild cardiomegaly with pulmonary congestion, but this was resolved spontaneously. For the prevention of serious heart failure, we recommend preprocedural evaluation of cardiac function. (author)

  2. Cerebral tissue oxygenation index and superior vena cava blood flow in the very low birth weight infant.

    LENUS (Irish Health Repository)

    Moran, M

    2012-02-01

    BACKGROUND: Superior vena cava (SVC) flow assesses blood flow from the upper body, including the brain. Near infrared spectroscopy (NIRS) provides information on brain perfusion and oxygenation. AIM: To assess the relationship between cerebral tissue oxygenation index (cTOI) and cardiac output measures in the very low birth weight (VLBW) infant in the first day of life. METHODS: A prospective observational cohort study. Neonates with birth weight less than 1500 g (VLBW) were eligible for enrollment. Newborns with congenital heart disease, major congenital malformations and greater than Papile grade1 Intraventricular Haemorrhage on day 1 of life were excluded. Echocardiographic evaluation of SVC flow was performed in the first 24 h of life. Low SVC flow states were defined as a flow less than 40 mL\\/kg\\/min. cTOI was measured using NIRO 200 Hamamatsu. RESULTS: Twenty-seven VLBW neonates had both echocardiography and NIRS performed. The median (range) gestation was 29\\/40 (25 + 3 to 31 + 5 weeks) and median birth weight was 1.2 kg (0.57-1.48 kg). The mean (SD) TOI was 68.1 (7.9)%. The mean (SD) SVC flow was 70.36(39.5) mLs\\/kg\\/min. The correlation coefficient of cerebral tissue oxygenation and SVC flow was r = 0.53, p-value 0.005. There was a poor correlation between right and left ventricular output and cTOI which is not surprising considering the influence of intra- and extracardiac shunts. CONCLUSION: There is a positive relationship between cerebral TOI values and SVC flow in the very low birth infant on day one of life.

  3. Scimitar vein descending from the right inferior lobe to the inferior vena cava beneath the diaphragm: a rare case.

    Science.gov (United States)

    Hayashi, Shogo; Hirai, Shuichi; Naito, Munekazu; Kawata, Shinichi; Qu, Ning; Hatayama, Naoyuki; Terayama, Hayato; Moriyama, Hiroshi; Itoh, Masahiro

    2015-03-01

    Scimitar syndrome is a rare anomaly involving a pulmonary vein flowing into the inferior vena cava (scimitar vein) and is commonly associated with lung hypoplasia wherein a scimitar vein drains the entire lung. We report a rare case of a scimitar vein draining only the right inferior lobe found in a 77-year-old male cadaver. In this case, no hypoplastic lung or abnormal lobulation were observed. The scimitar vein drained the inferior lobe of the right lung after piercing the diaphragm and draining into the inferior vena cava. The remaining two right pulmonary veins, draining the superior and middle lobes, terminated into the left atrium. To the best of our knowledge, this is the first report of a scimitar vein during gross anatomical dissection in an adult cadaver. In adults, scimitar veins are often benign, incidental findings, and little is known about them. The present case of a scimitar vein partially draining the lung without lung hypoplasia offers important insights into the formative processes of the pulmonary venous system. PMID:24633625

  4. Upper terminal of the inferior vena cava and development of the heart atriums: a study using human embryos

    Science.gov (United States)

    Hwang, Si Eun; Rodríguez-Vázquez, José Francisco; Murakami, Gen; Cho, Baik Hwan

    2014-01-01

    In the embryonic heart, the primitive atrium is considered to receive the bilateral sinus horns including the upper terminal of the inferior vena cava (IVC). To reveal topographical anatomy of the embryonic venous pole of the heart, we examined horizontal serial paraffin sections of 15 human embryos with crown-rump length 9-31 mm, corresponding to a gestational age of 6-7 weeks or Carnegie stage 14-16. The IVC was often fixed to the developing right pulmonary vein by a mesentery-like fibrous tissue. Rather than the terminal portion of the future superior vena cava, the IVC contributed to form a right-sided atrial lumen at the stage. The sinus venosus or its left horn communicated with the IVC in earlier specimens, but in later specimens, the left atrium extended caudally to separate the sinus and IVC. In contrast, the right atrium consistently extended far caudally, even below the sinus horn, along the IVC. A small (or large) attachment between the left (or right) atrium and IVC in adult hearts seemed to be derived from the left (or right) sinus valve. This hypothesis did not contradict with the incorporation theory of the sinus valves into the atrial wall. Variations in topographical anatomy around the IVC, especially of the sinus valves, might not always depend on the stages but partly in individual differences. PMID:25548721

  5. Correlation of inferior vena cava (ivc) diameter and central venous pressure (cvp) for fluid monitoring in icu

    International Nuclear Information System (INIS)

    To determine intravascular fluid status in critically ill patients using inferior vena cava diameter and correlating it with central venous pressure. Study Design: Cross sectional study. Place and Duration of Study: Intensive care department, Military Hospital Rawalpindi from Jan 2013 to Aug 2013. Material and Methods: We included 115 adult patients of both genders in age range of 18 to 87 years by consecutive sampling admitted in intensive care unit. Ultrasound guided IVC diameter was assessed in supine patients. Data was simultaneously collected from the CVP catheter. Variables included in study were age, gender, CVP, IVC diameter. Results: CVP ranged from -4 to 26 cm H/sub 2/O with mean of 8 cm H/sub 2/O (SD = 6.24). Mean IVC diameters increased with increase in CVP. Correlation between CVP and max IVC diameter was moderate and significant (r = 0.53, p < 0.001). Correlation between CVP and min IVC diameter was also moderate and significant (r = 0.58, p < 0.001). Conclusion: A simple bedside sonography of inferior vena cava diameter correlates well with extremes of CVP values and can be helpful in assessing intravascular fluid status in these patients. (author)

  6. Upper terminal of the inferior vena cava and development of the heart atriums: a study using human embryos.

    Science.gov (United States)

    Kim, Ji Hyun; Hwang, Si Eun; Rodríguez-Vázquez, José Francisco; Murakami, Gen; Cho, Baik Hwan

    2014-12-01

    In the embryonic heart, the primitive atrium is considered to receive the bilateral sinus horns including the upper terminal of the inferior vena cava (IVC). To reveal topographical anatomy of the embryonic venous pole of the heart, we examined horizontal serial paraffin sections of 15 human embryos with crown-rump length 9-31 mm, corresponding to a gestational age of 6-7 weeks or Carnegie stage 14-16. The IVC was often fixed to the developing right pulmonary vein by a mesentery-like fibrous tissue. Rather than the terminal portion of the future superior vena cava, the IVC contributed to form a right-sided atrial lumen at the stage. The sinus venosus or its left horn communicated with the IVC in earlier specimens, but in later specimens, the left atrium extended caudally to separate the sinus and IVC. In contrast, the right atrium consistently extended far caudally, even below the sinus horn, along the IVC. A small (or large) attachment between the left (or right) atrium and IVC in adult hearts seemed to be derived from the left (or right) sinus valve. This hypothesis did not contradict with the incorporation theory of the sinus valves into the atrial wall. Variations in topographical anatomy around the IVC, especially of the sinus valves, might not always depend on the stages but partly in individual differences. PMID:25548721

  7. Endovascular treatment of intrahepatic inferior vena cava obstruction from malignant hepatocellular tumor thrombus utilizing Luminexx self-expanding nitinol stents

    Energy Technology Data Exchange (ETDEWEB)

    Stambo, Glenn W. [Division of Vascular and Interventional Radiology, Department of Radiology, St. Joseph' s Hospital and Medical Center, 4516 North Armenia Avenue, Tampa, FL 33603 (United States)], E-mail: xraydoc2@yahoo.com; Leto, John [Division of Vascular and Interventional Radiology, Department of Radiology, St. Joseph' s Hospital and Medical Center, 3001 W. Dr. Martin Luther King Jr. Blvd., Tampa, FL 33607 (United States); George, Christopher [Department of Hematology and Oncology, St. Joseph' s Hospital and Medical Center, 4301 W. Habana Avenue, Suite 1, Tampa, FL 33607 (United States); Van Epps, Kelly; Woeste, Troy; Berlet, Mathew [Division of Vascular and Interventional Radiology, Department of Radiology, St. Joseph' s Hospital and Medical Center, 4516 North Armenia Avenue, Tampa, FL 33603 (United States)

    2008-05-15

    Inferior vena cava (IVC) obstruction is a well-described clinical entity. Most IVC obstructions from malignant neoplasms are a direct result of tumor compression [Oviedo J, Cerda S. Vascular invasion by hepatocellular carcinoma. Arch Pathol Lab Med 2001;125: 454-5; Furui S, Sawada S, et al. Gianturco stent placement in malignant caval obstruction: analysis of factors for predicting the outcome. Radiology 1995;195:147-52; Fletcher WS, Lakin PC, et al. Results of treatment of inferior vena cava syndrome with expandable metallic stents. Arch Surg 1998;133:935-8]. The symptoms of IVC obstruction include progressive ascites, scrotal edema and lower body edema. These constellations of symptoms are described as IVC syndrome and are devastating to a patient with end-stage cancer. We describe a palliative therapy utilizing Luminexx nitinol self-expanding stents to treat intracaval hepatoma thrombus obstructing the IVC. The procedure is rapidly performed, technically reliable, and has essentially no morbidity or mortality. This procedure can be performed in the interventional radiology suite with excellent results resolving the IVC syndrome soon after placement of the stents. We believe endovascular stenting as an excellent palliative therapy for patients with IVC syndrome and should be the treatment of choice for caval obstructions due to intraluminal tumor thrombus.

  8. British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry

    Energy Technology Data Exchange (ETDEWEB)

    Uberoi, Raman, E-mail: raman.Uberoi@orh.nhs.uk; Tapping, Charles Ross [Oxford University Hospitals, John Radcliffe Hospital, Department of Radiology (United Kingdom); Chalmers, Nicholas [Manchester Royal Infirmary, Department of Radiology (United Kingdom); Allgar, Victoria [University of York, Hull and York Medical School (United Kingdom)

    2013-12-15

    Purpose: The British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry was produced to provide an audit of current United Kingdom (UK) practice regarding placement and retrieval of IVC filters to address concerns regarding their safety. Methods: The IVC filter registry is a web-based registry, launched by the BSIR on behalf of its membership in October 2007. This report is based on prospectively collected data from October 2007 to March 2011. This report contains analysis of data on 1,434 IVC filter placements and 400 attempted retrievals performed at 68 UK centers. Data collected included patient demographics, insertion and retrieval data, and patient follow-up. Results: IVC filter use in the majority of patients in the UK follows accepted CIRSE guidelines. Filter placement is usually a low-risk procedure, with a low major complication rate (<0.5 %). Cook Gunther Tulip (560 filters: 39 %) and Celect (359 filters: 25 %) filters constituted the majority of IVC filters inserted, with Bard G2, Recovery filters, Cordis Trapease, and OptEase constituting most of the remainder (445 filters: 31 %). More than 96 % of IVC filters deployed as intended. Operator inexperience (<25 procedure) was significantly associated with complications (p < 0.001). Of the IVC filters initially intended for temporary placement, retrieval was attempted in 78 %. Of these retrieval was technically successful in 83 %. Successful retrieval was significantly reduced for implants left in situ for >9 weeks versus those with a shorter dwell time. New lower limb deep vein thrombosis (DVT) and/or IVC thrombosis was reported in 88 patients following filter placement, there was no significant difference of incidence between filter types. Conclusions: This registry report provides interventional radiologists and clinicians with an improved understanding of the technical aspects of IVC filter placement to help improve practice, and the potential consequences of IVC filter placement so that we are better able to advise patients. There is a significant learning curve associated with IVC filter insertion, and when a filter is placed with the intention of removal, procedures should be in place to avoid the patient being lost to follow-up.

  9. Obstruction of hepatic vein or inferior vena cava after liver transplantation: the diagnosis and interventional treatment

    International Nuclear Information System (INIS)

    Objective: To investigate the diagnosis and interventional therapeutic technology for the obstruction of hepatic vein (HV) or inferior vena cava (IVC) after liver transplantation. Methods: In the 831 patients who received orthotopic liver transplantation (OLT) and 26 patients who received living donor liver transplantation (LDLT), 11 cases were confirmed with HV or IVC obstruction by venography and received interventional treatment from 2 to 111 days after liver transplantation. Of the 11 patients, five had the obstruction of HV anastomosis, five had the obstruction of IVC anastomosis, and one had the obstruction of HV and IVC anastomosis. In the eleven patients, five patients underwent OLT, four patients underwent LDLT, and two pediatric patients underwent reduced-size OLT. Before interventional treatment, 9 patients function tests, clinical sympatom, and monitoring of HV or IVC flow. Pressure gradients before and after therapeutic technology of 11 cases were retrospectively analyzed. Results: In all 11 patients, CT or MRI could clearly show congested areas of the liver, and the location and degree of HV or IVC obstruction. Of the 11 patients, four with HV obstruction and five with IVC obstruction were treated with stent placement, one with HV obstruction was treated with percutaneous transluminal angioplasty (PTA), one with HV and IVC obstruction was treated with HV PTA and IVC stent placement. Interventional technical success was achieved in all patients. The venouss was achieved in all patients. The venous pressure gradient across obstruction was significantly reduced from (16.5 ± 4.1) mm Hg (1 mm Hg =0.133 kPa) before the procedure to (2.9 ± 1.7) mm Hg after the procedure (t=11.5, P<0.01). Clinical improvement was noted in 10 patients except one pediatric patient who died of multiple-organs failure at the 9 th day after the treatment. During the follow-up period of 9 to 672 days, two patients with PTA treatment had recurrent HV stenosis within one month after treatment, no patient with stent placement developed venous restenosis. No major complications occurred during the procedures. Conclusions: Stent placement is safe and effective for HV or IVC obstruction after liver transplantation. CT or MRI before treatment is of important value for the diagnosis of congested areas of the liver, and the observation of HV or IVC obstruction. (authors)

  10. Use of Retrievable Compared to Permanent Inferior Vena Cava Filters: A Single-Institution Experience

    International Nuclear Information System (INIS)

    The purpose of this study was to review the use, safety, and efficacy of retrievable inferior vena cava (IVC) filters in their first 5 years of availability at our institution. Comparison was made with permanent filters placed in the same period. A retrospective review of IVC filter implantations was performed from September, 1999, to September, 2004, in our department. These included both retrievable and permanent filters. The Recovery nitinol and Guenther tulip filters were used as retrievable filters. The frequency of retrievable filter used was calculated. Clinical data and technical data related to filter placement were reviewed. Outcomes, including pulmonary embolism, complications associated with placement, retrieval, or indwelling, were calculated. During the study period, 604 IVC filters were placed. Of these, 97 retrievable filters (16%) were placed in 96 patients. There were 53 Recovery filter and 44 Tulip filter insertions. Subjects were 59 women and 37 men; the mean age was 52 years, with a range of from 18 to 97 years. The placement of retrievable filters increased from 2% in year 1 to 32% in year 5 of the study period. The total implantation time for the permanent group was 145,450 days, with an average of 288 days (range, 33-1811 days). For the retrievable group, the total implantation time was 21,671 days, with an average of 226 days (range, 2-1217 days). Of 29 patients who returned for filter retrieval, the filter was successfully removed in 28. Therilter was successfully removed in 28. There were 14 of 14 successful Tulip filter retrievals and 14 of 15 successful Recovery filter retrievals. In one patient, after an indwelling period of 39 days, a Recovery nitinol filter could not be removed secondary to a large clot burden within the filter. For the filters that were removed, the mean dwell time was 50 days for the Tulip type and 20 days for the Recovery type. Over the follow-up period there was an overall PE incidence of 1.4% for the permanent group and 1% for the retrieval group. In conclusion, there was an increase in the use of retrievable filters over the study period and an overall increase in the total number of filters implanted. The increased use of these filters appeared to be due to expanded indications predicated by their retrievability. Placement and retrieval of these filters have a low risk of complications, and retrievable filters appeared effective, as there was low rate of clinically significant pulmonary embolism associated with these filters during their indwelling time

  11. Anomalía del retorno venoso sistémico Drenaje anómalo de la vena cava superior derecha a la aurícula izquierda: Revisión de la literatura y reporte de caso / Anomalous systemic venous return. Anomalous drainage of the right superior vena cava into the left atrium: Review of literature and case report

    Scientific Electronic Library Online (English)

    Ríos, Giovanny; Víctor M, Caicedo; Hernando, Orjuela; Hernando, Santos; Federico, Núñez; Darío, Andrade.

    2012-06-01

    Full Text Available La anomalía total del retorno venoso sistémico tiene gran variedad de presentaciones; sin embargo, la patología de más baja frecuencia es el drenaje de vena cava superior derecha a la aurícula izquierda, hecho de peso para que en el mundo se reporten pocos casos. En la Fundación Clínica Abood Shaio [...] se trató el caso de una paciente de seis años de edad con drenaje venoso total de cava superior derecha a la aurícula izquierda, mediante la técnica de movilización de cava superior y anastomosis cavo-atrial, y se obtuvieron buenos resultados. El caso es mención corresponde al número 21 en la literatura mundial. Abstract in english Total anomalous systemic venous return has a variety of presentations, being the drainage of right superior vena cava into the left atrium a low frequency condition. There are few reported cases in the world. In Shaio Clinic Foundation we have handled a case of total venous drainage of the right sup [...] erior vena cava into the left atrium in a 6-year old girl, using the superior vena cava mobilization technique and cavo-atrial anastomosis, with good results. This case is reported as case number 21 in the world.

  12. Angiolipoma renal con extensión tumoral a vena cava inferior y aurícula derecha Left kidney angiomyolipoma, spreading to the renal vein, inferior vena cava and involving the heart. Report of one case

    Directory of Open Access Journals (Sweden)

    FRANCO INNOCENTI C

    2008-04-01

    Full Text Available El angiomiolipoma renal es un tumor benigno mesenquimático. Constituyen sólo del 2 al 6% de los tumores renales. Existen alrededor de 12 casos reportados con invasión a las venas renales y la cava inferior. En menos de 5, hay extensión de trombo tumoral hasta aurícula derecha. Objetivo: Presentar el caso clínico, manejo y evolución de una paciente con un angiomiolipoma renal con extensión tumoral a vena renal y cava inferior y que compromete la cavidad auricular derecha casi en su totalidad. Paciente y método: 50 años, sexo femenino con hallazgo del tumor por un ultrasonografía abdominal motivada por el estudio de síntomas digestivos de origen probablemente funcional. Se confirma el diagnóstico con TAC y ecocardiograma doppler. Se realiza una cirugía combinada, abdominal y esternotómica, con la ayuda de un by pass aortopulmonar. Resultados: Nefrectomia izquierda, liberación intravascular del tumor que se empuja por cava inferior y se extrae en block por la aurícula derecha. Evoluciona inicialmente en forma satisfactoria, pero desarrolla distress respiratorio con angio TAC de tórax negativo para TEP a las 48 h de la cirugía. Se inicia anticoagulación empírica con HBPM y encontrándose extubada y en buenas condiciones hace un hemoperitoneo el día 14, encontrándose hemorragia en napa en los sitios de disección previa. De alta a los 21 días. El seguimiento alejado a los 2 años revela una hernia incisional, reparada sin incidentes, y sin otras complicaciones ni signos de recidiva de patología original. Conclusión: El manejo de equipo multidisciplinario nos permitió ayudar exitosamente a esta paciente con patología rara y complejaRenal angiomyolipoma is an uncommon benign tumor of mesenchymal origin. In less than five of 12 cases reported with renal vein and inferior vena cava involvement the thrombus extends to the right atrium. We report a 50 years old female with a left kidney angiomyolipoma, spreading to the renal vein, inferior vena cava and involving the heart, invading the right atrium almost completely. The tumor was found during a study for abdominal pain. She underwent combined abdominal and cardiac surgery with pulmonary bypass. A left nephrectomy, cavotomy and intravascular dissection of the tumor were performed. The intravascular mass was pushed from abdomen and pulled out through the right atrium. Forty eight hours after surgery, she developed respiratory distress. A chest angio CT scan negative for pulmonary thromboembolism. However, anticoagulation with low molecular weight heparin was started due to the high risk for thromboembolism. She recovered, but 14 days after the original surgery, presented a massive hemoperitoneum. She was operated again, finding a diffuse oozing from the sites of previous dissection. The dose of anticoagulation was lowered, with a good postoperative evolution, being discharged 21 days later. After two years of follow up, she developed an incisional hernia that is repaired

  13. Angiolipoma renal con extensión tumoral a vena cava inferior y aurícula derecha / Left kidney angiomyolipoma, spreading to the renal vein, inferior vena cava and involving the heart. Report of one case

    Scientific Electronic Library Online (English)

    FRANCO, INNOCENTI C; EMILIO, ALARCÓN C; ESTEBAN, ARIAS O; ALECK, STOCKINS L; ROBERTO, SÁNCHEZ U; JAIME, MADARIAGA B; RODRIGO, TORRES-QUEVEDO Q; FELIPE, CABRERA E; RAMÓN, DÍAZ J.

    2008-04-01

    Full Text Available El angiomiolipoma renal es un tumor benigno mesenquimático. Constituyen sólo del 2 al 6% de los tumores renales. Existen alrededor de 12 casos reportados con invasión a las venas renales y la cava inferior. En menos de 5, hay extensión de trombo tumoral hasta aurícula derecha. Objetivo: Presentar el [...] caso clínico, manejo y evolución de una paciente con un angiomiolipoma renal con extensión tumoral a vena renal y cava inferior y que compromete la cavidad auricular derecha casi en su totalidad. Paciente y método: 50 años, sexo femenino con hallazgo del tumor por un ultrasonografía abdominal motivada por el estudio de síntomas digestivos de origen probablemente funcional. Se confirma el diagnóstico con TAC y ecocardiograma doppler. Se realiza una cirugía combinada, abdominal y esternotómica, con la ayuda de un by pass aortopulmonar. Resultados: Nefrectomia izquierda, liberación intravascular del tumor que se empuja por cava inferior y se extrae en block por la aurícula derecha. Evoluciona inicialmente en forma satisfactoria, pero desarrolla distress respiratorio con angio TAC de tórax negativo para TEP a las 48 h de la cirugía. Se inicia anticoagulación empírica con HBPM y encontrándose extubada y en buenas condiciones hace un hemoperitoneo el día 14, encontrándose hemorragia en napa en los sitios de disección previa. De alta a los 21 días. El seguimiento alejado a los 2 años revela una hernia incisional, reparada sin incidentes, y sin otras complicaciones ni signos de recidiva de patología original. Conclusión: El manejo de equipo multidisciplinario nos permitió ayudar exitosamente a esta paciente con patología rara y compleja Abstract in english Renal angiomyolipoma is an uncommon benign tumor of mesenchymal origin. In less than five of 12 cases reported with renal vein and inferior vena cava involvement the thrombus extends to the right atrium. We report a 50 years old female with a left kidney angiomyolipoma, spreading to the renal vein, [...] inferior vena cava and involving the heart, invading the right atrium almost completely. The tumor was found during a study for abdominal pain. She underwent combined abdominal and cardiac surgery with pulmonary bypass. A left nephrectomy, cavotomy and intravascular dissection of the tumor were performed. The intravascular mass was pushed from abdomen and pulled out through the right atrium. Forty eight hours after surgery, she developed respiratory distress. A chest angio CT scan negative for pulmonary thromboembolism. However, anticoagulation with low molecular weight heparin was started due to the high risk for thromboembolism. She recovered, but 14 days after the original surgery, presented a massive hemoperitoneum. She was operated again, finding a diffuse oozing from the sites of previous dissection. The dose of anticoagulation was lowered, with a good postoperative evolution, being discharged 21 days later. After two years of follow up, she developed an incisional hernia that is repaired

  14. Retrievable Guenther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep venous thrombosis in perinatal period

    Energy Technology Data Exchange (ETDEWEB)

    Koecher, Martin [Department of Radiology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic)], E-mail: martin.kocher@seznam.cz; Krcova, Vera [Department of Hematooncology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic); Cerna, Marie [Department of Radiology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic); Prochazka, Martin [Department of Obstetrics and Gynaecology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic)

    2009-04-15

    Objectives: To evaluate the feasibility and efficacy of the retrievable Guenther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep vein thrombosis in the perinatal period and to discuss the technical demands associated with the filter's implantation and retrieval. Methods: Between 1996 until 2007, eight women (mean age 27.4 years, range 20-42 years) with acute deep iliofemoral venous thrombosis in the perinatal period of pregnancy and increased risk of pulmonary embolism during delivery were indicated for retrievable Guenther Tulip Vena Cava Filter implantation. All filters were inserted and removed under local anesthesia from the jugular approach. Results: The Guenther Tulip Vena Cava Filter was implanted suprarenally in all patients on the day of caesarean delivery. In follow-up cavograms performed just before planned filter removal, no embolus was seen in the filter in any patient. In all patients the filter was retrieved without complications on the 12th day after implantation. Conclusions: Retrievable Guenther Tulip Vena Cava Filters can be inserted and removed in patients during the perinatal period without major complications.

  15. Retrievable Guenther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep venous thrombosis in perinatal period

    International Nuclear Information System (INIS)

    Objectives: To evaluate the feasibility and efficacy of the retrievable Guenther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep vein thrombosis in the perinatal period and to discuss the technical demands associated with the filter's implantation and retrieval. Methods: Between 1996 until 2007, eight women (mean age 27.4 years, range 20-42 years) with acute deep iliofemoral venous thrombosis in the perinatal period of pregnancy and increased risk of pulmonary embolism during delivery were indicated for retrievable Guenther Tulip Vena Cava Filter implantation. All filters were inserted and removed under local anesthesia from the jugular approach. Results: The Guenther Tulip Vena Cava Filter was implanted suprarenally in all patients on the day of caesarean delivery. In follow-up cavograms performed just before planned filter removal, no embolus was seen in the filter in any patient. In all patients the filter was retrieved without complications on the 12th day after implantation. Conclusions: Retrievable Guenther Tulip Vena Cava Filters can be inserted and removed in patients during the perinatal period without major complications.

  16. Cardiovascular effects of simultaneous occlusion of the inferior vena cava and aorta in patients treated with hypoxic abdominal perfusion for chemotherapy

    OpenAIRE

    Hofland, J.; Tenbrinck, R.; van IJken, M G A; van Eijck, C. H. J.; Eggermont, A.M.M.; Erdmann, W.

    2002-01-01

    BACKGROUND: Animal studies suggest less cardiovascular disturbance if the aorta and vena cava are occluded simultaneously. We set out to establish the effects of simultaneous clamping in humans, because oncologists suggested that perfusion for chemotherapy could be done under local anaesthesia without invasive haemodynamic monitoring. METHODS: We studied the cardiovascular effects of the onset and removal of simultaneous occlusion of the t...

  17. Technical failure to perform cardiac resynchronization therapy: Use of cardiac magnetic resonance imaging techniques to clarify a left-sided superior vena cava and coronary sinus morphology

    OpenAIRE

    Keeble, William; Mohiaddin, Raad

    2008-01-01

    The most common reason for failure to implant a left ventricular lead to deliver cardiac resynchronization therapy is the presence of unfavourable coronary venous anatomy. The present report illustrates the use of cardiac magnetic resonance imaging to delineate the anatomy of a left-sided superior vena cava in two patients in whom permanent cardiac pacing was unattainable.

  18. Síndrome de vena cava superior y carcinoma insular de tiroides: el stent como alternativa terapéutica paliativa / Superior vena cava syndrome and insular thyroid carcinoma: the stent as a palliative therapeutic alternative

    Scientific Electronic Library Online (English)

    M., Lorenzo-Solar; J., Lado-Abeal; J., Cameselle-Teijeiro; M., García-Vázquez; J., Cabezas-Cerrato.

    2003-06-01

    Full Text Available El síndrome de vena cava superior (SVCS) es una complicación rara del cáncer de tiroides, que se produce como consecuencia de la invasión mediastínica por el tumor o por la invasión intravascular del mismo con trombosis. Creemos describir el primer caso de carcinoma insular de tiroides (variante tum [...] oral indiferenciada del ca. folicular) con SVCS resuelto mediante la colocación de un stent venoso, que deviene así una alternativa eficaz y menos agresiva que la quirúrgica. Se trata de un varón de 73 años que ingresa por un cuadro de disfonía y tumoración laterocervical derecha de dos meses de evolución; la PAAF de tiroides sugirió neoplasia folicular realizándose tiroidectomía total revelando el examen histológico un carcinoma insular de tiroides y administrándose una dosis ablativa de 100 mCi de I131. Al año desarrolla un SVCS, observándose en la TAC recidiva tumoral, con elevación de las cifras de tiroglobulina (Tg) previamente normales. Descartada la indicación quirúrgica se administra radioterapia (52Gy) con despreciable respuesta clínica y agravamiento del cuadro a los pocos meses. Ante la imposibilidad de cirugía y radioterapia, se realizó por vía venosa braquial una flebografía torácico-mediastínica demostrándose obstrución venosa a nivel de la vena cava superior. Se realizó angioplastia y colocación de un stent desde vena innominada hasta vena cava superior; asistiéndose inmediatamente a una franca mejoría clínica. La flebografía de control a los tres meses mostró la permeabilidad del stent con flujo venoso rápido y desaparición de la circulación colateral cérvico-mediastínica. Abstract in english The superior vena cava syndrome (SVCS) is a uncommon complication of thyroid cancers. It is produced as consequence of the mediastinal spread of the tumor or by intravascularr invasion with thrombosis. We describe a case of insular thyroid carcinoma with an SVCS solved by putting an intravenous sten [...] t. The patient was a 73 year old male that consulted by aphonia and presence of a tumor in the right side of the neck of two months of evolution. The PAAF of thyroid suggested the diagnostic of "follicular tumor". A total thyroidectomy was performed on the patient and the sample histological study revealed the existence of a insular carcinoma. An ablative dosis of 131I was adminestered to him. One year after the patient developed the SVCS. A TAC detected a tumoral relapses consistent with clinical syntoms, and was confirmed by a high level of Tg (with TgAntibodies -). As the patient showed a light response to radiotherapy (52Gy), a thoracic flebografy was realized demostrating an extense uper cave venous obstruction. After having accomplished an angioplastia a long stent (20 mm wide) was putt into the uper cave vein that was followed by a fast clinical and radiological improvement. A new flebgraphy practiced three month later showed a rapid venous flux throuhgt the stent, and near totall disappereance of collateral circulation on thorax wall and mediastine.

  19. Robotic-assisted radical nephrectomy for renal angiomyolipoma with inferior vena cava thrombus extension

    OpenAIRE

    Alrabeeah, Khalid A.; Alkhayal, Abdullah M.; Aprikian, Armen G.; Bladou, Frank

    2014-01-01

    Renal angiomyolipoma with inferior vena caval venous extension is rare with only 40 cases reported in the literature. We report a case of a 35-year-old lady with angiomyolipoma with inferior vena caval thrombus that was managed surgically with robotic-assisted radical nephrectomy.

  20. Clinical research of the obstructive interface morphology of the inferior vena cava and the method of choice for taking the 'pierce membrane'

    International Nuclear Information System (INIS)

    Objective: To evaluate the relation between the morphology of the obstructive interface of the inferior vena cava (IVC)and the method of choice for taking the 'pierce membrane'. Methods: Interventional therapy was performed in 155 patients with obstruction of inferior vena cave during 2003-2005. The types of proximal part and distal end of obstruction were classified on the base of inferior vane cavography and divid[d into two groups accordingly. The principle of taking 'pierce membrane' whether as accending or descending route was decided by the morphology of the obstructive interface. The complication rates of taking 'pierce membrane' were compared between the two groups including one of 2003-2005 and another of 1990 -1997 as the control. Results: 155 cases were classified to 7 types according to morphology of inferior vena cava obstruction of the distal interface, the type of membrane with hole (32 cases), the dome type (50 cases), the taper type (17 cases), the horizontal type (13 cases), the inclination type (10 cases), the irregular type (19 eases)and the type of obstruction with communicating branches (14 cases). The morphologies of the proximal part of the obstruction were mainly divided into the type of membrane with hole, dome type, taper type and horizontal type. All the cases were successfully taken 'pierce membrane', without complication of pericardial effusion and abdominal bleeding. In control group of 150 Budd-Chiari syndrome cases with obstruction of Chiari syndrome cases with obstruction of inferior vena cava, the complications of taking 'pierce membrane' included mis puncture into pericardium (16 cases) and abdominal hemorrhage because of rupturing the inferior vena cava in 2 cases. Comparing the two groups, there was statistical significance with severe complications. Conclusions: 'Pierce membrane' interventional technique for the obstruction of inferior vena eava by coinciding the morphology of the obstructive interface with suitable piercing direction can not only raise successful rate, but also can avoid and reduce the occurrence of severe complications. (authors)

  1. Migration of a fractured inferior vena cava filter strut to the right ventricle of the heart: a case report.

    Science.gov (United States)

    Shennib, Hani; Bowles, Bradley; Hickle, Kelli

    2014-01-01

    A 23 year old woman presented with sudden onset retrosternal chest pain following an attempt to move a heavy object from her vehicle. Multiple fractured struts of an inferior vena cava filter were identified in the distal right and left pulmonary artery branches, and in the free wall of the right ventricle. A small pericardial effusion was noted. Because of the depth of penetration into the right ventricle, it was perceived not to be amenable to endovascular retrieval. Over several days of observation, she continued to have progressive retrosternal and left shoulder pain. She underwent exploratory sternotomy and extraction of a strut that was partially protruding from the right ventricle and abrading the diaphragmatic pericardium. The patient recovered quite well and was discharged on the third postoperative day. PMID:25496694

  2. Tumor thrombectomy without bypass for low-grade malignant tumors extending into the inferior vena cava: report of two cases.

    Science.gov (United States)

    Jibiki, Masatoshi; Inoue, Yoshinori; Sugano, Norihide; Iwai, Takehisa; Katou, Tomoyasu

    2006-01-01

    Endometrial stromal sarcoma (ESS) rarely extends into the inferior vena cava (IVC). Two cases of ESS extending into the IVC were encountered. In the first case a low-grade sarcoma and cavography revealed the tumor thrombus to extend to just below the left renal vein from the right internal iliac vein, and the IVC was patent. A tumor thrombectomy was accomplished to prevent pulmonary embolism (PE) and to achieve a good prognosis. The second case was also a low-grade sarcoma. Abdominal computed tomography scanning revealed a large thrombus extending into the IVC just below the hepatic vein. A tumor thrombectomy with an IVC resection was performed. The postoperative course was uneventful for both cases. Aggressive surgical treatment is thus recommended to excise a tumor thrombus with or without an IVC resection in patients with ESS of low-grade malignancy extending into the IVC to prevent sudden death due to PE. PMID:16633754

  3. Nutcracker syndrome due to left-sided inferior vena cava compression and treated with superior mesenteric artery transposition.

    Science.gov (United States)

    Yang, Bao-Zhong; Li, Zhen; Wang, Zhong-Gao

    2012-09-01

    Left renal vein hypertension secondary to left renal vein compression has been described as a cause of persistent hematuria in nutcracker syndrome. Malformation of the inferior vena cava (IVC), although rare and frequently asymptomatic, may also result in left renal vein hypertension, with resultant hematuria when it is severely compressed. We report a 20-year-old man with persistent hematuria due to compression of left-sided IVC. The patient was successfully treated by means of superior mesenteric artery (SMA) transposition and division of the fibrous bundle at the origin of the SMA. His postoperative course was uneventful. Compression of the left IVC is a unique form of nutcracker syndrome. SMA transposition, together with division of a fibrous bundle at the origin of the SMA if present, is a safe and effective surgical procedure for this special entity. PMID:22819752

  4. Common bile duct motion artifacts caused by inferior vena cava pulsation on magnetic resonance cholangiopancreatography. Presidential award proceedings

    International Nuclear Information System (INIS)

    The common bile duct (CBD) moves back and forth, synchronized with the inferior vena cava (IVC) pulsation depending on the cardiac cycle. We retrospectively evaluated the frequency of CBD motion artifact caused by IVC pulsation in magnetic resonance cholangiopancreatography (MRCP). The frequency of pseudo-defects in MRCP was significantly higher in patients with ghost artifact than those without, which was observed at the ventral and dorsal aspects of the CBD on multi-slice half-Fourier acquisition single-shot turbo spin-echo trans-axial (HASTE-ax) images. The present study indicates that pseudo-defects of the CBD caused by IVC pulsation are observed on MRCP. The addition of HASTE-ax images during interpretation can diminish the potential for misinterpreting this CBD motion artifact as a bile duct tumor or biliary stone. (author)

  5. Xanthogranulomatous Pyelonephritis in a male child with renal vein thrombus extending into the inferior vena cava: a Case Report

    Directory of Open Access Journals (Sweden)

    Kotasthane Vaishali D

    2010-07-01

    Full Text Available Abstract Background We present a case of Xanthogranulomatous pyelonephritis (XGPN in a male child with renal vein thrombus extending into the inferior vena cava. This is a rare presentation. XGPN is a rare type of renal infection characterised by granulomatous inflammation with giant cells and foamy histiocytes. The peak incidence is in the sixth to seventh decade with a female predominance. XGPN is rare in children. Case presentation An 11 year old male child presented with a history of high grade fever and chills, right flank pain and progressive pyuria for two months. He had a history of vesical calculus for which he was operated four years back. In our case, a subcapsular right nephrectomy was performed. The surgical specimens were formalin fixed and paraffin embedded. The sections were stained with routine Hematoxylin & Eosin stain. Grossly; the kidney was enlarged with adherent capsule and thickening of the perinephric tissue. The pelvicalyceal system was dilated and was filled with a cast of pus. Histological evaluation revealed diffuse necrosis of the renal parenchyma and perinephric fat. Neutrophils, plasma cells, sheets of foamy macrophages and occasional multinucleate giant cells were seen. The renal vein was partially occluded by an inflammatory thrombus with fibrin, platelets and mixed inflammatory cells. The thrombus was focally adherent to the vein wall with organization. Conclusions The clinical presentation and the macroscopic aspect, together with the histological pattern, the cytological characteristics addressed the diagnosis towards XGPN with a vena caval thrombus. Our case illustrates that the diagnosis of XGPN should be considered even in paediatric age group when renal vein and vena caval thrombi are present.

  6. Interrupción de la vena cava inferior mediante filtros de inserción percutánea: Indicaciones y resultados en 287 pacientes Percutaneous inferior vena cava filters: Indications and results in 287 patients

    Directory of Open Access Journals (Sweden)

    Ivette Arriagada J

    2007-03-01

    Full Text Available Background: Anticoagulation is the treatment of choice for deep vein thrombosis (DVT and pulmonary embolism (PE. Occasionally this treatment is contraindicated or fails to prevent PE. In these patients, inferior vena caval (IVC interruption is indicated and insertion of a filter is the most commonly performed procedure. Aim: To report the experience with IVC filters. Material and methods: Retrospective review of all medical records and operative protocols of patients subjected to IVC filter implantations. Follow up was performed by telephone contact with the patient, relatives or primary physicians, ambulatory consultation or by death certificates. Results: During the period 1993-2005 we implanted IVC filters on 287 patients, 55.4% male, average age: 62.1 yrs (17-99. Indications for the procedure were DVT or PE and contraindication of anticoagulation in 141 patients (49.1%, DVT or PE and complication of anticoagulation in 65 patients (22.6%, prophylaxis in 39 patients (13.6%, massive PE or poor respiratory function in 31 patients (10.8%, paradoxal emboli in 4 patients (1.4% and other causes in seven patients. All percutaneous devices were successfully inserted. There was no morbidity or mortality related to the procedure. The most frequent access site was the internal jugular vein (66.6%. In 24 patients (8.4% the filter was intentionally deployed above the renal veins. Six patients (2.1% were lost to follow up after discharge. A mean follow up of 41.5 months was achieved. Ninety one patients died, with a 5 years survival of 64.7%. Symptomatic recurrent PE occurred in 6 patients (2.1% and was the cause of death on 3 of them (1%, DVT has been detected in 22 patients (7.7% during the follow up period. Conclusions: IVC filter implantation is a safe and effective short and long term measure to prevent PE and its consequences

  7. Interrupción de la vena cava inferior mediante filtros de inserción percutánea: Indicaciones y resultados en 287 pacientes / Percutaneous inferior vena cava filters: Indications and results in 287 patients

    Scientific Electronic Library Online (English)

    Ivette, Arriagada J; Renato, Mertens M; Francisco, Valdés E; Albrecht, Krämer Sch; Leopoldo, Mariné M; Michel, Bergoeing R; Sebastián, Soto G; Jeannette, Vergara G; Magaly, Valdebenito G.

    2007-03-01

    Full Text Available [...] Abstract in english Background: Anticoagulation is the treatment of choice for deep vein thrombosis (DVT) and pulmonary embolism (PE). Occasionally this treatment is contraindicated or fails to prevent PE. In these patients, inferior vena caval (IVC) interruption is indicated and insertion of a filter is the most commo [...] nly performed procedure. Aim: To report the experience with IVC filters. Material and methods: Retrospective review of all medical records and operative protocols of patients subjected to IVC filter implantations. Follow up was performed by telephone contact with the patient, relatives or primary physicians, ambulatory consultation or by death certificates. Results: During the period 1993-2005 we implanted IVC filters on 287 patients, 55.4% male, average age: 62.1 yrs (17-99). Indications for the procedure were DVT or PE and contraindication of anticoagulation in 141 patients (49.1%), DVT or PE and complication of anticoagulation in 65 patients (22.6%), prophylaxis in 39 patients (13.6%), massive PE or poor respiratory function in 31 patients (10.8%), paradoxal emboli in 4 patients (1.4%) and other causes in seven patients. All percutaneous devices were successfully inserted. There was no morbidity or mortality related to the procedure. The most frequent access site was the internal jugular vein (66.6%). In 24 patients (8.4%) the filter was intentionally deployed above the renal veins. Six patients (2.1%) were lost to follow up after discharge. A mean follow up of 41.5 months was achieved. Ninety one patients died, with a 5 years survival of 64.7%. Symptomatic recurrent PE occurred in 6 patients (2.1%) and was the cause of death on 3 of them (1%), DVT has been detected in 22 patients (7.7%) during the follow up period. Conclusions: IVC filter implantation is a safe and effective short and long term measure to prevent PE and its consequences

  8. Mixoma de átrio direito com origem na veia cava inferior: uma localização rara com implicações diagnósticas e terapêuticas Right atrium myxoma originating from the inferior vena cava: an unusual location with therapeutic and diagnostic implications

    Directory of Open Access Journals (Sweden)

    Noedir A. G. STOLF

    2000-09-01

    Full Text Available Os mixomas são os tumores cardíacos primários mais freqüentes. Sua localização habitual é o átrio esquerdo, sendo encontrados também em outros locais. É relatado o caso de paciente de 71 anos que, com diagnóstico de tumor em átrio direito, foi submetido a operação para retirada do tumor. A operação foi realizada, sendo confirmado o diagnóstico e procedida a ressecção do tumor com sucesso e sem intercorrência. Em estudo ecocardiográfico de controle no 4º mês de pós-operatório, evidenciou-se presença de massa residual que parecia originar-se na veia cava inferior. Foi submetida a nova operação, em que foi realizada a ressecção do mixoma, que se originava na veia cava inferior e se projetava para o interior do átrio direito. Com o tumor, foi ressecada, na sua implantação, uma porção da veia cava inferior. O presente relato mostra uma localização rara de origem do mixoma, bem como as complicações quanto ao diagnóstico e à abordagem no tratamento cirúrgico.The myxomas are the most frequent primary cardiac tumors. They are usually located in the left atrium but can be found in other places. This is a case report of a 71 year old patient with diagnosis of a tumor arising from the right atrium, submitted to a surgical resection of the tumor. The operation was realized and the diagnosis confirmed. Resection was successful and the procedure uneventful. Four months postoperatively a standard two-dimensional echocardiogram revealed a residual mass that seemed to arise from the inferior vena cava. He was reoperated and the myxoma originating from the inferior vena cava and extending to the interior of the right atrium was resected. At the basis of the tumor implantation, a portion of the inferior vena cave was resected. The present report shows an unusual location of the myxoma as well as the complications regarding the diagnosis and the approach to surgical treatment.

  9. Mixoma de átrio direito com origem na veia cava inferior: uma localização rara com implicações diagnósticas e terapêuticas / Right atrium myxoma originating from the inferior vena cava: an unusual location with therapeutic and diagnostic implications

    Scientific Electronic Library Online (English)

    Noedir A. G., STOLF; Anderson, BENÍCIO; Luiz Felipe P., MOREIRA; Eduardo, ROSSI.

    2000-09-01

    Full Text Available Os mixomas são os tumores cardíacos primários mais freqüentes. Sua localização habitual é o átrio esquerdo, sendo encontrados também em outros locais. É relatado o caso de paciente de 71 anos que, com diagnóstico de tumor em átrio direito, foi submetido a operação para retirada do tumor. A operação [...] foi realizada, sendo confirmado o diagnóstico e procedida a ressecção do tumor com sucesso e sem intercorrência. Em estudo ecocardiográfico de controle no 4º mês de pós-operatório, evidenciou-se presença de massa residual que parecia originar-se na veia cava inferior. Foi submetida a nova operação, em que foi realizada a ressecção do mixoma, que se originava na veia cava inferior e se projetava para o interior do átrio direito. Com o tumor, foi ressecada, na sua implantação, uma porção da veia cava inferior. O presente relato mostra uma localização rara de origem do mixoma, bem como as complicações quanto ao diagnóstico e à abordagem no tratamento cirúrgico. Abstract in english The myxomas are the most frequent primary cardiac tumors. They are usually located in the left atrium but can be found in other places. This is a case report of a 71 year old patient with diagnosis of a tumor arising from the right atrium, submitted to a surgical resection of the tumor. The operatio [...] n was realized and the diagnosis confirmed. Resection was successful and the procedure uneventful. Four months postoperatively a standard two-dimensional echocardiogram revealed a residual mass that seemed to arise from the inferior vena cava. He was reoperated and the myxoma originating from the inferior vena cava and extending to the interior of the right atrium was resected. At the basis of the tumor implantation, a portion of the inferior vena cave was resected. The present report shows an unusual location of the myxoma as well as the complications regarding the diagnosis and the approach to surgical treatment.

  10. Entrapment of J-Tip Guidewires by Venatech and Stainless-Steel Greenfield Vena Cava Filters During Central Venous Catheter Placement: Percutaneous Management in Four Patients

    International Nuclear Information System (INIS)

    We present four patients in whom bedside placement of a central venous catheter was complicated by entrapment of a J-tip guidewire by a previously placed vena cava (VC) filter. Two Venatech filters were fragmented and displaced into the superior VC or brachiocephalic vein during attempted withdrawal of the entrapped wire. Two stainless-steel Greenfield filters remained in place and intact. Fluoroscopically guided extraction of both wires entrapped by Greenfield filters was successfully performed in the angiography suite

  11. Three-dimensional reconstructed magnetic resonance imaging for diagnosing persistent left superior vena cava. Comparison with magnetic resonance angiography and plain chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Koito, Hitoshi; Suzuki, Junichi; Ohkubo, Naohiko; Ishiguro, Yuka; Iwasaka, Toshiji; Inada, Mitsuo; Nakano, Yoshihisa [Kansai Medical Univ., Moriguchi, Osaka (Japan)

    1996-09-01

    The usefulness of low-cost, three-dimensional (3D) images reconstructed from magnetic resonance (MR) imaging for investigating persistent left superior vena cava was assessed and compared to the diagnostic accuracy of chest radiography. MR imaging by the spin-echo technique and MR angiography were performed in 10 patients with this anomaly diagnosed previously by contrast echocardiography and radionuclide angiocardiography. Four patients had complicating cardiac anomalies, one with postoperative atrial septal defect, one with postoperative ventricular septal defect, one with atrial septal defect and partial anomalous pulmonary venous return, and one with aortic coarctation and patent ductus arteriosus. Multisectional and multiphasic MR images were used for the 3D-reconstruction of the cardiovascular and mediastinal structures with a NeXT workstation and a 3D-kit. The 3D-reconstructed MR imaging clearly showed the persistent left superior vena cava and the anatomical relationship with the other cardiovascular and mediastinal structures in all 10 patients. Vascular shadows were observed outside the upper left border of the aortic arch on the chest radiographs in seven patients, and the 3D-reconstructed MR images revealed these shadows to be compatible with superior caval vein. The ratios of the diameter between the left and right superior venae cavae with and without the left innominate vein were 0.63{+-}0.14 (mean{+-}SD) and 0.94{+-}0.08, respectively. Three-dimensional reconstructed MR imaging is a useful method for recognizing persistent left superior vena cava and precise examination of the chest radiographs often allowed detection of the vascular shadows caused by this anomaly. (author)

  12. Measurement of Anterior-Posterior Diameter of Inferior Vena Cava by Ultrasonography: A Non-Invasive Method for Estimation of Central Venous Pressure

    OpenAIRE

    Nafisi-moghadam, R.; Mansourian, H. R.

    2007-01-01

    Background and Objective: The assessment of blood volume is now one of the most commonly needed interventions in the first line of care and severe ill patients. Measuring central venous pressure (CVP) is an invasive method, most frequently used in clinical practice for the assessment of volume status. The di-ameter of the inferior vena cava (IVC) is a parameter to estimate central venous pressure. The purpose of this study was to determine whether measurement of the anterior-posterior diamete...

  13. Diagnosis of Icenko-Cushing's disease and syndrome by angiography and the determination of the content of hormones in blood samples from the adrenal vein and vena cava inferior

    International Nuclear Information System (INIS)

    The paper is concerned with the procedure of a comprehensive examination of patients with hypercorticoidism including angiography of the adrenals and the determination of the hydrocortisone level in the blood. The results of the studies on 32 patients with Icenko-Cushing's syndrome and 95 patients with Icenko-Cushing's disease are presented. X-ray appearance of the focal and diffuse adrenal disorders is described. The authors provide some data on the concentration of hydrocortisone in blood samples and on the content of corticotropin The importance of these data for diagnosis and differential diagnosis of Icenko-Cushing's disease and syndrome is shown. In the authors' opinion, the chief method in this diagnostic complex should be selective adrenal venography

  14. Tromboembolia pulmonar recurrente en paciente con trombofilia primaria, filtro en vena cava inferior y anticoagulada: Reporte de un caso / Appellant thrombophilia in patients with primary pulmonary thromboembolism, inferior vena cava filter and anticoagulation: A case report

    Scientific Electronic Library Online (English)

    Carlos Alberto, Solís-Olivares.

    2014-03-01

    Full Text Available La deficiencia de las proteínas C y S se consideran parte del grupo de las trombofilias primarias y ameritan un tratamiento anticoagulante de largo plazo, por el riesgo inherente de eventos tromboembólicos para los pacientes. Se presenta el caso de una paciente femenina de 51 años de edad portadora [...] de esta trombofilia, con obesidad, insuficiencia venosa de miembros inferiores, diabetes tipo 2 e hipertensión arterial, la cual 10 años antes había tenido un severo episodio de tromboembolia pulmonar, colocándosele desde entonces un filtro permanente en la vena cava inferior y continuando de manera indefinida con la terapia anticoagulante. La paciente ingresó al hospital en esta ocasión por presentar un dolor subesternal intenso de tipo opresivo, más disnea severa y diaforesis, en el contexto clínico de una crisis hipertensiva. A su ingreso la relación internacional normalizada se reportó en 2.55; su electrocardiograma y radiografía de tórax fueron normales. Las enzimas cardiacas, la ecografía Doppler color de miembros inferiores y el ecocardiograma Doppler color no reportaron anormalidades significativas. Finalmente, una angiotomografía demostró un trombo en una de las ramas segmentarias de la rama superior de la arteria pulmonar derecha, egresándose asintomática cinco días después. Aunque las guías no han establecido, como recomendación, el uso conjunto por tiempo indefinido del filtro permanente en la vena cava inferior asociado con la terapia anticoagulante, en los pacientes con este perfil clínico de riesgo tan singular, es posible un beneficio sinérgico, sobre todo al prevenir episodios recurrentes de tromboembolismo pulmonar masivo. Abstract in english Protein C and S deficiencies are considered part of the group of primary thrombophilia and merit long-term anticoagulant therapy, with the risk inherent thromboembolic events for patients. We report the case of a female patient 51 years old who carry the thrombophilia, obese, with lower limb venous [...] insufficiency, type 2 diabetes and hypertension, which 10 years ago presented a severe episode of pulmonary thromboembolism, standing from then a permanent filter in the inferior cava vein and continuing indefinitely with anticoagulant therapy. She arrived at the hospital on this occasion by presenting a severe substernal pain oppressive type and sweating more severe dysnea in the clinical setting of a hypertensive crisis. The INR on admission was reported in 2.55. His electrocardiogram and chest radiograph were normal. Cardiac enzymes, color Doppler ultrasound of the lower limbs and color Doppler echocardiography reported no significant abnormalities. Finally, a CT angiography showed a thrombus in one of the segmental branch of the upper right pulmonary artery, discharged asymptomatic form the hospital, after five days. Although the guidelines have not established a recommendation for use indefinitely permanent filter in the inferior cava vein associated with anticoagulant therapy, in patients with clinical risk profiles so unique, it is possible synergistic benefit primarily to prevent recurrent episodes of thromboembolism massive pulmonary.

  15. Intracardiac embolization of inferior vena cava filter associated with right atrium perforation and cardiac tamponade / Embolização de filtro de veia cava associado à perfuração de átrio direito e tamponamento cardíaco

    Scientific Electronic Library Online (English)

    Alexandre de Matos, Soeiro; Felipe Lourenço, Fernandes; Rafael Plens, Teixeira; Pedro Felipe Gomez, Nicz; Maria Carolina Feres de Almeida, Soeiro; Carlos V., Serrano Jr.; Múcio Tavares de, Oliveira Jr..

    2014-04-01

    Full Text Available A colocação percutânea de filtro de veia cava inferior é bem estabelecida em literatura, reduzindo a chance de ocorrência de tromboembolismo pulmonar após um episódio de trombose venosa profunda em pacientes com contraindicações à anticoagulação. O índice de complicações relacionadas ao procedimento [...] é pequeno, sendo embolização evento extremamente raro. Nesse contexto, descrevemos um caso de embolização intracardíaca de filtro de veia cava inferior associada ao tamponamento cardíaco. Abstract in english Insertion of inferior vena cava filters has been well established in literature, reducing occurrence of pulmonary embolism after an episode of deep venous thrombosis in patients with contraindication to anticoagulation. There are a small number of complications related to procedure and embolization [...] is rare. In this context, we described a case of intracardiac embolization associated with cardiac tamponade.

  16. Implante de filtro de veia cava inferior guiado por ultra-som: relato de dois casos / Placement of inferior vena cava filter guided by ultrasound: report of two cases

    Scientific Electronic Library Online (English)

    Rogério Abdo, Neser; Mauro, Capasso Filho; Cristina Mieko de Oliveira, Homa.

    2006-03-01

    Full Text Available A instalação percutânea dos filtros de veia cava inferior é realizada, tradicionalmente, em sala de angiografia ou em centro cirúrgico, utilizando-se fluoroscopia e infusão de contraste iodado para adequado posicionamento do dispositivo. Porém, para pacientes internados em unidades de tratamento int [...] ensivo com condição clínica ruim para o transporte ou com função renal deteriorada, o deslocamento e a nefrotoxicidade dos contrastes iodados são, freqüentemente, motivos de preocupação. Assim, a colocação, à beira do leito, de filtros de veia cava inferior guiada por ultra-som pode ser uma alternativa bastante atraente e segura para esses pacientes. Abstract in english The percutaneous placement of inferior vena cava filters is traditionally carried out in angiosuite or operating room using fluoroscopy and infusion of iodinated contrast for proper positioning of the device. However, for patients hospitalized in intensive care units under poor conditions for transp [...] ortation, and for patients with impaired renal function, their displacement and the nephrotoxicity of the iodinated contrast agents are frequently matters of concern. Thus, the bedside placement of inferior vena cava filters guided by ultrasound may be a reasonably safe and attractive alternative for these patients.

  17. Implante de filtro de veia cava inferior guiado por ultra-som: relato de dois casos Placement of inferior vena cava filter guided by ultrasound: report of two cases

    Directory of Open Access Journals (Sweden)

    Rogério Abdo Neser

    2006-03-01

    Full Text Available A instalação percutânea dos filtros de veia cava inferior é realizada, tradicionalmente, em sala de angiografia ou em centro cirúrgico, utilizando-se fluoroscopia e infusão de contraste iodado para adequado posicionamento do dispositivo. Porém, para pacientes internados em unidades de tratamento intensivo com condição clínica ruim para o transporte ou com função renal deteriorada, o deslocamento e a nefrotoxicidade dos contrastes iodados são, freqüentemente, motivos de preocupação. Assim, a colocação, à beira do leito, de filtros de veia cava inferior guiada por ultra-som pode ser uma alternativa bastante atraente e segura para esses pacientes.The percutaneous placement of inferior vena cava filters is traditionally carried out in angiosuite or operating room using fluoroscopy and infusion of iodinated contrast for proper positioning of the device. However, for patients hospitalized in intensive care units under poor conditions for transportation, and for patients with impaired renal function, their displacement and the nephrotoxicity of the iodinated contrast agents are frequently matters of concern. Thus, the bedside placement of inferior vena cava filters guided by ultrasound may be a reasonably safe and attractive alternative for these patients.

  18. Ruptured Angiomyolipoma with Fatty Tumor Thrombus of the Renal Vein and Inferior Vena Cava

    OpenAIRE

    Ching-Hwa Yang; Pei-Hui Chan; Siu-Kei La; Kuan-Ming Chiu

    2006-01-01

    Renal angiomyolipoma is a benign clonal neoplasm that consists of three constituents,namely, blood vessels, adipose tissue and smooth muscle. Although renal angiomyolipomahas a benign nature and grows slowly, extrarenal occurrences have been reported in the hilarlymph nodes, retroperitoneum, liver, colon and direct extension to the renal vein and inferiorvena cava as a tumor thrombus. Such a tumor thrombus is not an uncommon preoperativefinding in renal cell carcinoma but is a rare presentati...

  19. Iodine-125 Seeds Strand for Treatment of Tumor Thrombus in Inferior Vena Cava: An Experimental Study in a Rabbit Model

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Wen, E-mail: wenzhangxiao@126.com; Yan, Zhiping, E-mail: Yan.zhiping@zs-hospital.sh.cn; Luo, Jianjun, E-mail: luo.jianjun@zs-hospital.sh.cn; Fang, Zhuting, E-mail: 470389481@qq.com; Wu, Linlin, E-mail: linlinzhifubao@126.com; Liu, QingXin, E-mail: liu.qingxin@zs-hospital.sh.cn; Qu, Xudong, E-mail: qu.xudong@zs-hospital.sh.cn; Liu, Lingxiao, E-mail: liu.lingxiao@zs-hospital.sh.cn; Wang, Jianhua, E-mail: wang.jianhua@zs-hospital.sh.cn [Fudan University, Department of Interventional Radiology, Zhongshan Hospital (China)

    2013-10-15

    Objective: The purpose of this study was to establish an animal model of implanted inferior vena cava tumor thrombus (IVCTT) and to evaluate the effect of linear iodine-125 seeds strand in treating implanted IVCTT. Methods: Tumor cell line VX{sub 2} was inoculated subcutaneously into New Zealand rabbit to develop the parent tumor. The tumor strip was inoculated into inferior vena cava (IVC) to establish the IVCTT model. The IVCTT was confirmed by multidetector computed tomography (MDCT) after 2 weeks. Twelve rabbits with IVCTT were randomly divided into two groups. Treatment group (group T; n = 6) underwent Iodine-125 seeds brachytherapy, and the control group (group C; n = 6) underwent blank seeds strand. The blood laboratory examination (including blood routine examination, hepatic and renal function), body weight, survival time, and IVCTT volume by MDCT were monitored. All rabbits were dissected postmortem, and the therapeutic effects were evaluated on the basis of histopathology. The proliferating cell nuclear antigen index (PI) and apoptosis index (AI) of IVCTT were compared between two groups. T test, Wilcoxon rank test, and Kaplan-Meier survival curve analysis were used. Results: The success rate of establishing IVCTT was 100 %. The body weight loss and cachexia of rabbits in group C appeared earlier than in group T. Body weight in the third week, the mean survival time, PI, AI in groups T and C were 2.23 {+-} 0.12 kg, 57.83 {+-} 8.68 days, (16.73 {+-} 5.18 %), (29.47 {+-} 7.18 %), and 2.03 {+-} 0.13 kg, 43.67 {+-} 5.28 days, (63.01 {+-} 2.01 %), (6.02 {+-} 2.93 %), respectively. There were statistically significant differences between group T and group C (P < 0.05). The IVCTT volume of group T was remarkably smaller than that of group C. Conclusions: Injecting and suspensory fixing VX2 tumor strip into IVC is a reliable method to establish IVCTT animal model. The linear Iodine-125 seeds strand brachytherapy was a safe and effective method for treating IVCTT in rabbit model.

  20. Iodine-125 Seeds Strand for Treatment of Tumor Thrombus in Inferior Vena Cava: An Experimental Study in a Rabbit Model

    International Nuclear Information System (INIS)

    Objective: The purpose of this study was to establish an animal model of implanted inferior vena cava tumor thrombus (IVCTT) and to evaluate the effect of linear iodine-125 seeds strand in treating implanted IVCTT. Methods: Tumor cell line VX2 was inoculated subcutaneously into New Zealand rabbit to develop the parent tumor. The tumor strip was inoculated into inferior vena cava (IVC) to establish the IVCTT model. The IVCTT was confirmed by multidetector computed tomography (MDCT) after 2 weeks. Twelve rabbits with IVCTT were randomly divided into two groups. Treatment group (group T; n = 6) underwent Iodine-125 seeds brachytherapy, and the control group (group C; n = 6) underwent blank seeds strand. The blood laboratory examination (including blood routine examination, hepatic and renal function), body weight, survival time, and IVCTT volume by MDCT were monitored. All rabbits were dissected postmortem, and the therapeutic effects were evaluated on the basis of histopathology. The proliferating cell nuclear antigen index (PI) and apoptosis index (AI) of IVCTT were compared between two groups. T test, Wilcoxon rank test, and Kaplan–Meier survival curve analysis were used. Results: The success rate of establishing IVCTT was 100 %. The body weight loss and cachexia of rabbits in group C appeared earlier than in group T. Body weight in the third week, the mean survival time, PI, AI in groups T and C were 2.23 ± 0.12 kg, 57.83 ± 8.68 days, (16.73 ± 5.18 %), (29.47 ± 7.18 %), and 2.03 ± 0.13 kg, 43.67 ± 5.28 days, (63.01 ± 2.01 %), (6.02 ± 2.93 %), respectively. There were statistically significant differences between group T and group C (P < 0.05). The IVCTT volume of group T was remarkably smaller than that of group C. Conclusions: Injecting and suspensory fixing VX2 tumor strip into IVC is a reliable method to establish IVCTT animal model. The linear Iodine-125 seeds strand brachytherapy was a safe and effective method for treating IVCTT in rabbit model

  1. Rectal cancer presenting tumor thrombosis in the inferior vena cava and common iliac vein: case report

    International Nuclear Information System (INIS)

    We report the radiologic findings of a rectal carcinoma case with tumor thrombus in the inferior vana cava and left common iliac vein of a 48-year-old woman. The patient complained of swelling in the left leg and consequently underwent a lymphoscintigraphy, CT venography, abdominal CT, PET-CT, pelvis MRI, and ultrasound doppler. The rectal cancer was determined via a colonoscopy. The tissue biopsy of tumor thrombus in the IVC was done during insertion of IVC filter and poorly differentiated adenocarcinoma was revealed by pathology

  2. An uncommon clinical condition: chronic thrombosis of the inferior vena cava. A case report and review of literature.

    Science.gov (United States)

    Donati, Francesca; Misuraca, Leonardo; Grigoratos, Chrysanthos; Violo, Caterina; Vannucci, Stefano; Balbarini, Alberto

    2010-03-01

    The lifetime incidence of deep vein thrombosis (DVT) is approximately 0.1% in general population and even more uncommon in subjects below 40 years of age. Thrombosis of the inferior vena cava (IVC) is an exceptionally rare clinical condition, with etiological factors similar to lower limb DVT. We present a case of post-traumatic chronic obstruction of the IVC in 41 years-old man, caused by a prolonged squatted position, while he was working as a bricklayer. We visited the patient fifteen years after the onset of the first clinical setting showing a severe post thrombotic syndrome, as a consequence of the already diagnosticated thrombosis, involving predominantly the right inferior leg. Thrombophilia screening tests showed patient to be a heterozygous carrier of methylenetetrahydrofolate reductase (MTHFR) gene mutation. Computed tomography (CT) scan confirmed the thrombotic obstruction of the infrahepatic IVC, both common iliac veins, right external and internal iliac veins, with multiple collateral pathways. Because of thrombosis extension, inherited prothrombotic condition and the young age of the patient, we decided to continue life-long oral anticoagulant therapy. PMID:20925177

  3. Covered stent placement for the treatment of malignant superior vena cava syndrome: Is unilateral covered stenting and effective?

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Hoon; Gwon, Dong Il; Ko, Gi Young; Ko, Heung Kyu; Kim, Jin Hyoung; Shin, Ji Hoon; Yoon, Hyun Ki; Sung, Kyu Bo [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2014-02-15

    To evaluate the safety and efficacy of unilateral covered stent placement in patients with malignant superior vena cava (SVC) syndrome. Between October 2008 and November 2012, expanded polytetrafluoroethylene-covered stent placement for malignant SVC syndrome was performed in 40 consecutive patients (35 men and five women; mean age, 61.4 years; range, 35-81 years). All covered stents were unilaterally placed within the SVC or across the venous confluence when needed to relieve venous obstruction and prevent tumor overgrowth, regardless of patency of contralateral brachiocephalic veins. Stent placement was technically successful in all patients. There were no major complications. Of the 37 patients symptomatic prior to stent placement, 34 (92%) experienced complete symptomatic relief 1-8 days after stent placement. Of the 29 patients who underwent covered stent placement across the venous confluence, nine patients had patent contralateral brachiocephalic veins prior to stent placement. However, no sign of SVC obstruction or contralateral upper extremity venous thrombosis was observed during the follow-up period. Kaplan-Meier analysis revealed median patient survival of 163 days. Stent occlusion occurred in four (10%) of 40 patents. Cumulative stent patency rates at 1, 3, 6, and 12 months were 95%, 92%, 86%, and 86%, respectively. Unilateral covered stent placement appears to be a safe and effective method for treating malignant SVC syndrome, despite the location of SVC occlusion.

  4. Proton beam therapy for a patient with a giant thymic carcinoid tumor and severe superior vena cava syndrome

    Directory of Open Access Journals (Sweden)

    Kaori Sugawara

    2014-05-01

    Full Text Available Surgical resection is the first choice for treatment of a thymic carcinoid tumor and radiotherapy is often performed as adjuvant therapy. Here, we report a case of an unresectable and chemoresistant thymic carcinoid tumor that was treated successfully using standalone proton beam therapy (PBT. The patient was a 66-year-old woman in whom surgical resection of the tumor was impossible because of cardiac invasion. Therefore, chemotherapy was administered. However, the tumor grew to 15 cm in diameter and she developed severe superior vena cava (SVC syndrome. She was referred to our hospital and received PBT at a dose of 74 GyE in 37 fractions. PBT was conducted without severe early toxicities. After PBT, the tumor mildly shrunk to 13 cm in diameter and SVC syndrome almost disappeared. Subsequently, the tumor has continued to decrease in size slowly over the last 2 years and late toxicities have not been observed. Our experience with this case suggests that PBT may be effective for an unresectable thymic carcinoid tumor.

  5. Frequency of common bile duct motion artifacts caused by inferior vena cava pulsation on magnetic resonance cholangiopancreatography

    International Nuclear Information System (INIS)

    We assessed the frequency of common bile duct (CBD) motion artifacts caused by inferior vena cava (IVC) pulsation on magnetic resonance cholangiopancreatography (MRCP). We retrospectively evaluated CBD motion artifacts in 4 MRCP sequences from each of 115 consecutive patients. We observed 37 (32.2%) ghost artifacts at the ventral and dorsal aspects of the CBD on transaxial, half-Fourier acquisition single-shot turbo spin-echo (HASTE-ax) images; no such artifacts were observed on transaxial T2-weighted turbo spin-echo images. In 10 patients, we observed 9 (7.8%) pseudo-defects of the CBD on 3-dimensional T2-weighted turbo spin-echo with navigator-triggered prospective acquisition correction technique MRCP and 6 (5.2%) pseudo-defects on single-shot rapid acquisition with relaxation enhancement MRCP. Pseudo-defects were significantly more frequent in patients with ghost artifacts than without (9 of 37 [24.3%] versus one of 78 [1.3%]; P<0.01, McNemar test). Although uncommon, pseudo-defects of the CBD caused by IVC pulsation are observed on MRCP. MRCP interpretation that includes comparison with HASTE-ax images can diminish the potential misinterpretation of such CBD motion artifact as bile duct tumor or biliary stone. (author)

  6. Retrieval of Tip-embedded Inferior Vena Cava Filters by Using the Endobronchial Forceps Technique: Experience at a Single Institution.

    Science.gov (United States)

    Stavropoulos, S William; Ge, Benjamin H; Mondschein, Jeffrey I; Shlansky-Goldberg, Richard D; Sudheendra, Deepak; Trerotola, Scott O

    2015-06-01

    Purpose To evaluate the use of endobronchial forceps to retrieve tip-embedded inferior vena cava (IVC) filters. Materials and Methods This institutional review board-approved, HIPAA-compliant retrospective study included 114 patients who presented with tip-embedded IVC filters for removal from January 2005 to April 2014. The included patients consisted of 77 women and 37 men with a mean age of 43 years (range, 18-79 years). Filters were identified as tip embedded by using rotational venography. Rigid bronchoscopy forceps were used to dissect the tip or hook of the filter from the wall of the IVC. The filter was then removed through the sheath by using the endobronchial forceps. Statistical analysis entailed calculating percentages, ranges, and means. Results The endobronchial forceps technique was used to successfully retrieve 109 of 114 (96%) tip-embedded IVC filters on an intention-to-treat basis. Five failures occurred in four patients in whom the technique was attempted but failed and one patient in whom retrieval was not attempted. Filters were in place for a mean of 465 days (range, 31-2976 days). The filters in this study included 10 Recovery, 33 G2, eight G2X, 11 Eclipse, one OptEase, six Option, 13 Günther Tulip, one ALN, and 31 Celect filters. Three minor complications and one major complication occurred, with no permanent sequelae. Conclusion The endobronchial forceps technique can be safely used to remove tip-embedded IVC filters. PMID:25581368

  7. Ecocardiografia transesofágica e diagnóstico intraoperatório de veia cava superior esquerda persistente Ecocardiografía transesofágica y diagnóstico intraoperatorio de vena cava superior izquierda persistente Transesophageal echocardiography and intraoperative diagnosis of persistent left superior vena cava

    OpenAIRE

    Alexander Alves da Silva; Enis Donizetti Silva; Arthur Vitor Rosenti Segurado; Pedro Paulo Kimachi; Claudia Marquez Simões

    2009-01-01

    JUSTIFICATIVA E OBJETIVOS: A persistência da veia cava superior esquerda ocorre isoladamente em 0,5% da população normal, porém nos pacientes com cardiopatia congênita chega a estar presente em 3% a 10% dos casos. O objetivo deste relato foi apresentar um caso de diagnóstico intraoperatório com o auxílio da ecocardiografia transesofágica e ressaltar a importância da sua utilização rotineira em intervenções cirúrgicas para correção de cardiopatia congênita. RELATO DO CASO: Pa...

  8. The influence of atherosclerotic abdominal aorta on the shape of duplicated inferior vena cava: its potential clinical implications and vascular complications.

    Science.gov (United States)

    Polguj, M; Majos, M; Topol, M; Majos, A; Stefa?czyk, L

    2014-11-01

    Duplication of the inferior vena cava (IVC) is a congenital condition where there are 2 large vessels: right IVC (RIVC) and left IVC (LIVC) on both sides of the abdominal aorta. Here, we present 2 cases of duplicated inferior cava coexisting with rare morphology of left gonadal (ovarian/testicular) vein. Both were observed during multidetector 64-row computer tomography. In first case atherosclerotic, tortuous abdominal aorta models both inferior venae cavae. The shape of veins were more- (RIVC) and less-arcuate (LIVC). Two years ago, the patient had been diagnosed with pulmonary thromboembolism. In second case abdominal aortic aneurysm models both large veins. The RIVC has a highly right-arcuate shape, while the LIVC has a less left-arcade shape. Our observation would seem to be especially important, because the tortuous abdominal aorta changes the shape of both IVC, and may predispose them for thrombosis formation. The presented report precisely describes the topography and measurements of the vessels in the retroperitoneal area. The literature concerning this anomaly, potential clinical implications and vascular complications are reviewed and the possible practical aspects are discussed. A familiarity with the anatomy of the most common types of venous anomalies is crucial for all surgeons, urologists and oncologists to reduce the risk of severe haemorrhage during all abdominal procedures. PMID:25448915

  9. Comunicação interatrial do tipo seio coronário, comunicação interventricular e ausência de veia cava superior esquerda Coronary sinus atrial septal defect and ventricular septal defect with no left superior vena cava

    Directory of Open Access Journals (Sweden)

    Fábio Alves Almeida

    1998-10-01

    Full Text Available Relatamos um caso raro de um paciente de 21 meses, portador de comunicação interatrial do tipo seio coronário, associada a comunicação interventricular perimembranosa, e ausência de veia cava superior esquerda. O diagnóstico foi realizado através da ecocardiografia e confirmado pela angiografia. O paciente foi operado sem intercorrências, ambos os defeitos foram fechados com patch de pericárdio bovino e o fluxo das veias coronárias ficou direcionado para o átrio esquerdo. Um ecocardiograma mostrou ausência de shunt residual através dos defeitos.We report a rare case of a 21 month old child with a coronary sinus atrial septal defect associated with perimembranous ventricular septal defect and no left superior vena cava. The diagnosis was made by transthoracic echocardiogram and confirmed by angiography. The patient was operated on uneventfully, both defects were closed with bovine pericardial patches and the flow from the coronary veins was directed towards the left atrium. An echocardiogram revealed complete closure of both defects.

  10. Percutaneous transluminal angioplasty with stenting for treatment of superior vena cava obstructive syndrome

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical value of percutaneous transluminal angioplasty with stenting (PTAS) for the treatment of superior vana cava obstructive syndrome (SVCOS). Methods: 15 cases of SVCOS including 10 cases of lung cancer with mediastinal lymphatic metastasis, 3 cases as malignant lymphoma and 2 cases of esophageal cancer with mediastinal lymphadenopathy, were undergone right subclavian vein or elbow vein catheterization for pressure measurement and DSA imaging of SVC with displaying the obstructive characteristics. A self-expanding stent was then implanted through right femoral vein catheterization. Results: 15 cases were all successfully under-taken angioplasty and stenting, except 1 case with a long stricture over 10 cm requiring 2 stents. After successful stent placement, DSA revealed smooth flow of contrast with almost normal diameter of SVC lumen, together with disappearance or relief of SVCOS. The SVC pressure decreased from 30.5±2.3 cmH2O down to 8.8 ± 1.5 cmH2O after recanalization, with a significant difference in statistics (P<0.01). All the patients were followed up for 6 months and obstructive symptom did not reappear except one case complicated with thrombosis which was treated by regional thrombolysis and balloon dilation leading to obviously improved symptom. Conclusion: PTAS for the treatment of SVCOS is effective, safe, simple and of less complications. (authors)

  11. Bases anatómicas de la fibrilación atrial: Estudio descriptivo de la extensión de músculo cardiaco atrial hacia la vena cava superior.

    Scientific Electronic Library Online (English)

    Sebastián, Laza; Álvaro, Rivara; Nicolás, Casales; Marie, Poumayrac; María, Vergara; Pablo, Pereira; Diego, Freire; Beatriz, Villar; Angela, Cirilo; Guillermo, Carriquiry; Victor, Soria; Ricardo, Lluberas.

    Full Text Available Introducción: La fibrilación atrial (FA) puede originarse en la vena cava superior (VCS), desde el músculo cardíaco (MC) proveniente de la aurícula derecha (AD). Objetivo: Descripción anátomo-histológica de dicho MC, sus relaciones e implicancias clínicas. Material y métodos: Mediante disección de m [...] aterial cadavérico (n=43) y análisis histológico, se estudió la presencia y extensión de MC desde la AD hacia la VCS, dirección, disposición, distribución, altura total y por cuadrantes del MC y la unión venoatrial. Resultados: Todas las piezas presentaron MC en su pared, con 2 (63%), 3 (15,8%) o 4 (10,5%) vías de entrada provenientes de la cara lateral de la AD y orejuela derecha, ubicadas por frecuencia en los sectores anteroizquierdo, anteroderecho, posteroizquierdo y posteroderecho; las vinculadas al sector anteroderecho están en estrecha relación con el nervio frénico derecho y el nodo sinusal. La dirección fue ascendente en su cara anterior de derecha a izquierda, y descendente por su cara posterior de izquierda a derecha. La altura máxima se alcanzó en el cuadrante anteroizquierdo (15 a 56 mm, promedio 46 mm). Su distribución tuvo 2 patrones: continuo en 9,4% y fenestrado en 90,6%. Conclusiones: La extensión de MC de AD a VCS constituye un hecho constante, con orientación precisa, vías de entrada a predominio de los cuadrantes anteriores, y un patrón de distribución a modo de envoltura oblicua en la VCS, con máxima altura en los cuadrantes izquierdos. Las relaciones más relevantes se vinculan al nervio frénico y nodo sinusal. Abstract in english SUMMARY Introduction: Atrial fibrillation can be triggered from myocardial sleeves present in superior vena cava coming from the right atrium. Purpose: Anatomic and histologic description of myocardial sleeves, main relationships and clinical implications for catheter ablation. Methods: Fourty-three [...] human hearts were examined by dissection and histological analysis. Superior cavoatrial junction and presence, extension, disposition, distribution and maximum highness of myocardial sleeves in SVC were studied by quadrants. Results: All studied specimens showed myocardial extensions from right atrium to SVC. Myocardial breakthroughs (MB) were studied in 19 cases. 2 MB were found in 63%, 3 in 15,8% and 4 in 10,5% of the cases, coming from the high lateral right atrium and right atrial appendage, and located by frequency in the left anterior, right anterior, left posterior and right posterior quadrants of the cavoatrial junction. Those located in the right anterior quadrant were in close relationship with the right phrenic nerve and the sinus node. Direction of myocardial sleeves was oblique, ascending from right to left, and descending through the posterior quadrants of the vein. Maximum highness was reached in the left anterior quadrant (15 to 56 mm, average 46 mm). Two patterns of distribution were observed: continuous in 9,4% and fenestrated in 90,6%. Conclusions: The extension of myocardial sleeves from right atrium to SVC is a constant fact, with homogeneous distribution, wrapping SVC around obliquely and reaching its maximum in the left quadrants of the vein. Myocardial breakthroughs were located mainly in the anterior quadrants of the cavoatrial junction. Their main relationships were established with the right phrenic nerve and sinus node.

  12. A Primary Primitive Neuroectodermal Tumor Arising from Left Subclavian Vein and Extending along Left Brachiocephalic Vein and Superior Vena Cava into Right Atrium.

    Science.gov (United States)

    Wang, Jian; Wang, Weici; Li, Yiqing; Jin, Bi; Yu, Miao; Liu, Wenqi; Yao, Shaohua; Liao, Yonggui; Ouyang, Chenxi

    2015-05-01

    Primitive neuroectodermal tumor (PNET) is an extremely rare malignancy thought to be derived from fetal neuroectodermal precursor cells. It usually occurs in central and peripheral nervous system or soft tissue and bone, while intravenous or intracavitary PNET is considered as an extremely rare tumor. We reported a case of a 44-year-old woman who presented with the left unilateral facial and neck swelling. Magnetic resonance imaging revealed a tape-shaped solid mass within left subclavian vein, left brachiocephalic vein, superior vena cava, and right atrium; the proximal end proportion occupied almost the entire right atrium with a pedicle flip protruded into the right ventricle. Ultrasonography revealed an irregular hypoechnoic mass arising from the left subclavian vein, which extended along the left brachiocephalic vein and superior vena cava into the right atrium and up to the right ventricle. Positron emission tomography-computed tomography revealed several hypermetabolic thyroid nodules with no evidence of intravenous hyperactive lesion. The patient underwent tumor resection under cardiopulmonary bypass. At 15 days postoperatively, total thyroidectomy and resection of the left subclavian vein were simultaneously performed. The patient received chemotherapy and radiotherapy later. Histologically, the neoplasm displayed small, round, blue cells with hyperchromatic nuclei and scant cytoplasm. The neoplastic cells showed a strong immunopositivity for CD99, synaptophysin, CD56, CD57, and friend leukemia integration 1, thus confirming a diagnosis of the PNET. Histopathological examination of the thyroid showed papillary carcinoma. Thus, this PNET had no definitive organ or tissue of origin, which primarily originated from the left subclavian vein with tumor extension along the superior vena cava to the right ventricle. PMID:25725277

  13. Efficacy of Lower-Extremity Venous Thrombolysis in the Setting of Congenital Absence or Atresia of the Inferior Vena Cava

    International Nuclear Information System (INIS)

    Purpose: A rare but described risk factor for deep venous thrombosis (DVT), predominately in the young, is congenital agenesis or atresia of the inferior vena cava (IVC). The optimal management for DVT in this subset of patients is unknown. We evaluated the efficacy of pharmacomechanical catheter-directed thrombolysis (PCDT) followed by systemic anticoagulation in the treatment of acute lower-extremity DVT in the setting of congenital IVC agenesis or atresia. Materials and Methods: Between November of 2005 and May of 2010, six patients (three women [average age 21 years]) were referred to our department with acute lower-extremity DVT and subsequently found to have IVC agenesis or atresia on magnetic resonance imaging. A standardized technique for PCDT (the Angiojet Rheolytic Thrombectomy System followed by the EKOS Microsonic Accelerated Thrombolysis System) was used for all subjects. Successful thrombolysis was followed by systemic heparinization with transition to Coumadin or low molecular-weight heparin and compression stockings. Subjects were followed-up at 1, 3, and then every 6 months after the procedure with clinical assessment and bilateral lower-extremity venous ultrasound. Results: All PCDT procedures were technically successful. No venous stenting or angioplasty was performed. The average thrombolysis time was 28.6 h (range 12–72). Two patients experienced heparin-induced thrombocytopenia, and one patient developed a self-limited knee hemarthrosis, No pata self-limited knee hemarthrosis, No patients were lost to follow-up. The average length of follow-up was 25.8 ± 20.2 months (range 3.8–54.8). No incidence of recurrent DVT was identified. There were no manifestations of postthrombotic syndrome. Conclusions: PCDT followed by systemic anticoagulation and the use of compression stockings appears to be safe and effective in relatively long-term follow-up treatment of patients who present with acute DVT and IVC agenesis or atresia.

  14. Outcomes of retrievable inferior vena cava filters in patients with deep vein thrombosis and transient contraindication for anticoagulation

    Science.gov (United States)

    Kim, Hyung-Kee; Song, Incheol; Jang, Ji-Hoon; Oh, Chang-Wug; Lee, Jong-Min

    2015-01-01

    Purpose To determine the efficacy of a retrievable inferior vena cava filter (IVCF) for patients with deep vein thrombosis (DVT) and transient contraindication for anticoagulant therapy, and to analyze the risk factors for filter thrombus in these patients. Methods We retrospectively reviewed the records of 70 patients who received a retrievable IVCF from January 2007 to June 2014 because of documented DVT and transient contraindication for anticoagulant therapy. The protocol for follow-up care generally consisted of anticoagulant therapy after high-risk periods, follow-up CT around 2 weeks after IVCF placement, and retrieval if possible. Results The 70 patients had a mean age of 61.8 years (range, 17-88 years), and 30 were male (43%). The indications for IVCF were recent trauma including surgery in 48 patients, recent hemorrhage in 14, and planned major surgery with DVT in 8 patients. Follow-up CT of 61 patients (87%) was performed. Aggravation or new development of pulmonary embolism (PE) was not found in any patient. Filter thrombus was detected in 23% of patients with follow-up CT (14/61). Filter thrombus was not detected in patients with isolated calf vein thrombosis (ICVT) (P = 0.079). The risk factor for filter thrombus was DVT progression on follow-up CT (P = 0.007) on multivariate analysis. Conclusion For patients with DVT and transient contraindication for anticoagulant therapy, a retrievable IVCF could prevent the aggravation or new development of PE. DVT progression on follow-up CT was associated with filter thrombus and ICVT was not related to filter thrombus in the present study. PMID:26131442

  15. Effect of antithrombotic agents on the patency of PTFE-Covered stents in the inferior vena cava: An experimental study

    International Nuclear Information System (INIS)

    Purpose: To evaluate the efficacy of antithrombotic agents in the prevention of stenosis of polytetrafluororethylene (PTFE)-covered stents in the venous system.Methods: Spiral Z stents covered with PTFE (PTFE-covered stents) were placed in the inferior vena cava (IVC) of 34 dogs. Nineteen dogs, used as a control group, were sacrificed at 2, 4, and 12 weeks. Fifteen dogs, previously given antithrombotic agents [cilostazol (n=5), warfarin potassium (n=5), cilostazol plus warfarin potassium (n=5)] were sacrificed at 4 weeks, and then examined angiographically and histopathologically. The effect of the antithrombotic agents was compared between groups.Results: The patency rate of the antithrombotic agent group was 93% (14/15), which was higher than the control group rate of 63% (12/19). The mean stenosis rate of the patent stent at both ends and at the midportion was lower at 4 weeks in the antithrombotic agent group than in the control group. In particular, the mean stenosis rate in the cilostazol plus warfarin potassium group was significantly lower than the control group (Tukey's test, p < 0.05). The mean neointimal thickness of the patent stent at both ends and at the midportion was thinner at 4 weeks in the antithrombotic agent group than in the control group. In particular, the thickness of the neointima in the cilostazol plus warfarin potassium group was significantly decreased when compared with the control group (Tukey's test p < 0.05). At 4 weeks, endothelializatest p < 0.05). At 4 weeks, endothelialization in the antithrombotic agent group tended to be almost identical to that in the control group.Conclusion: The present study suggests that administration of an antithrombotic agent is an effective way of preventing the stenosis induced by a neointimal thickening of PTFE-covered stents in the venous system.

  16. Efficacy of Lower-Extremity Venous Thrombolysis in the Setting of Congenital Absence or Atresia of the Inferior Vena Cava

    Energy Technology Data Exchange (ETDEWEB)

    Ganguli, Suvranu, E-mail: sganguli@partners.org; Kalva, Sanjeeva; Oklu, Rahmi; Walker, T. Gregory; Datta, Neil [Massachusetts General Hospital and Harvard Medical School, Division of Vascular Imaging and Intervention, Department of Imaging (United States); Grabowski, Eric F. [Massachusetts General Hospital and Harvard Medical School, Division of Hematology and Oncology, Department of Pediatrics (United States); Wicky, Stephan [Massachusetts General Hospital and Harvard Medical School, Division of Vascular Imaging and Intervention, Department of Imaging (United States)

    2012-10-15

    Purpose: A rare but described risk factor for deep venous thrombosis (DVT), predominately in the young, is congenital agenesis or atresia of the inferior vena cava (IVC). The optimal management for DVT in this subset of patients is unknown. We evaluated the efficacy of pharmacomechanical catheter-directed thrombolysis (PCDT) followed by systemic anticoagulation in the treatment of acute lower-extremity DVT in the setting of congenital IVC agenesis or atresia. Materials and Methods: Between November of 2005 and May of 2010, six patients (three women [average age 21 years]) were referred to our department with acute lower-extremity DVT and subsequently found to have IVC agenesis or atresia on magnetic resonance imaging. A standardized technique for PCDT (the Angiojet Rheolytic Thrombectomy System followed by the EKOS Microsonic Accelerated Thrombolysis System) was used for all subjects. Successful thrombolysis was followed by systemic heparinization with transition to Coumadin or low molecular-weight heparin and compression stockings. Subjects were followed-up at 1, 3, and then every 6 months after the procedure with clinical assessment and bilateral lower-extremity venous ultrasound. Results: All PCDT procedures were technically successful. No venous stenting or angioplasty was performed. The average thrombolysis time was 28.6 h (range 12-72). Two patients experienced heparin-induced thrombocytopenia, and one patient developed a self-limited knee hemarthrosis, No patients were lost to follow-up. The average length of follow-up was 25.8 {+-} 20.2 months (range 3.8-54.8). No incidence of recurrent DVT was identified. There were no manifestations of postthrombotic syndrome. Conclusions: PCDT followed by systemic anticoagulation and the use of compression stockings appears to be safe and effective in relatively long-term follow-up treatment of patients who present with acute DVT and IVC agenesis or atresia.

  17. Successful treatment of central venous catheter induced superior vena cava syndrome with ultrasound accelerated catheter-directed thrombolysis.

    Science.gov (United States)

    Dumantepe, Mert; Tarhan, Arif; Ozler, Azmi

    2013-06-01

    Superior vena cava (SVC) syndrome results from obstruction of flow through the vessel either by external compression or thrombosis. External compression by intrathoracic neoplasms is the most common etiology, especially lung cancer and lymphoma. Thrombosis is becoming increasingly common due to the use of indwelling catheters and implantable central venous access devices. Most patients are unresponsive to anticoagulation alone which appears to be effective only in the mildest cases. However, recent advances in catheter-based interventions have led to the development of a variety of minimally invasive endovascular strategies to remove venous thrombus and accepted as an important first-line treatment given its high overall success rate and low morbidity as compared with medical and surgical treatments. Ultrasound accelerated catheter-directed thrombolysis (UACDT) has been developed to rapidly and completely resolve the existing thrombus. This technique integrates high frequency, low intensity ultrasound (US) with standard CDT in order to accelerate clot dissolution, reducing treatment time and the incidence of thrombolysis-related complications. An US wave enhances drug permeation through thrombus by disaggregating the fibrin matrix, exposing additional plasminogen receptor sites to the thrombolytic agent. The US energy affects thrombus in the entire venous segment, increasing the probability of complete thrombus clearing. We report the case of a 56-year-old man who presented with a 5 days history of SVC syndrome symptoms who had been receiving chemotherapy for colon cancer through a right subclavian vein port catheter. The patient successfully treated with UACDT with EkoSonic(®) Mach4e Endovascular device with an overnight infusion. © 2013 Wiley Periodicals, Inc. PMID:23404752

  18. Serum cortisol values, superior vena cava flow and illness severity scores in very low birth weight infants.

    LENUS (Irish Health Repository)

    Miletin, J

    2012-02-01

    OBJECTIVE: Recent evidence suggests that high cortisol concentrations are associated with increased morbidity and mortality in very low birth weight (VLBW) infants. Neonatal illness severity and mortality risk scores are reliable in predicting morbidity and mortality. The objectives were (i) to assess the correlation between serum cortisol levels and clinical assessment of multi-organ dysfunction\\/illness severity scores (CRIB II, SNAPPE-II and neonatal multiple organ dysfunction score (NEOMOD)) in first 24 h in VLBW infants and (ii) to assess the relationship between surrogates of end organ blood flow and serum cortisol levels. STUDY DESIGN: A prospective observational cohort study. Neonates with birth weight <1500 g were eligible for enrollment. Echocardiography evaluation of superior vena cava (SVC) flow was carried out in the first 24 h life. Cortisol levels were measured simultaneously and appropriate clinical scores were calculated. RESULT: A total of 54 VLBW neonates were enrolled following parental consent. Two patients were excluded because of congenital malformations. In 14 babies the cortisol value was not simultaneously obtained. The mean birth weight was 1.08 kg, mean gestational age was 27.8 weeks. There was a significant correlation between cortisol and NEOMOD score (P=0.006). There was no correlation between cortisol and CRIB II score (P=0.34), SVC flow (P=0.49) and mean arterial blood pressure respectively (P=0.35). CONCLUSION: There was no correlation between SVC flow and cortisol values or between cortisol and mean blood pressure values. There was a significant correlation between cortisol levels and neonatal organ dysfunction score evaluated suggesting that stressed VLBW infants do mount a cortisol response.

  19. IVC CLAMP: infrahepatic inferior vena cava clamping during hepatectomy - a randomised controlled trial in an interdisciplinary setting

    Directory of Open Access Journals (Sweden)

    Reissfelder Christoph

    2009-10-01

    Full Text Available Abstract Background Intraoperative haemorrhage is a known predictor for perioperative outcome of patients undergoing hepatic resection. While anaesthesiological lowering of central venous pressure (CVP by fluid restriction is known to reduce bleeding during transection of the hepatic parenchyma its potential side effects remain poorly investigated. In theory it may have negative effects on kidney function and tissue perfusion and bears the risk to result in severe haemodynamic instability in case of profound intraoperative blood loss. The present randomised controlled trial evaluates efficacy and safety of infrahepatic inferior vena cava (IVC clamping as an alternative surgical technique to reduce CVP during hepatic resection. Methods/Design The proposed IVC CLAMP trial is a single-centre randomised controlled trial with a two-group parallel design. Patients and outcome-assessors are blinded for the treatment intervention. Patients undergoing elective hepatic resection due to any reason are enrolled in IVC CLAMP. All patients admitted to the Department of General-, Visceral-, and Transplant Surgery, University of Heidelberg for elective hepatic resection are consecutively screened for eligibility and written informed consent is obtained on the day before surgery. The primary objective of this trial is to assess and compare the amount of blood loss during hepatic resection in patients receiving surgical CVP reduction by clamping of the IVC as compared to anaesthesiological CVP without infrahepatic IVC clamping reduction. In addition to blood loss a set of general as well as surgical variables are analysed. Discussion This is a randomised controlled patient and observer blinded two-group parallel trial designed to assess efficacy and safety of infrahepatic IVC clamping during elective hepatectomy. Trial registration ClinicalTrials NCT00732979

  20. Effect of Antithrombotic Agents on the Patency of PTFE-Covered Stents in the Inferior Vena Cava: An Experimental Study

    International Nuclear Information System (INIS)

    Purpose: To evaluate the efficacy of antithrombotic agents in the prevention of stenosis of polytetrafluoroethylene (PTFE)-covered stents in the venous system. Methods: Spiral Z stents covered with PTFE (PTFE-covered stents) were placed in the inferior vena cava (IVC) of 34 dogs. Nineteen dogs, used as a control group, were sacrificed at 2, 4, and 12 weeks. Fifteen dogs, previously given antithrombotic agents [cilostazol (n= 5), warfarin potassium (n= 5), cilostazol plus warfarin potassium (n= 5)] were sacrificed at 4 weeks, and then examined angiographically and histopathologically. The effect of the antithrombotic agents was compared between groups. Results: The patency rate of the antithrombotic agent group was 93% (14/15), which was higher than the control group rate of 63% (12/19). The mean stenosis rate of the patent stent at both ends and at the midportion was lower at 4 weeks in the antithrombotic agent group than in the control group. In particular, the mean stenosis rate in the cilostazol plus warfarin potassium group was significantly lower than the control group (Tukey's test, p < 0.05). The mean neointimal thickness of the patent stent at both ends and at the midportion was thinner at 4 weeks in the antithrombotic agent group than in the control group. In particular, the thickness of the neointima in the cilostazol plus warfarin potassium group was significantly decreased when compared with the control group (Tukey's test p < 0.05). At 4 weeks, endotheliay's test p < 0.05). At 4 weeks, endothelialization in the antithrombotic agent group tended to be almost identical to that in the control group. Conclusion: The present study suggests that administration of an antithrombotic agent is an effective way of preventing the stenosis induced by a neointimal thickening of PTFE-covered stents in the venous system

  1. Renal Sinus Fat Invasion and Tumoral Thrombosis of the Inferior Vena Cava-Renal Vein: Only Confined to Renal Cell Carcinoma

    Science.gov (United States)

    Harman, Mustafa; Guneyli, Serkan; Sen, Sait; Elmas, Nevra

    2014-01-01

    Epithelioid angiomyolipoma (E-AML), accounting for 8% of renal angiomyolipoma, is usually associated with tuberous sclerosis (TS) and demonstrates aggressive behavior. E-AML is macroscopically seen as a large infiltrative necrotic tumor with occasional extension into renal vein and/or inferior vena cava. However, without history of TS, renal sinus and venous invasion E-AML would be a challenging diagnosis, which may lead radiologists to misinterpret it as a renal cell carcinoma (RCC). In this case presentation, we aimed to report cross-sectional imaging findings of two cases diagnosed as E-AML and pathological correlation of these aforementioned masses mimicking RCC. PMID:25506021

  2. Congenital Absence of Inferior Vena Cava with Azygos Continuation Revealed by Vascular Echo in a Patient with Pulmonary Thromboembolism and Deep Vein Thrombosis: A Case Report

    OpenAIRE

    Namisaki, Hidehiro; Nishigami, Kazuhiro; Murakami, Mikiko; Yamamoto, Tami; Ogata, Yuri; Tomita, Ayako

    2013-01-01

    A 44-year-old man with an isolated anomaly of azygos continuation of the inferior vena cava (IVC) presented with dyspnea due to pulmonary thromboembolism (PTE) and deep-vein thrombosis (DVT). Sono-graphic examination disclosed not only pulmonary hypertension and DVT, but also infrahepatic interruption of the IVC with azygos continuation. A rare anomaly of azygos continuation of IVC could cause DVT and PTE. Vascular echo could play an important role in the examination of DVT and/or venous anom...

  3. Brain Abscess Associated with Isolated Left Superior Vena Cava Draining into the Left Atrium in the Absence of Coronary Sinus and Atrial Septal Defect

    International Nuclear Information System (INIS)

    A previously healthy 12-year-old girl presented with severe headache for 2 weeks. On physical examination, there was finger clubbing without apparent cyanosis. Neurological examination revealed only papiledema without focal neurologic signs. Cerebral magnetic resonance imaging showed the characteristic features of brain abscess in the left frontal lobe. Cardiologic workup to exclude a right-to-left shunt showed an abnormality of the systemic venous drainage: presence of isolated left superior vena cava draining into the left atrium in the absence of coronary sinus and atrial septal defect. This anomaly is rare, because only a few other cases have been reported

  4. Acute Budd-Chiari syndrome with hepatic failure and obstruction of the inferior vena cava as presenting manifestations of hereditary protein C deficiency.

    OpenAIRE

    Bourlie?re, M.; Le Treut, Y. P.; Arnoux, D.; Castellani, P.; Bordigoni, L.; Maillot, A.; Antoni, M.; Botta, D.; Pol, B.; Gauthier, A. P.

    1990-01-01

    The protein C system is essential in limiting the activation of coagulation in vivo. We report on a 29 year old woman with Budd-Chiari syndrome and occlusion of the inferior vena cava who presented with acute liver failure. She was successfully treated with an emergency mesoatrial shunt. Eight months after surgery, she has no ascites and normal liver function. She had a low concentration of plasma protein C on admission to hospital and during the follow up. Protein C deficiency subsequently w...

  5. Right sided double inferior vena cava with obstructed retrocaval ureter: Managed with single incision multiple port laparoscopic technique using "Santosh Postgraduate Institute tacking ureteric fixation technique"

    Science.gov (United States)

    Singh, Shivanshu; Garg, Nitin

    2015-01-01

    Right double inferior vena cava with obstructed retrocaval ureter is an extremely rare anomaly with only a few reported cases in the literature. To the best of our knowledge, this is the first case report describing ureteric repair by use of a single-incision laparoscopic technique. In addition, this report addresses the underlying surgical challenges of this repair and provides a brief review of the embryology of this anomaly. The "Santosh Postgraduate Institute ureteric tacking fixation technique" provides ease of end-to-end uretero-ureteric anastomosis in a single-incision laparoscopic surgery. PMID:25874048

  6. Endovascular treatment of venous graft stenosis in the inferior vena cava and the left hepatic vein after complex liver tumor resection.

    Science.gov (United States)

    Brechtel, Klaus; Tepe, Gunnar; Heller, Stephan; Schmehl, Joerg; Kueper, Markus; Claussen, Claus D; Wiskirchen, Jakub

    2009-02-01

    Endovascular treatment has been reported for a variety of conditions that result in venous obstruction in the iliocaval territory. The present report describes a patient who underwent a complex resection of a tumor that infiltrated the retrohepatic segment of the inferior vena cava (IVC), necessitating replacement of the IVC with a polytetrafluoroethylene (PTFE) graft. Postoperatively, symptomatic venous obstruction occurred in the graft and the left hepatic vein. Treatment required stent placement bridging native veins and the graft. The patient underwent placement of a self-expanding stent within the IVC and the PTFE graft with treatment of the hepatic vein stenosis via jugular vein access. PMID:19097806

  7. Suction against resistance: a new breathing technique to significantly improve the blood flow ratio of the superior and inferior vena cava

    International Nuclear Information System (INIS)

    Optimal contrast within the pulmonary artery is achieved by the maximum amount of contrast-enhanced blood flowing through the superior vena cava (SVC), while minimum amounts of non-contrasted blood should originate from the inferior vena cava (IVC). This study aims to clarify whether ''suction against resistance'' might optimise this ratio. Phase-contrast pulse sequences on a 1.5T MRI magnet were used for flow quantification mean flow (mL/s), stroke volume (Vol) in the SVC and IVC in volunteers. Different breathing manoeuvers were analysed repeatedly: free breathing; inspiration; expiration; suction against resistance, and Valsalva. To standardise breathing commands, volunteers performed suction and Valsalva manoeuvers with an MR-compatible manometer.??Suction against resistance was associated with a significant drop of the IVC/SVC flow quotient (1.63 [range 1.3-2.0] p 0.05).??Suction against resistance caused a significant drop in the IVC/SVC quotient. Theoretically, this breathing manoeuver might significantly improve the enhancement characteristics of CT angiography. (orig.)

  8. Repositioning and Leaving In Situ the Central Venous Catheter During Percutaneous Treatment of Associated Superior Vena Cava Syndrome: A Report of Eight Cases

    International Nuclear Information System (INIS)

    Purpose: To describe a combined procedure of repositioning and leaving in situ a central venous catheter followed by immediate percutaneous treatment of associated superior vena cava syndrome (SVCS). Methods: Eight patients are presented who have central venous catheter-associated SVCS (n = 6 Hickman catheters, n = 2 Port-a-cath) caused by central vein stenosis (n = 4) or concomitant thrombosis (n = 4). With the use of a vascular snare introduced via the transcubital or transjugular approach, the tip of the central venous catheter could be engaged, and repositioned after deployment of a stent in the innominate or superior vena cava. Results: In all patients it was technically feasible to reposition the central venous catheter and treat the SVCS at the same time. In one patient flipping of the Hickman catheter in its original position provoked dislocation of the released Palmaz stent, which could be positioned in the right common iliac vein. Conclusion: Repositioning of a central venous catheter just before and after stent deployment in SVCS is technically feasible and a better alternative than preprocedural removal of the vascular access

  9. Estrutura, ultraestrutura e morfometria da veia cava de paca (Cuniculus paca Linnaeus, 1766) criada em cativeiro / Structure, ultrastructure and morphometry of the Vena cava in the paca (Cuniculus paca Linnaeus, 1766) raised in captivity

    Scientific Electronic Library Online (English)

    Sérgio Pinter, Garcia Filho; Leandro Luís, Martins; Ana Carolina Gonçalves dos, Reis; Maria Rita, Pacheco; Márcia Rita Fernandes, Machado.

    2013-05-01

    Full Text Available A paca (Cuniculus paca) é o segundo maior roedor da fauna brasileira. Apresenta carne de excelente qualidade, o que incentiva a criação comercial. Além disso, este animal pode tornar-se uma opção válida em experimentação embora poucas sejam as informações detalhadas sobre sua morfologia. Assim, obje [...] tivou-se descrever a morfologia, morfometria e ultraestrutura de segmentos das porções cranial e caudal da veia cava de quatro pacas (Cuniculus paca) adultas excedentes do plantel do Setor de Animais Silvestres do Departamento de Zootecnia da FCAV-Unesp. Os segmentos venosos foram analisados à microscopia de luz e à microscopia eletrônica de varredura. Foram mensuradas as espessuras do complexo formado pelas túnicas íntima e média, além da túnica adventícia e analisou-se os resultados pela estatística descritiva, teste "T" pareado (p Abstract in english The paca (Cuniculus paca) is the second largest rodent of the Brazilian fauna. The excellent meat quality of this specie encourages the development of their commercial production. Moreover, this animal can become a viable alternative for animal experimentation although there exists scarce detailed i [...] nformation concerning their morphology. Therefore the purpose of this study is to describe the morphology, morphometry and ultrastructure in segments of the cranial and caudal portions of vena cava in four adult males and females of Cuniculus paca from the squad of Wild Animals Sector of Animal Science Department of FCAV-Unesp. Parts of the segments were examined by light microscopy and part by scanning electron microscopy. Thickness measures of the tunica intima and media complex and tunica adventitia of the vena cava were taken and analyzed using "T" test (p

  10. Electrophysiological characteristics of paroxysmal atrial fibrillation originating from superior vena cava: a clinical analysis of 30 cases.

    Science.gov (United States)

    Shi, Xiang-Min; Yuan, Hong-Tao; Guo, Hong-Yang; Guo, Jian-Ping; Shan, Zhao-Liang; Wang, Yu-Tang

    2015-01-01

    To analyze characteristics of electrocardiogram (ECG), electrophysiological intracardiac mapping and radiofrequency ablation (RF) of paroxysmal atrial fibrillation (PAF) originating from superior vena cava (SVC), aiming to investigate electrophysiological characteristics of PAF with SVC origin. Clinical data of 30 subjects (18 men and 12 women, aged, 58.6 ± 15.5 years) with PAF of SVC origin were retrospectively analyzed; All patients underwent RF during 2006.9-2012.7. ECG of AF and atrial premature contractions (APCs), procedure and fluoroscopic time, numbers of ablation sites within SVC, complications and success rate were studied. Compared with P wave of sinus rhythm (SR), APCs of SVC origin exhibited higher amplitude in lead II (0.23 ± 0.11 vs. 0.15 ± 0.06 mv), III (0.19 ± 0.09 vs. 0.13 ± 0.08 mv), AVF (0.21 ± 0.13 vs. 0.14 ± 0.10 mv), V2 (0.24 ± 0.07 vs. 0.15 ± 0.09 mv) and V3 (0.21 ± 0.09 vs. 0.12 ± 0.05 mv) (P AVL (60.0% vs. 6.7%, P < 0.05). In terms of left pulmonary vein (LPV) and right pulmonary vein (RPV) electrical isolation, procedure time (14.3 ± 11.5 vs. 33.7 ± 14.2, 28.1 ± 6.8 min, P < 0.05), fluoroscopic time (9.6 ± 3.8 vs. 21.1 ± 9.3, 19.4 ± 9.7 min, P < 0.05), ablation sites (11.2 ± 3.1 vs. 37.1 ± 13.7, 31.4 ± 10.4 points, P < 0.05) of SVC isolation (SVCI) remarkably decreased compared with that of mean LPV and RPV. After the procedure, 9 patients still presented paroxymal rapid firing within the SVC in the setting of SR restoration, 2 patients developed paroxysmal atrial flutter within 1 month after completion of ablation and were controlled by antiarrhythmic drugs. The APCs and AF of SVC origin manifested distinctive ECG features, which could be helpful to distinguish SVC from other foci before ablation, the completion of SVCI required shorter procedure and fluoroscopic time, as well as less ablation points, and meanwhile, the success rate was high with less complication. PMID:25784993

  11. Superior Vena Cava Syndrome Appearing Like Angioedema: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Bahar Sevimli Dikicier

    2014-06-01

    Full Text Available SVCS may present with periorbital and facial edema just like angioedema, especially at early stages. SVCS, which is frequently associated with malignancies like lung cancer and lymphoma, may be overlooked, patients may be diagnosed and treated as angioedema and the underlying disease is omitted. Our patients were referred to dermatology department as having angioedema but the diagnosis turned out to be SVCS associated with underlying malignancies.

  12. Estudo da resposta tissular à endoprótese recoberta de jugular bovina em veia cava inferior de suínos Bovine jugular covered stent-graft implanted in swine inferior vena cava - a study of tissue response

    Directory of Open Access Journals (Sweden)

    Cristina Ribeiro Riguetti Pinto

    2006-06-01

    Full Text Available OBJETIVO: Avaliar a resposta tissular a uma endoprótese, com cobertura biológica heteróloga, implantada em veia cava inferior de suínos. MÉTODO: Desenvolvemos uma endoprótese auto-expansível, revestida com um segmento de jugular bovina, conservada por processo L-hydro e suturada em um stent de aço inoxidável 316L. O dispositivo introdutor utilizado foi a bainha de liberação da endoprótese aórtica Taheri-Leonhardt (Flórida, EUA. Foram implantadas endopróteses em 10 suínos, todas na veia cava infra-renal. Os animais foram submetidos à flebografia peroperatória. À necropsia, após 2 meses, cada endoprótese foi retirada em bloco e analisada macroscopicamente, visando a avaliação da perviedade, aderência aos tecidos vizinhos e incorporação à parede venosa; e, histopatologicamente, visando a resposta histológica ao enxerto. RESULTADOS: Na análise macroscópica, todas as endopróteses encontravam-se pérvias e totalmente incorporadas à parede venosa, porém seis apresentavam trabeculações grosseiras no seu interior e quatro algum grau de fibrose perivascular. Três animais desenvolveram linfocele, uma retroperitoneal e as outras na parede abdominal. No estudo histopatológico, observamos reação inflamatória granulomatosa tipo corpo estranho em todos os casos, sendo predominante na camada média (80%. CONCLUSÃO: O modelo estudado apresentou baixa trombogenicidade, corroborando com a eficácia do meio de conservação e material escolhidos; porém, baixa biocompatibilidade, provavelmente pelo obstáculo imunológico dos xenoenxertos e resposta tissular exagerada do território venoso.OBJECTIVE: To evaluate tissue response to a bovine jugular vein covered stent when implanted in the swine inferior vena cava. METHOD: We developed a self-expanding stent, using a segment of L-hydro conserved bovine jugular vein, which was trimmed and sutured to a 316L stainless steel stent. We used the Taheri-Leonhardt delivery system for aortic stent-graft deployment (Florida, USA. Ten handmade stent-grafts were implanted in 10 swine inferior venae cavae. All animals were submitted to perioperative venography. At necropsy, 2 months later, the stent-grafts were removed en bloc and histopathologic analysis was undertaken, in order to analyze its patency, adherence to neighboring tissues and incorporation to the venous wall, as well as tissue response. RESULTS: All stent-grafts were patent and adherent to venous wall, but six presented with gross trabeculation and four had some degree of perivascular fibrosis at macroscopy. Three animals developed lymphocele, one in the retroperitoneal space and the others in the abdominal wall. At histopathology, we observed chronic inflammatory reaction with foreign body granulomatous response in all cases, with prevalence of the tunica media (80%. CONCLUSION: The model presented low thrombogenicity, which corroborates the efficacy of the chosen means of preservation and material. However, there was low compatibility, probably due to the immunological obstacle of xenografts and exaggerated tissue response of the venous territory.

  13. Tumor thrombus of inferior vena cava in patients with renal cell carcinoma – clinical and oncological outcome of 50 patients after surgery

    Directory of Open Access Journals (Sweden)

    Kocot Arkadius

    2012-06-01

    Full Text Available 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, who underwent radical surgical treatment for RCC and tumor thrombus of the IVC between 1997 and 2010. The charts were reviewed for pathological and surgical parameters, as well as complications and oncological outcome. Results The median follow-up was 26?months. In 21 patients (42% distant metastases were already present at the time of surgery. All patients underwent radical nephrectomy, thrombectomy and lymph node dissection through a flank (15 patients/30%, thoracoabdominal (14 patients/28% or midline abdominal approach (21 patients/42%, depending upon surgeon preference and upon the characteristics of tumor and associated thrombus. Extracorporal circulation with cardiopulmonary bypass (CPB was performed in 10 patients (20% with supradiaphragmal thrombus of IVC. Cancer-specific survival for the whole cohort at 5?years was 33.1%. Survival for the patients without distant metastasis at 5?years was 50.7%, whereas survival rate in the metastatic group at 5?years was 7.4%. Median survival of patients with metastatic disease was 16.4?months. On multivariate analysis lymph node invasion, distant metastasis and grading were independent prognostic factors. There was no statistically significant influence of level of the tumor thrombus on survival rate. Indeed, patients with supradiaphragmal tumor thrombus (n?=?10 even had a better outcome (overall survival at 5?years of 58.33% than the entire cohort. Conclusions An aggressive surgical approach is the most effective therapeutic option in patients with RCC and any level of tumor thrombus and offers a reasonable longterm survival. Due to good clinical and oncological outcome we prefer the use of CPB with extracorporal circulation in patients with supradiaphragmal tumor thrombus. Cytoreductive surgery appears to be beneficial for patients with metastatic disease, especially when consecutive therapy is performed. Although sample size of our study cohort is limited consistent with some other studies lymph node invasion, distant metastasis and grading seem to have prognostic value.

  14. Tumor thrombus involving the inferior vena cava in renal malignancy: is there a difference in clinical presentation and outcome among right and left side tumors?

    Scientific Electronic Library Online (English)

    Katkoori, Devendar; Manoharan, Murugesan; Gaetano, Ciancio; Mark S., Soloway.

    2009-12-01

    Full Text Available PURPOSE: Renal cell carcinoma (RCC) has a propensity to propagate into the renal vein and inferior vena cava (IVC). Due to inherent differences in the venous anatomy of the right and left kidneys, tumor thrombus involvement of IVC may vary. The aim of this study is to compare clinical presentation a [...] nd outcome of right vs. left RCC with IVC thrombus. MATERIALS AND METHODS: Patients who underwent radical nephrectomy and IVC thrombectomy between 1997 and 2008 were identified. All relevant data were collected and analyzed. Results: Eight-seven patients were included. Sixty patients (69%) had a right sided tumor. Mean tumor size was 10.2 (± 4) cm and was not significantly different on either side. Fifty-six percent of right sided tumors had level-III (intra-hepatic) or higher tumor thrombus, while 22% of left sided tumors had similar level thrombus extension (p

  15. Acute Budd-Chiari syndrome with hepatic failure and obstruction of the inferior vena cava as presenting manifestations of hereditary protein C deficiency.

    Science.gov (United States)

    Bourlière, M; Le Treut, Y P; Arnoux, D; Castellani, P; Bordigoni, L; Maillot, A; Antoni, M; Botta, D; Pol, B; Gauthier, A P

    1990-01-01

    The protein C system is essential in limiting the activation of coagulation in vivo. We report on a 29 year old woman with Budd-Chiari syndrome and occlusion of the inferior vena cava who presented with acute liver failure. She was successfully treated with an emergency mesoatrial shunt. Eight months after surgery, she has no ascites and normal liver function. She had a low concentration of plasma protein C on admission to hospital and during the follow up. Protein C deficiency subsequently was found in her father and two sisters, who were asymptomatic. Hereditary protein C deficiency should be considered in patients with Budd-Chiari syndrome. Images Figure 1 Figure 2 PMID:2387522

  16. Coexistence of Obstructive Sleep Apnea and Superior Vena Cava Syndromes Due to Substernal Goitre in a Patient With Respiratory Failure: A Case Report

    Science.gov (United States)

    Tunc, Mehtap; Sazak, Hilal; Karlilar, Bulent; Ulus, Fatma; Tastepe, Irfan

    2015-01-01

    Introduction: Substernal goiter may rarely cause superior vena cava syndrome (SVCS) owing to venous compression, and cause acute respiratory failure due to tracheal compression. Obstructive sleep apnea syndrome (OSAS) may rarely occur when there is a narrowing of upper airway by edema and vascular congestion resulting from SVCS. Case Presentation: We presented the clinical course and treatment of acute respiratory failure (ARF) developed in a patient with SVCS and OSAS due to substernal goiter. After treatment of ARF with invasive mechanical ventilation, weaning and total thyroidectomy were successfully performed through collar incision and median sternotomy without complications. Conclusions: Our case showed that if the respiratory failure occurred due to substernal goiter and SVCS, we would need to investigate the coexistence of OSAS and SVCS. PMID:26082848

  17. Drenagem anômala de veia pulmonar inferior direita em veia cava inferior associada a apêndice hepático intracardíaco Anomalous drainage of the right inferior pulmonary vein into the inferior vena cava associated to intrathoracic hepatic appendix

    Directory of Open Access Journals (Sweden)

    Carlos R Moraes

    1988-08-01

    Full Text Available Descreve-se o caso de uma paciente de 61 anos de idade, com drenagem anômala de veia pulmonar inferior direita em veia cava inferior, associada a apêndice hepático intratorácico, herniado através de fenda no diafragma. A correção cirúrgica foi realizada por anastomose direta da veia anômala com o átrio esquerdo, pela redução do apêndice hepático para a cavidade abdominal e, finalmente, pelo fechamento do defeito diafragmático. O pós-operatório decorreu sem qualquer complicação. Os autores chamam a atenção para a raridade do caso.The authors present a case of a 61-year-old woman with anomalous drainage of the right inferior pulmonary vein into the inferior vena cava associated to an intrathoracic hepatic appendix herniated through a diaphragmatic defect. Surgical correction was obtained by direct anastomosis of the anomalous vein to the left atrium, reduction of the hepatic appendix to the abdominal cavity and closure of the diphragmatic defect. The postoperative course was unevenftul. The rarity of this condition is stressed.

  18. Suction against resistance: a new breathing technique to significantly improve the blood flow ratio of the superior and inferior vena cava

    Energy Technology Data Exchange (ETDEWEB)

    Gutzeit, Andreas [Clinical Research Unit of St. Anna Hospital Luzern, Institute of Radiology and Nuclear Medicine, Luzern (Switzerland); Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Cantonal Hospital, Department of Radiology, Winterthur (Switzerland); Roos, Justus E. [Duke University, Department of Radiology, Durham, NC (United States); Hergan, Klaus [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Weymarn, Constantin von; Reischauer, Carolin; Froehlich, Johannes M. [Clinical Research Unit of St. Anna Hospital Luzern, Institute of Radiology and Nuclear Medicine, Luzern (Switzerland); Cantonal Hospital, Department of Radiology, Winterthur (Switzerland); Waelti, Stephan [Cantonal Hospital, Department of Radiology, Winterthur (Switzerland)

    2014-12-15

    Optimal contrast within the pulmonary artery is achieved by the maximum amount of contrast-enhanced blood flowing through the superior vena cava (SVC), while minimum amounts of non-contrasted blood should originate from the inferior vena cava (IVC). This study aims to clarify whether ''suction against resistance'' might optimise this ratio. Phase-contrast pulse sequences on a 1.5T MRI magnet were used for flow quantification mean flow (mL/s), stroke volume (Vol) in the SVC and IVC in volunteers. Different breathing manoeuvers were analysed repeatedly: free breathing; inspiration; expiration; suction against resistance, and Valsalva. To standardise breathing commands, volunteers performed suction and Valsalva manoeuvers with an MR-compatible manometer.??Suction against resistance was associated with a significant drop of the IVC/SVC flow quotient (1.63 [range 1.3-2.0] p < 0.05 at -10 mmHg and 1.48 [1.1-1.9] p < 0.01 at -20 mmHg) corresponding to increased blood flow from SVC and diminished flow originating from the IVC. The remaining breathing commands (free breathing 2.2; inspiration 2.4; expiration 2.4; Valsalva 10 mmHg 2.3; Valsalva 20 mmHg 2.6; and Valsalva 30 mmHg 2.2) showed no differences (p > 0.05).??Suction against resistance caused a significant drop in the IVC/SVC quotient. Theoretically, this breathing manoeuver might significantly improve the enhancement characteristics of CT angiography. (orig.)

  19. Síndrome de Cushing secundario a carcinoma de la glándula suprarrenal izquierda con metástasis hepáticas y trombosis tumoral masiva de la vena cava / Cushing´s syndrome due to a left adrenal cortical carcinoma with metastasis to the liver and a massive vena cava tumor thrombus

    Scientific Electronic Library Online (English)

    Martha Alejandra, Casallas; Carlos Mauricio, Calderón.

    2012-12-01

    Full Text Available Se presenta el caso de una mujer de 47 años con cuadro clínico de siete meses de evolución caracterizado por aumento progresivo de peso, hipertensión arterial y diabetes mellitus de reciente aparición, hirsutismo facial y en tórax, alopecia frontal, alteraciones en la menstruación e hipopotasiemia. [...] Se consideró el diagnóstico de síndrome de Cushing, por lo cual se iniciaron estudios e extensión para establecer su etiología. Durante su hospitalización presentó una evolución tórpida y falleció. En la autopsia clínica se encontró un carcinoma de la glándula suprarrenal izquierda, de 400 g, aproximadamente, con metástasis a hígado y trombosis masiva de la vena cava, lo que finalmente produjo su muerte. Abstract in english A 47-year-old woman with a seven-month history of increasing weight, hypertension and recently diagnosed diabetes presented features of hirsutism, frontal baldness, amenorrhea and hypokalemia. These characteristics were considered diagnostic of Cushing´s syndrome, and studies were initialized to ide [...] ntify its etiology. During hospitalization, the patient presented a torpid evolution resulting in death. Clinical autopsy revealed a 400 g carcinoma in the left adrenal gland, liver metastasis and a massive vena cava tumor thrombus which was the final cause of death.

  20. In Vivo Evaluation of the Effects of Gravitational Force (+Gz) on Over-the-Wire Stainless Steel Greenfield Inferior VenaCava Filter in Swine

    International Nuclear Information System (INIS)

    This study was done to determine the effect of exposure to gravitational force (acceleration stress) on invivo over-the-wire stainless steel Greenfield inferior vena cavafilters. Fifteen pigs underwent venous cut down and placement of a stainless steel Greenfield filter. A 4-week observation period simulated realistic convalescence and allowed sufficient time for epithelialization. Ten pigs were exposed to acceleration stress in a centrifuge (3G run for 15 sec followed by rest until return to baseline heart rate, then a 9G run for 15 sec), with inertial loading in ahead-to-tail direction (+Gz). Fluoroscopy during acceleration stress allowed assessment for filter migration. Five pigs were not exposed to acceleration stress. AP and lateral abdominal radiographs were obtained at post-filter placement, convalescence, and centrifuge exposure to determine the position and integrity of the filter. All 15 IVCs were resected and evaluated for gross or histological injury to the vessel wall. IVC filter placement was technically successful in all 15 pigs.Radiographic measurements were limited secondary to differences in pig positioning. Fluoroscopy showed no filter migration. All filters were securely attached to the vena cava by the hooks without gross evidence of perforation or hemorrhage. There were varying degrees of fibroplasia involving the hooks and tip of the filters in both the control and experimental groups. Histologically, there was evidence of prior hemorrhage at there was evidence of prior hemorrhage at the level of the hooks, which was similar between the control and experimental groups. It is concluded that Greenfield filter position and vena caval integrity at the implantation site is unaffected by high acceleration stress

  1. Prophylaxis of Pulmonary Embolism With Inferior Vena Cava Filter in a Patient With Tetraplegia in Chronic Stage

    OpenAIRE

    Ümüt GÜZELKÜÇÜK; ?ltekin DUMAN; Levent TEK?N; YILMAZ, Bilge; Arif Kenan TAN

    2013-01-01

    Spinal kordyaralanmal? (SKY) hastalarderinventrombozu (DVT) vepulmoner emboli (PE) geli?imiiçin en riskli hasta gruplar?ndanbiriniolu?turmaktad?r. Günümüzde DVT proflaksisindefarmakolojikolarakdü?ükmoleküla??rl?kl? heparin, mekanikolarakiseelastikbandaj, varisçorab?veintermittanpnömotikkompresyoncihazlar?kullan?lmaktad?r.SKY’lihastalarda, profilaksiile DVT ve PE riskiazalmaklabirliktedevametmektedir (1,2).Sadece PE proflaksisindekullan?labilecekdi?erbirmekanikyöntemise vena kava inferiora (VK...

  2. Persistent left superior vena cava: Review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients

    OpenAIRE

    Povoski Stephen P; Khabiri Hooman

    2011-01-01

    Abstract Persistent left superior vena cava (PLSVC) represents the most common congenital venous anomaly of the thoracic systemic venous return, occurring in 0.3% to 0.5% of individuals in the general population, and in up to 12% of individuals with other documented congential heart abnormalities. In this regard, there is very little in the literature that specifically addresses the potential importance of the incidental finding of PLSVC to surgeons, interventional radiologists, and other phy...

  3. Hipervolemia mais tríplice oclusão vascular no tratamento da lesão traumática da veia cava retro-hepática e veias hepáticas / Hypervolemia and triple vessel occlusion in the treatment of traumatic retrohepatic vena and hepatic vein injuries

    Scientific Electronic Library Online (English)

    Wilson Luiz, Abrantes.

    2001-10-01

    Full Text Available [...] Abstract in english BACKGROUND: Liver vascular isolation is essential for the treatment of the retrohepatic vena cava and hepatic veins. Triple vessel occlusion (TVO - occlusion of the portal triad, the inferior vena cava above the renal veins and within the pericardium) is the easiest isolation method for the surgeon. [...] Unfortunately, this technique cannot be applied to hypovolemic and/or shock (cardiac arrest) patients as it compromises venous return. OBJECTIVES: Our objective is to demonstrate that in the above mentioned patients, establishing a previous hypervolemic state allows the safe use of TVO. METHODS: The method includes efficient injury tamponade with aggressive fluid replacement until normal blood volume is reached (resuscitation). Normal blood volume is recognized by a return of arterial blood pressure to normal levels, inferior vena cava filling and an increase in aortic wall tension. Following this procedure, hypervolemia is obtained by the rapid additional infusion of 1.500 to 2.000 ml of fluids. TVO in this situation does not alter the heart rhythm and maintains a clear operative field which is essential for hepatotomy, venorrhaphy and or venous ligation. RESULTS: Three patients were successfully operated.

  4. Estudo da resposta tissular à endoprótese recoberta de jugular bovina em veia cava inferior de suínos / Bovine jugular covered stent-graft implanted in swine inferior vena cava - a study of tissue response

    Scientific Electronic Library Online (English)

    Cristina Ribeiro Riguetti, Pinto; Celso Luiz Muhlethaler, Chouin; Gaudencio, Espinosa Lopez.

    2006-06-01

    Full Text Available OBJETIVO: Avaliar a resposta tissular a uma endoprótese, com cobertura biológica heteróloga, implantada em veia cava inferior de suínos. MÉTODO: Desenvolvemos uma endoprótese auto-expansível, revestida com um segmento de jugular bovina, conservada por processo L-hydro e suturada em um stent de aço i [...] noxidável 316L. O dispositivo introdutor utilizado foi a bainha de liberação da endoprótese aórtica Taheri-Leonhardt (Flórida, EUA). Foram implantadas endopróteses em 10 suínos, todas na veia cava infra-renal. Os animais foram submetidos à flebografia peroperatória. À necropsia, após 2 meses, cada endoprótese foi retirada em bloco e analisada macroscopicamente, visando a avaliação da perviedade, aderência aos tecidos vizinhos e incorporação à parede venosa; e, histopatologicamente, visando a resposta histológica ao enxerto. RESULTADOS: Na análise macroscópica, todas as endopróteses encontravam-se pérvias e totalmente incorporadas à parede venosa, porém seis apresentavam trabeculações grosseiras no seu interior e quatro algum grau de fibrose perivascular. Três animais desenvolveram linfocele, uma retroperitoneal e as outras na parede abdominal. No estudo histopatológico, observamos reação inflamatória granulomatosa tipo corpo estranho em todos os casos, sendo predominante na camada média (80%). CONCLUSÃO: O modelo estudado apresentou baixa trombogenicidade, corroborando com a eficácia do meio de conservação e material escolhidos; porém, baixa biocompatibilidade, provavelmente pelo obstáculo imunológico dos xenoenxertos e resposta tissular exagerada do território venoso. Abstract in english OBJECTIVE: To evaluate tissue response to a bovine jugular vein covered stent when implanted in the swine inferior vena cava. METHOD: We developed a self-expanding stent, using a segment of L-hydro conserved bovine jugular vein, which was trimmed and sutured to a 316L stainless steel stent. We used [...] the Taheri-Leonhardt delivery system for aortic stent-graft deployment (Florida, USA). Ten handmade stent-grafts were implanted in 10 swine inferior venae cavae. All animals were submitted to perioperative venography. At necropsy, 2 months later, the stent-grafts were removed en bloc and histopathologic analysis was undertaken, in order to analyze its patency, adherence to neighboring tissues and incorporation to the venous wall, as well as tissue response. RESULTS: All stent-grafts were patent and adherent to venous wall, but six presented with gross trabeculation and four had some degree of perivascular fibrosis at macroscopy. Three animals developed lymphocele, one in the retroperitoneal space and the others in the abdominal wall. At histopathology, we observed chronic inflammatory reaction with foreign body granulomatous response in all cases, with prevalence of the tunica media (80%). CONCLUSION: The model presented low thrombogenicity, which corroborates the efficacy of the chosen means of preservation and material. However, there was low compatibility, probably due to the immunological obstacle of xenografts and exaggerated tissue response of the venous territory.

  5. The Optional VenaTech{sup Trade-Mark-Sign} Convertible{sup Trade-Mark-Sign} Vena Cava Filter: Experimental Study in Sheep

    Energy Technology Data Exchange (ETDEWEB)

    Le Blanche, Alain F., E-mail: le_blanche.alain@chu-amiens.fr [University of Picardie-Jules Verne (France); Ricco, Jean-Baptiste [University of Poitiers (France); Bonneau, Michel [Institut National de la Recherche Agronomique (I.N.R.A.) and Assistance Publique-Hopitaux de Paris (APHP), Centre of Research in Interventional Imaging - CRII (France); Reynaud, Philippe [Hopital Europeen Georges Pompidou (HEGP) APHP, Department of Respiratory Diseases (France)

    2012-10-15

    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{sup Trade-Mark-Sign} Convertible{sup Trade-Mark-Sign} 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{sup Trade-Mark-Sign} Convertible{sup Trade-Mark-Sign} 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.

  6. Outcome of a retrieval stent filter and 30 mm balloon dilator for patients with Budd-Chiari syndrome and chronic inferior vena cava thrombosis: a prospective pilot study

    International Nuclear Information System (INIS)

    Aim: To evaluate the mid-term safety and efficacy of a retrieval stent filter and 30 mm balloon dilator in the treatment of Budd-Chiari syndrome (BCS) patients with chronic inferior vena cava (IVC) thrombosis. Materials and methods: Twenty-three consecutive patients with BCS and chronic IVC thrombosis were treated with a retrieval stent filter and a 30 mm balloon dilator, and subsequently underwent color Doppler ultrasound follow-up at our hospital. Data relating to the technical success, angiographic and ultrasound results, mortality, morbidity, and final clinical outcome were collected retrospectively and follow-ups were performed 1, 3, 6, and 12 months after placement of the stent, and annually thereafter. Results: Stent filter placement and balloon dilation were technically successful in all patients, with no procedure-related complications. Removal of the stent filter was technically successful in 22 of 23 attempts, yielding a technical successful rate of 95.7% (95% confidence intervals (CI): 87%, 105%). Inferior vena cavagrams performed immediately before stent removal demonstrated that the IVC thrombus had completely resolved in all patients without pulmonary embolism. The mean primary patency rate 3, 6, 12, and 24 months after venoplasty was 0.91 (95% CI: 0.79-1.04), 0.87 (95% CI: 0.72-1.02), 0.87 (95% CI: 0.72-1.02), and 0.87 (95% CI: 0.72-1.02), respectively. The secondary patency rates were 1.00 throughout the follow-up period. All patients are alive with rw-up period. All patients are alive with resolution of the symptoms at the time of this report. Conclusions: The preliminary results indicate that the retrieval stent filter and 30 mm balloon dilator are a safe and effective treatment for BCS patients with chronic IVC thrombosis.

  7. Masa intraauricular derecha en paciente chagásico con marcapasos definitivo / A mass inside the lright atrium in a patient with Chagas Disease and a pacemaker

    Scientific Electronic Library Online (English)

    Gabriel, Castillo; Javier, Caviedes; Monica, Campos; Rafael, Ríos; Hernán, Ruiz.

    2015-04-01

    Full Text Available Se presenta un paciente de 60 años, chagásico crónico y usuario de marcapasos definitivo con masa en aurícula derecha asociada a Síndrome de Vena Cava Superior y baja de peso. [...] Abstract in english A 69 year old man, with Chagas Disease and an implanted pacemaker develop a superior vena cava syndrome and weight loss [...

  8. Recurrence-free survival of a hepatocellular carcinoma patient with tumor thrombosis of the inferior vena cava after treatment with sorafenib and hepatic resection.

    Science.gov (United States)

    Nakamura, Kenichi; Beppu, Toru; Hayashi, Hiromitsu; Okabe, Hirohisa; Imai, Kastunori; Nitta, Hidetoshi; Chikamoto, Akira; Ishiko, Takatoshi; Sasaki, Masato; Baba, Hideo

    2015-05-01

    Sorafenib (Nexabar, Bayer, Berlin, Germany), one of multikinase inhibitors, can infrequently downstage advanced hepatocellular carcinoma (HCC). There are some reports that sorafenib in combination with other modalities, such as transcatheter arterial chemoembolization (TACE) or radiation therapy, could represent a bridge to surgery. We have observed a progressive HCC case with hepatic vein tumor thrombosis proceeding to the inferior vena cava (IVC-HVTT) convert to a state of feasible curative resection after a multidisciplinary treatment which included sorafenib. The patient underwent a successful resection in consequence of this therapy. A 45-year-old male with Hepatitis B Virus-associated chronic hepatitis was diagnosed as HCC with IVC-HVTT. To obtain oncological curative resection, we performed TACE, radiation therapy followed by administration of sorafenib (800 mg per day, total 72 g). The tumor including IVC-HVTT remarkably shrank, therefore, an extended posterior sectionectomy and total removal of the IVC-HVTT was successfully performed. The operation time was 736 minutes and the amount of intraoperative hemorrhage was 805 mL. No postoperative complication occurred. Adjuvant therapy with sorafenib was started four weeks after the operation and continued for 6 months (800 mg per day, total 144 g). The patient is alive without recurrence for about 4 years from the initial therapy. Multidisciplinary therapy including sorafenib, TACE, radiation, and hepatic resection may be an effective strategy to treat HCC patients with IVC-HVTT. PMID:26011214

  9. Thrombolysis for treating deep venous thrombosis by high-dose urokinase: the usefulness of preventive placement of inferior vena cava filter

    International Nuclear Information System (INIS)

    Objective: To investigate the feasibility and efficacy of high-dose urokinase thrombolysis for treating lower limb deep venous thrombosis (DVT) after inferior vena cava (IVC) filter placement. Methods: Thirteen patients of venographically proved DVT underwent preventive IVC filter placement for thrombolysis by high-dose urokinase. Antegrade infusion of high-dose urokinase was performed via the dorsalis pedis vein of the involved lower limb. The total dose of urokinase was 9 000 000 ? 16 000 000 units, and the procedure of thrombolysis was performed in ICU ward where the patients were closely monitored clinically and laboratorially. Results: A total of 13 IVC filters were successfully deployed without disposition and migration. The therapeutic effects were divided into four scales as follows: complete disappearance of the venous thrombosis and clinically asymptomatic (n = 2); remarkable recovery characterized by markedly improved clinical symptoms and venographically proved patent lumen in which the diameter was larger than 70% (n = 9); effective treatment indicating improved symptoms to some degrees and venographically proved patent lumen in which the diameter was smaller than 70% ( n = 2); and ineffective treatment (n = 0). No pulmonary embolism and hemorrhage occurred during the procedure of thrombolysis. Conclusion: High-dose urokinase for treating DVT is safe and effective after preventive placement of IVC filter

  10. Measurement of Anterior-Posterior Diameter of Inferior Vena Cava by Ultrasonography: A Non-Invasive Method for Estimation of Central Venous Pressure

    Directory of Open Access Journals (Sweden)

    R. Nafisi-Moghadam

    2007-05-01

    Full Text Available Background and Objective: The assessment of blood volume is now one of the most commonly needed interventions in the first line of care and severe ill patients. Measuring central venous pressure (CVP is an invasive method, most frequently used in clinical practice for the assessment of volume status. The di-ameter of the inferior vena cava (IVC is a parameter to estimate central venous pressure. The purpose of this study was to determine whether measurement of the anterior-posterior diameter of the IVC by ultra-sonography, correlates with CVP. Materials and Methods: It was a descriptive and pro-spective study on 50 patients; CVP was measured in supine position by CVP manometer. Anterior – pos-terior IVC diameter was assessed by ultrasonography during inspiration and expiration. Results: The mean of CVP during inspiration and ex-piration was 11.31+5.59, 12.20 + 5.65cmH2o, respec-tively. The mean of inspiratory and expiratory IVC diameter was 7.71+3.56, 11.97+3.28 mm, respectively. There was significant relation between CVP and IVC diameter in the inspiration (r=0.664, p<0.0001 and expiration (r=0.495, p=0.001. The relation between these two variables was linear. Conclusion: Result of this study showed that IVC di-ameter measurement by ultrasonography can be used to estimate the mean of CVP.

  11. Contrast-fluid level in the inferior vena cava (IVC niveau sign) in patients with acute type A aortic dissection. Computed tomography findings during acute cardiac tamponade

    International Nuclear Information System (INIS)

    The purpose of this study was to report a new computed tomography (CT) finding in acute cardiac tamponade: a contrast-fluid level in the hepatic inferior vena cava (IVC) during an arterial dominant phase CT study (IVC niveau sign) in patients with acute type A aortic dissection. We retrospectively reviewed CT studies with the diagnosis of proximal aortic dissection (Stanford type A) with acute cardiac tamponade. There were 12 patients enrolled in the study (6 women, 6 men; mean age 66 years). A total of 62 patients were selected as a control chronic pericardial effusion group to compare with the acute cardiac tamponade group. Among the 12 patients with acute cardiac tamponade, the IVC niveau sign was seen in 7 (58%). In the control chronic pericardial effusion group (n=62), we identified the IVC niveau sign in only one patient (1.6%). There was a significant difference in the presence of the IVC niveau sign between the acute cardiac tamponade and chronic pericardial effusion groups (P<0.0001). The presence of the IVC niveau sign suggests acute cardiac tamponade in patients with acute type A aortic dissection. (author)

  12. A false aneurysm with an aorto-superior vena cava fistula after replacement of the ascending aorta: report of a case.

    Science.gov (United States)

    Iwaki, Ryuma; Nakagiri, Keitaro; Morimoto, Naoto; Murakami, Hirohisa; Honda, Tasuku; Yoshida, Masato; Mukohara, Nobuhiko

    2014-12-01

    A 58-year-old female presenting with congestive heart failure due to a fistula between an aortic false aneurysm and the superior vena cava (SVC) is described. She had a history of Takayasu's arteritis (TA) and she had undergone aortic valve and ascending aorta replacement and coronary artery bypass grafting 6 years before. The false aneurysm had occurred 1 year after the surgery, and she had been conservatively managed. The operation revealed that the cause of the false aneurysm was the detachment of the two proximal saphenous vein anastomoses to the ascending aortic graft. After the surgery, the patient made an uneventful recovery. A false aneurysm of the ascending aorta is one of the most serious complications after replacement of the ascending aorta for patients with TA (Miyata et al. in J Vasc Surg 27:438-445, 1998). We herein present the exceptional case of a fistula between an aortic false aneurysm and the SVC that occurred after ascending aorta graft replacement. PMID:24197671

  13. Correlação entre os índices dopplervelocimétricos da veia cava inferior e ducto venoso e a concentração de hemoglobina do cordão em fetos de gestantes isoimunizadas / Correlation between the Doppler indices of inferior vena cava and ductus venosus and fetal umbilical cord blood concentration of hemoglobin in pregnant women with isoimmunization

    Scientific Electronic Library Online (English)

    Marcos Roberto, Taveira; Antônio Carlos Vieira, Cabral; Henrique Vítor, Leite.

    2003-09-01

    Full Text Available OBJETIVO: o objetivo principal desse estudo foi verificar se existe correlação entre os índices dopplervelocimétricos da veia cava inferior e do ducto venoso e a concentração sérica da hemoglobina fetal. MÉTODOS: estudo transversal e prospectivo, realizado entre janeiro de 1998 e junho de 2001. Fora [...] m acompanhadas 31 gestantes isoimunizadas com resultado do teste de Coombs indireto maior que 1:8, que foram submetidas à pesquisa de hemólise fetal. Quando foram indicadas as transfusões intra-uterinas intravasculares, a hemoglobina do cordão foi dosada no início do procedimento. Nos demais casos, a hemoglobina do cordão foi mensurada no momento do parto, sempre por cesariana eletiva. Obteve-se um total de 74 procedimentos estudados, definidos como sendo cada transfusão intra-uterina precedida pela dopplervelocimetria venosa. A mensuração da concentração da hemoglobina fetal foi realizada no Hemocue® (B-Hemoglobin Photometer Hemocue AB; Angelholm, Sweden), dispositivo usado para a determinação quantitativa de hemoglobina no sangue. A dopplervelocimetria da cava inferior e do ducto venoso foi realizada antecedendo a coleta do sangue fetal, sempre em intervalo de tempo inferior a 24 horas. Os índices dopplervelocimétricos estudados foram o índice de pulsatilidade para veias (IPV), o índice do pico de velocidade para veias (IPVV) e a relação entre o pico de velocidade durante a fase de contração atrial e o pico de velocidade na sístole ventricular (relação CA/SV ou índice de pré-carga), na veia cava inferior, e o IPV, IPVV e a relação entre os picos de velocidade da sístole ventricular e da contração atrial (relação SV/CA), no ducto venoso. Foi realizado estudo de correlação entre a dopplervelocimetria da veia cava inferior e do ducto venoso e a hemoglobina do cordão, pela técnica de regressão linear simples. Realizou-se também estudo de associação entre os índices dopplervelocimétricos do compartimento venoso e a hemoglobina fetal inferior a 10 g/dL, por meio do teste do c². RESULTADOS: foi efetuado um total de 74 procedimentos. Em 23 desses a hemoglobina fetal era inferior a 7,0 g/dL. Houve correlação negativa significativa entre todos os índices dopplerfluxométricos estudados e a concentração de hemoglobina fetal (p Abstract in english PURPOSE: to determine the relationship between the Doppler indices of inferior vena cava and ductus venosus and the fetal hemoglobin concentration. METHODS: a cross-sectional prospective study was performed at the "Centro de Medicina Fetal HC UFMG" from January 1998 to July 2001. Thirty-one pregnant [...] women with isoimmunization, detected by an indirect Coombs test >1:8, underwent a protocol for the identification of fetal hemolysis. When intrauterine transfusions were indicated, the umbilical cord hemoglobin concentration was measured at the begining of the procedure. In the other cases, it was measured at delivery. Every single intrauterine transfusion preceded by Doppler flow velocity waveforms from inferior vena cava and ductus venosus was defined as one case. Hemocue® (B-Hemoglobin Photometer Hemocue AB; Angelholm, Sweden) was used to measure the fetal hemoglobin concentration. In all cases, inferior vena cava and ductus venosus Doppler examinations were performed before the collection of fetal blood samples. For the inferior vena cava Doppler, the studied indices were pulsatility index for veins (PVI), peak velocity index for veins (PVIV) and atrial/systole ratio (CA/SV ratio or preload index); for ductus venosus, PVI, PVIV and systole/atrial ratio (SV/CA ratio). The relationship between inferior vena cava and ductus venosus Doppler indices and cord blood hemoglobin concentration was obtained by simple linear regression analysis. Moreover, an association between those indices and the finding of fetal hemoglobin

  14. Long-term Outcomes of Percutaneous Venoplasty and Gianturco Stent Placement to Treat Obstruction of the Inferior Vena Cava Complicating Liver Transplantation

    International Nuclear Information System (INIS)

    PurposeEvaluation of long-term outcomes of venoplasty and Gianturco stents to treat inferior vena cava (IVC) obstruction after liver transplantation.MethodsWe retrospectively analyzed records from 33 consecutive adult patients referred with the intent to treat suspected IVC obstruction after liver transplantation. Treatment was performed for occlusion or stenosis with a gradient exceeding 3 mmHg. The primary treatment was venoplasty and, if refractory, Gianturco stent placement. Recurrence prompted repeat venoplasty or stent placement.ResultsOf the 33 patients, 25 (aged 46.9 ± 12.2 years) required treatment at a mean of 2.3 years (14 days to 20.3 years) after transplantation. For technically successful cases, primary treatment was venoplasty alone (14) or with stent placement (10). Technical success was 96 % (24 of 25) reflecting failure to cross one occlusion. Clinical success was 88 % (22 of 25) reflecting the technical failure and two that died of unrelated complications within 5 weeks. Cumulative primary patencies were 57.1 % at 6 months (n = 21) and 51.4 % at 1 (n = 10), 3 (n = 7), 5 (n = 6), and 7 (n = 5) years. Cumulative primary assisted patency was 95.2 % at 6 months (n = 21) and at 1 (n = 15), 3 (n = 9), 5 (n = 8), and 7 (n = 8) years. The 17 patients stented for refractory (n = 10) or recurrent (n = 7) stenosis had cumulative primary and primary assisted patencies of 86.0 and 100 %, respectively, from 6 months (n = 14) to 7 years (n = 3). No major complications occurred; one fractured stent was observed after 11.6 years.ConclusionFor IVC obstruction following liver transplantation, excellent long-term outcomes can be achieved by venoplasty and Gianturco stent placement

  15. Acute Pulmonary Thromboembolism and Deep Vein Thrombosis during the Medical Treatment of Acute Aortic Dissection was Successfully Treated by the Combination of Inferior Vena Cava Filter Installation and Anti-Coagulant Therapy: A Case Report

    Science.gov (United States)

    Ota, Satoshi; Hoshino, Kozo; Yamada, Norikazu; Nakamura, Mashio; Ito, Masaaki

    2015-01-01

    A 71-year-old woman was admitted with Stanford type A acute aortic dissection (AAD). Computed tomography (CT) revealed thrombosis of the false lumen, and we planned to treat medically. She developed transient pleural effusion and hypoxemia, which persisted despite her pleural effusion disappeared. We performed CT and found a large thrombus in the pulmonary artery and femoral vein. We administered low dose- unfractionated heparin and installed a retrievable inferior vena cava filter, which caused the thrombus in the pulmonary artery to disappeared without exacerbating AAD. Our strategy seems to be suitable for acute pulmonary thromboembolism that occurs during the treatment of AAD. PMID:25848430

  16. Placement and retrieval of a Guenther tulip filter in patients with a free floating thrombus in inferior vena cava

    International Nuclear Information System (INIS)

    We wanted to assess the technical feasibility and clinical efficacy of the placement and retrieval of a Guenther Tulip filter for the prevention of fatal pulmonary embolism during the management of patients with a free floating thrombus in their inferior vena ca va (IVC). Six patients having a free floating thrombus in their IVC (three patients with an isolated free floating thrombus in the IVC that resulted from immobilization due to traumatic liver injury or cerebral infarction, two patients with coexisting deep vein thrombosis in the left lower extremity that was caused by May-Thurner syndrome, and one patient with coexisting deep vein thrombosis in the right lower extremity that was due to nephrotic syndrome and immobilization after hip joint replacement) underwent placement and retrieval of a Guenther Tulip filter. The placement of the filter was performed through the right internal jugular vein to prevent the risk of detachment of the thrombus during the procedure. Retrieval of filter was performed after the free floating thrombus of the IVC had disappeared on follow-up CT because of anticoagulation therapy, aspiration thrombectomy or catheter directed Urokinase thrombolysis. The Guenther Tulip filter was successfully placed in the IVC in all six patients and it was retrieved after the management of the free floating thrombus. The mean duration of the placement of the filter was 11 days (range:7-25 days). Two patients underwent placement of an iliac vein stent fderwent placement of an iliac vein stent for the management of May-Thurner syndrome. Detachment of the free floating thrombus in the IVC and the subsequent thrombus entrapment in the filter were documented during aspiration thrombectomy or Urokinase thrombolysis in four patients. Recurrent thrombus didn't occur during the follow-up period (range:3-20 months) in five of the six patients. In one patient, a recurrent thrombus due to the discontinuance of anticoagulation therapy was identified at the filter detachment site of the IVC on the follow-up CT 10 days after the filter retrieval, but it disappeared 15 days after proper anticoagulation therapy was done. Temporary Guenther Tulip filter placement is technically feasible and efficacious for the prophylaxis of pulmonary embolism in those patients with a free floating thrombus in the IVC, and particularly in those patients who will have subsequent aspiration thrombectomy or catheter directed Urokinase thrombolyis performed

  17. Placement and retrieval of a Guenther tulip filter in patients with a free floating thrombus in inferior vena cava

    Energy Technology Data Exchange (ETDEWEB)

    Seong, Min Hyun; Kim, Young Hwan; Lee, Sang Kwon; Choi, Jin Soo; Kim, Mi Jeong; Koo, Ja Hyun; Kim, Hyoung Tae; Cho, Won Hyun [Keimyung University College of Medicine, Daegu (Korea, Republic of); Seong, Nak Kwan [Daegu Catholic School of Medicine, Daegu (Korea, Republic of)

    2005-07-15

    We wanted to assess the technical feasibility and clinical efficacy of the placement and retrieval of a Guenther Tulip filter for the prevention of fatal pulmonary embolism during the management of patients with a free floating thrombus in their inferior vena ca va (IVC). Six patients having a free floating thrombus in their IVC (three patients with an isolated free floating thrombus in the IVC that resulted from immobilization due to traumatic liver injury or cerebral infarction, two patients with coexisting deep vein thrombosis in the left lower extremity that was caused by May-Thurner syndrome, and one patient with coexisting deep vein thrombosis in the right lower extremity that was due to nephrotic syndrome and immobilization after hip joint replacement) underwent placement and retrieval of a Guenther Tulip filter. The placement of the filter was performed through the right internal jugular vein to prevent the risk of detachment of the thrombus during the procedure. Retrieval of filter was performed after the free floating thrombus of the IVC had disappeared on follow-up CT because of anticoagulation therapy, aspiration thrombectomy or catheter directed Urokinase thrombolysis. The Guenther Tulip filter was successfully placed in the IVC in all six patients and it was retrieved after the management of the free floating thrombus. The mean duration of the placement of the filter was 11 days (range:7-25 days). Two patients underwent placement of an iliac vein stent for the management of May-Thurner syndrome. Detachment of the free floating thrombus in the IVC and the subsequent thrombus entrapment in the filter were documented during aspiration thrombectomy or Urokinase thrombolysis in four patients. Recurrent thrombus didn't occur during the follow-up period (range:3-20 months) in five of the six patients. In one patient, a recurrent thrombus due to the discontinuance of anticoagulation therapy was identified at the filter detachment site of the IVC on the follow-up CT 10 days after the filter retrieval, but it disappeared 15 days after proper anticoagulation therapy was done. Temporary Guenther Tulip filter placement is technically feasible and efficacious for the prophylaxis of pulmonary embolism in those patients with a free floating thrombus in the IVC, and particularly in those patients who will have subsequent aspiration thrombectomy or catheter directed Urokinase thrombolyis performed.

  18. Colapsibilidade da Veia Cava Inferior e sinais e sintomas de insuficiência cardíaca: novos insights e possíveis associações / Inferior Vena Cava collapsibility and heart failure signs and symptoms: new insights about possible links

    Scientific Electronic Library Online (English)

    Renato, De Vecchis; Antonio, Ciccarelli; Carmelina, Ariano.

    2012-06-01

    Full Text Available FUNDAMENTO: Nos pacientes com Insuficiência Cardíaca Crônica (ICC) foram propostas medidas ultrassonográficas do Índice de Colapsibilidade da Veia Cava Inferior (ICVCI) para obter uma avaliação e classificação minuciosa da congestão hemodinâmica. OBJETIVO: A finalidade deste estudo era correlacionar [...] os achados no exame físico com o ICVCI em pacientes com ICC. MÉTODOS: De acordo com um projeto de coorte retrospectivo, analisamos 54 pacientes com ICC, direita ou biventricular, classe NYHA III. O plano era determinar se alguma faixa de ICVCI basal poderia predizer uma persistência ou agravamento da congestão clínica achada no final do acompanhamento subsequente (isto é, após 1-2 meses do tratamento oral otimizado). Para essa finalidade, os pacientes foram subdivididos em três grupos de acordo com o valor de ICVCI basal: ? 15% (13 pts), 16 - 40% (21 pts) e > 40% (20 pts). Diversos critérios clínicos de congestão foram comparados por meio dos três grupos e incorporados subsequentemente ao modelo multivariado de Cox. RESULTADOS: Preditores multivariados de alto escore de congestão foram distensão da veia jugular (FC: 13,38 95% IC: 2,13 - 84 p = 0,0059) e estertores (FC: 11 95% C.I : 1,45 - 83,8 p = 0,0213). O ICVCI ? 15% esteve sempre associado com um alto escore de congestão na segunda visita; todavia, o ICVCI o ? 15% não predisse um alto escore de congestão na segunda visita. CONCLUSÃO: No âmbito da ICC, um baixo ICVCI não predisse, em forma confiável, um elevado escore de congestão. Não obstante, o conjunto com ICVCI ? 15% sempre se achou associado com sinais e sintomas de uma ICC descompensada, tanto do lado direito como do esquerdo. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0) Abstract in english BACKGROUND: In chronic heart failure patients (CHF), ultrasound measurement of inferior vena cava collapsibility index (IVCCI) has been proposed to yield careful assessment and grading of the hemodynamic congestion. OBJECTIVE: The purpose of this study was to correlate the findings of physical exami [...] nation with IVCCI in CHF patients. METHODS: According to a retrospective cohort design, we analyzed 54 CHF patients with right or biventricular CHF, belonging to III NYHA class. We planned to determine whether any basal IVCCI range would be able to predict persistent or worsening clinical congestion found at the end of subsequent follow up (i.e. after 1-2 months of oral optimized therapy). For this purpose, the patients were subdivided by three groups according to the basal IVCCI value: ? 15% (13 pts), 16 - 40% (21 pts) and > 40% (20 pts).Several clinical criteria of congestion were compared across the three groups and subsequently entered in the Cox multivariate model. RESULTS: Multivariate predictors of high congestion score were jugular venous distension (HR: 13,38 95% C.I.: 2,13 - 84 p = 0,0059) and rales (HR: 11 95% C.I : 1,45 - 83,8 p = 0,0213). IVCCI ? 15% was always associated with high congestion score at the second visit; but IVCCI ? 15% failed to predict high congestion score at the second visit. CONCLUSION: In CHF setting, low IVCCI did not reliably predict high congestion score. Nevertheless, the cluster with IVCCI ? 15% was always found associated with signs and symptoms from both right and left-sided decompensated CHF. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0).

  19. Colapsibilidade da Veia Cava Inferior e sinais e sintomas de insuficiência cardíaca: novos insights e possíveis associações Inferior Vena Cava collapsibility and heart failure signs and symptoms: new insights about possible links

    Directory of Open Access Journals (Sweden)

    Renato De Vecchis

    2012-06-01

    Full Text Available FUNDAMENTO: Nos pacientes com Insuficiência Cardíaca Crônica (ICC foram propostas medidas ultrassonográficas do Índice de Colapsibilidade da Veia Cava Inferior (ICVCI para obter uma avaliação e classificação minuciosa da congestão hemodinâmica. OBJETIVO: A finalidade deste estudo era correlacionar os achados no exame físico com o ICVCI em pacientes com ICC. MÉTODOS: De acordo com um projeto de coorte retrospectivo, analisamos 54 pacientes com ICC, direita ou biventricular, classe NYHA III. O plano era determinar se alguma faixa de ICVCI basal poderia predizer uma persistência ou agravamento da congestão clínica achada no final do acompanhamento subsequente (isto é, após 1-2 meses do tratamento oral otimizado. Para essa finalidade, os pacientes foram subdivididos em três grupos de acordo com o valor de ICVCI basal: ? 15% (13 pts, 16 - 40% (21 pts e > 40% (20 pts. Diversos critérios clínicos de congestão foram comparados por meio dos três grupos e incorporados subsequentemente ao modelo multivariado de Cox. RESULTADOS: Preditores multivariados de alto escore de congestão foram distensão da veia jugular (FC: 13,38 95% IC: 2,13 - 84 p = 0,0059 e estertores (FC: 11 95% C.I : 1,45 - 83,8 p = 0,0213. O ICVCI ? 15% esteve sempre associado com um alto escore de congestão na segunda visita; todavia, o ICVCI o ? 15% não predisse um alto escore de congestão na segunda visita. CONCLUSÃO: No âmbito da ICC, um baixo ICVCI não predisse, em forma confiável, um elevado escore de congestão. Não obstante, o conjunto com ICVCI ? 15% sempre se achou associado com sinais e sintomas de uma ICC descompensada, tanto do lado direito como do esquerdo. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0BACKGROUND: In chronic heart failure patients (CHF, ultrasound measurement of inferior vena cava collapsibility index (IVCCI has been proposed to yield careful assessment and grading of the hemodynamic congestion. OBJECTIVE: The purpose of this study was to correlate the findings of physical examination with IVCCI in CHF patients. METHODS: According to a retrospective cohort design, we analyzed 54 CHF patients with right or biventricular CHF, belonging to III NYHA class. We planned to determine whether any basal IVCCI range would be able to predict persistent or worsening clinical congestion found at the end of subsequent follow up (i.e. after 1-2 months of oral optimized therapy. For this purpose, the patients were subdivided by three groups according to the basal IVCCI value: ? 15% (13 pts, 16 - 40% (21 pts and > 40% (20 pts.Several clinical criteria of congestion were compared across the three groups and subsequently entered in the Cox multivariate model. RESULTS: Multivariate predictors of high congestion score were jugular venous distension (HR: 13,38 95% C.I.: 2,13 - 84 p = 0,0059 and rales (HR: 11 95% C.I : 1,45 - 83,8 p = 0,0213. IVCCI ? 15% was always associated with high congestion score at the second visit; but IVCCI ? 15% failed to predict high congestion score at the second visit. CONCLUSION: In CHF setting, low IVCCI did not reliably predict high congestion score. Nevertheless, the cluster with IVCCI ? 15% was always found associated with signs and symptoms from both right and left-sided decompensated CHF. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0.

  20. Malignant thrombosis of the superior vena cava caused by non-small-cell lung cancer treated with radiation and erlotinib: a case with complete and prolonged response over 3 years

    Directory of Open Access Journals (Sweden)

    Wang JY

    2013-07-01

    Full Text Available Jianyang Wang,1 Jun Liang,1 Wenqing Wang,1 Han Ouyang,2 Luhua Wang11Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 2Department of Diagnostic Radiology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of ChinaAbstract: Most cases of superior vena cava (SVC syndrome resulting from neoplasm, especially from lung cancer, remain a serious challenge to treat. Here, for the first time as far as we are aware, we report the case of a non-small-cell lung cancer patient with a massive SVC malignant thrombosis who was treated with thoracic irradiation and erlotinib. The treatment regimen consisted of erlotinib 150 mg/day and a total dose of 66 Gy/33 fractions delivered to the tumor, malignant thrombosis, and metastasis mediastinal lymph nodes. The malignant thrombosis responded dramatically and the combined regimen was well tolerated. After discharge, the erlotinib was prescribed as maintenance therapy. The patient was followed closely for the next 3 years. During this time, positron emission tomography/computed tomography scans and serum tumor marker screens were undertaken. By 6 months, the primary tumor showed complete response and by 9 months, the SVC thrombosis had disappeared. No sign of relapse has been found to date.Keywords: superior vena cava syndrome, radiotherapy, thoracic irradiation, neoplasm

  1. Rare case of primary inferior vena cava leiomyosarcoma on F-18 fluorodeoxyglucose positron emission tomography-computed tomography scan: Differentiation from nontumor thrombus in a background of procoagulant state

    International Nuclear Information System (INIS)

    We report a rare case of leiomyosarcoma of the inferior vena cava (IVC) in which F-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography-computed tomography (PET-CT) scan provided vital evidence, which led to its diagnosis, in a background of procoagulant state of the patient, where previous ultrasound-Doppler and echocardiography studies were nonspecific and revealed bilateral lower limb deep vein thrombosis with thrombus in IVC. The whole body F-18 FDG PET-CT scan was done in view of no significant improvement in clinical status of the patient over few months in spite of appropriate medical management. FDG PET-CT scan revealed high grade uptake in a large mass lesion occupying the right atrium, extending superiorly into terminal superior vena cava, inferiorly into dilated IVC and probably into hepatic veins. CT guided biopsy of this F-18 FDG avid mass was consistent with the diagnosis of leiomyosarcoma, which however was not amenable to surgery at this stage. F-18 FDG PET-CT accurately differentiated tumor mass from bland thrombus and further had a significant impact on the management, since aggressive surgery combined with adjuvant therapy offers the best outcome for patients with leiomyosarcoma of the IVC

  2. Ultrasound Assessment of Inferior Vena Cava Collapsibility Is Not a Valid Measure of Preload Changes During Triggered Positive Pressure Ventilation: A Controlled Cross-Over Study

    DEFF Research Database (Denmark)

    Juhl-Olsen, Peter; Frederiksen, C A

    2012-01-01

    Purpose: Respiratory changes in the diameter of the inferior vena cava (IVC) have been validated as a measure of volume status and preload responsiveness during spontaneous breathing and mechanical ventilation. However, many intensive care patients are ventilated with triggered positive pressure ventilation (PPV). In this setting, there is no evidence regarding IVC collapsibility (IVCc) as a surrogate for preload. We aimed to elucidate the effects of increasing levels of triggered PPV and of varying preload conditions on the IVCc. Materials and Methods: 10 healthy volunteers were connected to a ventilator through a tight-fitting mask and exposed to 6 different levels of positive end-expiratory pressure (PEEP) and pressure support (PS) after a baseline reading. All ventilator settings were performed at neutral preload (horizontal position), low preload (reverse-Trendelenburg) and high preload (Trendelenburg position with an intravenous fluid bolus). At each ventilator setting, the IVC was imaged throughout at least 1 respiratory cycle using 3 commonly used ultrasound techniques including sagittal M-mode and 2-dimensional echocardiography in both sagittal and transverse views. Results: Increasing PS diminished IVCc (p?=?0.01) in the reverse-Trendelenburg position, and increasing PEEP caused a higher IVCc in the Trendelenburg position (p =?0.02). In the horizontal position, no significant effects of increasing PS, PEEP or a combination of the two were seen. Overall ANOVA analysis showed that IVCc was not independent of preload. During PPV, IVCc was highest at neutral preload at most ventilator settings, IVCc was lowest at low preload, while high preload generally facilitated an IVCc between neutral and high preload. In addition, sagittal M-mode and transverse 2-dimensional echocardiography overestimated IVCc as compared to sagittal 2-dimensional echocardiography. Conclusion: The compiled results of this study show that IVCc cannot be held as a valid measure of preload status during PPV. This may be explained by systematic alterations in other determinants for IVCc. Comparison of methods encourages the use of sagittal 2-dimensional echocardiography for dynamic imaging of the IVC. Sagittal M-mode and transverse 2-dimensional echocardiography overestimate IVCc as compared to sagittal 2-dimensional echocardiography.

  3. Axitinib for preoperative downstaging of renal cell carcinoma with sarcomatoid differentiation and direct invasion of the duodenum and inferior vena cava: a case report

    Directory of Open Access Journals (Sweden)

    Yuki H

    2014-02-01

    Full Text Available Hideo Yuki,1,* Takao Kamai,1,* Keiichi Kubota,2 Hideyuki Abe,1 Daisaku Nishihara,1 Tomoya Mizuno,1 Akinori Masuda,1 Hironori Betsunoh,1 Masahiro Yashi,1 Yoshitatsu Fukabori,1 Ken-Ichiro Yoshida1 1Department of Urology, 2Department of Gastroenterological Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan *These authors contributed equally to this manuscript Background: Renal cell carcinoma (RCC with sarcomatoid differentiation is invasive, refractory to treatment, and has a higher mortality. Therefore, systemic therapy is still challenging, and the curative resection of localized or locally advanced RCC with sarcomatoid differentiation is very important. Axitinib is a potent and selective second-generation vascular endothelial growth factor receptor tyrosine kinase inhibitor with improved safety and tolerability. Axitinib is generally recommended as second-line therapy for advanced RCC because the phase III axitinib versus sorafenib in advanced RCC (AXIS trial demonstrated that it achieved longer progression-free survival than sorafenib in patients with metastatic RCC after failure of an approved first-line regimen. Methods: We present a 73-year-old man who had a large (13 cm in diameter right RCC with sarcomatoid differentiation that directly invaded the duodenum and inferior vena cava. The patient presented with gastrointestinal bleeding, was unable to eat solid food, and had become emaciated. Thus, his classification was poor risk with anemia, hypercalcemia, and poor performance status, according to the Memorial Sloan-Kettering Cancer Center criteria. He seemed unlikely to survive if radical nephrectomy, cavotomy with thrombectomy, and pancreatoduodenectomy were performed. To reduce the tumor burden and potential operative complications, we administered axitinib as first-line neoadjuvant therapy. Results: Six weeks of treatment reduced the tumor burden without causing severe toxicities. Subsequently, radical right nephrectomy, cavotomy with thrombectomy, and pancreatoduodenectomy were performed successfully. The pathological treatment effect of axitinib was grade 2 (two-thirds necrosis. The resected tumor showed a heterogeneous reaction for phosphorylated Akt (Ser-473 by Western blotting and immunohistochemistry, indicating that parts of the tumor were sensitive to axitinib and other parts were not. Conclusion: Axitinib might be promising as preoperative or neoadjuvant therapy for locally advanced RCC (>cT3b or >cTanyN1. Keywords: renal cell carcinoma, sarcomatoid differentiation, axitinib, tyrosine kinase inhibitors, phosphorylated Akt

  4. Surgical resection of a renal cell carcinoma involving the inferior vena cava: the role of the cardiothoracic surgeon

    LENUS (Irish Health Repository)

    Parissis, Haralabos

    2010-11-05

    Abstract Background The techniques for the resection of renal tumors with IVC extension are based on the experience of individual units. We attempt to provide a logical approach of the surgical strategies in a stepwise fashion. Methods Over 6-years 9 patients with renal cell carcinoma invading the IVC, underwent surgery. There were 6 males. The extension was at level IV in 4 and III in 5 cases. CPB used in 8 and hypothermia and circulatory arrest in all patients with level IV disease. The results and an algorithm of the plan of action, as per level of extension are presented. Results Plan of action: For level I-II disease: No Cardiothoracic involvement, For level III: Cardiopulmonary Bypass (CPB) & control of the cavo-atrial junction. For level IV: use of brief periods of Circulatory Arrest & repair of the Cavotomy with a pericardial patch. Postoperative morbidity: prolonged ICU stay, 3 patients (33.3%); tracheostomy, 1 (11.1%); Sepsis, 2 (22.2%); CVA 1, (11.1%). Mortality: 2 patients (22.2%) Conclusions Total clearance of the IVC from an adherent tumor is important, therefore extensive level IV disease presents a surgical challenge. We recommend CPB for level III and brief periods of Total Circulatory Arrest (TCA) for level IV disease.

  5. An unusual constellation of congenital malformations in a single patient including partial anomalous pulmonary venous return, persistent left superior vena cava, aberrant pulmonary fissure, anomalous aortic arch, tracheal diverticulum and annular pancreas.

    Science.gov (United States)

    Lapa, T; Vedelago, J; Kim, H; Patrick, E

    2014-01-01

    We report a case of a male patient with a constellation of rare congenital anomalies consisting of: partial anomalous pulmonary venous return (PAPVR), persistent left superior vena cava, 'bovine arch' aortic branching, tracheal diverticulum, aberrant lung fissure anatomy and an annular pancreas. He had presented with a history of worsening dyspnoea. To the best of our knowledge, this is the first reported case of a single patient with such a vast constellation of anomalies. The radiological evaluations, epidemiology, embryology and clinical features of the anomalies are discussed. It is important for radiologists to be aware of each of these anomalies as distinct entities; detection of a single anomaly should alert to the possibility that further anatomic aberrancies may be present. PMID:25362184

  6. Staphylococcus aureus septicemia presenting as disseminated intravascular coagulation - thrombotic thrombocytopenic purpura overlap and thrombus in inferior vena cava, right atrium and right ventricle: a case report

    Directory of Open Access Journals (Sweden)

    Khwaja Saifullah Zafar

    2015-01-01

    Full Text Available Staphylococcal sepsis following furunculosis and complicated by suspected deep vein thrombosis and septic inferior vena caval, right atrium, right ventricle emboli accompanied by disseminated intravascular coagulation (DIC - thrombotic thrombocytopenic overlap in a 65 years old lady is presented. She was managed successfully with antibiotics and anticoagulation. The case is reported for its rarity and brings to light the vivid manifestations of septicemia specially staphylococcal. [Int J Res Med Sci 2015; 3(1.000: 368-372

  7. Usefulness of vascular stenting with and without transvenous pacing leads for vena caval obstruction among children and adults with repaired congenital heart disease.

    Science.gov (United States)

    Kobayashi, Daisuke; Forbes, Thomas J; Turner, Daniel R; Singh, Harinder R; Karpawich, Peter P; Gowda, Srinath T

    2015-06-15

    Vena caval obstruction (VCO) is a common complication after vascular manipulation for congenital heart disease. Long-term efficacy of stent therapy for relief of VCO and long-term stent patency with and without intrastent transvenous pacing leads (TPLs) is not well described. This was a retrospective review of patients treated for VCO, including those who received intrastent TPLs, between 1995 and 2012. Patient demographics, diagnoses, vascular pressure gradients, and vessel diameters were analyzed. Forty-one patients (mean age 23.5 ± 10.3 years) with and without congenital heart disease underwent stent implantation, 26 of whom also received intrastent TPLs. Short-term stent implantation success in relieving obstructions was 93%. Poststent vascular pressure gradients and percentage vascular narrowing significantly improved (from 6.2 ± 4.5 to 1.1 ± 1.6 mm Hg and from 63.1 ± 19.5% to 18.0 ± 17.1%, respectively, p <0.05). On follow-up in 38 of 41 patients from 0.2 to 18 years (median 6.0), all survived; 6 (14%) required stent reintervention. Freedom from reintervention was 87% at 15 years. Patients with short-term procedural failure were at higher risk for stent reintervention. Among 27 patients with intrastent TPLs, freedom from reintervention was 96%. In 26 patients with follow-up catheterization, intrastent intimal proliferation was not significantly associated with TPL but was higher in the superior vena cava-innominate vein junction compared with other stent locations (p <0.05). In conclusion, stent therapy for VCO can be successfully and safely performed with good long-term results. Pre-pacing lead stent placement for VCO is effective in allowing TPL placement with encouraging long-term patency. PMID:25910527

  8. Clinical value of 18F-FDG PET/CT in evaluation of hepatic vein,inferior vena cava and right atrium tumor thrombi in hepatocellular carcinoma: Initial results

    International Nuclear Information System (INIS)

    In this paper,eleven consecutive hepatocellular carcinoma (HCC) patients with an embolus in the hepatic vein (HV), inferior vena cava (IVC) and right atrium (RA) were studied with 18F-FDG PET/CT and contrast enhanced CT. When correlated with final diagnosis, 18F-FDG PET/CT and contrast enhanced CT was positive in 11 patients (100%), 7 patients (63.6%), respectively. The accuracy of PET/CT and contrast-enhanced CT were 100%, 63.6%. Three cases with secondary blood thrombi in the distant IVC, which were confirmed by PET/CT, cannot be identified by contrast enhanced CT. The average survival was 3 months(range, 1-12 mo). The 12 months survival rate was 9.1%. Our results suggest that highly metabolic tumor thrombus in the HV, IVC and RA may be depicted on 18F-FDG PET/CT in HCC patients. It may discriminate between malignant and secondary benign blood thrombi. (authors)

  9. Endoprótese revestida de jugular preservada de bovino: estudo comparativo da resposta tecidual em aorta torácica descendente e veia cava inferior de suínos / Bovine preserved jugular covered stent-graft: comparative study of tissue response at swine thoracic descendent aorta and inferior vena cava

    Scientific Electronic Library Online (English)

    Celso Luiz Muhlethaler, Chouin; Cristina Ribeiro Riguetti, Pinto; Gaudencio Espinosa, Lopez.

    2008-08-01

    Full Text Available OBJETIVO: Avaliar e comparar a resposta tecidual de uma endoprótese biosintetica implantada na aorta torácica descendente e veia cava inferior de suínos. MÉTODO: Foi implantada uma endoprótese auto-expansível composta de aço inoxidável, revestida por veia jugular de bovino, processada pelo método L- [...] hydro, com auxilio de uma bainha de liberação Taheri-Leonhardt (Flórida, EUA) na aorta torácica descendente, e a veia cava infra-renal de 10 suínos. Sessenta dias após, as endopróteses foram retiradas e analisadas sob o ponto de vista macro e microscópicos. Foram observados: perviedade, grau de incorporação a parede do vaso, tipo de reação inflamatória, e local de maior resposta, tanto em relação a camada do vaso quanto ao local de contato com o anel de aço RESULTADOS: Todas as endopróteses encontravam-se pérvias, e incorporadas à parede. No setor venoso, seis apresentaram traves fibrosas em sua luz, e quatro apresentaram fibrose perivascular. No setor arterial somente uma prótese apresentou discreta estenose, sem fibrose perivascular. A reação inflamatória crônica tipo corpo estranho ocorreu em 100% das peças, a camada média foi a mais acometida no setor venoso, enquanto a íntima foi mais constante na artéria, o grau de incorporação foi mais firme na veia em comparação a artéria. A reação tecidual mostrou maior tendência nas áreas em intimo contato com o anel de aço (intra-anelar), mais intensa na artéria do que na veia. CONCLUSÃO: A prótese apresentou baixa trombogenicidade em ambos os sistemas, houve maior reação tecidual e baixa biocompatibilidade no setor venoso. Abstract in english BACKGROUND: To evaluate and compare the tissue response, in swine, to a biosynthetic stent-graft when implanted in both thoracic aorta and inferior vena cava. METHOD: It was used a self-expanding stainless stent, covered by segment of bovine jugular veins, processed by the method L-hydro, and delive [...] red by Taheri-Leonhardt system (Florida, USA) . The implants were done in the descending thoracic aorta, and in the infra-renal vena cava of 10 swines. Sixty days after, the endoprosthesis were removed and analyzed under macro and microscopic view. The following parameters were analyzed: patency, incorporation to the vessel wall, type of inflammatory reaction, tissue response concerning the layer of the vessel as for the contact with the ring steel. RESULTS: All implanted stent-grafts were patent, and incorporated to the vessel wall. Six presented fibrous bars, and four presented perivascular fibrosis at the venous section. At the arterial section, only one prosthesis developed a very small stenosis, without perivascular fibrosis. We observed chronic inflammatory reaction with a foreign body granulomatous response in 100% of the samples, the medium layer was the more prevalent at the vein section, while the intima layer was more constant at the artery, venous incorporation was stronger than artery incorporation, and tissue response was enhanced in the inner contact between the vessel wall and the ring steel. CONCLUSION: The prosthesis in study presented low thrombogenicity in both systems. It was also present, larger tissue response and low biocompatibility at the venous system, and better biocompatibility at the arterial system.

  10. Endoprótese revestida de jugular preservada de bovino: estudo comparativo da resposta tecidual em aorta torácica descendente e veia cava inferior de suínos Bovine preserved jugular covered stent-graft: comparative study of tissue response at swine thoracic descendent aorta and inferior vena cava

    Directory of Open Access Journals (Sweden)

    Celso Luiz Muhlethaler Chouin

    2008-08-01

    Full Text Available OBJETIVO: Avaliar e comparar a resposta tecidual de uma endoprótese biosintetica implantada na aorta torácica descendente e veia cava inferior de suínos. MÉTODO: Foi implantada uma endoprótese auto-expansível composta de aço inoxidável, revestida por veia jugular de bovino, processada pelo método L-hydro, com auxilio de uma bainha de liberação Taheri-Leonhardt (Flórida, EUA na aorta torácica descendente, e a veia cava infra-renal de 10 suínos. Sessenta dias após, as endopróteses foram retiradas e analisadas sob o ponto de vista macro e microscópicos. Foram observados: perviedade, grau de incorporação a parede do vaso, tipo de reação inflamatória, e local de maior resposta, tanto em relação a camada do vaso quanto ao local de contato com o anel de aço RESULTADOS: Todas as endopróteses encontravam-se pérvias, e incorporadas à parede. No setor venoso, seis apresentaram traves fibrosas em sua luz, e quatro apresentaram fibrose perivascular. No setor arterial somente uma prótese apresentou discreta estenose, sem fibrose perivascular. A reação inflamatória crônica tipo corpo estranho ocorreu em 100% das peças, a camada média foi a mais acometida no setor venoso, enquanto a íntima foi mais constante na artéria, o grau de incorporação foi mais firme na veia em comparação a artéria. A reação tecidual mostrou maior tendência nas áreas em intimo contato com o anel de aço (intra-anelar, mais intensa na artéria do que na veia. CONCLUSÃO: A prótese apresentou baixa trombogenicidade em ambos os sistemas, houve maior reação tecidual e baixa biocompatibilidade no setor venoso.BACKGROUND: To evaluate and compare the tissue response, in swine, to a biosynthetic stent-graft when implanted in both thoracic aorta and inferior vena cava. METHOD: It was used a self-expanding stainless stent, covered by segment of bovine jugular veins, processed by the method L-hydro, and delivered by Taheri-Leonhardt system (Florida, USA . The implants were done in the descending thoracic aorta, and in the infra-renal vena cava of 10 swines. Sixty days after, the endoprosthesis were removed and analyzed under macro and microscopic view. The following parameters were analyzed: patency, incorporation to the vessel wall, type of inflammatory reaction, tissue response concerning the layer of the vessel as for the contact with the ring steel. RESULTS: All implanted stent-grafts were patent, and incorporated to the vessel wall. Six presented fibrous bars, and four presented perivascular fibrosis at the venous section. At the arterial section, only one prosthesis developed a very small stenosis, without perivascular fibrosis. We observed chronic inflammatory reaction with a foreign body granulomatous response in 100% of the samples, the medium layer was the more prevalent at the vein section, while the intima layer was more constant at the artery, venous incorporation was stronger than artery incorporation, and tissue response was enhanced in the inner contact between the vessel wall and the ring steel. CONCLUSION: The prosthesis in study presented low thrombogenicity in both systems. It was also present, larger tissue response and low biocompatibility at the venous system, and better biocompatibility at the arterial system.

  11. Ultrasound evaluation of the inferior vena cava collapsibility index in congestive heart failure patients treated with intravenous diuretics: new insights about its relationship with renal function: An observational study

    Directory of Open Access Journals (Sweden)

    Adelaide Fusco

    2012-08-01

    Full Text Available Objective: In chronic heart failure (CHF, collapsibility index of the inferior vena cava (IVCCI is used for noninvasive ultrasonographic appraisal of central venous pressure, but it also may be related both to estimated glomerular filtration rate (eGFR and renal outcome.Methods: On the basis of retrospective observational cohort study, we analyzed 49 patients with right or biventricular CHF in III NYHA class, who had undergone intravenous intensive treatment with furosemide. Aggravated renal dysfunction (ARD was defined by serum creatinine (Cr increase of ?0.3 mg/dL from baseline. IVCCI was categorized in three layers (IVCCI ?15%, IVCCI 16-40% and IVCCI >40%. The predictors of ARD were searched for as well as any relation between basal IVCCI and both eGFR at admission and occurrence of ARD.Results: Overall, 15 cases and 34 controls were compared. Multivariate predictors of ARD were a lower basal eGFR (HR: 0.82 CI: 0.72-0.94 p=0.0045 and intravenous furosemide daily mean dose >80 mg (HR: 48.62 CI: 1.62-3841.5 p=0.0430. A very significant positive correlation was found between IVCCI at admission ? 15% and basal eGFR (r=0.96 p40% range (r=-0.696 p=0.0013. Furthermore, the category with basal IVCCI >40% showed a higher rate of ARD compared to that with basal IVCCI 16-40% (p40% and the one with the lowest (?15% basal IVCCI may be associated with increased risk of ARD.

  12. Ablação com radiofreqüência do flutter atrial tipo I. Importância do bloqueio bidirecional do istmo entre a veia cava inferior e o anel da valva tricúspide / Type I atrial flutter radiofrequency ablation. Importance of bidirectional line of block in the inferior vena cava tricuspide annulus isthmus

    Scientific Electronic Library Online (English)

    Mauricio, Scanavacca; Eduardo, Sosa; José Luis, Velarde; André, D' Ávila; Denise, Hachul; Basileu, Reolão; Osvaldo, Sanches; Márcio, Silva; Francisco, Darrieux.

    1998-11-01

    Full Text Available OBJETIVO: Estudar a importância clínica da determinação eletrofisiológica da presença de bloqueio bidirecional na condução pelo istmo localizado entre a veia cava inferior e o anel da valva tricúspide (VCI - AT), após a ablação do flutter atrial tipo I (FL) com radiofreqüência (RF). MÉTODOS: Quarent [...] a pacientes consecutivos (idade média 51±11 anos) com FL foram submetidos a ablação do istmo VCI-AT com RF. Em 30 pacientes (GI), o sucesso foi avaliado pela interrupção e não reindução do FL com estimulação atrial programada. Nos últimos 10 pacientes foi avaliada também a condução bidirecional pelo istmo, com cateteres posicionados na sua entrada e saída e em cada lado da linha de bloqueio. O bloqueio foi considerado bidirecional quando ocorrido nos dois sentidos e unidirecional quando ocorrido em um só sentido. RESULTADOS: Vinte e seis (86%) pacientes do GI e 10 (100%) do GII tiveram sucesso imediato (p= 0,5558). Durante o seguimento, 7 (30%) de 23 pacientes do GI e 3 (30%) de 9 do GII tiveram recorrência de FL (p= NS). Os três pacientes do GII que apresentaram recorrência tinham bloqueio unidirecional, enquanto os seis casos sem recorrência tinham bloqueio bidirecional (p=0,012). CONCLUSÃO: A demonstração de bloqueio bidirecional no istmo VCI-AT, obtida imediatamente após a ablação do FL com RF, relaciona-se a menor índice de recorrência clínica, devendo ser o critério preferencial para término do procedimento. Abstract in english PURPOSE: To determine the clinical importance of a bi-directional line of block demonstration in the inferior vena cava-tricuspid annulus isthmus as an end-point for radiofrequency (RF) atrial flutter (FL) ablation. METHODS: Forty consecutive patients (51±11 years) with type I FL were divided in 2 g [...] roups: GI (30 patients) anatomic, non-electrophysiologic isthmus ablation technique (interruption and non-induction FL criteria); and GII (10 patients) anatomic with electrophysiologic evaluation of bi-directional isthmus conduction. The isthmus activation was analyzed before and after anatomic RF ablation with a cateter exploring each side of the line of block, depending on the conduction evaluation (anterograde or retrograde). RESULTS: FL was interrupted and not reinduced in 26/30 (86.6%) GI patients and in 10 (100%) GII patients (p= 0.5558). During follow-up FL recurred in 30% of the patients in both groups. In GII, 6 patients with bi-directional block remained assymptomatic, whereas 3 patients with unidirectional block presented recurrence (p= 0.012). CONCLUSION: Electrophysiologic demonstration of bi-directional line of block in the isthmus is related to long-term success and should be the criterion for interruption of type I atrial FL RF ablation.

  13. Flutter auricular: Resultados inmediatos y alejados de la fulguración con radiofrecuencia del istmo cavo-tricuspídeo Results of radiofrequency ablation of the inferior vena cava-tricuspid valve isthmus for atrial flutter

    Directory of Open Access Journals (Sweden)

    Carlos Almendares M

    2005-02-01

    Full Text Available Background: Radiofrequency ablation of the inferior vena cavatricuspid valve isthmus relieves atrial flutter in 95% of cases. Aim: To evaluate the long term results of radiofrequency ablation of the inferior vena cavatricuspid valve isthmus in atrial flutter. Material and methods: Retrospective review of 86 patients with common atrial flutter, treated with radiofrequency ablation of the isthmus, while in sinus rhythm or flutter. Patients were contacted by telephone for a new clinical and electrocardiographic assessment, three to 40 months after the procedure. Results: Of all the patients treated, five died and five were lost from follow up, thus 76 patients (mean age 56 years, 58 males were contacted for reassessment. At the moment of the procedure, 51% had an underlying cardiac disease and 25% had high blood pressure. All referred palpitations, 25% had dyspnea, 84% were receiving antiarrhythmic drugs and 33% were on oral anticoagulants. Flutter was paroxystic in 83% and chronic in 17%. Fulguration was successful in all patients; one patient presented a high grade atrioventricular block as a complication of the procedure. At reassessment, 82% of patients were in sinus rhythm, 16% had atrial fibrillation and 2%, an atypical flutter. Conclusions: Radiofrequency fulguration is a safe and effective treatment of atrial flutter (Rev Méd Chile 2005; 133: 159-66

  14. Patrón común y variantes anatómicas de la vena renal

    Directory of Open Access Journals (Sweden)

    Ismet Lidia Batista Hern\\u00E1ndez

    2010-01-01

    Full Text Available Fundamento: las venas renales son los vasos que drenan al riñón y generalmente en los textos clásicos se describen como acompañantes de las arterias renales, con un trayecto inverso. Objetivo: caracterizar el patrón común y las variantes anatómicas de número, trayecto y terminación de la vena renal en el hombre adulto. M étodo: se realizó un estudio observacional descriptivo con una muestra de cincuenta bloques de riñón en un universo constituido por cuatrocientos fallecidos a los que se le realizó necropsia en el Departamento de Medicina Legal del Hospital Universitario "Amalia Simoni" de Camagüey, entre Abril de 2005 y Diciembre de 2006. Resultados: en cuanto al número predominó la vena renal única. El trayecto regular retroarterial en su inicio. La terminación uniforme de la vena renal se observó en cara lateral de la vena cava inferior. Conclusiones: la vena renal única, retroarterial en su inicio, con terminación en la cara lateral de la vena cava inferior constituyó el patrón común. Las principales variantes de la norma incluyen venas renales dobles y triples paralelas y cruzadas, con trayecto pre o retroarterial. Se observó un riñón izquierdo con vena renal doble circunaórtica.

  15. Primitive neuroectodermal tumour of the kidney with vena caval and atrial tumour thrombus: a case report

    OpenAIRE

    Ong Poh; Manikandan Ramaswamy; Philip Joe; Hope Kirsten; Williamson Michael

    2008-01-01

    Abstract Introduction Renal primitive neuroectodermal tumour is an extremely rare malignancy. Case presentation A 21-year-old woman presented with microscopic haematuria, a palpable right loin mass, dyspnoea, dizziness and fatigue. Initial ultrasound scan of the kidneys revealed an 11 cm right renal mass with venous extension into the inferior vena cava. Computed tomography of the thorax and abdomen revealed an extension of the large renal mass into the right renal vein, inferior vena cava an...

  16. Massive thrombosis after central venous catheterization in a patient with previously undiagnosed Behcet's disease.

    OpenAIRE

    Ko, S. H.; Kang, S. K.; Lee, S. K.; Song, H. S.

    2001-01-01

    Thrombosis is an important complication of central venous catheterization. Among the many intrinsic and extrinsic factors, the patient's medical disease can play a role in thrombogenesis. Behcet's disease (BD), classified as a vasculitis, is a multisystem disease involving the small blood vessels. It is often difficult to recognize and diagnose the disease. A 24-yr-old female patient showed massive central venous thrombosis which caused superior vena cava syndrome after subclavian vein cathet...

  17. Ablação com radiofreqüência do flutter atrial tipo I. Importância do bloqueio bidirecional do istmo entre a veia cava inferior e o anel da valva tricúspide Type I atrial flutter radiofrequency ablation. Importance of bidirectional line of block in the inferior vena cava tricuspide annulus isthmus

    OpenAIRE

    Mauricio Scanavacca; Eduardo Sosa; José Luis Velarde; André d'Ávila; Denise Hachul; Basileu Reolão; Osvaldo Sanches; Márcio Silva; Francisco Darrieux

    1998-01-01

    OBJETIVO: Estudar a importância clínica da determinação eletrofisiológica da presença de bloqueio bidirecional na condução pelo istmo localizado entre a veia cava inferior e o anel da valva tricúspide (VCI - AT), após a ablação do flutter atrial tipo I (FL) com radiofreqüência (RF). MÉTODOS: Quarenta pacientes consecutivos (idade média 51±11 anos) com FL foram submetidos a ablação do istmo VCI-AT com RF. Em 30 pacientes (GI), o sucesso foi avaliado pela interrupção e não reindução do FL com e...

  18. The home-made retrievable ZQL-type vena caval filter: results of a prospective pilot study

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical value of the home-made retrievable ZQL-type vena cava filter for the prevention of pulmonary embolism. Methods: The filter was implanted via the right jugular vein or the healthy femoral vein in 24 cases of deep vein thrombosis (DVT) with/without pulmonary embolism (PE). At the same time, angiography of pulmonary artery was carried out. The abdominal X-ray plane graph was obtained on the third and seventh day after the operation. On the third, 6th, 12th and 18th month after operation, abdominal plane graphs and angiography of inferior vena cava and pulmonary artery were obtained. If the deep vein thrombosis was cleared out completely in 2 weeks, the filter was retrieved after the abdominal plane graph and angiography of the inferior vena cava and pulmonary artery were obtained. Otherwise, the filter was retained. The patients were asked to be followed up as will. All the radiology data of the cases were evaluated by two director physicians by blind way. Results: All the vena cava filters were implanted successfully in the proper position in the 24 cases (suprarenal inferior vena cava filter in 1 case and infrarenal inferior vena caval filter in 23 cases). Two filters were retrieved on the 7th and 9th day,respectively. The mean follow-up period was 6 months. There were no filter migration (>10 mm) and filter tilting (>10 degree). There were no filter fracture and no IVC wall penetration. There was no filter thrombosis except a filtere was no filter thrombosis except a filter catching a thrombus. There was no obstruction of inferior vena cava and pulmonary embolism. Conclusion: The implantation of the home-made retrievable ZQL-type vena cava filter is simple, the orientation is accurate, and the position of the filter can be regulated. It is a valuable option for clinical application because of its excellent stability and efficacy

  19. Triple Right Renal Vein: An Uncommon Variation Vena Renal Derecha Triple: Una Variación Rara

    Directory of Open Access Journals (Sweden)

    R. M. P. Fernandes

    2005-01-01

    Full Text Available We report an unilateral three renal veins the right kidney in an elderly male cadaver. They were three calibrous veins having independent courses up to the inferior vena cava. No other vascular anomalies were noted in this specimen. This anatomical curiosity should be kept in mind by clinicians and academics that may manipulate this anatomical areaPresentamos una variación anatómica consistente en tres venas renales unilaterales presentes en el riñón derecho de un cadáver de un individuo adulto de sexo masculino. Las tres venas eran de calibre considerable, las cuales tenían cursos independientes hasta la vena cava inferior. No se observó ninguna otra variación vascular en este individuo. Tanto los clínicos como los académicos deben tener presente esta variación anatómica cuando se acceda a esta área anatómica

  20. Spontaneous tilting after placement of the gunther-tulip inferior vena caval filter: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Tae Seok; Cha, In Ho; Seol, Hae Young; Park, Cheol Min [Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

    2006-10-15

    Tilting of a deployed filter in the inferior vena cava (IVC) is a particular kind of periprocedural complication and this can reduce the filter's clot-trapping ability and increase the occlusion of the IVC at a later period. The authors report here on a case of spontaneous tilting of an inferior vena caval filter that was associated with thrombosis in the IVC within 2 weeks of the initially successful placement of the filter without tilting.

  1. The histogenesis of cranial cava veins under influence of ethanol

    Directory of Open Access Journals (Sweden)

    Gadjieva A. U.

    2014-12-01

    Full Text Available Background. The structural changes in veins are influenced by a variety of chemicals, including ethanol. Effect of ethanol is primarily manifested in violation of structures of blood vessels and heart. Objective. To detect changes of morphological and functional features of intrapericardial division of the cranial venae cavae in 132 rats aged 1-30 days when exposed to ethanol. Methods. 60 rats received milk with ethanol in lactation period from females which were intraperitoneal? injected 40° ethanol in a dose of 8 ml/kg from 2 to 22 day. 72 intact rats were used as controls. Results. As a result of the experiment reduction of the wall thickness of intrapericardial part of the cranial venae cavae and violation of their growth were observed. Conclusion. Admission of ethanol with maternal milk results in the thickening of the collagen and elastic fibers, destruction of reticular fibers, muscle cells and endothelial cells. Citation: Gadjieva AU. [The histogenesis of cranial cava veins under influence of ethanol]. Morphologia. 2014;8(4:12-6. Russian.

  2. Electrolytic Inferior Vena Cava Model (EIM) of Venous Thrombosis

    OpenAIRE

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

    2011-01-01

    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 t...

  3. Dramatic Vascular Course of Behcet's Disease

    International Nuclear Information System (INIS)

    Vascular involvement in Behcet's disease is rare (approximately 14% venous and 1.6% arterial), serious and recurrent. We report a case of Behcet's disease with deep venous thrombosis and right iliac pseudoaneurysm which was repaired with polytetrafluoroethylene (PTFE) graft. The patient received warfarin, aspirin, clopidogrel, immunosupressive and corticosteroids. Two months later the patient developed manifestations of superior vena cava thrombosis and the graft was blocked. Three months later, ischemia of the right foot deteriorated and left femoral artery crossover (PTFE) graft was performed. (author)

  4. Superior vena thrombosis with peripartum dilated cardiomyopathy

    International Nuclear Information System (INIS)

    A 30 years multiparous female with history of emergency caesarean section 10 days back was referred to us with cough, severe breathlessness at rest, orthopnea with pain in neck and arms. Clinical examination revealed signs of heart failure. Echocardiography showed ejection fraction of 15%, with no right ventricular strain. A diagnosis of peripartum cardiomyopathy was made. Doppler ultrasound of neck veins showed bilateral internal jugular vein thrombosis. Subsequent multislice CT examination showed thrombosis of superior vena cava and both internal jugular veins (with collateral formation) and pulmonary embolism. There were no mediastinal abnormalities on the CT scan. Her thrombophilia screen and CT scan brain was normal. She was managed in collaboration with cardiologist. Following treatment with subcutaneous enoxaparin therapy and warfarin her symptoms of upper limb pain improved. She responded very well to medical therapy for heart failure with marked improvement of NYHA functional class. (author)

  5. DESCRIPTION OF NODAL FIBERS IN THE CRANIAL VEIN CAVA WALLS OF THE BOVINE (Bos indicus DESCRIPCION DE FIBRAS NODALES EN LAS PAREDES DE LA CAVA CRANEAL DE BOVINO (Bos indicus

    Directory of Open Access Journals (Sweden)

    Maria Lúcia Eleutério

    1998-07-01

    Full Text Available Muchas investigaciones han estudiado la presencia de fibras musculares estriadas cardíacas, con características de fibras nodales en las paredes de la vena cava y del seno coronario de mamíferos. Sin embargo no hay un consenso sobre la localización exacta de estas fibras. El objetivo de este trabajo fue identificar estas fibras en la vena cava craneal de bovino. Para este propósito, utilizamos 10 corazones bovinos con los vasos de la base, fijados en formol 10%. Después de la fijación, el segmento intrapericárdico fue aislado e incluido en paraplástico. Se obtuvieron cortes transversales y longitudinales los que fueron sometidos a coloración con tricrómicos de Masson y Mallory, orceína clorhídrica de Unna-Taenzer y Calleja. Los resultados microscópicos revelaron que estas fibras nodales están localizadas en las paredes ventral e izquierda de la vena cava craneal a nivel de la desembocadura en el atrio derecho. Concluimos que estas fibras presentes en las paredes de la vena cava craneal, transmiten el estímulo eléctrico originado en el nodo sinoatrial para toda musculatura atrial, hasta las paredes venosas, causando la constricción del ostio venoso impidiendo el reflujo venoso durante la sístole atrial

  6. Unconventional Endovascular Treatment of Iatrogenic Ilio-Cava Fistula / Tratamento endovascular não convencional da Fistula Ilio-cava Iatrogénica

    Scientific Electronic Library Online (English)

    Clara, Nogueira; Rui, Machado; Carolina, Vaz; Luís, Loureiro; José, Tavares; Rui, Almeida.

    2012-12-01

    Full Text Available A fístula arteriovenosa (FAV), pós discectomia lombar, é uma complicação rara, potencialmente grave. O recurso ao tratamento endovascular tem sido crescente. Os autores apresentam o caso clínico de uma doente de 58 anos de idade, com FAV ilio-cava iatrogénica e oclusão da artéria ilíaca externa (AIE [...] ) direita. Foram efectuadas várias tentativas de cateterização, retrógrada e anterógrada, do eixo arterial ilíaco direito, com progressão sistemática dos fios-guia para a veia cava inferior. Com o auxílio de um Goose neck snare, foi possível enlaçar o fio guia contra-lateral (que já se encontra no eixo venoso) e recolocá-o no eixo arterial. Procedeu-se a angioplastia transluminal da AIE e exclusão de FAV com endoprótese recoberta. Dicas e truques, como o descrito, são de elevada utilidade para o cirurgião vascular. Abstract in english Arteriovenous fistula (AVF) following lumbar discectomy is an uncommon, threatening complication. Endovascular treatment is increasing worldwide. A 58-years-old woman was admitted with iatrogenic ilio-cava AVF and right external iliac artery (EIA) occlusion. Several attempts, retrograde and antegrad [...] e, to cross EIA occlusion failed, with both guidewires progressing to vena cava. Goose neck snare was used to snare contralateral guidewire (on venous system) and it was exteriorized on femoral artery, followed by EIA angioplasty and endograft exclusion of the AVF. Tips and tricks, like the one described, are essential for any vascular surgeon.

  7. Patrón común y variantes anatómicas de la vena renal / Common pattern and anatomical variants of renal veins

    Scientific Electronic Library Online (English)

    Ismet Lidia, Batista Hernández; Clara, García Barrios; Cristina, Hernández Cuan.

    2010-08-01

    Full Text Available Fundamento: las venas renales son los vasos que drenan al riñón y generalmente en los textos clásicos se describen como acompañantes de las arterias renales, con un trayecto inverso. Objetivo: caracterizar el patrón común y las variantes anatómicas de número, trayecto y terminación de la vena renal [...] en el hombre adulto. Método: se realizó un estudio observacional descriptivo con una muestra de cincuenta bloques de riñón en un universo constituido por cuatrocientos fallecidos a los que se le realizó necropsia en el Departamento de Medicina Legal del Hospital Universitario "Amalia Simoni" de Camagüey, entre Abril de 2005 y Diciembre de 2006. Resultados: en cuanto al número predominó la vena renal única. El trayecto regular retroarterial en su inicio. La terminación uniforme de la vena renal se observó en cara lateral de la vena cava inferior. Conclusiones: la vena renal única, retroarterial en su inicio, con terminación en la cara lateral de la vena cava inferior constituyó el patrón común. Las principales variantes de la norma incluyen venas renales dobles y triples paralelas y cruzadas, con trayecto pre o retroarterial. Se observó un riñón izquierdo con vena renal doble circunaórtica. Abstract in english Background: renal veins are vessels that drain to kidney and generally in the classic texts are described as companions of renal arteries, with an inverse course. Objective: to characterize the common pattern and the anatomical variants of number, course and renal vein ending in the adult man. Metho [...] d: a descriptive observational study was carried out with a sample of fifty kidney blocks in a universe constituted by four-hundred deceaseds to those were performed autopsy in the Legal Medicine Department at the University Hospital "Amalia Simoni" of Camagüey, between April 2005 and December 2006. Results: as far as number the unique renal vein and the retroarterial regular course in its beginning prevailed. The uniform ending of the renal vein was observed in the lateral face of the inferior vena cava. Conclusions: the unique renal vein, retroarterial in its beginning, with ending in the lateral face of the inferior vena cava constituted the common pattern. The main variants of the model include double renal veins, triple parallel and crossed ones, with pre or retroarterial course. A left kidney with circumaortic double renal vein was observed.

  8. Thoracic CT findings of behcet disease

    International Nuclear Information System (INIS)

    Objective: To illustrate the thoracic CT findings of Behcet disease and to assess the CT diagnostic role in patients with Behcet disease. Methods: Thoracic CT images and medical records were retrospectively reviewed in 13 patients with thoracic Behcet disease. The diagnosis was based on the criteria set by the international study group for Behcet disease. Results: Of 13 patients, subpleural patchy consolidations were showed in 3, bilateral diffuse ground glass opacities in 3, left low lobe collapse with a right small nodule in 1, subpleural solitary pulmonary nodule in 1, bilateral pleural effusion in 2, mediastinal lymphoadenopathy in 2, diffuse bilateral miliary lung nodules in 1 during treatment. Thoracic vascular involvement was presented in 8 patients, two with superior vena cava thrombosis, one with left subclavicle artery aneurysm, one with left low pulmonary artery aneurysm and mural thrombosis, one with bilateral low pulmonary arteries and left basilar artery aneurysm, three with right pulmonary artery thrombosis in which there were two with left pulmonary artery occlusion and one with left basilar artery branch aneurysm. Conclusions: Thoracic CT findings of Behcet disease are variable and nonspecific. Contrast-enhanced CT scan can be helpful by showing thrombosis of the superior vena cava and pulmonary artery as well aneurysm of the pulmonary artery. (authors)

  9. Vena Renal Izquierda Recurrente Retroaórtica: Reporte de una Rara Variación / Recurrent Retroaortic Left Renal Vein: Report of an Uncommon Anomaly

    Scientific Electronic Library Online (English)

    Oscar, Inzunza H; Martín, Inzunza A; Guillermo, Salgado A.

    2011-06-01

    Full Text Available Este trabajo describe el trayecto aberrante de la vena renal izquierda detectado en un cadáver de sexo masculino, utilizado con fines docentes en nuestro Departamento de Anatomía, cuya causa de muerte fue un cuadro de neumonía intrahospitalaria. En este caso, la vena renal izquierda tiene un trayect [...] o descendente de 89 mm, dispuesta a la izquierda de la aorta abdominal, entre los niveles vertebrales L II-L V. A la altura de la V vértebra lumbar la vena recurrente se curva hacia medial, pasando por dorsal de la aorta abdominal, para abocarse a la vena ilíaca común izquierda justo en el punto donde esta forma, junto con la vena homónima de la antímera derecha, la vena cava inferior. La vena renal izquierda recurrente tiene un calibre final de 14,86 mm y recibe como afluentes a la vena adrenal, la vena gonadal y finas ramas parietales de la región lumbar izquierda. La vena renal derecha, de situación normal, tiene un diámetro de 12,10 mm y desemboca en la vena cava inferior a 101,85 mm del punto de formación de esta. En relación con las tributarias de la vena cava inferior, la vena ilíaca común derecha presenta un calibre de 18,44 mm mientras que su homóloga izquierda, que recibe como afluente a la vena renal recurrente, presenta un diámetro de 23,74 mm. La causa de esta rara anomalía, cuya incidencia es del orden del 0,16% y que aparece escasamente descrita en la literatura, radica en la persistencia del segmento posrrenal de la vena supracardinal izquierda y el cierre de las anastomosis supracardinal y subcardinal. Este hallazgo, que es especialmente atractivo para los alumnos durante la disección, representa un problema en la clínica debido a que más del 40% de estas venas de trayecto aberrante son interesadas en la cirugía de la aorta abdominal. Abstract in english This paper describes the aberrant trajectory of the left renal vein. The present study describes the aberrant trajectory of the left renal vein detected in a cadaver used for teaching purposes in the Department of Anatomy, School of Medicine, Pontificia Universidad Católica de Chile. In this case, t [...] he left renal vein has a recurrent, retro aortic downward path, between vertebrae levels L II to L V. At level of L V, the vein curves medially, passing dorsal to the abdominal aorta and joins the left common iliac vein. The recurrent left renal vein has a final diameter of 14.86 mm and receives as tributaries to the adrenal vein, the testicular vein and fine parietal branches of the left lumbar region. The normal right renal vein has diameter of 12.10 mm and converges in the inferior vena cava at 101.85 mm above the point of union of both common iliac veins. At this point, the right common iliac vein has an 18.44 mm caliber while its left counterpart which receives the recurrent left renal vein, has a diameter of 23.74 mm. The cause of this rare anomaly which incidence is around 0.16% and is only scarcely described in the literature, is based in the persistence of the postrenal segment of the left supracardinal vein and closure of the supracardinal and subcardinal anastomosis. This finding, particularly attractive for students during dissection, as they represent a clinical problem since over 40% of these aberrant veins are of interest during surgical procedures of the abdominal aorta.

  10. Vena Renal Izquierda Recurrente Retroaórtica: Reporte de una Rara Variación Recurrent Retroaortic Left Renal Vein: Report of an Uncommon Anomaly

    Directory of Open Access Journals (Sweden)

    Oscar Inzunza H

    2011-06-01

    Full Text Available Este trabajo describe el trayecto aberrante de la vena renal izquierda detectado en un cadáver de sexo masculino, utilizado con fines docentes en nuestro Departamento de Anatomía, cuya causa de muerte fue un cuadro de neumonía intrahospitalaria. En este caso, la vena renal izquierda tiene un trayecto descendente de 89 mm, dispuesta a la izquierda de la aorta abdominal, entre los niveles vertebrales L II-L V. A la altura de la V vértebra lumbar la vena recurrente se curva hacia medial, pasando por dorsal de la aorta abdominal, para abocarse a la vena ilíaca común izquierda justo en el punto donde esta forma, junto con la vena homónima de la antímera derecha, la vena cava inferior. La vena renal izquierda recurrente tiene un calibre final de 14,86 mm y recibe como afluentes a la vena adrenal, la vena gonadal y finas ramas parietales de la región lumbar izquierda. La vena renal derecha, de situación normal, tiene un diámetro de 12,10 mm y desemboca en la vena cava inferior a 101,85 mm del punto de formación de esta. En relación con las tributarias de la vena cava inferior, la vena ilíaca común derecha presenta un calibre de 18,44 mm mientras que su homóloga izquierda, que recibe como afluente a la vena renal recurrente, presenta un diámetro de 23,74 mm. La causa de esta rara anomalía, cuya incidencia es del orden del 0,16% y que aparece escasamente descrita en la literatura, radica en la persistencia del segmento posrrenal de la vena supracardinal izquierda y el cierre de las anastomosis supracardinal y subcardinal. Este hallazgo, que es especialmente atractivo para los alumnos durante la disección, representa un problema en la clínica debido a que más del 40% de estas venas de trayecto aberrante son interesadas en la cirugía de la aorta abdominal.This paper describes the aberrant trajectory of the left renal vein. The present study describes the aberrant trajectory of the left renal vein detected in a cadaver used for teaching purposes in the Department of Anatomy, School of Medicine, Pontificia Universidad Católica de Chile. In this case, the left renal vein has a recurrent, retro aortic downward path, between vertebrae levels L II to L V. At level of L V, the vein curves medially, passing dorsal to the abdominal aorta and joins the left common iliac vein. The recurrent left renal vein has a final diameter of 14.86 mm and receives as tributaries to the adrenal vein, the testicular vein and fine parietal branches of the left lumbar region. The normal right renal vein has diameter of 12.10 mm and converges in the inferior vena cava at 101.85 mm above the point of union of both common iliac veins. At this point, the right common iliac vein has an 18.44 mm caliber while its left counterpart which receives the recurrent left renal vein, has a diameter of 23.74 mm. The cause of this rare anomaly which incidence is around 0.16% and is only scarcely described in the literature, is based in the persistence of the postrenal segment of the left supracardinal vein and closure of the supracardinal and subcardinal anastomosis. This finding, particularly attractive for students during dissection, as they represent a clinical problem since over 40% of these aberrant veins are of interest during surgical procedures of the abdominal aorta.

  11. Symptom severity and viral protein or RNA accumulation in lettuce affected by big-vein disease Severidad de síntomas y acumulación de proteínas o ARN virales en lechugas afectadas por la enfermedad de las venas grandes

    Directory of Open Access Journals (Sweden)

    Carolina Araya

    2011-03-01

    Full Text Available Big-vein disease (BVD is a widespread and economically damaging disease in lettuce (Lactuca sativa L.. Typical symptoms are chlorotic clearing around leaf veins, leaf deformations, and impaired head development. In this research, we studied the relationship between symptom intensity and protein and viral RNA accumulation in infected plants. Naturally infected lettuce plants, from the field or greenhouse, were classified according to their symptomatology: mild, moderate, severe, and symptomless. Coat protein accumulation was evaluated by a double antibody sandwich/enzyme-linked immunosorbent assay (DAS-ELISA, and RNA levels were studied by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR and quantitative RT-PCR. Virus coat protein accumulation did not differ for the two viruses associated with this disease among lettuce plants showing different symptom severity. Similarly, abundance of Mirafiori lettuce big-vein virus (MLBVV-RNA3 or Lettuce big-vein associated virus (LBVaV-RNA-2 were not different (P > 0.05 for diverse big vein disease severity rating scales. This suggests that symptom severity expressed by big-vein diseased lettuce plants did not necessarily reflect the accumulation of viruses associated with this disease in the host. Therefore, lettuce plants showing mild symptoms of BVD do not necessarily present lower virus levels than plants showing more severe symptomatology.La enfermedad de las venas grandes de la lechuga (Lactuca sativa L. es de origen viral, está ampliamente distribuida en el mundo, y provoca graves daños económicos en este cultivo. Los síntomas típicos de la enfermedad son clorosis alrededor de las venas, deformación de hojas y ausencia de formación de cabezas. En este trabajo se estudió la relación entre la intensidad de síntomas y la acumulación de proteínas y ARNs de origen viral en plantas afectadas por esta enfermedad. Lechugas infectadas naturalmente, provenientes de campo y de invernadero fueron clasificadas con sintomatología leve, intermedia, severa, y asintomáticas. La acumulación de proteínas de cubiertas virales fue evaluada utilizando DAS-ELISA (sandwich con doble anticuerpo-ensayo inmunoabsorbente ligado a enzima, y los niveles de ARN viral se estudiaron por medio de transcripción reversa-reacción en cadena de la polimerasa (RT-PCR semicuantitativa y RT-PCR cuantitativa. No hubo diferencia en la acumulación de proteínas virales para los dos virus asociados a esta enfermedad, al comparar plantas de lechugas con distintos niveles de severidad de síntomas. De forma similar, cuando se analizó la acumulación de ARNs virales en los diferentes niveles de la escala de severidad de síntomas utilizada, no hubo diferencias (P > 0,05 en la abundancia del ARN-3 del Virus Mirafiori de las venas grandes de la lechuga (MLBVV o el ARN-2 del Virus asociado de las venas grandes de la lechuga (LBVaV entre estos grupos. Esto sugiere que la severidad de los síntomas expresados en plantas afectadas por esta enfermedad no se relaciona necesariamente con una mayor acumulación de los virus asociados en el hospedero. Por lo tanto, lechugas que muestran síntomas suaves o moderados de venas grandes no necesariamente presentan menor acumulación de virus que plantas que muestran sintomatología más severa.

  12. Symptom severity and viral protein or RNA accumulation in lettuce affected by big-vein disease / Severidad de síntomas y acumulación de proteínas o ARN virales en lechugas afectadas por la enfermedad de las venas grandes

    Scientific Electronic Library Online (English)

    Carolina, Araya; Elizabeth, Peña; Erika, Salazar; Lisset, Román; Claudia, Medina; Roxana, Mora; Agustín, Aljaro; Inés-Marlene, Rosales.

    2011-03-01

    Full Text Available La enfermedad de las venas grandes de la lechuga (Lactuca sativa L.) es de origen viral, está ampliamente distribuida en el mundo, y provoca graves daños económicos en este cultivo. Los síntomas típicos de la enfermedad son clorosis alrededor de las venas, deformación de hojas y ausencia de formació [...] n de cabezas. En este trabajo se estudió la relación entre la intensidad de síntomas y la acumulación de proteínas y ARNs de origen viral en plantas afectadas por esta enfermedad. Lechugas infectadas naturalmente, provenientes de campo y de invernadero fueron clasificadas con sintomatología leve, intermedia, severa, y asintomáticas. La acumulación de proteínas de cubiertas virales fue evaluada utilizando DAS-ELISA (sandwich con doble anticuerpo-ensayo inmunoabsorbente ligado a enzima), y los niveles de ARN viral se estudiaron por medio de transcripción reversa-reacción en cadena de la polimerasa (RT-PCR) semicuantitativa y RT-PCR cuantitativa. No hubo diferencia en la acumulación de proteínas virales para los dos virus asociados a esta enfermedad, al comparar plantas de lechugas con distintos niveles de severidad de síntomas. De forma similar, cuando se analizó la acumulación de ARNs virales en los diferentes niveles de la escala de severidad de síntomas utilizada, no hubo diferencias (P > 0,05) en la abundancia del ARN-3 del Virus Mirafiori de las venas grandes de la lechuga (MLBVV) o el ARN-2 del Virus asociado de las venas grandes de la lechuga (LBVaV) entre estos grupos. Esto sugiere que la severidad de los síntomas expresados en plantas afectadas por esta enfermedad no se relaciona necesariamente con una mayor acumulación de los virus asociados en el hospedero. Por lo tanto, lechugas que muestran síntomas suaves o moderados de venas grandes no necesariamente presentan menor acumulación de virus que plantas que muestran sintomatología más severa. Abstract in english Big-vein disease (BVD) is a widespread and economically damaging disease in lettuce (Lactuca sativa L.). Typical symptoms are chlorotic clearing around leaf veins, leaf deformations, and impaired head development. In this research, we studied the relationship between symptom intensity and protein an [...] d viral RNA accumulation in infected plants. Naturally infected lettuce plants, from the field or greenhouse, were classified according to their symptomatology: mild, moderate, severe, and symptomless. Coat protein accumulation was evaluated by a double antibody sandwich/enzyme-linked immunosorbent assay (DAS-ELISA), and RNA levels were studied by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) and quantitative RT-PCR. Virus coat protein accumulation did not differ for the two viruses associated with this disease among lettuce plants showing different symptom severity. Similarly, abundance of Mirafiori lettuce big-vein virus (MLBVV)-RNA3 or Lettuce big-vein associated virus (LBVaV)-RNA-2 were not different (P > 0.05) for diverse big vein disease severity rating scales. This suggests that symptom severity expressed by big-vein diseased lettuce plants did not necessarily reflect the accumulation of viruses associated with this disease in the host. Therefore, lettuce plants showing mild symptoms of BVD do not necessarily present lower virus levels than plants showing more severe symptomatology.

  13. Acetylcholinesterase and Butyrylcholinesterase Inhibitory Compounds from Corydalis cava (Fumariaceae).

    Czech Academy of Sciences Publication Activity Database

    Chlebek, J.; Macáková, K.; Cahlíková, L.; Kurfürst, Milan; Kuneš, J.; Opletal, J.

    2011-01-01

    Ro?. 6, ?. 5 (2011), s. 607-610. ISSN 1934-578X Institutional research plan: CEZ:AV0Z40720504 Keywords : corydalis cava * fumariaceae * alzheimer ´s disease Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 1.242, year: 2011

  14. Long Term Survival in TARP Syndrome and Confirmation of RBM10 as the Disease Causing Gene

    Science.gov (United States)

    Gripp, Karen W.; Hopkins, Elizabeth; Johnston, Jennifer J.; Krause, Caitlin; Dobyns, William B.; Biesecker, Leslie G.

    2011-01-01

    TARP syndrome, comprising Talipes equinovarus, Atrial septal defect, Robin sequence (micrognathia, glossoptosis, and cleft palate), and Persistence of the left superior vena cava, is an X-linked condition with pre- or postnatal lethality in affected males. Based on linkage studies and massively parallel sequencing of X-chromosome exons in two families, the disease causing gene was identified as RBM10. We identified a maternally inherited frameshift mutation in an unrelated patient, confirming RBM10 as the disease gene. This is the first reported individual with TARP syndrome who survived past early infancy, thus expanding the phenotypic spectrum of this disorder. In addition to the characteristic cleft palate, atrial septal defect and persistent superior vena cava, he had low-set and posteriorly angulated ears, upslanting palpebral fissures, cryptorchidism and structural brain abnormalities including partial agenesis of the corpus callosum, dysplastic enlarged caudate, and cerebellar hypoplasia with megacisterna magna. Preterm delivery, suspected pulmonary hypoplasia and pulmonary hypertension resulted in chronic lung disease. At the age of 3 7/12 years, he remained ventilator-dependent at night, and he was fed exclusively through a gastro-jejunal tube. Sensorineural hearing loss required a hearing aid. Optic atrophy and cortical visual impairment were noted. He was unable to sit independently, was non-communicative and he had severe intellectual disability. Atrial flutter required recurrent ablation of intra-atrial re-entry pathways. The mother's heterozygosity for the RBM10 mutation underscored the importance of accurate diagnosis and counseling for TARP syndrome. PMID:21910224

  15. Conexión anómala de venas pulmonares: Correlación anatomoembriológica / Anomalous pulmonary venous connection

    Scientific Electronic Library Online (English)

    Luis, Muñoz Castellanos; Magdalena, Kuri Nivón; Clementina Aurelia, Sánchez Vargas; Nilda, Espinóla Zavaleta.

    2008-09-01

    Full Text Available Se presenta una correlación anatomoembriológica de la conexión anómala de venas pulmonares que permite comprender la patogénesis de esta malformación. Se analizaron los trabajos fundamentales sobre el desarrollo embrionario venoso pulmonar en sus dos etapas: la primaria en que dicho seno se conecta [...] con los sistemas venosos embrionarios que originan a las venas definitivas. Estos canales desaparecen después de que el seno venoso pulmonar se conecta con el atrio izquierdo (conexión secundaria definitiva). Cuando esto no ocurre persiste cualquiera de las conexiones primarias del seno venoso pulmonar, lo que origina las variantes anatómicas de esta malformación cardiovascular. Los sistemas venosos embrionarios son los cardinales derecho (vena cava superior y cayado de la ácigos) e izquierdo (vena vertical y seno venoso coronario) y umbilicovitelino (vena porta y conducto venoso). Se incluyen otros mecanismos como el desarrollo ectópico de la vena pulmonar primitiva del techo del atrio derecho y la malposición izquierda del tabique interatrial. La comunicación interatrial está condicionada por el status hemodinámico de esta malformación. Se concluye que el conocimiento embriológico del desarrollo venoso pulmonar es de gran utilidad para comprender la estructura de esta cardiopatía así como el origen de sus diferentes tipos en las formas total y parcial. Abstract in english An anatomical-embryological correlation of anomalous venous pulmonary connection is presented to gain an insight of its pathogenesis. The basic publications on embryonic development of the pulmonary veins were analyzed in its two stages: the primary connection of these veins (collectors) with the em [...] bryonic systemic veins from which the definitive veins arise. These channels normally disappear once the pulmonary veins sinus is connected with the roof of the left atrium (secondary definitive connection); when the latter does not exist, any of the primitive channels persist and originates the anatomic sites of the anomalous venous pulmonary connection. The embryonic systemic veins are the right cardinal (superior vena cava and azygos vein), the left cardinal (venous coronary sinus and vertical vein) and the umbilical-vitelline (portal vein and ductus venosus). Other mechanisms are discussed such as ectopic origin of the primitive pulmonary vein in the roof of the right atrium and misplaced left of the atrial septum. The atrial septal defect is conditioned by the hemodynamics of this malformation. The knowledge of the pulmonary venous development is of great value in understanding the structure and the anatomic variants of this cardiovascular malformation in its total and partial forms.

  16. Acute superior vena caval syndrome with airway obstruction following elective mediastinoscopy.

    LENUS (Irish Health Repository)

    Power, C K

    2012-02-03

    A 47-year-old female patient had a subclinical superior vena caval syndrome which developed into the \\'full blown\\' acute condition when she was placed into the left lateral position after mediastinoscopy. She developed airway obstruction requiring urgent re-intubation and subsequent admission to the intensive care unit. This subclinical condition might have been suspected pre-operatively if closer attention had been paid to the history, physical examination and review of the computerised axial tomography scan: she had a history of intermittent dysponea, wheeze and cough which was worse on waking and improved as the day progressed, she had a positive Pemberton\\'s sign and the computerised axial tomography scan showed that the lesion was encroaching on the superior vena cava.

  17. Long-term survival in TARP syndrome and confirmation of RBM10 as the disease-causing gene.

    Science.gov (United States)

    Gripp, Karen W; Hopkins, Elizabeth; Johnston, Jennifer J; Krause, Caitlin; Dobyns, William B; Biesecker, Leslie G

    2011-10-01

    TARP syndrome, comprising Talipes equinovarus, atrial septal defect (ASD), Robin sequence (micrognathia, glossoptosis, and cleft palate), and persistence of the left superior vena cava, is an X-linked condition with pre- or postnatal lethality in affected males. Based on linkage studies and massively parallel sequencing of X-chromosome exons in two families, the disease-causing gene was identified as RBM10. We identified a maternally inherited frameshift mutation in an unrelated patient, confirming RBM10 as the disease gene. This is the first reported individual with TARP syndrome who survived past early infancy, thus expanding the phenotypic spectrum of this disorder. In addition to the characteristic cleft palate, ASD, and persistent superior vena cava, he had low-set and posteriorly angulated ears, upslanting palpebral fissures, cryptorchidism, and structural brain abnormalities including partial agenesis of the corpus callosum, dysplastic enlarged caudate, and cerebellar hypoplasia with megacisterna magna. Preterm delivery, suspected pulmonary hypoplasia, and pulmonary hypertension resulted in chronic lung disease. At the age of 3(7)/(12) years, he remained ventilator-dependent at night, and he was fed exclusively through a gastro-jejunal tube. Sensorineural hearing loss required a hearing aid. Optic atrophy and cortical visual impairment were noted. He was unable to sit independently, was non-communicative and he had severe intellectual disability. Atrial flutter required recurrent ablation of intra-atrial re-entry pathways. The mother's heterozygosity for the RBM10 mutation underscored the importance of accurate diagnosis and counseling for TARP syndrome. PMID:21910224

  18. Estudo comparativo da biocompatibilidade da submucosa intestinal porcina e pericárdio bovino usados como enxertos na veia cava de cães Comparative study of the biocompatibility of the porcine intestinal submucosa and bovine pericardium used as grafts in the inferior cava vein of dogs

    Directory of Open Access Journals (Sweden)

    Fernando Hintz Greca

    2005-08-01

    Full Text Available OBJETIVO: Comparar a biocompatibilidade entre submucosa de intestino delgado (SID porcino e o pericárdio bovino como enxerto no reparo de lesões criadas na veia cava inferior de cães. MÉTODOS: Dezesseis cães foram submetidos a laparotomia. Após a abertura da cavidade abdominal a veia cava foi identificada e em seguida procedeu-se com a retirada de um segmento elíptico de 1,5X3cm de sua parede anterior. Em 8 animais o defeito foi reparado com SID porcino (grupo A e nos 8 animais restantes o defeito foi reparado com pericárdio bovino (grupo B.No 30° dia de P.O. realizou-se uma ultra-sonografia e a eutanásia foi realizada no 40°dia de pós-operatório. RESULTADOS: Observou-se estenose da veia cava em 1 cão do grupo do grupo A e em 2 animais do grupo B além de trombose em 1 cão desse mesmo grupo. A análise microscópica revelou um processo inflamatório crônico moderado em ambos os grupos. A endotelização do enxerto, regeneração de fibras musculares lisas e depósito de colágeno também foi similar nos 2 grupos estudados. CONCLUSÃO: A SID provou ser um excelente substrato para a regeneração vascular quando implantado em veia cava superior, contudo os resultados encontrados não diferem daqueles observados com o uso de pericárdio bovino.PURPOSE: To compare the biocompatibility of the bovine pericardium and the small intestine submucosa (SIS when used to repair a created defect in the inferior vena cava of dogs. METHODS: Sixteen male mongrel dogs were submitted to a midline laparotomy incision. An elliptical segment (1,5 X 3,0 cm of the inferior vena cava, below the renal veins, was excised. In 8 dogs, the A group, a patch of porcine small bowel submucosa was used to repair the defect. In the 8 remaining dogs, the B group, a bovine pericardium was implanted in the vena cava. On the 30th post-operative day an ultrasound was performed in order to identify stenosis. The euthanasia was accomplished in the 40th post-operative day. Stenosis of the vein was observed in 1 dog of A group and in 2 of the B group. RESULTS: Partial thrombosis with collateral circulation was evidenced in 1 dog of the bovine pericardium group. A moderated chronic inflammatory process was evidenced in both groups. Microscopic evaluation, regarding endothelization of the implant, collagen deposition, smooth muscle growth, was similar in both groups. CONCLUSION: SIS proved to be a functional graft patch for possessing local vena cava remodeling and its biocompatibility was similar to bovine pericardium.

  19. Comparison of tricuspid inflow and superior vena caval Doppler velocities in acute simulated hypovolemia: new non-invasive indices for evaluating right ventricular preload

    OpenAIRE

    Duan Yun-You; Yuan Li-Jun; Cao Tie-Sheng; Liu Jie; Yang Yi-Lin

    2006-01-01

    Abstract Background Assessment of cardiac preload is important for clinical management of some emergencies related to hypovolemia. Effects of acute simulated hypovolemia on Doppler blood flow velocity indices of tricuspid valve (TV) and superior vena cava (SVC) were investigated in order to find sensitive Doppler indices for predicting right ventricular preload. Methods Doppler flow patterns of SVC and TV in 12 healthy young men were examined by transthoracic echocardiography (TTE) during gra...

  20. Percutaneous insertion of inferior vean cava filter:clinical results of 8 patients

    International Nuclear Information System (INIS)

    To evaluate the efficacy and clinical results of percutaneous insertion of inferior vena cava(IVC) filter. Over a two year period, eight IVC filters were placed in eight patients with pulmonary thromboembolism resulting from deep vein thrombosis of the legs. The indications for placement were contraindication to anticoagulation(3), and recurrent pulmonary embolism during anticoagulant therapy(5). Both femoral(7) and jugular(1) routes were used for percutaneous transvenous insertion. To delineate the caval anatomy and to ensure placement just caudal to the renal vein, a cavogram was obtained before filter placement. Bird's Nest (7) and Greenfield (1) filters were inserted. Follow-up information was obtained by means of duplex sonography, CT scan, abdominal radiograph, and perfusion scan of the lungs, followed by clinical evaluation. In all cases, procedures were technically successful. Placement complications occurred in three patients. In one, the filter was inadvertently placed above the iliac bifurcation; in the other two, prolapse of the Bird's Nest filter wire occurred. Occlusion of IVC occurred in two patients, and recurrent pulmonary embolism was suspected in one, who suffered from chest pain and short-ness of breath. In the other patients, there was no clinical evidence of recurrence of the pulmonary embolism. Insertion of an inferior vena cava filter is a safe and effective method for the prevention of pulmonary embolism when anticoagulant therapy is either insm when anticoagulant therapy is either ineffective or contraindicated

  1. Carcinoma de células renais com invasão da veia cava inferior: a propósito de um caso clínico / Renal cell carcinoma with IVC invasion: clinical report

    Scientific Electronic Library Online (English)

    Rita, Sousa; Luís Mendes, Pedro; Sérgio, Pereira; Helena, Correia; Ruy, Fernandes e Fernandes; Jose L., Gimenez; Tomé, Lopes; A., Dinis da Gama.

    2011-09-01

    Full Text Available O carcinoma de células renais (CCR) é uma neoplasia com propensão à extensão ao sistema venoso sob a forma de trombo tumoral, sendo o tumor maligno mais frequentemente associado a trombose da veia cava inferior (VCI). A clínica é muitas vezes inespecífica até um estadio avançado da doença, com a trí [...] ade clássica de dor no flanco, hematúria e massa abdominal palpável a surgir como forma de apresentação em apenas 6-10% dos casos. Os métodos imagiológicos não invasivos têm, por isso, assumido um papel cada vez mais importante no diagnóstico e estadiamento desta neoplasia. Quando existe trombo tumoral associado, a terapêutica curativa passa pela intervenção cirúrgica que consiste na remoção do rim e do trombo tumoral, técnica que se reveste de algumas particularidades consoante o nível cefálico atingido pelo trombo venoso na VCI. Abstract in english Renal cell carcinoma (RCC) is a tumor with propensity for extending into the venous system as tumor thrombus. It is the malignant tumor most frequently associated with inferior vena cava (IVC) thrombosis. The symptoms are often nonspecific until an advanced stage of the disease, with the classic tri [...] ad of flank pain, haematuria and palpable abdominal mass found at presentation in only 6-10% of all cases, thus the increasing role of noninvasive imaging in the diagnostic and staging of this tumor. In the presence of a tumor thrombus, the curative treatment relies on surgery, which consists of the ressection of the kidney and the thrombus. This technique has its particularities according to the cephalic level achieved by the thrombus in the IVC.

  2. CT imaging of hepatic veno-occlusive disease (an analysis 14 cases)

    International Nuclear Information System (INIS)

    Objective: To probe imaging characteristics of the hepatic veno-occlusive disease (VOD) based on clinical features and abdomen CT findings. Methods: Fourteen patients including 6 male and 8 female aged from 41 to 73 years were enrolled in this study. They all had previous trauma history and notoginseng was given as herbal remedy. Dynamic enhanced CT and color Dopplor ultrasound examinations were routinely used. Two of them received venous angiography and four cases were pathologically proved as VOD after CT guided needle biopsy. Results: Hepatic swelling and ascites were found on plain CT scan. Diffuse patchy areas without enhancement indicative of poorly hepatic perfusion were found. Hepatic veins were compressed and became thin, and inferior vena cava was flat and narrow without distal dilation or collateral circulation. No obstruction of hepatic veins and inferior vena cava was found on ultrasound and venography. Conclusion: Dynamic enhanced CT is highly valuable for early assessing VOD and imaging features of venous hepatic congestion found on CT was strongly suggestive of VOD if there's previous history of treatment of gynura segetum. (authors)

  3. Bilateral Duplication of Gonadal Veins: a Case Report Duplicación Bilateral de las Venas Gonadales: Reporte de Caso

    Directory of Open Access Journals (Sweden)

    Juliana Ruiz Fernandes

    2012-12-01

    Full Text Available The duplication of gonadal vessels is mainly found on the left side, with less numbers of bilateral cases. The objective of this work is describing a case of bilateral duplication of gonadal veins, where two veins were draining to inferior vena cava, being that the closest vein of kidney medial margin had a thickness of 2.68mm and was distant 64.41 mm of the organ. The second vessel had a thickness of 1.43mm and was distant 73.76mm. Two veins follow to left renal vein, being that the first vessel had a thickness of 2.7mm and was distant 21.8mm of the kidney medial margin; the other had a thickness of 1.64mm and was distant 35.13mm of the organ. The presence of variations on the local of drainage of gonadal vessels has clinical importance for comprehension of origin of varicocele cases, as well as the recurrence of them after surgical procedures.La duplicación de las venas gonadales es más común en el lado izquierdo, con pocos casos bilaterales. El propósito de este reporte fue describir el caso de una duplicación bilateral de las venas gonadales, dos de las cuales desembocaban en la vena cava inferior. El vaso próximo del margen medial del riñon tenía un diámetro de 2,68mm y una longitud de 64,41 mm. La segunda vena tenía un diámetro de 1,43 mm y una longitud de 73,76 mm. Los dos vasos desembocaban en la vena renal izquierda. La primera vena tenía un diámetro de 2,7 mm y estaba a 21,8 mm del margen medial del riñon. La otra tenía un diámetro de 1,64 mm y se se localizaba a 35,13 mm del margen medial del riñon. La presencia de variaciones donde se produce el drenaje de los vasos gonadales tiene importancia clínica para la comprensión del origen del varicocele y la recurrencia del mismo, después de procedimientos quirúrgicos.

  4. Bilateral Duplication of Gonadal Veins: a Case Report / Duplicación Bilateral de las Venas Gonadales: Reporte de Caso

    Scientific Electronic Library Online (English)

    Juliana, Ruiz Fernandes; Maíra, Bassi Strufaldi; Bruno dos Santos, Machado; Sergio Ricardo, Rios Nascimento; Nader, Wafae; Cristiane Regina, Ruiz.

    2012-12-01

    Full Text Available La duplicación de las venas gonadales es más común en el lado izquierdo, con pocos casos bilaterales. El propósito de este reporte fue describir el caso de una duplicación bilateral de las venas gonadales, dos de las cuales desembocaban en la vena cava inferior. El vaso próximo del margen medial del [...] riñon tenía un diámetro de 2,68mm y una longitud de 64,41 mm. La segunda vena tenía un diámetro de 1,43 mm y una longitud de 73,76 mm. Los dos vasos desembocaban en la vena renal izquierda. La primera vena tenía un diámetro de 2,7 mm y estaba a 21,8 mm del margen medial del riñon. La otra tenía un diámetro de 1,64 mm y se se localizaba a 35,13 mm del margen medial del riñon. La presencia de variaciones donde se produce el drenaje de los vasos gonadales tiene importancia clínica para la comprensión del origen del varicocele y la recurrencia del mismo, después de procedimientos quirúrgicos. Abstract in english The duplication of gonadal vessels is mainly found on the left side, with less numbers of bilateral cases. The objective of this work is describing a case of bilateral duplication of gonadal veins, where two veins were draining to inferior vena cava, being that the closest vein of kidney medial marg [...] in had a thickness of 2.68mm and was distant 64.41 mm of the organ. The second vessel had a thickness of 1.43mm and was distant 73.76mm. Two veins follow to left renal vein, being that the first vessel had a thickness of 2.7mm and was distant 21.8mm of the kidney medial margin; the other had a thickness of 1.64mm and was distant 35.13mm of the organ. The presence of variations on the local of drainage of gonadal vessels has clinical importance for comprehension of origin of varicocele cases, as well as the recurrence of them after surgical procedures.

  5. Variation in the Origin of the Testicular Arteries and Drainage of the Right Testicular Vein / Variación en el Origen de las Arterias Testiculares y el Drenaje de la Vena Testicular Derecha

    Scientific Electronic Library Online (English)

    Royana, Singh; Amit, Jaiswal; S. N, Shamal; S. P, Singh.

    2011-06-01

    Full Text Available Durante una disección de rutina de un cadáver, perteneciente a un hombre indio de 42 años, se observaron variaciones en los vasos testiculares en la pared abdominal posterior. La arteria testicular derecha se originó desde la arteria renal accesoria, proveniente de la cara ventral de la parte abdomi [...] nal de la aorta. La arteria testicular izquierda se originó en la cara ventral de la parte abdominal de la aorta, casi en la misma línea horizontal de la arteria renal accesoria derecha, justo distal a la arteria mesentérica superior y 1,79 cm sobre el origen de las arterias renales. La vena renal derecha drenaba en la vena renal accesoria en lugar de la vena cava inferior, mientras que la vena testicular izquierda drenaba en la vena renal izquierda. En muy pocas ocasiones es posible observar de manera conjunta, variaciones tanto de las arterias como de las venas testiculares. Abstract in english During routine dissection of a 42 year old male Indian cadaver posterior abdominal wall, variations in the testicular vessels were observed. The right testicular artery arose from the right accessory renal artery, which originated from the ventral aspect of the abdominal aorta. The left testicular a [...] rtery originated from the ventral aspect of the aorta in almost the same horizontal line as the right accessory renal artery, just below the superior mesenteric artery and 1.79 cm, above the origin of the renal arteries. The right vein drained into the right accessory renal vein instead of the inferior vena cava, while the left testicular vein drained into the left renal vein. The presence of variation of both the testicular arteries as well as the testicular vein is seldom seen together.

  6. Magnetic resonance imaging (MRI) in diffuse liver diseases

    International Nuclear Information System (INIS)

    MRI (Magnetic Resonance Imaging) was performed in 74 patients with chronic hepatitis, liver cirrhosis, idiopathic portal hypertension, Budd-Chiari syndrome, extrahepatic protal vein occlusion, Wilson disease and hemochromatosis. We measured relaxation time of the liver and the spleen in these patients and compared MRI with CT in the diagnostic capability. MRI was superior to plain CT in the detection of collateral vessels in liver cirrhosis and extrahepatic protal vein occlusion. MRI could also demonstrate the occluded part of the inferior vena cava in Budd-Chiari syndrome. However, MRI was almost the same as CT in the visualization of the hepatic configuration in liver cirrhosis. In liver cirrhosis, T1 values of the liver and the spleen were longer than those in normal controls, and T1 values of the liver were correlated with ICG R-15. Hepatic T1 values in Budd-Chiari syndrome were longer than those in normal controls. (author)

  7. Adequate X-ray control of central and peripher vena cava catheters

    International Nuclear Information System (INIS)

    Central venous catheters are frequently used not only in intensive care patients. Attention is drawn to the possible displacements of catheters and to the need for correct radiological control of the catheter position. Since not recognized extravasal catheterposition is followed by serious complications s.e. tension pneumothorax and infusions into the pleural cavity or the mediastinum, adequate X-ray control has to be carried out with simultaneous administration of contrast medium. Correction of displaced catheters should be done under fluoroscopy. (orig.)

  8. Introducer Curving Technique for the Prevention of Tilting of Transfemoral Gunther Tulip Inferior Vena Cava Filter

    Energy Technology Data Exchange (ETDEWEB)

    Xiao, Liang; Shen, Jing; Tong, Jia Jie [The First Hospital of China Medical University, Shenyang (China); Huang, De Sheng [College of Basic Medical Science, China Medical University, Shenyang (China)

    2012-07-15

    To determine whether the introducer curving technique is useful in decreasing the degree of tilting of transfemoral Tulip filters. The study sample group consisted of 108 patients with deep vein thrombosis who were enrolled and planned to undergo thrombolysis, and who accepted transfemoral Tulip filter insertion procedure. The patients were randomly divided into Group C and Group T. The introducer curving technique was Adopted in Group T. The post-implantation filter tilting angle (ACF) was measured in an anteroposterior projection. The retrieval hook adhering to the vascular wall was measured via tangential cavogram during retrieval. The overall average ACF was 5.8 {+-} 4.14 degrees. In Group C, the average ACF was 7.1 {+-} 4.52 degrees. In Group T, the average ACF was 4.4 {+-} 3.20 degrees. The groups displayed a statistically significant difference (t = 3.573, p = 0.001) in ACF. Additionally, the difference of ACF between the left and right approaches turned out to be statistically significant (7.1 {+-} 4.59 vs. 5.1 {+-} 3.82, t = 2.301, p = 0.023). The proportion of severe tilt (ACF {>=} 10 degree) in Group T was significantly lower than that in Group C (9.3% vs. 24.1%, X{sup 2} = 4.267, p = 0.039). Between the groups, the difference in the rate of the retrieval hook adhering to the vascular wall was also statistically significant (2.9% vs. 24.2%, X{sup 2} = 5.030, p = 0.025). The introducer curving technique appears to minimize the incidence and extent of transfemoral Tulip filter tilting.

  9. Retroperitoneal leiomyosarcoma infiltrating the inferior vena cava (IVC)--a case report.

    Science.gov (United States)

    Nambiar, Rajesh; Mathew, George; Ponnaiah, Manickam; Samuel, Rekha; Chacko, Raju Titus; Govil, Shalini; Sitaram, Venkatramani

    2005-01-01

    Retroperitoneal soft tissue sarcomas are difficult to treat because the retroperitoneal organs and great vessels are often involved by the time the patients come to a surgeon. We present the case of a 48 year old woman with a retroperitoneal leiomyosarcoma that had infiltrated the IVC and the renal veins. PMID:16512470

  10. Duodenal perforation by an inferior vena cava filter in a polyarteritis nodosa sufferer

    Directory of Open Access Journals (Sweden)

    Anthony Dat

    2014-01-01

    CONCLUSION: Duodenal perforation is a rare complication of IVC filter insertion. This case however illustrates the potentially catastrophic consequences of a relatively common endovascular procedure. Caution should be taken when considering the insertion of IVC filters in patients with longstanding vasculopathies who are on immunosuppressants.

  11. Varicose veins: Look before you strip - the occluded inferior vena cava and other lurking pathologies

    Scientific Electronic Library Online (English)

    T, Mokoena.

    2014-10-01

    Full Text Available Lower limb varicose veins are a common complication of bipedal human movement and deep-vein thrombosis. However, they may have unusual causes, e.g. forming as collaterals around an obstruction or resulting from vascular malformations. Surgery in these cases can be inappropriate or harmful. Five case [...] s of lower limb varicose veins in which there was underlying pathology highlight the fact that cursory examination of patients with varicose veins and inappropriate special investigations can miss rare but significant underlying pathology. Patients should be examined systematically, and varicose veins in unusual situations should alert the clinician. Inappropriate surgery can be harmful.

  12. Introducer Curving Technique for the Prevention of Tilting of Transfemoral Gunther Tulip Inferior Vena Cava Filter

    International Nuclear Information System (INIS)

    To determine whether the introducer curving technique is useful in decreasing the degree of tilting of transfemoral Tulip filters. The study sample group consisted of 108 patients with deep vein thrombosis who were enrolled and planned to undergo thrombolysis, and who accepted transfemoral Tulip filter insertion procedure. The patients were randomly divided into Group C and Group T. The introducer curving technique was Adopted in Group T. The post-implantation filter tilting angle (ACF) was measured in an anteroposterior projection. The retrieval hook adhering to the vascular wall was measured via tangential cavogram during retrieval. The overall average ACF was 5.8 ± 4.14 degrees. In Group C, the average ACF was 7.1 ± 4.52 degrees. In Group T, the average ACF was 4.4 ± 3.20 degrees. The groups displayed a statistically significant difference (t = 3.573, p = 0.001) in ACF. Additionally, the difference of ACF between the left and right approaches turned out to be statistically significant (7.1 ± 4.59 vs. 5.1 ± 3.82, t = 2.301, p = 0.023). The proportion of severe tilt (ACF ? 10 degree) in Group T was significantly lower than that in Group C (9.3% vs. 24.1%, X2 = 4.267, p = 0.039). Between the groups, the difference in the rate of the retrieval hook adhering to the vascular wall was also statistically significant (2.9% vs. 24.2%, X2 = 5.030, p = 0.025). The introducer curving technique appears to minimize the incidence and extent of transfemhe incidence and extent of transfemoral Tulip filter tilting.

  13. Obstruction of Vena Cava and Collateral Flow after Abdominal Reconstruction for Gastroschisis

    Science.gov (United States)

    Ramos, Manuel R.; Coelho, Paulo; Alves, Júlio R.; Ochoa de Castro, António

    2015-01-01

    Summary: The upper limit of intra-abdominal pressure after closure of gastroschisis has been suggested around 20?mm Hg. An acute abdominal compartmental syndrome may produce intestinal ischemia with perforation and hepatic or renal failure. We present a case of a baby born with gastroschisis and ileal atresias 2 decades ago. The closure of the defect entailed a borderline abdominal compartmental syndrome with caval occlusion and development of collateral venous circulation. This was evidenced by a phlebographic study at the age of 8. At the age of 19, the patient continued to show a superficial, varicose net and some aesthetic concerns. This minor condition seems not previously reported. The authors intend to raise awareness about current methods for indirect assessment of intra-abdominal pressure when performing abdominal reconstruction for a gastroschisis defect. PMID:25750843

  14. X-ray examination in diagnosis of hepatic segment deficiency of inferior cava

    International Nuclear Information System (INIS)

    Data on clinical and X-ray examination of 29 patients aged 2 weeks to 66 years with vena cava inferior hepatic segment deficiency are presented. The blood outflow from the lower part of the body was effected through the azygos vein in 17 patients, and through the hemiazygos one in 12 patients. The data obtained were in all cases correlated with the results of intracardiac research methods (the right and left heart cavities catherization and angiocardiography), with intraoperative and autopsy findings. An anomaly was found to prevail in patients (89.6%) with different types of abnormal heart position in the thoracic cavity. Along with examination of the cardiovascular system, the abdominal organs study was carried out: standard roentgenoscopy and radiography, both aiming to detect the liver position, gastrointestinal tract examination, and cholecystography

  15. Aneurisma de la vena de Galeno / Galen's vein aneurysm

    Scientific Electronic Library Online (English)

    Sergio, Piloña Ruiz; Yanett, Sarmiento Portal; Angelicia, Crespo Campos; Ivón Aimée, Sánchez Monterrey; Omar León, Vara Cuesta; Mirka Rosa, Torres.

    2010-09-01

    Full Text Available La malformación arteriovenosa de la vena de Galeno es una enfermedad congénita poco frecuente que se produce a partir de un defecto en la fusión de las venas cerebrales internas y que, debido a la baja resistencia, produce un cuadro de falla cardíaca de alto gasto. Las manifestaciones clínicas son m [...] uy variables y dependen de la edad de presentación. El pronóstico depende del tamaño del aneurisma. Se presenta el caso de un recién nacido del sexo masculino, con diagnóstico prenatal de aneurisma de la vena de Galeno y, desde el nacimiento, graves signos de insuficiencia cardíaca congestiva de difícil tratamiento. Se realiza una revisión sobre el tema. Abstract in english Arteriovenous malformation of Galen's vein is an uncommon congenital disease present from a defect in internal cerebral veins fusion and that due to the low resistance, produces a high output heart failure. Clinical manifestations are very variables depending on age of presentation. Prognosis depend [...] s on the size of aneurysm. This is the case of a male newborn diagnosed prenatally with Galen's vein aneurysm and from his birth severe signs of congestive heart failure of difficult treatment. A literature review on this subject is made.

  16. Erosion of inferior vena caval filter noted during robotic assisted laparoscopic partial nephrectomy

    Scientific Electronic Library Online (English)

    Ryan C., Hutchinson; David D., Thiel; Todd C., Igel.

    2012-10-01

    Full Text Available Inferior Vena Cava (IVC) filters are mechanical devices implanted to provide prophylaxis against pulmonary emboli in patients for whom standard anticoagulation is either inadequate or contraindicated. A 67-year-old female with a 10-year-old indwelling IVC filter underwent robotic assisted laparoscop [...] ic partial nephrectomy for a right upper pole renal mass. Renal hilum dissection was complicated by adhesions secondary to eroded IVC filter struts. IVC filter erosion is a well-described phoenomena in both the radiologic and surgical literature. As many as 25% of filters are noted to be radiographically eroded; however, the incidence of clinically significant erosion is much less. Given the placement of endovascularly delivered IVC filters in close proximity to many urologic operative fields, it is important for urologists to be aware of the potential of eroded devices when pursuing para-caval dissections.

  17. Cisterna chyli in patients with malignancy-Influence of cardiovascular disease on the prevalence of the cisterna

    Energy Technology Data Exchange (ETDEWEB)

    Feuerlein, Sebastian, E-mail: sfeuerlein@yahoo.com [Department of Diagnostic and Interventional Radiology, University of Ulm, Steinhoevelstrasse 9, 89075 Ulm (Germany); Stolz, Jochen [Department of Diagnostic and Interventional Radiology, University of Ulm, Steinhoevelstrasse 9, 89075 Ulm (Germany); Muche, Rainer [Institute of Biometry, University of Ulm (Germany); Hetzel, Martin [Dept. of Pulmonology, Red Cross Hospital Stuttgart (Germany); Klass, Oliver; Brambs, Hans-Juergen; Pauls, Sandra [Department of Diagnostic and Interventional Radiology, University of Ulm, Steinhoevelstrasse 9, 89075 Ulm (Germany)

    2011-08-15

    The purpose of this study was to investigate the potential correlation between the presence and size of the cisterna chyli (CC) on computed tomography (CT) and the presence of cardiovascular disease. Materials and methods: Out of a 3000-patient cohort 2599 patients who received a CT examination of the chest and/or abdomen with measurable inferior vena cava and azygos vein were included in this retrospective study. To assess the presence of cardiovascular disease the following parameters were recorded from the PACS or clinical information system: diameter of vena cava and azygos vein, presence of ascitis, serum creatinine, history of congestive heart failure, coronary artery disease or arterial hypertension and medication (diuretics, beta-blocker). In addition the volume of the CC and the presence or absence of malignant disease were recorded. Mean values (vessel diameters, creatinine) or percentages were calculated and compared for the groups with (n = 416) and without (n = 2183) a cisterna. Multivariate logistic regression analysis was performed for all parameters to identify the potential association with the presence and size of a cisterna. In addition the simultaneous influence of the parameter malignancy, cardiovascular disease and age on presence and size of the CC was analyzed in a logistic regression model. Results: The presence or absence of a CC was not associated with any of the measured parameter. Regarding the size of the CC, there was a positive correlation with the diameter of the azygos vein, the presence of ascitis and diuretic medication. The influences of malignancy, elevated central venous pressure and age on the development of a CC proved to be highly significant but could not be separated or quantified. Conclusion: The volume of the cisterna chyli is influenced by pathologic states with an increased central venous pressure, while the presence or absence of the cisterna seems to be independent of those factors.

  18. Research progress in non-permanent vein cava filters

    International Nuclear Information System (INIS)

    Vein cava filter placement has already become one of the most effective measures for preventing pulmonary embolism which is usually secondary to deep vein thrombosis. With the development of research, non-permanent vein cava filter has been widely used. This paper aims to describe the recent progress in the research of non-permanent vein cava filters. (authors)

  19. Estudio morfopatológico de la conexión anómala total de venas pulmonares / Morphopathologic study of total anomalous pulmonary venous connection

    Scientific Electronic Library Online (English)

    Luis, Muñoz Castellanos; Clementina Aurelia, Sánchez Vargas; Magdalena, Kuri Nivon.

    2007-12-01

    Full Text Available Se estudiaron con el sistema secuencial segmentario 106 corazones con conexión anómala total de venas pulmonares pertenecientes a la colección patológica del Instituto Nacional de Cardiología "Ignacio Chávez" para conocer sus características y la frecuencia de sus tipos. Se determinó situs atrial, c [...] onexiones de los segmentos cardíacos, morfología de las cámaras, tabique interatrial, colector venoso, sitios de conexión anómala, y malformaciones asociadas; se utilizó la clasificación de Darling modificada. El situs atrial fue solitus (73), dextroisomerismo (30), inversus (3). En el nivel supradiafragmático (83), la conexión supracardíaca (44) fue: a vena cava superior (24) y a vena vertical (20). La cardíaca (39) fue: a seno venoso coronario (22) y al atrio derecho (17). En el infradiafragmático (10) fue a vena porta. El grupo mixto (13) tuvo diferentes combinaciones. 100 presentaron comunicación interatrial y 6 foramen oval permeable. Los corazones con dextroisomerismo mostraron múltiples malformaciones; 14 especímenes tuvieron obstrucción del colector venoso. Tres aspectos importantes en el diagnóstico son: sitio de conexión anómala, dimensión de la comunicación interatrial y presencia de obstrucción del colector. Esta información es valiosa para comprender la fisiopatología, fundamentar el diagnóstico clínico y orientar al cirujano en la elección de la mejor estrategia quirúrgica. Abstract in english To know the morphological features and the frequency of pulmonary anomalous connection types, 106 hearts from the collection of the Instituto Nacional de Cardiología "Ignacio Chávez" were studied with the segmental sequential system. The atrial situs, connections of cardiac segments, morphology of c [...] ardiac chambers, interatrial septum, venous collector, sites of anomalous pulmonary venous connection and associated anomalies were determined. Darling's classification was used. The atrial situs was: solitus (73), dextroisomerism (30) and inversus (3). In the supradiaphragmatic level the supracardiac connection (44) was distributed into superior vena cava (24) and vertical vein (20). The cardiac level (39) was divided into venous coronary sinus (22) and to the right atrium (17). The infradiaphragmatic level was to the portal vein (10) and the mixed group (13) had different combinations. 100 hearts had atrial septal defect and 6 had patent foramen ovale. The hearts with dextroisomerism had several intracardiac malformations; 14 specimens had obstructed venous collectors. Three important aspects in diagnosis are: site of anomalous connection, size of atrial septal defect and obstruction in the venous collector; this information is valuable to understand the physiopathology, to establish the diagnosis and to help the surgeon to chose the best surgical strategy.

  20. Frequency of inferior vena caval abnormalcy due to a juxtaposed pathology

    International Nuclear Information System (INIS)

    Radionuclide inferior vena cavagrams were done in 135 patients who had hepatomegaly, splenomegaly or a mass in the vicinity of the inferior vena cava (I.V.C.). 2-5mCi sup(99m)Tc phytate, sup(99m)Tc S colloid, sup(99m)Tc O4-, sup(99m)Tc-LIDA, sup(99m)Tc pyridoxyledene glutamate or sup(113m)In colloid were injected dir