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Sample records for vena cava disease

  1. Inferior Vena Cava Filter Placement and Removal

    Science.gov (United States)

    ... Professions Site Index A-Z Inferior Vena Cava Filter Placement and Removal What is Inferior Vena Cava ... benefits vs. risks? What is Inferior Vena Cava Filter Placement and Removal? In an inferior vena cava ...

  2. 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.

  3. 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 ...

  4. 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.

  5. 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

    Scientific Electronic Library Online (English)

    Cyrillo Rodrigues de, Araújo Júnior; Tarcísio Nunes, Carvalho; Sérgio Roberto, Fraguas Filho; Marlos Augusto Bitencourt, Costa; Beatriz Mahmud, Jacob; Márcio Martins, Machado; Kim-Ir-Sen Santos, Teixeira; Carlos Alberto, Ximenes.

    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 reto [...] rno 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. Abstract in english 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.

  6. 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.

  7. Superior vena cava syndrome in children

    OpenAIRE

    Gupta, Vineeta; Ambati, Srikanth R.; Pant, P. (Preeti); Bhatia, Baldev

    2008-01-01

    Superior vena cava syndrome (SVCS) is rare in childhood. 18 cases of SVCS were seen in children ranging from 3–14 years with a mean age of 8.8 years. There were 15 males and 3 female children. Diagnosis could be confirmed in 17 cases as one child succumbed to severe respiratory distress without a definitive diagnosis. The commonest cause of SVCS was lymphoma. Non-Hodgkin’s lymphoma (NHL) was more common than Hodgkin’s disease. In two cases the final diagnosis was tuberculosis of mediastinal l...

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

    OpenAIRE

    Ahmet Kale; Levent Akyildiz; Nurten Akdeniz; Ebru Kale

    2006-01-01

    ABSTRACT Behcet disease is a multisystemic 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 cava thrombosis, and pulmonary embolism in a patient with Behcet disease.

  9. Filtering through the data on retrievable inferior vena cava filters.

    Science.gov (United States)

    Weinberg, Ido; Drachman, Douglas E

    2015-10-01

    Technical success rates with implantation and retrieval of retrievable inferior vena cava filters are high Inferior vena cava filters are being used for a wide range of indications Systems should be put in place to ensure prompt and effective retrieval of inferior vena cava filters once these are no longer needed. PMID:26386236

  10. Superior and inferior vena cavae: Embryology, variants, and pathology

    International Nuclear Information System (INIS)

    The superior and inferior venae cavae may be involved in a host of disease processes. Knowledge of the normal anatomy and variants of these structures is valuable in interpreting plain films and the results of angiographic procedures and all cross-sectional modalities. The authors review the embryology of venae cavae and proceed to describe their normal anatomy and variants. An awareness of the variants can prevent mistaking variants for pathologic processes. Finally, the authors describe pathology involving these vessels and demonstrate the radiographic manifestations

  11. 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.

  12. 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.

  13. 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.

  14. Retrieving the Amplatz retrievable vena cava filter.

    Science.gov (United States)

    Hunter, D W; Lund, G; Rysavy, J A; Castaneda-Zuniga, W; Cardella, J F; Young, A T; Vladover, Z; Amplatz, K

    1987-01-01

    The new Amplatz retrievable filter was placed 15 times into the inferior vena cava (IVC) of 7 dogs. Retrieval of the filter was attempted in 11 cases after 1 week and in 3 cases after 2 weeks. The retrieval was successful and without complication in all 14 cases. The 15th placement resulted in thrombotic occlusion of the IVC, and no retrieval was attempted. PMID:3102067

  15. 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

  16. [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 9 cm angiomyolipoma of the right kidney with inferior vena cava thrombosis, managed by active surveillance during pregnancy and delayed surgery after childbirth. PMID:25638747

  17. 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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-10-01

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

  20. Radiation therapy for superior vena cava syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hee [Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2005-06-15

    We studied the effect of such variables as the symptom improvement rate, survival and prognostic factors on the treatment results of radiation therapy for Superior Vena Cava Syndrome (SVCS). From 1988 to 2003, seventy two patients with SVCS were treated with radiation therapy at the Department of Radiation Oncology, Keimyung University Dongsan Medical Center. The patients' ages ranged from 10 to 83 years old with the median age being 61, and sixty four patients were male. For the causes of the SVCS, 64 patients had lung cancer, four had metastatic lung cancer, two had malignant lymphoma and two had thymoma. The radiotherapy was delivered with 6-MV X-ray and all patients received above 900 cGy up to 6,600 cGy, with the median dose being 4,000 cGy. The follow-up periods were from 1 to 180 months with a median of 5.6 months. The main clinical manifestations were dyspnea (84.7%), facial edema (81.9%), arm edema (22.2%), neck vein distension (25%), hoarseness (12.5%) and facial plethora (5.6%). Eighty percent of patients achieved excellent to good symptom improvement and 19.4% experienced minimal improvement. The median survival period was 5.1 months, and overall survival rates were 17.7% at 2 years (2YOS) and 14.8% at five years (5YOS) for all the patients. The median survival period, the two and five year disease free survival rates were 4.3 months, 16.7% and 13.4% for the lung cancer patients, respectively. The total tumor dose was a statistically significant survival factor on the univariate analysis for the patients with lung cancer (2YSR; > 30 Gy, 25.6%, {<=} 30 Gy 6.7%, {rho} < 0.01). On the multivariated analysis, a higher total tumor dose ({rho} < 0.01) and younger age ({rho} < 0.05) were statistically significant factors of survival for the lung cancer patients. Patients with NSCLC showed better survival than did the patients with SCLC, but this was not statistically significant ({rho} > 0.05). Radiation therapy for the patients with SVCS due to malignancy could be an effective treatment. We considered that radiation therapy above 30 Gy of the total tumor dose may improve survival for SVCS due to lung cancer.

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

    Scientific Electronic Library Online (English)

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

    2001-04-01

    Full Text Available [...] Abstract in english The treatment of superior vena cava syndrome is usually oriented to the underlying cause, that can be too slow in emergency cases. We report a 49 years old woman with a multiple myeloma that was admitted due to a superior vena cava syndrome caused by a central venous catheter used for chemotherapy f [...] or 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)

  2. 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

  3. Troubleshooting OptEase inferior vena cava filter retrieval.

    Science.gov (United States)

    Nakashima, Masaya; Kobayashi, Hideaki; Kobayashi, Masayoshi

    2016-01-01

    For treatment of deep vein thrombosis and prevention of pulmonary thromboembolism, a retrievable inferior vena cava filter is commonly utilized as an effective bridge to anticoagulation. However, we have experienced difficulties in retrieving inferior vena cava filters. Endovascular retrieval assisted by disposable biopsy forceps is an appropriate approach because it provides a less-invasive low-cost way to remove a migrated filter. We suggest this troubleshooting technique to deal with filter hook migration into the caval wall. PMID:24828829

  4. Traumatismos de veia cava inferior Inferior vena cava injuries

    Directory of Open Access Journals (Sweden)

    Cleinaldo de Almeida Costa

    2005-10-01

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

  5. Leiomyosarcoma of the inferior vena cava.

    Science.gov (United States)

    Naphade, Prashant S; Raut, Abhijit A; Hira, Priya; Vaideeswar, Pradip; Vadeyar, Hemant

    2014-05-01

    The purpose of this article is to present the CT features in five cases of pathologically verified Inferior vena cava (IVC) leiomyosarcoma. In this retrospective analysis, we reviewed CT features in 5 cases of clinicopathologically confirmed IVC leiomyosarcoma with respect to its location (infra renal, trans renal, supra renal), its extent (with or without involvement of renal vein, hepatic IVC with or without involvement of hepatic vein, right atrial & extra caval extension) and pattern of enhancement. CT guided biopsy was performed in four patients while the last patient underwent successful resection of the tumor. Three male and two female patients (aged 45 to 72 years) were included in the study. Heterogeneously enhancing retroperitoneal mass involving IVC is the most common imaging feature. The intra and extra luminal extension was demonstrated excellently in all patients. IVC leiomyosarcoma is a rare neoplasm often presenting very late with non-specific symptoms. Cross sectional imaging establishes the exact location and extension and plays a vital role in determining the resectibility and planning the management. PMID:24784870

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-11-01

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

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

    International Nuclear Information System (INIS)

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

  8. 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.

  9. The superior vena cava syndrom as emergency case in radiotherapy

    International Nuclear Information System (INIS)

    Between 1983 and 1988 90 patients with bronchial neoplasms needed emergency irradiation to treat superior vena cava syndrome. Pathohistologically verified were 30 cases with squamous cell carcinoma, twelve with adenocarcinoma, five cases with large cell carcinoma, 30 with a small cell carcinoma, and non-differentiated in five others. No histological examination was carried out in eight cases. In 30 patients distant metastases were evident at the initial diagnosis. The average duration of follow-up was 118 days. The survival course proved to be independent of histopathological grading, previous treatment, and age. Similarly no influence of the fractionation employed could be seen. Very important to the prognosis however, were the stage of disease, the Karnofsky index, and dependent on that, the total reference dose applied. Patients with a Karnofsky index of 50% or lower survived on average only 17 days. (orig.)

  10. 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.

  11. Surgical management of superior vena cava syndrome after failed endovascular stenting

    OpenAIRE

    De Raet, Jan M.; Vos, Jan A.; Morshuis, Wim J.; van Boven, Wim-Jan P

    2012-01-01

    The superior vena cava syndrome encompasses a constellation of symptoms and signs resulting from obstruction of the superior vena cava. We report a successful surgical management after failed endovascular stenting for superior vena cava syndrome, caused by a postradiation fibrosis after conventional radiotherapy for breast cancer. We emphasize the rarity of this uncommon surgical procedure and the bailout procedure for failed angioplasty and intravascular stenting. Key points of superior vena...

  12. Injuries of the retrohepatic inferior vena cava and the liver

    Directory of Open Access Journals (Sweden)

    Koprivica Radenko

    2008-01-01

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

  13. Leiomiossarcoma de veia cava inferior Leiomiossarcoma of the inferior vena cava

    Directory of Open Access Journals (Sweden)

    Eduardo Crema

    2008-12-01

    Full Text Available Leiomyosarcoma of the inferior vena cava is an extremely rare tumor, and it is reported to have a poor prognosis. The clinical findings are nonspecific and may precede the diagnosis by several years. Symptoms depend on the location and extension of the tumor. A complete surgical resection is the only proven therapeutic modality that prolongs the survival in patients with this lesion. We report a case of a 50 year-old patient with inferior vena cava leiomyosarcoma, who was submitted to a surgical treatment.

  14. 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

    Directory of Open Access Journals (Sweden)

    Miriam Davis G.

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

  15. 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

  16. 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.

  17. Recurrent Ascending Colon Cancer Manifesting as Inferior Vena cava Thrombus

    OpenAIRE

    Tori, Masayuki; Akamatsu, Hiroki; Ueshima, Shigeyuki; Tsujimoto, Masahiko; Nakahara, Masaaki

    2008-01-01

    We report an extremely rare case of recurrent ascending colon cancer manifesting as inferior vena cava (IVC) thrombus. A 77-year-old woman previously diagnosed with ascending colon cancer underwent right hemicolectomy with lymph node dissection. Though the tumor invaded the retroperitoneum and involved the right ovarian artery and vein, curative operation was performed. The patient took 5-FU p.o. Two and a half years later, tumor thrombus in the IVC extending into the right atrium was inciden...

  18. Fast-Track Management of Malignant Superior Vena Cava Syndrome

    International Nuclear Information System (INIS)

    We report our experience with a combined approach of endovascular biopsy followed by immediate stenting in the management of superior vena cava (SVC) syndrome secondary to obstructing mediastinal masses. A diagnosis of malignancy was obtained in six of eight (75%) biopsies and symptomatic relief was accomplished in all patients. We have found this to be a rapid, safe and effective management strategy that we now consider for all patients presenting with de novo SVC syndrome

  19. 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...

  20. 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.

  1. 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 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.

  2. Filtros de vena cava en pacientes con cáncer

    Directory of Open Access Journals (Sweden)

    Fernando A. Díaz Couselo

    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 enfermedad. En este trabajo se revisaron las indicaciones, complicaciones y frecuencia de retiro de los filtros de vena cava en una población de pacientes oncológicos con TEV. Se analizaron 27 pacientes a quienes se les había colocado filtros de vena cava. Veinticinco tenían tumores sólidos y dos linfomas no Hodgkin. Veinticinco estaban bajo tratamiento activo (cirugía y/o quimioterapia. Diecinueve se hallaban en estadio IV de su enfermedad. El motivo de su indicación fue profilaxis en el período perioperatorio en 14 casos (51.9%, hemorragia (n = 5, trombocitopenia (n = 4, metástasis en sistema nervioso central (n = 2, accidente cerebrovascular (n = 1 y neurocirugía previa no reciente (n = 1. Se retiraron 8 (29.6% filtros. La mediana del tiempo de permanencia fue 21 días (6-75. No hubo diferencias estadísticamente significativas en la frecuencia de retiro entre los filtros colocados en el perioperatorio (6/14 y los colocados por otras contraindicaciones para la anticoagulación (2/13; p = 0.2087. No hubo fracasos ni complicaciones en los procedimientos de colocación y retiro.

  3. Síndrome de compresión de vena cava inferior secundario a fibrosis retroperitoneal Inferior vena cava compression syndrome secondary to retroperitoneal fibrosis

    Directory of Open Access Journals (Sweden)

    Alberto Miranda Bravo

    2010-09-01

    Full Text Available Se estudió un paciente de 57 años de edad, de tez negra, con edemas en miembros inferiores relevantes por su volumen y extensión. Se realizó la discusión clínica la cual orientó hacia la búsqueda de una lesión o tumor retroperitoneal asociado a un síndrome de compresión u obstrucción de vena cava inferior y se comprobó imagenológicamente. La confirmación histológica se obtuvo por vía quirúrgica.We studied a 57 year-old patient of black complexion, with swelling of the lower limbs which was relevant due to its mass and extension. The clinical discussion guided us to search for a lesion or retroperitoneal tumor associated with a compression syndrome or obstruction of the inferior vena cava, which was determined radiologically. Histological confirmation was obtained through surgery.

  4. Síndrome de compresión de vena cava inferior secundario a fibrosis retroperitoneal / Inferior vena cava compression syndrome secondary to retroperitoneal fibrosis

    Scientific Electronic Library Online (English)

    Alberto, Miranda Bravo; Milagros I, Collazo-Ramos; Asbel Vicente, de la Cruz; Digna, Chávez Jiménez.

    2010-09-01

    Full Text Available Se estudió un paciente de 57 años de edad, de tez negra, con edemas en miembros inferiores relevantes por su volumen y extensión. Se realizó la discusión clínica la cual orientó hacia la búsqueda de una lesión o tumor retroperitoneal asociado a un síndrome de compresión u obstrucción de vena cava in [...] ferior y se comprobó imagenológicamente. La confirmación histológica se obtuvo por vía quirúrgica. Abstract in english We studied a 57 year-old patient of black complexion, with swelling of the lower limbs which was relevant due to its mass and extension. The clinical discussion guided us to search for a lesion or retroperitoneal tumor associated with a compression syndrome or obstruction of the inferior vena cava, [...] which was determined radiologically. Histological confirmation was obtained through surgery.

  5. Role of bilateral inferior petrosal sinus sampling (BIPSS) in the diagnosis of Cushing’s disease in a patient with double superior vena cava

    Science.gov (United States)

    Tashi, Sonam; Ng, Keng Sin

    2015-01-01

    Cushing’s syndrome is known to have a wide spectrum of clinical presentation with debilitating consequences and morbidity if not diagnosed and treated in time. Sometimes the diagnosis of Cushing’s syndrome can be challenging to the endocrinologist, especially when the usual battery of biochemical tests and advanced cross-sectional imaging is negative or inconclusive. We described a case in which the use of bilateral inferior petrosal sinus sampling (BIPSS) was conclusive albeit being technically challenging (due to a rare incidental finding of double superior vena cava) and invasive in nature. PMID:26629301

  6. 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.

  7. Complications of stenting in superior vena cava syndrome

    International Nuclear Information System (INIS)

    Objective: To investigate the incidence and causes of complication of stenting in the treatment of superior vena cava syndrome (SVCS) for its proper prevetions. Methods: Thirty nine patients with SVCS due to various diseases were retrospectively analyzed. The location, extension and degree of the stenosis were identified on venography before stent placement. Lumen narrowing becoming less than 50% or 20% improvement after stenting was taken as effective. Complications after stenting were analyzed. Results: Thirty-five (89.7%, 35/39) patients relieved after stenting. Six patients (15.4%) had complications, including stents displacement due to mass lessened after chemotherapy in 1 cases, stents displacement and thrombogenesis due to lack of anticoagulant therapy and mass lessened after chemotherapy in 1 cases, restenosis due to mass growing into the screening of Gianturco Z-type stent in 1 cases, acute pericardial effusion in 1 cases, 1 of acute pulmonary embolism (PE) in 1 cases and acute congestive right heart failure and relieved after treatment in 1 cases. Conclusions: Some complications of stenting in SVCS is serious. Proper procedure, stents selection and skillful handling can reduce the frequency of the complications. (authors)

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

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yoo Keun [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    1974-10-15

    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.

  9. 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

  10. Importance of cholescintigraphy and inferior vena cava flow studies in the differential diagnosis of hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Botha, U.; Pilloy, W.; Strydom, W.J.

    1989-01-01

    In order to assess the usefulness of inferior vena cava flow studies and cholescintigraphy complementary to the routine static liver scintigraphy in the differential diagnosis of hepatocellular carcinoma (HCC), we studied 37 patients with a proven diagnosis of HCC and 11 patients with a liver abcess or cyst. The procedure followed was (1) a {sup 99m}Tc-colloid flow study of the inferior vena cava (IVC) and iliac veins followed by static liver imaging and (2) cholescintigraphy using a dynamic acquisition mode to determine the perfusion as well as the concentration/excretion of the liver and pathological area. The hepatic perfusion index (HPI) was calculated by the slope method of Sarper et al.: Radiology 141:179-184 (1981) and the area method of Biersack et al. The results were compared with data previously collected in patients without liver disease (control) and other liver pathologies.

  11. 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

  12. 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 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

  13. Endovascular treatment of superior vena cava syndrome by percutaneous venoplasty.

    Science.gov (United States)

    Lauten, Alexander; Strauch, Justus; Jung, Christian; Goebel, Bjoern; Krizanic, Florian; Baer, Frank M

    2010-11-01

    Thrombosis of the superior vena cava leads to obstruction of venous outflow of the head and upper extremities and causes severe clinical symptoms. The management of SVC syndrome depends on aetiology and acuity at clinical presentation and ranges from conservative medical treatment to bypass surgery. Endovascular treatment can provide rapid relief of symptoms and substantial clinical improvement independent of aetiology. We report a case of successful interventional treatment in a patient with catheter-induced SVC thrombosis and present a review of the literature. PMID:20702137

  14. An unusual cause of intraoperative acute superior vena cava syndrome

    Directory of Open Access Journals (Sweden)

    Adam W Amundson

    2013-01-01

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

  15. 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.

  16. 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)

  17. Vena cava filter migration: an unappreciated complication. About four cases and review of the literature.

    Science.gov (United States)

    Bélénotti, Pauline; Sarlon-Bartoli, Gabrielle; Bartoli, Michel-Alain; Benyamine, Audrey; Thevenin, Benjamin; Muller, Cyril; Serratrice, Jacques; Magnan, Pierre-Edouard; Weiller, Pierre-Jean

    2011-11-01

    Inferior vena cava filter placement is performed to prevent pulmonary risk secondary to deep venous thrombosis. Indications for this treatment are limited to patients experiencing recurrences under well-managed anticoagulant treatment or presenting with contraindication to anticoagulant treatment. Nowadays, as these clinical situations are rare, this device is less and less used, all the more since, for several years now, thrombosis, fracture, or infectious complications as well as filter migration have been reported. Filter migrations are responsible for atypical and varied clinical presentations likely to defer diagnosis. To treat them, the filter is extracted, which is very risky in patients with a thromboembolic history. In our center, during a period of 14 years, we retrospectively collected and studied partial or complete vena cava filter migration cases that had been treated by extraction. We are reporting four very different clinical cases and, more specifically, the second published case of migration to a renal vein, which mimicked a systemic disease. Because of its very atypical clinical presentations, cava filter migration is an unappreciated and certainly underdiagnosed complication. However, this complication must not question cava filter placement when it is justified. In contrast, it prompts early filter extraction or long-term radiological surveillance. PMID:22023951

  18. 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.

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    Elton Correia Alves

    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 relatar 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.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-year-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.

  1. 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 IVC. (orig.)

  2. Congenital absence of the azygos vein with persistent left superior vena cava: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Yim, Young Hee; Yi, Jeong Geun; Song, In Young; Park, Jeong Hee [Dept. of Radiology, Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2014-03-15

    Absence of the azygos vein is a very rare variant of venous tributary arrangement which has been reported only in few cases so far. We hereby introduce the chest radiographic and computed tomographic findings of the congenital absence of the azygos vein with bilateral superior vena cava, incidentally detected during a follow-up for rectal cancer. The hemiazygos vein is drained into persistent left superior vena cava via left superior intercostal vein, so called the 'aortic nipple'.

  3. Heart Transplantation in a Patient with Persistent Left Superior Vena Cava

    OpenAIRE

    Lee, Jae-Hong; Park, Eun-Ah; Lee, Whal; Cho, Hyun-Jai; Kim, Ki-Bong; Hwang, Ho Young

    2014-01-01

    A 56-year-old male presented with severe exertional dyspnea and pitting edema in the lower extremities. The pre-operative evaluation demonstrated biventricular dysfunction associated with severe tricuspid valve regurgitation and a persistent left superior vena cava. He was registered as a transplantation candidate, and orthotopic heart transplantation was performed using the standard bicaval technique. The left superior vena cava was connected to the right atrial appendage after the construct...

  4. STRUCTURE OF THE Vena cava caudalis OF THE DOG (Canis familiaris) / ESTRUCTURA DE LA VENA CAVA CAUDAL DEL PERRO (Canis familiaris)

    Scientific Electronic Library Online (English)

    Josiane, Medeiros de Mello; Carlos Roberto, Piffer; Antonio Marcos, Orsi; Maria Lúcia, Eleutério.

    Full Text Available El objetivo de este trabajo fue proporcionar datos exactos que permitan indentificar la estructura y comportamiento de los elementos "tisulares" presentes en las porciones de origen "pre renal" y "post renal" de la pared de la vena cava caudal del perro. Las observaciones nos permitieron concluir qu [...] e la la vena cava caudal es un vaso fibromuscular que tiene la capacidad para propulsar la sangre venosa de vuelta al atrio derecho Abstract in english The objective of the present study was to provide precise data that would permit the identification of the structure and behavior of tissue elements present in the portion of origin and in the prerenal and postrenal portions of the wall of the caudal vena cava of the dog. The observations made permi [...] tted us to conclude that this is a fibromuscular vessel with the ability to propel venous blood returning to the right atrium

  5. Axial pressure gradient in the canine superior vena cava.

    Science.gov (United States)

    Minten, J; Van de Werf, F; Eaubert, A; De Geest, H

    1986-12-01

    In the superior vena cava of anaesthetised open chest dogs the axial pressure gradient was measured simultaneously with the blood flow velocity under different preload conditions. Both pressure gradient and velocity curves showed distinct systolic and diastolic waves. Peak pressure gradient ranged between 26 and 93 Pa X cm-1 (0.2-0.7 mm Hg X cm-1) and velocity varied between 0.095 and 0.19 m X s-1. Peak systolic pressure gradient, but not peak diastolic pressure gradient, was significantly linearly correlated to peak systolic velocity and peak diastolic velocity respectively. The shape of the two curves corresponded fairly well, but variations in pressure gradient preceded the variations in velocity. Both the correspondence in shape and the phase lag between pressure gradient and velocity waves were evaluated by the normalised cross correlation technique. During volume expansion the shape correspondence improved and the phase lag decreased. It is concluded that the transient vena caval blood velocity variations are directly related to the pulsatile axial pressure gradient. PMID:3802130

  6. Mathematical modeling of the fibrosis process in the implantation of inferior vena cava filters.

    Science.gov (United States)

    Nicolás, M; Peña, E; Malvè, M; Martínez, M A

    2015-12-21

    An inferior vena cava filter is a medical device that is implanted in the inferior vena cava and is in charge of capturing blood clots before they reach the lungs, preventing from pulmonary embolism. There are some clinical problems regarding the use of inferior vena cava filters. One of them is the difficulty when retrieving the device due to the remodeling of the vena cava. Huge effort has been made in creating computational models that reproduce tissue remodeling, but no attention has been paid to the fibrosis phenomenon occurring in the inferior vena cava. In this work, a continuum computational model that reproduces the fibrosis in the presence of an antithrombotic filter is presented. Diffusion-reaction equations are used for modeling the mass balance between species in the venous wall. The main species considered to play a key role in the process of fibrosis are smooth muscle cells, endothelial cells, matrix metalloproteinases, vascular growth factors and the extracellular matrix. The developed model has been implemented on an idealized axisymmetric geometric vena cava model. Moreover, a sensitivity analysis has been performed to study the parameters influence on the evolution of the model. Results show that the computational model is able to predict the behavior of the species considered and it captures the key characteristics of lesion growth and the healing process within a vein subjected to non-physiological mechanical forces. Our results suggests that the vessel wall response is mainly caused by the endothelium denudation area and the collagen turnover among other factors. PMID:26458786

  7. 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.

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

    International Nuclear Information System (INIS)

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

  9. ICD Leads Extraction and Clearing of Access Way in a Patient With Superior Vena Cava Syndrome

    Science.gov (United States)

    Kiuchi, Márcio Galindo; Andrade, Ricardo Luiz Lima; da Silva, Gustavo Ramalho; Souto, Hanry Barros; Chen, Shaojie; Junior, Humberto Villacorta

    2015-01-01

    Abstract Central vein disease is defined as at least 50% narrowing up to total occlusion of central veins of the thorax including superior vena cava, brachiocephalic, subclavian, and internal jugular vein. Thrombosis due to intravascular leads occurs in approximately 30% to 45% of patients early or late after implantation of a pacemaker by transvenous access. In this case, we report a male patient, 65-years old, hypertensive, type 2 diabetic, with atherosclerotic disease, coronary artery disease, underwent coronary artery bypass surgery in the past 10 years, having already experienced an acute myocardial infarction, bearer automatic implantable cardioverter defibrillator for 8 years after an episode of aborted sudden death due to ischemic cardiomyopathy, presenting left superior vena cava syndrome. The use of clopidogrel and rivaroxaban for over a year had no benefit on symptoms improvement. After atrial and ventricular leads extraction, a new shock lead was positioned in the right ventricle using active fixation and a new atrial lead was positioned in the right atrium, passing inside of the stents. Two days after the procedure the patient was asymptomatic and was discharged. PMID:26402803

  10. 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.

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

    International Nuclear Information System (INIS)

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

  12. 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.

  13. 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.

  14. Doppler ultrasonographic imaging of obstruction of inferior vena cava

    International Nuclear Information System (INIS)

    Budd-Chiari syndrome is a rare condition caused by hepatic venous outflow obstruction. Although liver biopsy and venography have been considered to be conclusive in the diagnosis of Budd-Chiari syndrome, those procedures involve a great deal of disecomfort and risk for the patient. As the recently developed Doppler ultrasonography is able to define the direction of blood flow and measure the blood flow velocity and volume in the portal vein, inferior vena cava(IVC) and hepatic vein, it can be used in the diagnosis of Budd-Chiari syndrome. We analyzed Doppler ultrasonographic findings in two patients with membraneous obstruction of the IVC, suspected from Doppler ultrasonographic findings and confirmed by venocavography. Doppler ultrasonography demonstrated reversed laminar flow on inspiration and no significant flow on expiration in the dilated IVC proximal to the stenosis and turbulent flow in the proximal portion of the stenosis. After balloon dilatation, the flow was changed and directed normally. These findings correlated very well with venocavographic findings. Our results suggest that Doppler ultrasonography is a simple, non-invasive and effective method for the initial evaluation of patients suspected of having obstruction of the IVC and the evaluation of therapeutic effect

  15. Endovascular infection following inferior vena cava (IVC) filter insertion.

    Science.gov (United States)

    Rottenstreich, Amihai; Bar-Shalom, Rachel; Bloom, Allan I; Kalish, Yosef

    2015-11-01

    Inferior vena cava filter (IVC) placement is increasing significantly. However, due to low retrieval rates, many filters are left in place indefinitely thereby exposing patients to long-term filter-related complications. This study reports a series of three patients with IVC filter infection. Cases were identified during retrospective review of medical records of all patients undergoing an IVC filter insertion at a single tertiary care university hospital between 2009 and 2013. Clinical presentation, radiological features and management are discussed. Two patients presented within days of filter placement, while the other one presented 1 year later. In two patients, fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) was found to be a sensitive method to diagnose IVC filter infection. Endovascular infection of IVC filter is a rare event. In patients with IVC filter in place and fever of unknown origin or persistent bacteremia, this complication should be suspected. FDG PET/CT has a diagnostic value in this challenging diagnosis. PMID:25894477

  16. Apparent pulse wave velocity in the canine superior vena cava.

    Science.gov (United States)

    Minten, J; Van de Werf, F; Aubert, A E; Kesteloot, H; De Geest, H

    1983-10-01

    In order to evaluate clinically recorded jugular vein pulses it is necessary to understand the transmission process of the right atrial pressure pulse through the caval veins up to the jugular veins. The transmission speed at distinct points of the venous pressure curve was studied in the superior vena cava of 20 anaesthetised dogs. Under control conditions the propagation velocities varied from 1.2 +/- 0.49 to 2.5 +/- 1.36 m . s-1. During increased preload of the heart propagation velocities rose significantly from 2.2 to 4.2 m . s-1 per kPa as a function of mean venous pressure and from 2.3 to 5.8 m . s-1 per kPa as a function of phasic pressures. Right atrial pacing (between 60 and 120 beats . min-1) did not influence the propagation velocity of the studied distinct points. It was found that the summits of the pressure pulse propagate at only a slightly higher speed than the nadirs. PMID:6627270

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

    Scientific Electronic Library Online (English)

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

    1998-09-01

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

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

    International Nuclear Information System (INIS)

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

  19. 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.

  20. 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

  1. 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

  2. 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

  3. Radiotherapeutic handling in the compression syndrome of the superior vena cava

    International Nuclear Information System (INIS)

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

  4. 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 PE. Prospective studies or large clinical registries should be conducted to clarify whether this practice improves outcomes.

  5. 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

  6. Multidisciplinary Management of Airway Obstruction and Superior Vena Cava Obstruction Secondary to Huge Retrosternal Goiter

    Directory of Open Access Journals (Sweden)

    Chen YC

    2014-06-01

    Full Text Available Airway obstruction and superior vena cava syndrome (SVC secondary to huge retrosternal goiter are medical emergencies which need meticulous attention to prevent potentially life threatening events. We reported a case of huge retrosternal goiter which was neglected for years and later complicated by obstruction to airway and superior vena cava. Team effort which mainly involved endocrine surgeon, cardiothoracic surgeon and anaesthetist had successfully removed the gland without significa t morbidity. He was on tracheostomy due to tracheomalacia and was managed by ENT surgeon. He was discharged well after 2 weeks.

  7. 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.)

  8. Regional Histomorphometry of the Hepatic Inferior Vena Cava; a Possible Sphincteric Mechanism Histomorfometría Regional de la Vena Cava Inferior Hepática; un Posible Mecanismo de Esfínter

    OpenAIRE

    P. K Bundi; J. A Ogeng'o; J HASSANALI; P. O Odula

    2009-01-01

    This study was aimed at identifying the changes in diameter and structural composition of the Hepatic Inferior Vena Cava in its infrahepatic, intrahepatic and suprahepatic portions. Eighty adult liver specimens from the Chiromo and Nairobi City mortuaries were used for morphometry, while twenty of them were processed for light microscopy. A constriction was noted in the mid-portion of the HIVC, while structurally; the intrahepatic portion had thicker fibromuscular adventitia. It is plausible ...

  9. 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.

  10. Stenting in malignant obstruction of inferior vena cava

    International Nuclear Information System (INIS)

    Objective: To evaluate the effectiveness of endovascular deployment of homemade metallic Z-type self-expandable stent in treating the patients with malignant obstruction of inferior vena cava (IVC). Methods: Seventy-eight [66 men, 12 women, mean age (50.45 +- 11.81) years, age range 20-78 years] patients with IVC obstruction due to malignant compression were enrolled into this study, including 66 cases of primary hepatic carcinoma and 12 cases of metastatic hepatic carcinoma. Before therapy every patient underwent CT, MRI or color doppler ultrasound examination and the diagnosis of IVC obstruction was made. All patients' clinical signs and symptoms due to malignant IVC syndrome were classified and scored. The venography was performed via right femoral vein and homemade metallic Z-type self-expandable stent was placed across the stenotic segment of IVC. The diameter of stenotic segment and the scores of patients' IVC syndrome were compared before and after stent placement. The patency of IVC was followed by CT, color doppler ultrasound or venography every two months. The primary and secondary patency of IVC were calculated respectively. Data were analyzed by paired-sample rank sum test. Results: The length of IVC stenosis was 1.5-18.5 cm (median length was 7.2 cm) and 94 stents were precisely placed across the stenotic segment of patients' IVC. The length of stent in patients' IVC was 7.5 - 20.0 cm (median length was 10.0 cm). Technical successful rate of stent placement was 98%. The diameter of stenotic segment of IVC was increased from 0-0.5 cm (median 0.15 cm) to 0.3-1.6 cm (median 1 cm) (Z=-54.365, P < 0.0001) and scores of patients' IVC syndrome were declined from 4-5 (median 4) to 0-2 (median 0) (Z = -56.132, P < 0.0001). The difference showed statistical significance. There was no serious procedure-related complication except one patient experienced acute thrombosis in IVC on the second day after therapy. The primary and secondary patency of IVC was 83% and 93%, respectively. Conclusion: Endovascular deployment of homemade metallic Z-type self-expandable stent was an effective palliative treatment for patients with malignant obstruction of IVC

  11. 'RecoveryTM' Vena Cava Filter: Experience in 96 Patients

    International Nuclear Information System (INIS)

    The purpose of the study was to assess the clinical safety and efficacy of the 'RecoveryTM' (Bard) inferior vena cava (IVC) filter. We retrospectively evaluated the clinical and imaging data of patients who had a 'RecoveryTM' IVC filter placed between January 2003 and December 2004 in our institution. The clinical presentation, indications, and procedure-related complications during placement and retrieval were evaluated. Follow-up computed tomography (CT) examinations of the abdomen and chest were evaluated for filter-related complications and pulmonary embolism (PE), respectively. 'Recovery' filters were placed in 96 patients (72 males and 24 females; age range: 16-87 years; mean: 46 years). Twenty-four patients presented with PE, 13 with deep vein thrombosis (DVT) and 2 with both PE and DVT. The remaining 57 patients had no symptoms of thromboembolism. Indications for filter placement included contraindication to anticoagulation (n = 27), complication of anticoagulation (n = 3), failure of anticoagulation (n = 5), and prophylaxis (n = 61). The device was successfully deployed in the infrarenal (n = 95) or suprarenal (n = 1) IVC through a femoral vein approach. Retrieval was attempted in 11 patients after a mean period of 117 days (range: 24-426). The filter was successfully removed in nine patients (82%). Failure of retrieval was due to technical difficulty (n = 1) and the presence of thrombus in the filter (n = 1). One of the nine patients who had the filter removed developed IVC thrombus after retrieval and another had an intimal tear of the IVC. Follow-up abdominal CT (n = 40) at a mean of 80 days (range: 1-513) showed penetration of the IVC by the filter arms in 11, of which 3 had fracture of filter components. In one patient, a broken arm migrated into the pancreas. Asymmetric deployment of the filter legs was seen in 12 patients and thrombus within the filter in 2 patients. No filter migration or caval occlusion was encountered. Follow-up chest CT (n = 27) at a mean of 63 days (range: 1-386) showed PE in one patient (3%). During clinical follow-up, 12 of 96 patients developed symptoms of PE and only 1 of the 12 had PE on CT. There was no fatal pulmonary embolism in our group of patients following 'Recovery' filter placement. However, the current version of the filter is associated with structure weakness, a high incidence of IVC wall penetration, and asymmetric deployment of the filter legs

  12. 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.

  13. White matter change on CT associated with superior vena cava syndrome: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Fukuda, M. (Department of Nephrology, Metropolitan Kiyose Children' s Hospital, Tokyo (Japan)); Nagai, T. (Department of Neurology, Metropolitan Kiyose Children' s Hospital, Tokyo (Japan)); Kamiyama, Y. (Department of Nephrology, Metropolitan Kiyose Children' s Hospital, Tokyo (Japan)); Kawamura, K. (Department of Nephrology, Metropolitan Kiyose Children' s Hospital, Tokyo (Japan)); Kawahara, K. (Department of Nephrology, Metropolitan Kiyose Children' s Hospital, Tokyo (Japan)); Honda, M. (Department of Nephrology, Metropolitan Kiyose Children' s Hospital, Tokyo (Japan))

    1993-03-01

    An 11-year-old Japanese girl with nephrotic syndrome developed superior vena cava syndrome associated with hypercoagulability and an indwelling catheter. Cranial CT revealed diffuse low-density lesions in paraventricular white matter. Thrombectomy brought prompt relief of symptoms and correction of CT abnormalities. (orig.)

  14. White matter change on CT associated with superior vena cava syndrome: a case report

    International Nuclear Information System (INIS)

    An 11-year-old Japanese girl with nephrotic syndrome developed superior vena cava syndrome associated with hypercoagulability and an indwelling catheter. Cranial CT revealed diffuse low-density lesions in paraventricular white matter. Thrombectomy brought prompt relief of symptoms and correction of CT abnormalities. (orig.)

  15. The relationship between inferior vena cava diameter measured by bedside ultrasonography and central venous pressure value

    OpenAIRE

    Citilcioglu, Serenat; Sebe, Ahmet; Oguzhan Ay, Mehmet; Ferhat ICME; Avci, Akkan; Gulen, Muge; Mustafa SAHAN; Satar, Salim

    2014-01-01

    Objective: We aimed to present inferior vena cava (IVC) diameter as a guiding method for detection of relationship between IVC diameter measured noninvasively with the help of ultrasonography (USG) and central venous pressure (CVP) and evaluation of patient's intravascular volume status.

  16. Surgical strategy in cases of retroperitoneal tumors involving vena cava inferior

    International Nuclear Information System (INIS)

    Possibilities of surgical treatment of retroperitoneal tumors involving vena cava inferior (VCI) are shown. Iliocavography was applied to specify the degree of involving VCI and ilioveins in tumor process as well as to determine the character of rebuilding the venous bed. Schemes of operations performed on nonorgan retroperitoneal tumors are presented

  17. Allergic Reaction following Implantation of a Nitinol Alloy Inferior Vena Cava Filter.

    Science.gov (United States)

    Jia, Zhongzhi; Tu, JianFei; Wang, Kai; Jiang, Guomin; Wang, Weiping

    2015-09-01

    A 67-year-old woman developed severe pruritus after implantation of a retrievable nitinol inferior vena cava (IVC) filter (55.4% nickel and 44.6% titanium). The pruritus resolved only after filter retrieval. The patient's hypersensitivity to nickel was confirmed by a positive skin patch test substantiating a systemic allergic reaction to the implanted nitinol IVC filter. PMID:26314647

  18. Bird's Nest Filter Causing Symptomatic Hydronephrosis Following Transmural Penetration of the Inferior Vena Cava

    International Nuclear Information System (INIS)

    We report a case of symptomatic hydronephrosis caused by transcaval penetration of a Bird's Nest filter. Perforation of the wall of the inferior vena cava (IVC) following insertion of a caval filter is a well-recognized complication. Whilst two cases of hydronephrosis have been described with Greenfield filters, no case involving a Bird's Nest filter has been reported previously

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    Lipp Rainer W

    2010-07-01

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

  1. 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.

  2. 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)

  3. An unusual cause of cardiogenic shock: tricuspid regurgitation and right ventricular perforation due to vena cava filter migration

    OpenAIRE

    Mocavero, P E; Staglianò, A; Coppola, M; Langella, S; Conte, A.; Pappalardo, F. (Francesco); Martiniello, A R; Pieri, M.; MATTEI, A.

    2012-01-01

    Dislocation and migration of the inferior vena cava filter to the right heart is an uncommon but serious complication, requiring prompt diagnosis and appropriate therapy. We report the case of a seventy-year old man, who had previously undergone vena cava filter implantation and who was admitted to the Intensive Care Unit due to acute respiratory distress with the suspect of pneumonia-related sepsis. Due to the worsening of hemodynamics and the development of cardiogenic shock, the patient un...

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

    Scientific Electronic Library Online (English)

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

    2009-04-01

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

  5. 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)

  6. 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.

  7. A case of absent right and persistent left superior vena cava

    Directory of Open Access Journals (Sweden)

    Nagy Endre

    2006-01-01

    Full Text Available Abstract Background and purpose: Our case report deals with the importance of detailed echocardiographic examination for differential diagnosis of coronary sinus dilation and development of abnormalities of great thoracic veins. Case presentation: A 49-year-old man underwent transthoracic echocardiography for atypical chest pain. A dilated coronary sinus was found and venous contrast echocardiography raised the suspicion of absent right and persistent left superior vena cava. Transesophageal echocardiography showed absence of right superior vena cava. The echocardiographic findings were confirmed by upper venous digital subtraction cavography. Conclusion: combination of agenesia of right SVC and isolated persistent left SVC in adult patients is a very rare abnormality. Both clinicians and sonographers should be alerted to the possible presence of this combined venous anomaly. Transthoracic echocardiograpy – including agitated saline infusion to the antecubital vein – is an important diagnostic tool for accurate diagnosis of this congenital thoracic venous malformation.

  8. 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.

  9. 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.

  10. Percutaneous retrieval of a vena cava filter from the right atrium: case report

    Energy Technology Data Exchange (ETDEWEB)

    Rasuli, P. [The Ottawa Hospital and University of Ottawa, Dept. of Radiology, Ottawa, Ontario (Canada); Mehran, R. [The Ottawa Hospital and University of Ottawa, Dept. of Thoracic Surgery, Ottawa, Ontario (Canada); French, G. [The Ottawa Hospital and University of Ottawa, Dept. of Radiology, Ottawa, Ontario (Canada); Turek, M. [The Ottawa Hospital and University of Ottawa, Dept. of Internal Medicine, Ottawa, Ontario (Canada); Lalonde, K.A. [The Ottawa Hospital and University of Ottawa, Dept. of Thoracic Surgery, Ottawa, Ontario (Canada); Cardinal, P. [The Ottawa Hospital and University of Ottawa, Dept. of Internal Medicine, Ottawa, Ontario (Canada)

    2000-07-01

    Migration of vena cava filters can occur spontaneously, but it can also occur as a result of entanglement of the filter with a guidewire, particularly during 'blind' (unguided) insertion of a central venous line. When a filter migrates to the heart, traditional practice has been either to leave the filter in place or to remove it surgically by means of open heart surgery and cardiopulmonary bypass. We found only 6 reports of successful percutaneous retrieval or repositioning of a vena cava filter (Table 1). We describe a new interventional technique for retrieving a filter from the right atrium and a novel endosurgical method for removing a filter from the innominate vein. (author)

  11. 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.)

  12. Correlation between mechanical properties and wall composition of the canine superior vena cava.

    Science.gov (United States)

    Minten, J; Verheyen, A; Cornelissen, F; Rombauts, W; Dequeker, J; De Geest, H

    1986-12-01

    The mechanical properties (modulus of elasticity and stress-relaxation) of different venous segments of the canine superior vena cava were determined as well as the composition of the vessel wall by means of physical, biochemical and histological methods. It was found that the wall of the vena cava was structurally and mechanically a function of the metric position with respect to the right heart: the modulus of elasticity increased, the stress-relaxation decreased, the concentration of hydroxyproline, collagen and elastin increased and the amount of muscle fibres decreased with increasing distal distance from the right heart. A significant linear correlation coefficient was observed between the modulus of elasticity and the structural wall components. The data presented show the axial heterogeneity and the dependency of the mechanical properties upon the venous vessel wall composition. PMID:2440411

  13. Best approach to measuring the inferior vena cava in spontaneously ventilating patients: a pilot study.

    Science.gov (United States)

    Baker, Elinor C; Pott, Jason; Khan, Faisal; Freund, Yonathan; Harris, Tim

    2015-02-01

    The objective of this study was to establish the reliability of different measurements of inferior vena cava (IVC) size and respiratory variation in response to changes in circulating volume. Transabdominal ultrasound measurements of the IVC were obtained in longitudinal (B and M modes) and transverse planes (B-mode height and ellipse circumference) during inspiration and expiration, and inferior vena cava collapsibility indices (IVCci) were calculated. Measurements were repeated following venesection of ?450 ml. Thirty patients underwent venesection. Their IVCci increased significantly for transverse and longitudinal height measurements following venesection, but not for transverse circumference measurements. Transverse views were inadequate in 27% of patients, compared with 7% for longitudinal views (P=0.04). Changes in IVCci are sensitive to small changes in circulating volume. Measurements are most frequently achieved in the longitudinal plane. There is an urgent need for standardization of sonographic IVC measurement techniques. PMID:24710112

  14. A case of absent right and persistent left superior vena cava

    OpenAIRE

    Nagy Endre; Morvai Zita; Forster Tamás; Nagy Edit; Pálinkás Attila; Varga Albert

    2006-01-01

    Abstract Background and purpose: Our case report deals with the importance of detailed echocardiographic examination for differential diagnosis of coronary sinus dilation and development of abnormalities of great thoracic veins. Case presentation: A 49-year-old man underwent transthoracic echocardiography for atypical chest pain. A dilated coronary sinus was found and venous contrast echocardiography raised the suspicion of absent right and persistent left superior vena cava. Transesophageal ...

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

    OpenAIRE

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

    2010-01-01

    Abstract Introduction Patent paraumbilical and abdominal subcutaneous veins are found frequently as collaterals in patients due to portal hypertension mainly in liver cirrhosis. Case presentation For evaluation of portal hypertension in a 72-year-old Caucasian man without liver cirrhosis, magnetic resonance imaging with gadolinium contrast-enhancement was performed and demonstrated a missing inferior vena cava. A blood return from the lower extremities was shown through enlarged collateral ve...

  16. 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

  17. Radiofrequency Guide Wire Recanalization of Venous Occlusions in Patients with Malignant Superior Vena Cava Syndrome

    International Nuclear Information System (INIS)

    Fibrotic central venous occlusions in patients with thoracic malignancy and prior radiotherapy can be impassable with standard catheters and wires, including the trailing or stiff end of a hydrophilic wire. We report two patients with superior vena cava syndrome in whom we successfully utilized a radiofrequency guide wire (PowerWire, Baylis Medical, Montreal, Quebec, Canada) to perforate through the occlusion and recanalize the occluded segment to alleviate symptoms.

  18. Occlusion of Inferior Vena Cava: A Singular Presentation of Abdominal Aortic Aneurysm

    OpenAIRE

    Guedes Vaz; Sandrina Braga; Joana Ferreira; Miguel Maia; Daniel Brandão; João Correia Simões; João Vasconcelos; Alexandra Canedo

    2009-01-01

    Even though the majority of abdominal aortic aneurysm s(AAAs) are asymptomatic, they can occasionally manifest as a result of adjacent structures involvement. Although the most frequent venous complication of AAA is rupture into the inferior vena cava (IVC), venous compression can infrequently occur. The authors report a particularly rare case of compression and thrombosis of the IVC by AAA. Patient was treated by preoperative placement of an IVC filter to impede pulmonary embolism and subseq...

  19. 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.

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

    International Nuclear Information System (INIS)

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

  1. 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

  2. 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.

  3. Scintiangiographic Visualization of Systemic-Portal Venous Shunting as a Cause of 'hot Spot' in Superior Vena Cava Obstruction

    International Nuclear Information System (INIS)

    A small number of pathologic entities such as Budd-Chiari Syndrome, cirrhosis, focal nodular hyperplasia, and superior and inferior vena cava obstruction has been reported to result in focal areas of increased uptake of radiocolloid on the hepatoscintigram. We recently studied a patient with focal accumulation of 99mTc-phytate at the inferior aspect of the liver, at the junction of the right and left lobe. The superior vena cava scintiangiogram was taken for the evaluation of the superior vena cava obstruction and collateral circulations. As a result of superior vena caval obstruction a considerable amount of blood flowed to the liver through the anterior parietal and periumblical venous channels. A certain fraction of radiocolloid delivered by the rete mirabile perfused to a localized area of the liver. This would explain the hot spot around the porta hepatis in this case.

  4. 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.

  5. 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.

    2014-11-01

    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.

  6. 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

  7. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Poletti, P.A.; Prina, L.; Didier, D.; Schneider, P.A.; Terrier, F. [Department of Radiology, Division of Diagnostic and Interventional Radiology, Geneva University Hospital (Switzerland); Becker, C.D. [Department of Radiology, Division of Diagnostic and Interventional Radiology, Geneva University Hospital (Switzerland)]|[Institute of Diagnostic Radiology, University of Bern (Switzerland); Ruijs, P. [Institute of Diagnostic Radiology, University of Bern (Switzerland); Bounameaux, H. [Division of Angiology and Haemostasis, Geneva University Hospital, Geneva (Switzerland)

    1998-03-01

    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 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.) With 5 figs., 2 tabs., 31 refs.

  10. The Analysis of Postoperative Complications after Thrombectomy From Inferior Vena Cava in Renal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Atduev V.A.

    2012-06-01

    Full Text Available The aim of the investigation is to analyze the results of thrombectomy from inferior vena cava in renal cell carcinoma to reveal the main prognostic factors of postoperative complications. Materials and Methods. Nephrectomy with thrombectomy from inferior vena cava was performed in 34 patients. Thrombus level ?3b was revealed in 27 patients (79.4% (thrombus length — 5.10±1.75 cm, ?3? — in 7 patients (20.6% (thrombus length — 14.80±0.98 ??. Postoperative complications were analyzed according to Clavien–Dindo classification of surgical complications. Results. Blood loss volume in operation was on average 866 ml (250–4000 ml. 18 patients (52.9% had no complications. Two patients (5.9% had I degree complication (anemia. The II degree of complication was revealed in 11 patients (32.3%, after the operation they underwent blood transfusion. One patients (2.9% had IIIa degree of complications (after the operation he required pleural punctures and pericardium drainage under local anesthesia, and one patients had III? degree of complications (descending colon perforation — he underwent relaparotomy and colostomy. There were no IV degree complications. One patient (2.9% died (V degree from pulmonary embolism. Correlation analysis determined high (r=0.7 complications dependence of thrombus size and blood loss volume (r=0.6 and low dependence — of tumour size (r=0.44. There were revealed no complication dependence of patients age (r=0.1, status on Karnofsky scale (r=0.0. All 33 patients discharged from hospital had lived over 6 months after the operation. Conclusion. After nephrectomy with thrombectomy from inferior vena cava there is high risk of postoperative complications, the frequency and type of which to a greater degree depend on thrombus size and blood loss volume.

  11. Vena cava thrombosis associated with nephrotic syndrome in the puerperal gestational cycle

    Scientific Electronic Library Online (English)

    Maíta Poli, Araújo; Carla, Gonçalves; Roberta, Gonçalves; José Wilson Ramos, Braga Júnior; Thaís Vilela, Peterson; Álvaro Nagib, Atallah; Emília Inoue, Sato; Virgínia Fernandes Moça, Trevisani.

    2001-01-04

    Full Text Available CONTEXTO: A gestação é acompanhada de um estado fisiológico de hipercoagulabilidade. Fenômenos de Trombose podem ocorrer. OBJETIVO: Relatar um caso clínico envolvendo uma paciente que apresentava história importante de trombifilia familiar, e que desenvolveu trombose venosa profunda no membro inferi [...] or e trombose da veia cava durante o ciclo gravídico-puerperal, apresentando síndrome nefrótica como principal complicação. TIPO DE ESTUDO: Relato de caso. Abstract in english CONTEXT: The puerperal gestational cycle is accompanied by a state of physiological hypercoagulability. Thromboembolic phenomena may occur at this time. OBJECTIVE: To report on a clinic case involving a patient that presented a family history of thromboembolism and developed deep vein thrombosis in [...] a lower limb and vena cava thrombosis during the puerperal gestational cycle, displaying nephrotic syndrome as the main complication. DESIGN: Case report.

  12. 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.

  13. 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.

  14. 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

  15. 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

  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. Transiliac catheterization of the inferior vena cava for long-term venous access in children.

    Science.gov (United States)

    Ikeda, S; Sera, Y; Ohshiro, H; Izaki, T; Uchino, S; Akizuki, M; Goto, H

    1998-11-01

    In infants and children requiring prolonged, multiple central venous (CV) catheterizations, the superior (SVC) and inferior vena cava may become thrombosed or stenotic, making CV access a difficult problem. Use of the iliac vein may be an acceptable alternative. We report a patient with thrombosis of the SVC in whom the external iliac vein was accessed through a retroperitoneal approach for placement of an implantable port. This technique is easy to perform, and there are no special materials or patient positioning required. PMID:9880726

  18. Gradient echo sequences in the diagnosis of inferior vena cava obstruction

    International Nuclear Information System (INIS)

    The capability for studying noninvasively vessels has been dramatically improved with the use of gradient echo sequences. Twenty-one patients presenting a suspected inferior vena cava obstruction on cavography underwent MR examination with axial, sagittal and coronal gradient echo images. Eighteen patients were also imaged with ultrasound and/or CT. Gradient echo sequences visualized a thrombus in 19 cases and a normal vein in the remaining 2 cases. The potential MR pitfalls are illustrated and the two cases of false positive on cavography are discussed. Gradient echo sequences allow a fast and performant examination of the vessels

  19. Superior Vena Cava Stent Migration into the Pulmonary Artery Causing Fatal Pulmonary Infarction

    International Nuclear Information System (INIS)

    Migration of superior vena cava (SVC) stents is a well-recognised complication of their deployment, and numerous strategies exist for their retrieval. To our knowledge, only three cases of migration of an SVC stent to the pulmonary vasculature have previously been reported. None of these patients developed complications that resulted in death. We report a case of SVC stent migration to the pulmonary vasculature with delayed pulmonary artery thrombosis and death from pulmonary infarction. We conclude that early retrieval of migrated stents should be performed to decrease the risk of serious complications.

  20. [Placement of a central venous catheter in cases of persistent left superior vena cava].

    Science.gov (United States)

    Seemann, M; Zech, N; Kieninger, M; Graf, B; Künzig, H

    2014-03-01

    This article presents a case report on the placement of a central venous catheter (CVC) in a patient with an unknown persistent left superior vena cava (PLSVC). Normally, PLSVCs remain asymptomatic but can be associated with disastrous consequences for the patient during placement of a CVC particularly due to vascular perforation and pulmonary injury. A PLSCV is particularly common in association with congenital heart defects; however, otherwise healthy patients can also be affected. As the presence of a PLSCV is normally unknown special attention must be paid in every patient during placement of a CVC. PMID:24566941

  1. 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.

  2. "Caval Reconstruction for Lower-Extremity Sarcoma Metastasis Trapped within Inferior Vena Cava Filter".

    Science.gov (United States)

    Lajoie, Lidie; Benevenia, Joseph; Curi, Michael A

    2016-01-01

    This report describes the management of a hematogenously spread metastasis from a lower-extremity sarcoma found trapped within an inferior vena cava (IVC) filter. Although endovascular techniques for treating thrombosed IVC filters are successful in a majority of cases, the malignant nature of this lesion required a novel approach. In this unique case, the segment of infrarenal IVC with the thrombosed filter was resected and reconstruction performed with an interposition prosthetic graft. There were no early or late complications, and the patient remains clinically free of recurrence at 24-month follow-up. PMID:26381326

  3. 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.

  4. Residual Inferior Vena Cava Thrombus Detected by Transesophageal Echocardiography After Resection of a Malignant Adrenal Mass.

    Science.gov (United States)

    Burbano, Nelson H; Vlah, Claudene; Argalious, Maged

    2015-10-15

    A 43-year-old woman with a history of the Cushing syndrome secondary to adrenocortical carcinoma presented to the operating room for right adrenalectomy, hepatectomy, nephrectomy, and inferior vena cava (IVC) thrombectomy. Initial intraoperative transesophageal echocardiogram (TEE) confirmed the presence of an IVC tumor below the hepatic veins. Total vascular exclusion of the liver was necessary to perform the operation. A repeat TEE showed a residual thrombus within the IVC prompting an additional cavotomy to successfully remove the entire mass. The remainder of the procedure finalized uneventfully. The case highlights the importance of TEE monitoring for noncardiac surgery with thrombotic involvement of the IVC. PMID:26466307

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-01-15

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

  7. Right-sided superior vena cava draining into the left atrium: a rare anomaly of systemic venous return

    Energy Technology Data Exchange (ETDEWEB)

    Aminololama-Shakeri, Shadi; Wootton-Gorges, Sandra L.; Reyes, Melissa; Moore, Elizabeth H. [University of California Davis, Medical Center and Children' s Hospital, Department of Radiology, Sacramento, CA (United States); Pretzlaff, Robert K. [University of California Davis, Medical Center and Children' s Hospital, Department of Pediatrics, Sacramento, CA (United States)

    2007-03-15

    The most commonly encountered systemic thoracic venous anomaly is a persistent left superior vena cava that drains into the right atrium via the coronary sinus. A much rarer systemic venous anomaly is that of isolated anomalous drainage of a normally positioned right superior vena cava (RSVC) into the left atrium (LA). This has been reported in approximately 20 patients with the diagnosis usually being made by cardiac catheterization. We report the case of a toddler with asymptomatic hypoxemia resulting from anomalous drainage of a normal RSVC into his LA. This was diagnosed non-invasively by contrast-enhanced chest CT. (orig.)

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

    International Nuclear Information System (INIS)

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

  9. 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.

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

    Scientific Electronic Library Online (English)

    Juan F, Jaramillo; Mercy H, Estrada Perea; Yina Y, Muriel.

    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 cora [...] zón 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. Abstract in english 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.

  11. Surgical interruption of a left inferior vena cava following the transfemoral implantation of a permanent pacing lead.

    Science.gov (United States)

    Trigano, A J; Paganelli, F; Alimi, Y; Juhan, C

    1997-05-01

    This report describes the case of a patient in whom, after an unsuccessful attempt through the subclavian vein, a permanent pacing lead was inserted through the femoral vein and a left inferior vena cava with azygos continuation. The procedure was followed 4 months later by a pulmonary embolism complicating a right femoroiliac thrombosis. The patient was successfully treated by a percutaneous lead extraction procedure combined with an inferior vena caval surgical interruption. PMID:9170140

  12. 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.

  13. 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.

  14. Endovascular stenting in superior vena cava syndrome: utility of a through-and-through guidewire technique

    International Nuclear Information System (INIS)

    Objective: To describe an ancillary technique when a conventional femoral approach to superior vena cava (SVC) stent placement is not feasible because of buckling of balloon catheters or stent-deployment systems during device advancement. Patients and methods: Three patients in whom device advancement across the SVC lesion from a femoral or axillary approach was unsuccessful were managed by accessing the right jugular vein; SVC lesions were crossed from an antegrade direction, and the jugular guidewire was secured at the femoral access site to create a through-and-through guidewire. Results: Countertraction on the through-and-through guidewire during stent placement and dilation permitted unhindered advancement of stent delivery systems and catheters across the SVC. Technical and clinical success was achieved in each patient with relief of SVC syndrome within 24-72 hours. Survival ranged from 26 to 137 days. Conclusion: A through-and-through guidewire technique is useful when stenting a highly stenotic or thrombosed SVC in patients with superior vena cava syndrome. (author)

  15. Endovascular stenting in superior vena cava syndrome: utility of a through-and-through guidewire technique

    Energy Technology Data Exchange (ETDEWEB)

    Clark, T.W.I. [Dalhousie Univ., Queen Elizabeth II Health Sciences Centre, Section of Interventional Radiology, Dept. of Diagnostic Imaging, Halifax, NS (Canada)

    2000-08-01

    Objective: To describe an ancillary technique when a conventional femoral approach to superior vena cava (SVC) stent placement is not feasible because of buckling of balloon catheters or stent-deployment systems during device advancement. Patients and methods: Three patients in whom device advancement across the SVC lesion from a femoral or axillary approach was unsuccessful were managed by accessing the right jugular vein; SVC lesions were crossed from an antegrade direction, and the jugular guidewire was secured at the femoral access site to create a through-and-through guidewire. Results: Countertraction on the through-and-through guidewire during stent placement and dilation permitted unhindered advancement of stent delivery systems and catheters across the SVC. Technical and clinical success was achieved in each patient with relief of SVC syndrome within 24-72 hours. Survival ranged from 26 to 137 days. Conclusion: A through-and-through guidewire technique is useful when stenting a highly stenotic or thrombosed SVC in patients with superior vena cava syndrome. (author)

  16. 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 course of patients with SVCS and to avoid dilatation greater than 16 mm.

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

    Energy Technology Data Exchange (ETDEWEB)

    Fagedet, Dorothee, E-mail: DFagedet@chu-grenoble.fr [CHU de Grenoble, Clinique universitaire de medecine interne, Pole Pluridisciplinaire de Medecine (France); Thony, Frederic, E-mail: FThony@chu-grenoble.fr [CHU de Grenoble, Clinique universitaire de radiologie et imagerie medicale, Pole d' Imagerie (France); Timsit, Jean-Francois, E-mail: JFTimsit@chu-grenoble.fr [CHU de Grenoble, Clinique universitaire de reanimation, Pole Medecine Aiguee Communautaire (France); Rodiere, Mathieu, E-mail: MRodiere@chu-grenoble.fr [CHU de Grenoble, Clinique universitaire de radiologie et imagerie medicale, Pole d' Imagerie (France); Monnin-Bares, Valerie, E-mail: v-monnin@chu-montpellier.fr [CHRU Arnaud de Villeneuve, Imagerie Medicale Thoracique Cardiovasculaire (France); Ferretti, Gilbert R., E-mail: GFerretti@chu-grenoble.fr [CHU de Grenoble, Clinique universitaire de radiologie et imagerie medicale, Pole d' Imagerie (France); Vesin, Aurelien; Moro-Sibilot, Denis, E-mail: DMoro.pneumo@chu-grenoble.fr [University Grenoble 1 e Albert Bonniot Institute, Inserm U823 (France)

    2013-02-15

    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 course of patients with SVCS and to avoid dilatation greater than 16 mm.

  18. Pure Conventional Laparoscopic Radical Nephrectomy with Level II Vena Cava Tumor Thrombectomy

    Scientific Electronic Library Online (English)

    Mingshuai, Wang; Hao, Ping; Yinong, Niu; Junhui, Zhang; Nianzeng, Xing.

    2014-04-01

    Full Text Available The surgical management with laparoscopic technique for renal cell carcinoma with inferior vena cava tumor thrombus (IVTT) remains challenging and technically demanding in urological oncology. We present two patients with level II IVTT that were managed with pure conventional laparoscopic radical ne [...] phrectomy and thrombectomy. Two patients were diagnosed with a renal tumor with level II IVTT from December 2011 to January 2012. They both underwent pure conventional laparoscopic radical nephrectomy with thrombectomy. During these operations, intraoperative laparoscopic ultrasonography was used to detect the thrombus and ensure complete removal. Two patients were operated through retroperitoneal approach for right renal tumor and transperitoneal approach for left renal tumor respectively. The demographics, perioperative and follow-up data were recorded for the study. Both operations were successfully performed without conversion. They both had no radiographic evidence of recurrence during follow-up. It is concluded that it is feasible to manage renal cell carcinoma with level II IVTT through pure conventional laparoscopic approach in carefully selected patients, which might expand the indication for laparoscopic surgery. The pure laparoscopic approach in the treatment of renal cell carcinoma with level II vena cava tumor thrombus is challenging and requires advanced laparoscopic skills. Multicenter prospective randomized control trials are needed to prove the benefits of this approach.

  19. 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.

  20. Inferior venacaval compression due to excessive abdominal packing / Comprensión de la vena cava inferior debido al exceso de taponamiento abdominal / Compressão da veia cava inferior por causa do excesso de tamponamento abdominal

    Scientific Electronic Library Online (English)

    M.C.B., Santhosh; Rohini Bhat, Pai; Roopa, Sachidanand; Varun, Byrappa; Raghavendra P., Rao.

    2014-06-01

    Full Text Available Compressão da veia cava inferior é um problema comum no fim da gravidez. Também pode ocorrer por causa da compressão da veia cava inferior por tumores abdominais ou pélvicos. Relatamos um caso de compressão iatrogênica aguda da veia cava inferior por causa do excesso de tamponamento durante uma ciru [...] rgia intra-abdominal. Abstract in spanish La compresión de la vena cava inferior es un problema común al final del embarazo. También puede ocurrir debido a la compresión de la vena cava inferior por tumores abdominales o pélvicos. Relatamos un caso de compresión iatrogénica aguda de la vena cava inferior debido al exceso de taponamiento dur [...] ante una cirugía intraabdominal. Abstract in english Inferior venacaval compression is a common problem in late pregnancy. It can also occur due to compression of inferior venacava by abdominal or pelvic tumors. We report a case of acute iatrogenic inferior venacaval compression due to excessive abdominal packing during an intraabdominal surgery. [...

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

    International Nuclear Information System (INIS)

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

  2. Early and Late Retrieval of the ALN Removable Vena Cava Filter: Results from a Multicenter Study

    International Nuclear Information System (INIS)

    Retrieval of removable inferior vena cava (IVC) filters in selected patients is widely practiced. The purpose of this multicenter study was to evaluate the feasibility and results of percutaneous removal of the ALN removable filter in a large patient cohort. Between November 2003 and June 2006, 123 consecutive patients were referred for percutaneous extraction of the ALN filter at three centers. The ALN filter is a removable filter that can be implanted through a femoral/jugular vein approach and extracted by the jugular vein approach. Filter removal was attempted after an implantation period of 93 ± 15 days (range, 6-722 days) through the right internal jugular vein approach using the dedicated extraction kit after control inferior vena cavography. Following filter removal, vena cavograms were obtained in all patients. Successful extraction was achieved in all but one case. Among these successful retrievals, additional manipulation using a femoral approach was needed when the apex of the filter was close to the IVC wall in two patients. No immediate IVC complications were observed according to the postimplantation cavography. Neither technical nor clinical differences between early and late filter retrieval were noticed. Our data confirm the safety of ALN filter retrieval up to 722 days after implantation. In infrequent cases, additional endovenous filter manipulation is needed to facilitate extraction.

  3. Rationale and clinical effects of stent therapy and radiotherapy to superior vena cava syndrome, tracheobronchial stenosis, and esophageal stenosis or fistula due to malignant tumor

    Energy Technology Data Exchange (ETDEWEB)

    Kishi, Kazushi; Sato, Morio [Wakayama Medical Coll. (Japan)

    1998-06-01

    A total of 152 patients who underwent stent therapy or radiotherapy for the treatment of malignant superior vena cava syndrome, malignant tracheal stenosis, or malignant esophageal stenosis were retrospectively comparatively analyzed. Those response rates in superior vena cava syndrome were 93.3% in stent therapy, 61.7% in radiotherapy; respectively, 76.4% and 46.2%, in malignant tracheobronchial stenosis; 91.3% and 69.4% in malignant esophageal stenosis. Stent treatment for superior vena cava syndrome provided highest benefit among these strategies. (author). 60 refs.

  4. Rationale and clinical effects of stent therapy and radiotherapy to superior vena cava syndrome, tracheobronchial stenosis, and esophageal stenosis or fistula due to malignant tumor

    International Nuclear Information System (INIS)

    A total of 152 patients who underwent stent therapy or radiotherapy for the treatment of malignant superior vena cava syndrome, malignant tracheal stenosis, or malignant esophageal stenosis were retrospectively comparatively analyzed. Those response rates in superior vena cava syndrome were 93.3% in stent therapy, 61.7% in radiotherapy; respectively, 76.4% and 46.2%, in malignant tracheobronchial stenosis; 91.3% and 69.4% in malignant esophageal stenosis. Stent treatment for superior vena cava syndrome provided highest benefit among these strategies. (author). 60 refs

  5. 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.

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

    OpenAIRE

    João Carlos Coelho Filiio; Jorge Pereira; Álvaro Rabello Júnior

    1989-01-01

    The first case of mediastinal and pulmonary entomophthoromycosis with supe rior vena cava syndrome is reported. The patient presented with a history of edema of the face, neck and upper limbs as well as collateral circulation in the anterior wall of the chest. Histological examination of tissue from mediastinum revealed a granulomatous reaction with microabscesses surrounded by eosinophilic amorphous material and with broad hyphae in the center. Culture was not performed because a preliminary...

  7. Extensive Thrombosis of the Inferior Vena Cava and Left Renal Vein in a Neonate

    Science.gov (United States)

    Kdous, Moez; Khlifi, Oussema; Brahem, Marwene; Khrouf, Mohamed; Amari, Sarah; Ferchiou, Monia; Zhioua, Fethi

    2015-01-01

    Antenatal renal vein thrombosis is a rarely described diagnostic finding, with variable consequences on kidney function. We present the case of an affected fetus, born at 35-week gestation, with intrauterine oligohydramnios and two small kidneys. A renal ultrasound carried out after birth confirmed the presence of prenatal abnormalities. Renal vein thrombosis was not diagnosed at the time. The baby died 20 days later of kidney failure, metabolic acidosis, and polypnea with severe hypotrophy. Autopsy revealed atrophied kidneys and adrenal glands. The vena cava had thrombosis occupying most of its length. The right renal vein was normal, while the left renal vein was threadlike and not permeable. Histologically, there was necrosis of the left adrenal gland with asymmetrical bilateral renal impairment and signs of ischemic and hemorrhagic lesions. A review of thrombophilia was carried out and a heterozygous mutation in Factor V was found in both the mother and the child. PMID:26124971

  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. Significant caval penetration by the celect inferior vena cava filter: attributable to filter design?

    Science.gov (United States)

    Sadaf, Arifa; Rasuli, Pasteur; Olivier, Andre; Hadziomerovic, Adnan; French, Gordon J; Aquino, Jose; O'Kelly, Kevin; Al-Mutairi, Badr

    2007-11-01

    This report describes transmural penetration of the inferior vena cava (IVC) by a newly introduced IVC filter within 9 days of its placement. A computed tomographic study demonstrated filter penetration with one of the primary struts lodging in the uncinate process of the pancreas. Because of the close resemblance of this new filter to another filter that has not been associated with penetration injuries, the key differences between the two designs were examined and the determination was made that the new filter, unlike the older one, has unprotected primary struts. Only filters with an unprotected primary strut design have been associated with penetration injuries such as the one described in this case. PMID:18003998

  10. Complete Surgical Resection of a Leiomyosarcoma Arising from the Inferior Vena Cava

    Science.gov (United States)

    Sonoda, Hirofumi; Minamimura, Keisuke; Endo, Yuhei; Irie, Shoichi; Hirata, Toru; Kobayashi, Takashi; Mafune, Ken-ichi; Mori, Masaya

    2015-01-01

    A 76-year-old Japanese man was referred to our hospital with chief complaint of right hypochondoralgia. Abdominal ultrasound showed a retroperitoneal tumor in the suprarenal region of the right kidney. Computed tomography revealed an enhanced lobular tumor with irregular, circumscribed, and indistinct border. Ultrasound-guided biopsy was performed. The tumor consisted of spindle-shaped cells with a giant nucleus and multinuclear cells. The diagnosis was leiomyosarcoma by immunohistochemical staining. The patient underwent surgery accessed by a right eighth intercostal thoracoabdominal incision. The tumor was completely resected, accompanied by removal of the posterosuperior segment of the right hepatic lobe, right adrenal gland, and a portion of the inferior vena cava (IVC). The histopathologic diagnosis was leiomyosarcoma arising from the IVC. We present a rare case of a successfully managed leiomyosarcoma of the IVC. This case suggests the importance of curative surgical resection of the tumor due to low efficacy of adjuvant chemotherapy for leiomyosarcoma. PMID:26167180

  11. Influence of transmural pressure on retrograde pressure pulse transmission velocity in the canine superior vena cava.

    Science.gov (United States)

    Minten, J; Van de Werf, F; Aubert, A E; Kesteloot, H; De Geest, H

    1984-11-01

    The influence of intrathoracic and intraluminal pressure on venous pressure pulse propagation velocity in the superior vena cava was investigated in acute canine experiments. The propagation velocity of distinct points of the venous pressure curve was measured under different conditions of preload, during expiratory and inspiratory apnea and during positive-negative pressure respiration. Under control conditions transmission velocities varied from 1.07 m/s to 3.29 m/s. After volume expansion propagation velocities rose significantly and varied from 1.09 m/s to 6.48 m/s. During expiratory apnea and at peak negative expiratory pressure, the propagation speed of distinct pressure points was higher than during inspiratory apnea and at peak positive inspiratory pressure. Significant linear correlation coefficients were found between the transmission velocities of different distinct pressure points and the transmural pressure, but not between the propagation speed and the intraluminal pressure. PMID:6085251

  12. 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.

  13. 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)

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

    International Nuclear Information System (INIS)

    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 192Ir. 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)

  15. 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

  16. Dorsal cavoatrial bypass graft for coarctation of inferior vena cava-trial of aortic occlusion technique.

    Science.gov (United States)

    Victor, S; Jayanthi, V; Alagesan, R; Kandasamy, I; Madanagopalan, N

    1991-01-01

    Male aged 28, presented with coarctation of inferior vena cava (IVC) causing chronic Budd-Chiari syndrome (CBCS). The coarcted IVC was exposed by transthoracic, transdiaphragmatic, retroperitoneal approach. There was no evidence of inflammation or compression. Venotomy was done immediately below the coarctation after clamping the descending aorta above the diaphragm. Distal IVC was occluded with a Fogarty balloon catheter passed through the venotomy. There was no flow through hepatic veins. But a dry field was not obtained because of bleeding from the systemic collaterals draining into IVC above the venotomy. Hence the veno-tomy was sutured. Dorsal cavoatrial bypass (DCAB) was done anastomosing the graft, end to side of IVC at a lower level, after partial clamping of IVC. Cross clamping the descending aorta appears to be a useful technique for surgery of retrohepatic IVC to arrest blood flow from distal IVC and hepatic veins. PMID:1841453

  17. Transcatheter closure of patent ductus arteriosus and interruption of inferior vena cava with azygous continuation using an Amplatzer duct occluder II

    Directory of Open Access Journals (Sweden)

    Koh Ghee

    2009-01-01

    Full Text Available We report a case of transcatheter closure of patent ductus arteriosus using the new Amplatzer duct occluder II in an adult patient with interrupted inferior vena cava with azygous continuation via the femoral artery approach.

  18. Giant saphenous vein graft pseudoaneurysm to right posterior descending artery presenting with superior vena cava syndrome.

    Science.gov (United States)

    Vargas-Estrada, Andres; Edwards, Dianna; Bashir, Mohammad; Rossen, James; Zahr, Firas

    2015-06-26

    Saphenous vein grafts (SVG) pseudoaneurysms, especially giant ones, are rare and occur as a late complication of coronary artery bypass grafting. This condition affects both genders and typically occurs within the sixth decade of life. The clinical presentation ranges from an asymptomatic incidental finding on imaging studies to new onset angina, dyspnea, myocardial infarction or symptoms related to compression of neighboring structures. An 82-year-old woman presented with acute onset back pain, dyspnea and was noted to have significantly engorged neck veins. In the emergency department, a chest computed tomographic angiogram with intravenous contrast revealed a ruptured giant bilobed SVG pseudoaneurysm to the right posterior descending artery (RPDA). This imaging modality also demonstrated compression of the superior vena cava (SVC) by the SVG pseudoaneurysm. Coronary angiogram with bypass study was performed to establish the patency of this graft. Endovascular coiling and embolization of the SVG to RPDA was initially considered but disfavored after the coronary angiogram revealed preserved flow from the graft to this arterial branch. After reviewing the angiogram films, a surgical strategy was favored over a percutaneous intervention with a Nitinol self-expanding stent since the latter would have not addressed the superior vena cava compression caused by the giant pseudoaneurysm. Intraoperative transesophageal echocardiogram demonstrated SVC compression by the giant pseudoaneurysm cranial lobe. Our patient underwent surgical ligation and excision of the giant pseudoaneurysm and the RPDA was regrafted successfully. In summary, saphenous vein grafts pseudoaneurysms can be life-threatening and its therapy should be guided based on the presence of mechanical complications, the patency of the affected vein graft and the involved myocardial territory viability. PMID:26131340

  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. Venous collateralisation via vasa vasorum after neoplastic thrombosis of renal vein and inferior vena cava mediated by the ovarian vein from an occult uterine carcinoma

    International Nuclear Information System (INIS)

    Renal vein and inf. vena caval occlusion by neoplasticthrombus mediated by the ovarian vein from an occult uterine carcinoma is an extraordinary diagnosis. The special angiographic feature consists in demonstrating the renal venous drainage via vasa vasorum of the renal vein and inf. vena cava. (orig.)

  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. CT diagnosis of membranous obstruction of the hepatic segment of the inferior vena cava (primary Budd-Chiari syndrome)

    International Nuclear Information System (INIS)

    Five cases of primary Budd-Chiari syndrome were examined by CT. In all cases CT demonstrated enlargement of the caudate lobe of the liver, reticular low density in the liver parenchyma, splenomegaly and collateral channels via the ascending lumbar vien-the azygos system. In two cases patchy calcification was shown near the hepatic segment of the inferior vena cava. Reticular low density corresponded to fibrosis or cirrhosis of the liver parenchyma pathologically. In one case shrinkage of collaterals was seen after angioplasty. Our result suggested that CT was very useful in the diagnosis, evaluation and follow-up of primary Budd-Chiari syndrome nevertheless membranous obstruction of the inferior vena cava was not demonstrated birectly. (author)

  3. Retroperitoneal schwannoma between the inferior vena cava and the abdominal aorta resected by laparoscopic surgery: A case report.

    Science.gov (United States)

    Nishizawa, Nobuyuki; Kumamoto, Yusuke; Hirata, Mitsuhiro; Watanabe, Masahiko

    2015-08-01

    A 22-year-old woman presented with backache. Imaging analysis revealed a retroperitoneal tumor, 40?mm in diameter, surrounded by the abdominal aorta, inferior vena cava, caudate lobe of liver, and the left renal vein. The tumor consisted of multilocular cystic parts, and a solid part showed contrast enhancement. The possibility of malignancy could not be excluded, so we planned a laparoscopic tumorectomy. After placement of a transjugular vascular sheath for an occlusion balloon catheter in the inferior vena cava, the operation was performed with six ports. There was a strong fibrotic adhesion between the tumor and the abdominal aorta, with other weak adhesions. The tumor was successfully resected by a laparoscopic operation with minimal bleeding. The histopathological diagnosis was a benign schwannoma. This case demonstrates that a retroperitoneal tumor adjacent to major vessels can be resected safely by laparoscopic surgery if the surgeon is especially careful of the possibility of accidental bleeding. PMID:26303739

  4. Relationship between the impact of blood flow, diaphragm movement and the pathogenesis of membranous obstruction of inferior vena cava

    International Nuclear Information System (INIS)

    Objective: To explore the relationship between the impact of blood flow (the flow from right atrium and hepatic vein), diaphragm movement and the pathogenesis of membranous obstruction of inferior vena cava (MOVC). Methods: Twenty cadavers were involved, measuring widths of inferior vena cava (IVC)at the diaphragmatic hiatus and the thoracic cage; and taking the IVC segment between the diaphragmatic hiatus and hepatic vein for tissue examination of IVC intimal thickness and type I collagen accumulation as group A and comparing with those of IVC above level of renal vein in Group B. Results: IVC intimal thickness and type I collagen distribution area of Group A were greater than those of group B, showing statistically significant difference (P<0.05); and no correlation existed with those of group A, regarding the widths of diaphragmatic hiatus. Conclusion: The pathogenesis of MOVC involves the impact role of blood flow and diaphragm movement; and the latter would be the main key. (authors)

  5. Repeat hepatectomy with inferior vena cava re-resection for colorectal liver metastases: case report and review of the literature.

    Science.gov (United States)

    Marangoni, Gabriele; Hakeem, Abdul; Khan, Atif; Rotimi, Olorunda; Lodge, J Peter

    2015-11-01

    Liver resection in patients with inferior vena cava (IVC) involvement is becoming more common with the adoption of vascular exclusion techniques and replacement of the IVC. Repeat hepatectomy and an aggressive surgical approach can offer satisfactory disease-free survival and a cure in selected patients. We herein describe a case of repeat hepatectomy with en bloc re-do IVC resection and reconstruction with Gore-Tex graft for recurrent colorectal liver disease. The patient had previously undergone non-anatomical right liver resection with IVC partial excision and reconstruction with a porcine pericardial patch. The patient is currently disease-free at 12 months' follow-up. Surgical treatment of liver tumors involving the IVC offers the only hope for prolonged survival. Re-do liver surgery with concomitant re-excision of the IVC is feasible and can be contemplated when macroscopic removal of the tumor is expected. Management of these complex cases by a specialist team with expertise in liver transplantation and vascular techniques is advised. PMID:25466296

  6. Endovascular stent-graft placement for the treatment of the aneurysm of the superior vena cava : a case report

    International Nuclear Information System (INIS)

    Venous aneurysm of the superior vena cava (SVC) is a rare congenital lesion and can be classified morphologically as either fusiform or saccular. Although there is a controversy with regard to the need for either conservative or surgical treatment, surgery is recommended for the saccular types as major complications of the aneurysm may occur. We report a case of saccular aneurysm of the SVC, treated by means of an endoluminal stent-graft. (author)

  7. Endovascular stent-graft placement for the treatment of the aneurysm of the superior vena cava : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Gyeong Ip; Jung, Gyoo Sik; Park, Sung Dal; Huh, Jin Do; Joh, Young Duk [Medical College of Kosin University, Pusan (Korea, Republic of)

    2000-01-01

    Venous aneurysm of the superior vena cava (SVC) is a rare congenital lesion and can be classified morphologically as either fusiform or saccular. Although there is a controversy with regard to the need for either conservative or surgical treatment, surgery is recommended for the saccular types as major complications of the aneurysm may occur. We report a case of saccular aneurysm of the SVC, treated by means of an endoluminal stent-graft. (author)

  8. 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; DE 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 ...

  9. Double inferior vena cava in a patient with bilateral testicular tumor: A case report with review of literature

    OpenAIRE

    Satheesan B; Suresh Kumar D; Kathiresan N

    2009-01-01

    Double inferior vena cava (IVC) is a rare developmental anomaly of IVC with a prevalence rate of 0.2-0.3%. Preoperative identification of major vascular anomalies is of paramount importance for a retroperitoneal surgeon. In addition, more anomalies are to be expected in those situations. Radiological studies in similar cases may be reported as retroperitoneal lymph nodes or masses if the radiologist is unaware. In this case report, a patient with bilateral testicular tumor with double ...

  10. Endovascular therapy of acute tumour-related obstruction of the superior vena cava using a self-expanding Nitinol stent

    Directory of Open Access Journals (Sweden)

    Peter Kamusella

    2013-11-01

    Full Text Available Objective: To evaluate, in a retrospective study, the clinical efficacy and safety of the self-expanding Nitinol stent in the superior vena cava to alleviate upper venous congestion.Method: In 22 patients (15 men, 7 women, a tumour-related compression of the superior vena cava was diagnosed by spiral CT after intravenous application of contrast medium. Clinically, acute superior vena cava syndrome was found in all patients. Histologically, a bronchial carcinoma was present in 14/22, a lymphoma in 6/22, and mediastinal lymphnode metastases (1 breast carcinoma, 1 malignant melanoma in 2/22. After a transfemoral approach, cavography was initially performed. The degree of stenosis was classified according to the Stanford classification. In accordance with the degree of stenosis, a self-expanding Nitinol stent was placed.Results: Endovascular stent implantation was conducted without complications in all patients. A marked improvement in acute symptoms was observed clinically within 24 hours in all patients. In the follow-up period of up to 2 years, there were no cases of stent migration. In 7/22 patients, the CT follow-ups revealed tumour progression (3/7 after 3 months, 2/7 after 6 months, and 2/7 after 12 months with evidence of residual stenosis caused by tumour growth through the stent mesh. During the follow-up period, 15/22 patients died (mean survival 6.4 months.Conclusion: Self-expanding Nitinol stents provide endovascular therapy for superior vena cava syndrome, having a high radial expansive force and the facility to be placed precisely, and alleviating acute, life-threatening symptoms in the palliative situation.

  11. Successful recanalization of occluded intrahepatic inferior vena cava in post-liver transplant Budd-Chiari syndrome.

    Science.gov (United States)

    Garg, Deepak; Lopera, Jorge Enrique

    2013-07-01

    Budd-Chiari syndrome following a liver transplant is an uncommon phenomenon. We present a case of endovascular management of a focal circumferential inferior vena cava (IVC) occlusion at the anastomosis that developed 10 years after orthotopic liver transplantation. It was successfully recanalized using the stiff end of the guidewire and percutaneous transluminal angioplasty with a high-pressure balloon. During a 14-month follow up, the IVC remained patent and did not require further intervention. PMID:23475545

  12. Percutaneous closure of patent ductus arteriosus via internal jugular vein in patient with interrupted inferior vena cava

    Directory of Open Access Journals (Sweden)

    Patel Nehal

    2009-01-01

    Full Text Available Transcatheter closure of patent ductus arteriosus (PDA using various occluders and coils via femoral vein is a well established therapeutic option. However, in patients with interrupted inferior vena cava (IVC it is not feasible to close the PDA percutaneously using traditional methods. We present a nine-year-old girl with IVC interruption in whom percutaneous closure of PDA was successfully accomplished via the transjugular approach.

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

    Directory of Open Access Journals (Sweden)

    Farzanah I. Ismail

    2014-04-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Farzanah I. Ismail

    2014-05-01

    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.

  15. Deep venous thrombosis caused by congenital inferior vena cava agenesis and heterozygous factor V Leiden mutation – a case report

    OpenAIRE

    Vasco, Pablo Guisado; López, Angel Ruedas; Piñeiro, María Laiño; Rivera, José Ignacio Gallego

    2009-01-01

    The unusual clinical presentation, importance of imaging techniques and role of low molecular weight heparin are described for an initial treatment of thrombosis in inferior vena cava agenesis associated with heterozygous factor V Leiden. The patient, a 36-year-old woman, presented to the emergency room with sudden onset of back pain, swelling of the legs and thighs, and claudication while walking. Abdominal ultrasonography was immediately ordered. Anomalies in vascular blood flow were detect...

  16. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  18. 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.

  19. 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.

  20. 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 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.

  1. Experiência preliminar com novo filtro de veia cava: resultados de 15 implantes / Preliminary experience with a new vena cava filter: results of 15 implantations

    Scientific Electronic Library Online (English)

    Winston B., Yoshida; Hamilton A., Rollo; Mariângela, Giannini; Marcone L., Sobreira; Regina, Moura.

    2008-09-01

    Full Text Available Este estudo apresenta resultados preliminares obtidos com um novo filtro permanente de veia cava, baseado no desenho de Greenfield, com três hastes prolongadas de um total de seis, para dar estabilidade central ao filtro na luz da veia cava. Neste artigo, relatamos sua avaliação clínica preliminar q [...] uanto à aplicabilidade, eficácia e segurança. De agosto de 2004 a dezembro de 2006, 15 filtros foram implantados em nove homens e seis mulheres, com idades variando de 38 a 79 anos (média de 57,8 anos). O acesso foi feito sempre por via transjugular. As indicações foram: trombose venosa proximal, com contra-indicação de anticoagulação em 12 pacientes; complicações hemorrágicas com anticoagulação em dois pacientes; e embolia pulmonar, apesar de anticoagulação adequada, em um paciente. Os filtros foram avaliados quanto à liberação, inclinação, mau posicionamento e perfuração de cava. No seguimento, avaliou-se trombose no local de acesso, tromboembolismo venoso recorrente, migração do filtro e trombose de cava pelo ultra-som. Nenhum paciente recebeu anticoagulantes no seguimento. O filtro foi liberado com sucesso em todos os casos sem mau posicionamento, inclinação, perfuração ou trombose de acesso. Os pacientes foram seguidos entre 3 e 23 meses (média de 11 meses). Nenhum paciente teve recorrência de tromboembolismo venoso. Não houve casos de trombose de veia cava ou migração do filtro. Óbito ocorreu em sete casos, todos relacionados com a moléstia de base. Os resultados preliminares indicam potencial eficácia e segurança do uso do novo filtro no período estudado. Abstract in english This study presents preliminary results obtained from a new permanent filter, based on Greenfield's filter design, with prolongations on three of six struts to stabilize it centrally in the vena caval lumen. The preliminary clinical evaluation of the filter with regard to feasibility, efficacy and s [...] afety is reported. From August 2004 to December 2006, 15 vena cava filters were deployed in nine men and six women, who ranged in age from 38 to 79 years (mean, 57.8 years). The approach used was always transjugular. Indications for filter placement were proximal deep venous thrombosis with a contraindication to anticoagulation in 12 patients; hemorrhagic complications with anticoagulation in two patients; and pulmonary embolism, despite adequate anticoagulation in one patient. New vena cava filters were evaluated for releasing, tilting, malpositioning and caval perforation. Follow-up included assessment of access site thrombosis and filter migration, recurrent venous thromboembolism, and caval thrombosis by duplex ultrasound. No patient received anticoagulants in the follow-up. In all patients the filter was successfully released, with no malpositioning, tilting, perforation or access thrombosis. The patients were followed for 3 to 23 months (mean = 11 months). No patient developed recurrent venous thromboembolism. No other patients developed inferior vena cava thrombosis or filter migration. Death occurred in seven patients, all related to baseline illness. This preliminary study suggests good feasibility and safety of the new filter up to the observation period.

  2. 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.

  3. Failed Retrieval of an Inferior Vena Cava Filter During Pregnancy Because of Filter Tilt: Report of Two Cases

    International Nuclear Information System (INIS)

    Thromboembolic disease during pregnancy is an important cause of obstetric morbidity and mortality. Pregnant patients with venous thromboembolism are usually managed by conventional anticoagulation. However, this must be discontinued during vaginal or caesarian delivery to avoid haemorrhage and to reduce the risk of possible epidural haematoma. Retrievable inferior vena cava filters (IVCFs) offer protection against pulmonary embolism during this high-risk period, when anticoagulation is discontinued, while avoiding potential long-term sequelae of a permanent IVCF. Here we report two patients who presented in the third trimester of pregnancy with floating ileofemoral deep vein thrombosis. Both patients were initially treated with standard anticoagulation; however, shortly before delivery both patients had a retrievable IVCF placed in a suprarenal position. In both patients, retrieval failed at 28 days after insertion because of filter tilt. The timing and mechanism of filter tilt remains uncertain. We believe that a number of factors could have been involved, including change in the anatomic configuration with lateral displacement of the IVCF as a result of the gravid uterus as well as forceful uterine contractions during labour, which modified the shape and diameter of the IVC. We showed that failure to retrieve the IVCF has had considerable implications for the two young patients regarding long-term anticoagulation and have highlighted the need for further clinical trials regarding the safe use of retrievable IVCFs during pregnancy.

  4. 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 <30 years of age with unprovoked lower limb 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

  5. Predictors of Mortality in Patients with Penetrating Inferior Vena Cava Injuries Surviving to the Operating Room.

    Science.gov (United States)

    Maciel, James D; Plurad, David; Gifford, Edward; deVirgilio, Christian; Koopmann, Matt; Neville, Angela; Putnam, Brant; Kim, Dennis Y

    2015-10-01

    Inferior vena cava (IVC) injuries are associated with significant morbidity and mortality. To identify clinical factors associated with mortality in patients undergoing operative intervention for penetrating IVC injuries, a retrospective review of 98 patients was performed, excluding blunt injuries (n = 20) and deaths before surgery (n = 16). The overall mortality was 58 per cent. Nonsurvivors more commonly presented with hypotension (50% vs 23%, P = 0.03) and underwent resuscitative thoracotomy more frequently (42% vs 4%, P = 0.01). Retrohepatic injuries were more common among nonsurvivors (P = 0.04). There was no difference in the use of ligation (7% vs 17%, P = 0.29) or the massive transfusion protocol (35% vs 25%, P = 0.41). On multivariate analysis, after controlling for mechanism of injury, admission hypotension, Glasgow Coma Scale score , preoperative cumulative fluids, resuscitative thoracotomy , absence of spontaneous tamponade, and location of IVC injury, the only independent predictor of mortality was the absence of spontaneous tamponade at the time of laparotomy (odds ratio = 5.4, 95% confidence interval: 1.11-25.95; P = 0.04). Penetrating IVC injuries continue to be associated with a high mortality, particularly among patients with free intraabdominal hemorrhage at laparotomy. Large multicenter studies are required to define the optimal resuscitative and operative management techniques in these severely injured patients. PMID:26463297

  6. Bird's nest versus the Kimray-Greenfield inferior vena cava filter: Randomized clinical study

    International Nuclear Information System (INIS)

    A randomized clinical study was conducted comparing the percutaneously introduced bird's nest inferior vena cava (IVC) filter and the Kimray-Greenfield IVC filter. Study end points included recurrent pulmonary embolism, new or worse leg venous stasis symptoms, IVC thrombosis, and ease of filter introduction. Of the 109 patients in the study, 58 were randomly assigned to the BN and 51 to the KG filter. Demographic factors were comparable between the two groups. Follow-up entailed cavography, noninvasive assessment of the femoral veins, and standardized telephone interviews. The follow-up period was extended to 1 year after filter insertion. Results for the bird's nest versus the Kimray-Greenfield filter respectively were as follows: death due to massive pulmonary embolism, 3% versus 5%; recurrent pulmonary embolism, 1.5% versus 7.5%; filter migration, 1.1% versus 0.0%; IVC thrombosis, 6% versus 2.5%; new or worse leg edema, 28.5% versus 22%; ease of introduction (qualitative), maximal versus minimal; patient discomfort (qualitative), minimal versus maximal. The authors conclude the bird's nest filter is better than the Kimray-Greenfield filter in terms of prevention of recurrent pulmonary embolism and ease of introduction. In terms of venous stasis, the bird's nest filter is not better and may be worse than the Kimray-Greenfield filter. Filter migration is a problem with the bird's nest filter

  7. Interventional treatment of lung cancer complicated with superior vena cava syndrome

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical value of expansible metallic stent implantation with transcatheter arterial chemoembolization in the treatment of superior vena cava syndrome (SVCS)due to primary lung carcinoma. Methods: 28 patients with SVCS due to lung cancer were clearly diagnosed with spiral CT and venography. Stents were placed in the SVC only when the pressure was over 22 mmHg in the distal part; in case of thrombosis, the initial treatment of choice was anticoagulation and local thrombolysis through infusion catheters. Angioplasty and stenting were performed through antecubital vein or femoral vein after the thrombi had been dissolved. Transcatheter arterial chemoembolization was carried out before and after the stent implanted. Results: 30 stents were successfully implanted in 28 patients. Acute thrombosis occurred in 3 cases after the procedure and cured by local thrombolytic therapy; pulmonary embolization in 2 cases with symptoms relieved alter anticoagulation, thrombolysis and aspiration; and 1 case recurred 3 months after the stent implantation was successfully treated with a second stent placement. Other cases had no recurrence of SVCS during their survival periods. Conclusions: Expansible metallic stent implantation combined transcatheter arterial chemoembolization is rapidly effective, minimally invasive and less complication for SVCS caused by primary lung carcinoma, with obvious improvement of patient's survival quality. (authors)

  8. Gigantic coronary sinus associated with concurrent persistent left superior vena cava and right ventricular volume overload.

    Science.gov (United States)

    Krim, Selim R; Jiang, Aibo F; Vivo, Rey P; Little, Stephen H; Chang, Su Min

    A 76-year-old women with known atrial fibrillation and congestive heart failure presented with increasing shortness of breath. A 2-dimensional (2-D) transthoracic echocardiogram was performed to assess left ventricular function. An incidental finding of a very large coronary sinus with a diameter of 4.8 cm was seen, raising a suspicion for the possibility of a persistent left superior vena cava (PLSVC) (Figure 1). Additional pertinent positive findings included a massively dilated right atrium (estimated volume: 538 mL), dilated tricuspid annulus with poor leaflet coaptation, severe tricuspid regurgitation, and pulmonary artery systolic pressure (PASP) of 50 mmHg with an estimated mean right atrial pressure (RAP) of 25 mmHg. After agitated saline administration into the left brachial vein, there was immediate and sequential opacification of the dilated coronary sinus, right atrium, and right ventricle, confirming the presence of a PLSVC (Figure 2). CT angiography provided detailed anatomical and morphological characterization demonstrating drainage of the PLSVC into the gigantic coronary sinus and right-sided cardiac chambers and absence of other vascular or congenital anomaly (Figures 3 and 4). PMID:21088659

  9. Use of a temporary inferior vena cava filter during pregnancy in patients with thromboembolic events.

    Science.gov (United States)

    González-Mesa, E; Azumendi, P; Marsac, A; Armenteros, A; Molina, N; Narbona, I; Herrera, J; Artero, I; Rodríguez-Mesa, J M

    2015-11-01

    There are circumstances in the management of thromboembolic events during pregnancy when anticoagulant therapy is either contraindicated or not advisable, such as when pulmonary embolism (PE) or deep venous thrombosis is diagnosed close to term, given the risk of bleeding during delivery. In these cases, the thromboembolic risk can be controlled using temporary inferior vena cava filters (T-IVCFs). We present the case of a pregnant woman with thrombophilia who remained at rest for eight weeks due to an amniotic prolapse and for whom the placement of a T-IVCF was decided at 32 weeks' gestation after anticoagulant therapy had failed. An emergency caesarean section was performed at 33 weeks' gestation due to placental abruption following the spontaneous onset of preterm labour. The risk of bleeding during delivery when high doses of heparin are used, and the risk of PE when the heparin dose is decreased, needs to be evaluated versus the risks related to T-IVCF placement procedure and, as such, a review of the published experience in this field is warranted. We have concluded that T-IVCFs can be a safe alternative treatment for pregnant women in whom anticoagulation therapy is either contraindicated or not advisable. PMID:25692613

  10. 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.

  11. 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.

  12. Carcinoma de células renales con extensión a vena cava: puesta al día y revisión de nuestra casuística / Renal cell carcinoma with vena cava involvement: update and review of our series

    Scientific Electronic Library Online (English)

    Fernando, Vázquez Alonso; Francisco J., Vicente de Prados; José M., Cózar Olmo; Manrique, Pascual Geler; Francisco J., Rodríguez Herrera; Antonio, Martínez Morcillo; Eduardo, Espejo Maldonado; Miguel, Tallada Buñuel.

    2009-05-01

    Full Text Available Objetivo:Valorar la situación actual en el tratamiento del carcinoma renal con extensión a vena cava inferior (VCI): Clasificación, diagnóstico, abordaje quirúrgico, terapia adyuvante, factores de pronóstico y supervivencia. Materiales y Métodos: Se revisan 19 casos de carcinomas renales con extensi [...] ón a VCI intervenidos entre enero de 1988 y agosto de 2008. Se valoran la edad, el sexo, lateralidad y función renal de los pacientes. Con respecto al tumor se valoran: estadio según TNM y la clasificación de Neves-Zincke. Se describe el abordaje quirúrgico según el nivel del trombo. Resultados: Con una tasa de mortalidad perioperatoria del 10.5% y una media de seguimiento de 22,65 meses (rango 2-79), sobreviven 5 pacientes; 11 han fallecido por la enfermedad; uno por otra causa y 2 se han perdido. Los pacientes metastásicos han recibido tratamiento adyuvante con Inmunoterapia o inhibidores de las kinasas. La supervivencia media es de 15,1 meses. Existen diferencias significativas a tres y cinco años en la supervivencia de los pacientes estadiados como N0M0 vs resto (N+M0, N0M+, N+M+). No hay diferencias en función del nivel del trombo. Conclusiones: El carcinoma renal con trombo en VCI es un tumor con alta mortalidad. El abordaje quirúrgico del mismo es la opción más valida y precisa una correcta valoración prequirúrgica y el apoyo de un equipo multidisciplinar preparado y con experiencia. La supervivencia depende de la extensión de la enfermedad. Abstract in english Objective: To assess current management of renal cell carcinoma (RCC) extending into the inferior vena cava (IVC): staging, diagnosis, surgical approach, adjuvant therapy, prognostic factors and survival rate. Materials and Methods: Nineteen cases of RCC extending into the IVC undergoing surgical re [...] section from January 1988 to August 2008 were reviewed. TNM staging and Neves-Zincke grading of the tumor were also assessed. Surgical approach depended on thrombus level. Results: With a perioperative mortality rate of 10.5% and a mean follow-up of 22.65 months (range 2-79), 5 patients are still alive, while 11 patients died from the disease, 1 from an unrelated cause, and 2 were lost to follow-up. Patients with metastatic disease received adjuvant treatment with immunotherapy or kinase inhibitors. Mean survival was 15.1 months. Significant differences were found in 3- and 5-year survival rates in patients staged as N0M0 as compared to all other stages (N+M0, N0M+, N+M+). No differences were found depending on thrombus level. Conclusions: RCC with thrombus in the IVC is a tumor with a high mortality rate. Surgery continues to be the best option, and requires adequate preoperative evaluation and the support of an experienced and well trained multidisciplinary team. Survival depends on disease extension.

  13. Inferior Vena Cava Oxygen Saturation during the First Three Postnatal Days in Preterm Newborns with and without Patent Ductus Arteriosus

    Science.gov (United States)

    Yapakç?, Ece; Ecevit, Ay?e; ?nce, Deniz Anuk; Gökdemir, Mahmut; Tekindal, M. Agah; Gülcan, Hande; Tarcan, Aylin

    2014-01-01

    Background: Inferior vena cava (IVC) oxygen saturation as an indicator of mixed venous oxygenation may be valuable for understanding postnatal adaptations in newborn infants. It is unknown how this parameter progresses in critically ill premature infants. Aims: To investigate IVC oxygen saturation during the first three days of life in preterm infants with and without patent ductus arteriosus (PDA). Study Design: Case-control study. Methods: Twenty-seven preterm infants were admitted to the Neonatal Intensive Care. Preterm infants with umbilical venous catheterization were included in the study. Six umbilical venous blood gas values were obtained from each infant during the first 72 hours of life. Preterm infants in the study were divided into two groups. Haemodynamically significant PDA was diagnosed by echocardiography in 11 (41%) infants before the 72nd hour of life in the study group and ibuprofen treatment was started, whereas 16 (59%) infants who didn’t have haemodynamically significant PDA were included in the control group. Results: In the entire group, the highest value of mean IVC oxygen saturation was 79.9% at the first measurement and the lowest was 64.8% at the 72nd hour. Inferior vena cava oxygen saturations were significantly different between the study and control groups. Post-hoc analysis revealed that the first and 36th hour measurements made the difference (p=0.01). Conclusion: Inferior vena cava oxygen saturation was found to be significantly different between preterm infants with and without PDA. Further studies are needed to understand the effect of foetal shunts on venous oxygenation during postnatal adaptation in newborn infants. PMID:25337418

  14. Uso de balão intra-hepático para controle temporário da hemorragia em lesão da veia cava retro-hepática / Intrahepatic balloon tamponade for temporary control of retrohepatic vena cava injury bleeding

    Scientific Electronic Library Online (English)

    João Eduardo Leal, Nicoluzzi; Marlon, Rangel; Luís Carlos, VonBahten.

    2007-06-01

    Full Text Available [...] Abstract in english Juxtahepatic veins, retrohepatic vena cava or major hepatic veins injuries carry a very high mortality rate regardless the technique used for its repair. Isolated survivor reports have for the most part been managed by vascular isolation techniques, usually with atriocaval shunt. We report one case [...] with a unique management technique in a patient who sustained gunshot wound to the retrohepatic vena cava. Hemorrhage control had been obtained by intrahepatic balloon tamponade after others maneuvers have failed. The balloon was left in situ for two days as damaged control laparotomy principles and planned reoperation has been chosen.

  15. Implante de filtro de veia cava com uso de dióxido de carbono como meio de contraste: série de casos / Carbon dioxide use as contrast for vena cava filter implantation: case series

    Scientific Electronic Library Online (English)

    Matheus Pessanha de, Rezende; Bernardo, Massière; Arno von, Ristow; Alberto, Vescovi; Alexandre A., Duarte; Daniel A., Drummond; Leonardo, Stambovsky; Antonio Luiz de, Medina.

    2012-03-01

    Full Text Available OBJETIVO: Avaliar o resultado do implante de filtro em veia cava inferior empregando angiografia digital por subtração com dioxide de carbono (CO2) como meio de contraste. MÉTODOS: No período de abril de 2010 a fevereiro de 2011, sete pacientes foram submetidos ao implante de filtro na veia cava inf [...] erior, utilizando-se CO2 como meio de contraste em subtração digital. Os pacientes apresentaram como critério de inclusão trombose venosa profunda no setor ilíaco-femoral e contraindicação à anticoagulação. RESULTADOS: Foi obtido sucesso técnico em todos os casos, com adequada visualização da veia cava e veias renais, não havendo complicações relacionadas ao uso do CO2 ou ao procedimento. CONCLUSÃO: O implante de filtro de veia cava utilizando o CO2 como meio de contraste é segura e efetiva em pacientes portadores de alergia ao contraste iodado ou com insuficiência renal não dialítica. Abstract in english OBJECTIVE: To assess the use of digital subtraction with carbon dioxide (CO2 ) for vena cava filter implant. METHODS: From April (2)010 to February (2)011, seven patients underwent inferior vena cava filter placement with digital subtraction angiography with the use of CO2 as contrast media. All pat [...] ients had iliac and femoral deep venous thrombosis and contraindications for anticoagulation. RESULTS: Technical success was achieved in all cases. Inferior vena cava e renal veins were identified in all cases. There were no evidences of complications related to the use of CO2 during or after the procedure. CONCLUSION: The placement of inferior vena cava filter with CO2 and digital subtraction angiography is safe and effective with good results in patients with renal insufficiency and allergy to iodine.

  16. Physiologic Effect of Stent Therapy for Inferior Vena Cava Obstruction Due to Malignant Liver Tumor

    International Nuclear Information System (INIS)

    Purpose. To understand systemic the influence of stent therapy for inferior vena cava (IVC) obstruction due to advanced liver tumor. Methods. Seven patients with symptomatic IVC obstruction due to advanced primary (n 4) or secondary (n = 3) liver tumor were subjected to stent therapy. Enrollment criteria included high IVC pressure over 15 mmHg and the presence of edema and ascites. Z-stents were deployed using coaxial sheath technique via femoral venous puncture. Physiologic and hematobiochemical parameters were analyzed. Results. All procedures were successful, and the stents remained patent until patient death. Promptly after stent placement, the IVC flow recovered, and the venous blood pressure in the IVC below the obstruction level showed a significant decrease from 20.8 ± 1.2 mmHg (mean ± SE) to 10.7 ± 0.7 mmHg (p 0.6) with the urine volume increase, and with the decreased volume of edema and ascites. The urine volume increase correlated well with the decrement of edema, but not with that of ascites. Improvements for various durations in the levels of blood urea nitrogen, serum creatinine, lactate dehydrogenase, fibrinogen, and platelet count were found (p < 0.05). These hematobiochemical changes were well correlated with each other and with the decrement of ascites. Two patients showed a low blood sodium level of 128.5 mEq/l after intensive natriuresis, and one of them died on day 21 with hepatic failure, which was interpreted as maladaptation aggravation. The mean survival time was 94.1 ± 34.1 days (mean ± SD), ranging from 21 to 140 days after stent treatment. Conclusion. The stent therapy for IVC obstruction due to malignant liver tumors was followed by a series of physiologic and hematobiochemical consequences, most of them favorable but some possibly unfavorable. Rational interpretations and predictions of sequelae based on physiologic science including cardiology, hepatology, and nephrology would facilitate the best management of stent therapy for malignant IVC obstruction

  17. 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.

  18. 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

  19. Clinical Outcome after Intrahepatic Venous Stent Placement for Malignant Inferior Vena Cava Syndrome

    International Nuclear Information System (INIS)

    We evaluated the clinical outcome of malignant inferior vena cava (IVC) syndrome after intrahepatic IVC stent placement by retrospective analysis of 50 consecutive patients (25 men, 25 women, age 32-83 years) with malignant IVC syndrome who were treated with intrahepatic stent placement. Gianturco-Rosch-Z (GRZ) stents (n = 45), and Wallstents (n = 5) were inserted. Clinical outcome was assessed from patients' records using a score based on leg swelling, scrotal/vulvar edema, ascites and anasarca before and after stent placement, as well as at last follow-up visit before death. Clinical follow-up was supplemented by duplex sonography in 36 patients. Inferior venocavography was performed in 5 patients prior to re- intervention. Follow-up time ranged from 1 to 932 days (mean 62 days). Mean pressure gradient in the IVC was reduced from 14 ± 4.1 mmHg before to 2.9 ± 3.2 mmHg after stent placement (p < 0.001). Four patients had stent occlusion, 2 of whom were successfully re-stented. Primary and secondary patency was 59% and 100%, respectively at 540 days. Immediate clinical data were available in 44 patients: 38 improved; 6 did not respond. Last follow-up visit data were available in 36 patients: 24 showed persistent symptom relief till death. All symptom scores were significantly improved after stent placement (p < 0.001) and with the exception of ascites, remained significantly improved (p < 0.05) until the last follow-up. Increased serum bilirubin was a common characteristic of clinical failures and recurrences. Intrahepatic IVC stent placement resulted in significant symptomatic relief in patients with malignant IVC syndrome. Palliation was effective even in patients with a very short life expectancy

  20. 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.

  1. 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

  2. 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.

  3. A case of primary mediastinal Ewing?s sarcoma /primitive neuroectodermal tumor presenting with initial compression of superior vena cava

    Directory of Open Access Journals (Sweden)

    Alessia Reali

    2013-01-01

    Full Text Available Ewing?s sarcomas and peripheral primitive neuroectodermal tumors (ES/PNETs are high grade malignant neoplasms. These malignancies are characterized by a chromosome 22 rearrangement, arise from bone or soft tissue, predominantly affect children and young adults, and are grouped in the Ewing family of tumors. Multimodality treatment programs are the treatment of choice. Primary localization of ES/PNET in the mediastinum is extremely rare. We describe a case of ES/PNET presenting as a mediastinal mass with tracheal compression and initial signs of superior vena cava in a 66-year-old woman.

  4. 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

  5. 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

  6. Pseudo interruption of the inferior vena cava complicating the device closure of patent ductus arteriosus: Case report and short review of venous system embryology

    Directory of Open Access Journals (Sweden)

    Venkateshwaran Subramanian

    2014-01-01

    Full Text Available A nineteen-month-old girl was taken up for patent ductus arteriosus (PDA device closure. A diagnostic catheter from the right femoral venous access entered the superior vena cava (SVC, through the azygos vein suggesting interruption of inferior vena caval with azygos continuity. Therefore, the PDA device was closed from the right jugular venous access. However, a postprocedure echocardiogram (echo showed a patent inferior vena caval connection into the right atrium. An angiogram from femoral veins showed communication between the iliac veins and the azygos system, in addition to normal drainage into the inferior vena cava (IVC. Congenital communication between the iliac veins and the azygos system can mimic IVC interruption. An attempt to theoretically explain the embryological origin of the communication has been made.

  7. Pseudo interruption of the inferior vena cava complicating the device closure of patent ductus arteriosus: Case report and short review of venous system embryology

    Science.gov (United States)

    Subramanian, Venkateshwaran; Mahadevan, Krishnamoorthy Kavassery; Sivasubramonian, Sivasankaran; Tharakan, Jaganmohan

    2014-01-01

    A nineteen-month-old girl was taken up for patent ductus arteriosus (PDA) device closure. A diagnostic catheter from the right femoral venous access entered the superior vena cava (SVC), through the azygos vein suggesting interruption of inferior vena caval with azygos continuity. Therefore, the PDA device was closed from the right jugular venous access. However, a postprocedure echocardiogram (echo) showed a patent inferior vena caval connection into the right atrium. An angiogram from femoral veins showed communication between the iliac veins and the azygos system, in addition to normal drainage into the inferior vena cava (IVC). Congenital communication between the iliac veins and the azygos system can mimic IVC interruption. An attempt to theoretically explain the embryological origin of the communication has been made. PMID:24701092

  8. 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.

  9. Trombosis de vena cava superior asociada a catéter en paciente crítico: reporte de un caso y breve revisión de la literatura / Superior vena cava thrombosis associated with catheter in critical patients: a case report and brief literature review

    Scientific Electronic Library Online (English)

    Ricardo, Bohórquez; Ángel A, García; David, Santacruz; José F, Zuluaga.

    2012-12-01

    Full Text Available Los fenómenos de hipercoagulabilidad son comunes en los pacientes politraumatizados críticamente enfermos. Los principales factores de riesgo para esta complicación son la cirugía, las invasiones vasculares, la inmovilidad y los procesos inflamatorios. Los catéteres intravasculares proveen un acceso [...] necesario para la administración de terapia intravenosa, toma de muestras sanguíneas y monitorización. Sin embargo, su uso se asocia frecuentemente con complicaciones locales y sistémicas serias incluyendo infecciones diseminadas, tromboflebitis séptica y endocarditis. En este contexto, debe sospecharse de tromboflebitis séptica de la vena cava superior en el paciente con bacteriemia persistente después de 72 horas de terapia antimicrobiana apropiada. La base del tratamiento incluye: remoción del foco infeccioso, administración temprana de antibióticos intravenosos y anticoagulación. Así mismo, debe considerarse el tratamiento quirúrgico en aquellos con evolución inadecuada. Abstract in english Hypercoagulability phenomena are common in critically ill polytraumatized patients. The main risk factors for this complication are surgery, vascular invasions, immobility and inflammatory processes. Intravascular catheters provide a necessary access for the administration of intravenous therapy, bl [...] ood sampling and monitoring. However, their use is frequently associated with serious local and systemic complications including disseminated infections, septic thrombophlebitis and endocarditis. In this context, septic thrombophlebitis of the superior vena cava should be suspected in patients with persistent bacteremia after 72 hours of appropriate antimicrobial therapy. The mainstay of treatment includes the removal of the source of infection, early administration of intravenous antibiotics and anticoagulation. Also, surgical treatment should be considered in those with inadequate clinical evolution.

  10. 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.

  11. Inferior vena cava reconstruction for leiomyosarcoma of zone I-III requiring complete hepatectomy and bilateral nephrectomy with autotransplantation.

    Science.gov (United States)

    Fernandez, Hoylan T; Kim, Peter T W; Anthony, Tiffany L; Hamman, Baron L; Goldstein, Robert M; Testa, Giuliano

    2015-12-01

    The inferior vena cava (IVC) is the most common site of leiomyosarcomas arising from a vascular origin. Leiomyosarcomas of the IVC are categorized by anatomical location. Zone I refers to the infrarenal portion of the IVC, Zone II from the hepatic veins to the renal veins, and Zone III from the right atrium to the hepatic veins. This is a rare presentation of a Zone I-III leiomyosarcoma. Fifty-two-years-old female with a medical history significant only for HTN was admitted to the hospital with bilateral lower extremity edema and dyspnea. Two-dimensional echo demonstrated a right atrial thrombus, extending into the IVC. On subsequent CT and MRI, a 15?cm mass was noted that began in the right atrium and extended into the IVC, with continuation below the renal veins to above the level of the confluence of the common iliac veins. The patient underwent a complete resection of the mass, replacement of the IVC with Dacron graft, total hepatectomy and bilateral nephrectomy, with liver and kidney autotransplantation. Pathology was consistent with a high grade spindle cell sarcoma of vena cava origin. Patient was readmitted approximately 4 weeks postoperatively to begin adjuvant chemotherapy. This case represents a zone I-III IVC leiomyosarcoma treated with surgical R0 resection. This included a hepatectomy, bilateral nephrectomy, and hepatic and left renal autotransplantation. These complex tumors should be treated with surgical resection, and require a multidisciplinary approach. J. Surg. Oncol. 2015; 112:481-485. © 2015 Wiley Periodicals, Inc. PMID:26356493

  12. 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)

  13. 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.

  14. 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 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)

  15. Inferior vena cava filters and postoperative outcomes in patients undergoing bariatric surgery: a meta-analysis.

    Science.gov (United States)

    Kaw, Roop; Pasupuleti, Vinay; Wayne Overby, D; Deshpande, Abhishek; Coleman, Craig I; Ioannidis, John P A; Hernandez, Adrian V

    2014-01-01

    Background: Pulmonary embolism(PE)accounts for almost 40% of perioperative deaths after bariatric surgery.Placement of prophylactic inferior vena cava(IVC) filter before bariatric surgery to improve outcomes has shown varied results. We performed a meta-analysis to evaluate post- operative outcomes associated with the preoperative placement of IVC filters in these patients. Methods: A systematic review was conducted by three investigators independently in PubMed, EMBASE, the Web of Science and Scopus until February 28,2013.Our search was restricted to studies in adult patients undergoing bariatric surgery with and without IVC filters. Primary outcomes were postoperative deep vein thrombosis(DVT),pulmonary embolism (PE),and postoperative mortality. Meta-analysis used random effects models to account for heterogeneity,and Sidik- Jonkman method to account for scarcity of outcomes and studies. Associations are shown as Relative Risks(RR) and 95% Confidence Intervals(CI). Results: Seven observational studies were identified (n=102,767), with weighted average inci- dences of DVT(0.9%),PE(1.6%),and mortality(1.0%)for a follow-up ranging from 3 weeks to 3 months. Use of IVC filters was associated with an approximately 3-fold higher risk of DVT and death that was nominally significant for the former outcome, but not the latter (RR2.81,95%CI 1.33-5.97, p=0.007; and RR 3.27,95%CI0.78-13.64, p=0.1, respectively);there was no difference in the risk of PE(RR1.02,95%CI0.31-3.77,p=0.9). Moderate to high heterogeneity of effects was noted across studies. Conclusions: Placement of IVC filter before bariatric surgery Is associated with higher risk of postoperative DVT and mortality. A similar risk of PE inpatients with and without IVC filter placement cannot exclude a benefit, given the potential large imbalance in risk at baseline.Ran- domized trials are needed before IVC placement can be recommended. (SurgObesRelatDis 2015;11:268-269.) r 2015 American Society for Metabolic and Bariatric Surgery. PMID:25224168

  16. 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

  17. 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

  18. A simplified technique for non-surgical catheterization of the vena cava cranialis in pigs and an evaluation of the method.

    Science.gov (United States)

    Damm, B I; Pedersen, L J; Ladewig, J; Jensen, K H

    2000-04-01

    Restraint and venepuncture affect blood parameters and are stressful for pigs. Therefore, when experiments require frequent blood sampling, catheterization is the best option, both ethically and scientifically. A simplified non-surgical method for catheterization of the vena cava cranialis in sows is described. The vena cava is catheterized via the vena jugularis externa, which is punctured while the sow is restrained by nose snaring. The procedure can be carried out by two experimenters in 5 min, it requires little equipment and can be performed under farm or very simple experimental conditions. Results from 89 catheterizations are reported. Seventy-three of the catheters remained functional for 5 days or more. There was a tendency for a higher success rate in dry sows than in highly pregnant sows. The only behavioural effect observed after catheterization was a short-lasting increase in motivation for wallowing in some sows. No illness that could be attributed to the catheterization occurred. PMID:10817457

  19. 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 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)

  20. Superior vena cava (SVC reconstruction using autologous tissue in two cases of differentiated thyroid carcinoma presenting with SVC syndrome

    Directory of Open Access Journals (Sweden)

    Uchida Keiichi

    2009-10-01

    Full Text Available Abstract Herein, we report two extremely rare cases of differentiated thyroid carcinoma (DTC with extended tumor thrombus or mediastinum lymph node metastasis (LNM involving the superior vena cava (SVC, causing SVC syndrome. Both of these patients were successfully treated with radical resection and reconstruction of the SVC using autologous tissue instead of an expanded polytetrafluoroethylene (ePTFE graft. The left brachiocephalic vein was used to reconstruct the SVC in a papillary thyroid carcinoma patient with mediastinum LNM and a pericardial patch was used in a follicular thyroid carcinoma patient with tumor thrombus. Our search of the English-language literature found sporadic reports of SVC resection with reconstruction by vascular graft (ePTFE, interposed between the brachiocephalic vein and the right atrium. However, SVC reconstruction using autologous tissue in thyroid carcinoma has not been reported to date. To our knowledge, this is the first report describing such an unusual technique in DTC patients.

  1. CT-Guided Percutaneous Fine-Needle Aspiration Biopsy of the Inferior Vena Cava Wall: A Posterior Coaxial Approach

    International Nuclear Information System (INIS)

    A 72-year-old man was referred to our department with an incidentally diagnosed bronchogenic carcinoma of the right upper lobe. Positron emission tomography (PET) combined with computed tomography (PET-CT) revealed an unexpected hot spot in the ventral wall of the infrarenal segment of the inferior vena cava (IVC). Diagnostic biopsy of this lesion was performed under CT guidance with semiautomated 20G fine-needle aspiration (FNA) through a 19G coaxial needle. Cytology revealed few carcinoma cells, which led to the remarkable diagnosis of a distant metastasis to the IVC wall. Both the immediate postinterventional CT control and the further surveillance period of the patient were unremarkable; in particular, no signs of bleeding complications were detected. We conclude that coaxial FNA of an IVC wall lesion is technically feasible and may even help diagnose distant metastasis.

  2. An Experimental Study to Determine the Role of Inferior Vena Cava Filter in Preventing Bone Cement Implantation Syndrome

    Science.gov (United States)

    Guo, Wangang; Zheng, Qiangsun; Li, Bingling; Shi, Xiaoqin; Xiang, Dingcheng; Wang, Chen

    2015-01-01

    Background: Inferior vena cava filters (IVCF) are frequently used for preventing pulmonary embolism (PE) following deep venous thromboembolism. Objectives: The present study was designed to investigate whether IVCF could prevent or impede the occurrence of bone cement implantation syndrome (BCIS), since PE is considered as the central mechanism of BCIS. Materials and Methods: Fifteen sheep were divided into three groups: bone cement free (BCF) group, cement implantation (CI) group and IVCF group. In all the groups, an osteotomy proximal to the greater trochanter of left femur was carried out. In BCF group, the femoral canal was not reamed out or packed with any bone cement. In CI and IVCF groups, the left femoral canals were packed with bone cement, to simulate the cementing procedures carried out in hip replacement. An OptEase® filter was placed and released in inferior vena cava, prior to packing cement in the femoral canal in IVCF group, while the IVCF was not released in the CI group. The BCF group was considered as control. Results: Systolic blood pressure (SBP), saturation of oxygen (SaO2) and partial pressure of carbon dioxide (PaCO2) declined significantly 10 min after the bone cement packing, in CI group, compared to those in BCF group. This was accompanied by a rise in the arterial pH. However, IVCF prevented those changes in the CI group. On ultrasonography, there were dotted echoes in right atrium in the CI group, after bone cement packing, while such echoes were hardly seen in the IVCF group. Conclusion: This study demonstrates that IVCF could prevent BCIS effectively, and, as a corollary, suggests that PE represents the leading cause of the constellation of BCIS symptoms.

  3. Comparision of ultrasound-based methods of jugular vein and inferior vena cava for estimating central venous pressure

    Science.gov (United States)

    Avcil, Mucahit; Kapci, Mucahit; Dagli, Bekir; Omurlu, Imran Kurt; Ozluer, Emre; Karaman, Kivanc; Yilmaz, Ali; Zencir, Cemil

    2015-01-01

    Objective: The aim in this study was to compare the ultrasound estimation of the jugular vein diameter (IJVmax, IJVmin) and area (IJVarea), the height of the right internal jugular vein (CVPusg), the vena cava diameter (IVCmax, IVCmin), and the vena cava index (IVCindex) with direct estimation of central venous pressure (CVPinv). Methods: Ultrasonography was performed on 37 nonventilated and 36 ventilated patients while monitoring central venous pressure. The IJV and IVC were measured during the respiratory cycle and the IJVarea and IVCindex were calculated. Tapering portion of the right IJV defined and height from this point to the sternal angle was used to estimate CVPusg. Results: A CVP of 10 mmHg was chosen as a clinically significant cutoff for high CVP, and 6 mmHg was chosen for low CVP estimation. The CVPusg, IJVmax and IJVmin correlated moderately with CVPinv (R² = 0.66, 0.53, and 0.54, respectively) whereas the IVCmax, IVCmin and IVCindex showed poor correlation (R² = 0.29, 0.32 and 0.27, respectively). The CVPusg cutoff value of 7 predicted CVPinv > 10 mmHg with sensitivity of 90%, specific-ity of 67.3% and predicted CVPinv < 6 mmHg with sensitivity of 77%, specificity of 68%. IJVmax, IJVmin, IJVarea and IVCmax showed high sensitivity (90.32%, 83.87%, 90.32%, and 93.10%, respectively) for low CVP levels. The IVCindex has high sensitivity (95.2%) and poor specificity (42.9%) for high CVP levels. Conclusion: IVCindex and CVPusg has better diagnostic performance for estimating high CVP. IJVmax, IJV area, and IVCmax showed high sensitivity and NPV for low CVP levels. PMID:26379848

  4. Tumor de células de Leydig, ginecomastia y trombosis de vena cava inferior / Leydig cell tumor, gynecomastia and inferior cava vein thrombosis

    Scientific Electronic Library Online (English)

    J., Moltó Marhuenda; A., Mora Rufete; A., Gonzálvez Gasch; Á., Sánchez Sevillano; V., López Menéndez; A., Martín Hidalgo.

    2001-08-01

    Full Text Available El tumor de células de Leydig es un tumor testicular de baja incidencia caracterizado por la secreción de estrógenos por las células tumorales. Sus manifestaciones clínicas más frecuentes son la presencia de un nódulo testicular acompañado o no de manifestaciones endocrinas secundarias a la hipersec [...] reción estrogénica. Comunicamos un caso de tumor de células de Leydig con elevadas concentraciones plasmáticas de estradiol, ginecomastia y trombosis de la vena cava inferior, que no ha sido descrita como manifestación de estos tumores hasta la actualidad. Los fenómenos trombóticos vasculares se han descrito en otras situaciones clínicas de hiperestrogenismo y también podrían presentarse asociados a estos tumores. Los pacientes con tumores de células de Leydig podrían tener un mayor riesgo de desarrollar fenómenos tromboembólicos secundarios al hiperestrogenismo de origen tumoral y podrían presentar complicaciones trombóticas como manifestación clínica. Abstract in english Leydig cell tumor is a testicular tumor with a low incidence characterized by a high estrogens secretion from the tumoral cells. Its more frecuent clinical presentation is a testicular nodule with or without other endocrine manifestations due to estrogenic hipersecretion. We're reporting a case of a [...] Leydig cell tumor with high plasmatic levels of estradiol, gynecomastia and inferior cava vein thrombosis, which hasn't been described among its clinical features up to now. Vascular thombotic phenomenons have already been reported in other clinical situations with hiperestrogesism and they could also be associated with these tumors. Patients with Leydig cell tumors could be at a higher risk of developing thromboembolic phenomenons because of tumoral hiperestrogenism and could present thrombotic complications among the clinical findigs.

  5. Tratamiento quirúrgico de un tumor testicular retroperitoneal metastásico con trombo en la vena cava inferior mediante derivación cardiopulmonar, paro circulatorio e hipotermia profunda: un caso clínico / Surgical management of retroperitoneal metastatic testicular tumor with inferior vena caval thrombus using cardiopulmonary bypass, arrested circulation, and profound hypothermia: a case report

    Scientific Electronic Library Online (English)

    Ricardo, Miyaoka; Leonardo, Oliveira Reis; Fernandes, Denardi; Lia, Ikari; Ubirajara, Ferreira.

    2009-10-01

    Full Text Available Los tumores testiculares son el tipo más frecuente de neoplasia sólida en los varones de 18 a 35 años de edad. Su tasa de curación aproximada es del 90%1,2. En algunos casos puede producirse invasión vascular del tumor, que exigirá resección quirúrgica para detener la progresión de la enfermedad y p [...] revenir episodios tromboembólicos. La cirugía es la única opción terapéutica válida, aunque el procedimiento entraña un riesgo elevado. Presentamos el caso clínico de un paciente sometido con éxito a quimioterapia y cirugía por un tumor del testículo derecho asociado con un trombo tumoral en la vena cava inferior que se extendía desde la vena renal a la aurícula derecha y linfadenopatía retroperitoneal extensa. Abstract in english Testicular tumors represent the most common type of solid neoplasia in men aged between 18 and 35 years. Its cure rate is approximately 90%1,2. In some cases, tumoral vascular invasion can occur and demands surgical ressection to stop disease progression and prevent thromboembolic events. That is th [...] e only valuable therapeutic choice although it is a high risk procedure. We present a case report of a patient who underwent successful chemotherapy and surgery for a right-sided testicular tumor associated with an inferior vena cava tumor thrombus extending from the renal vein to the right atrium and extensive retroperitoneal lymph node disease.

  6. In Vivo Evaluation of a Retrievable Vena Cava Filter-The Dibie-Musset Filter: Experimental Results

    International Nuclear Information System (INIS)

    Purpose: To evaluate, in an animal model, the efficacy and safety of a 7 Fr percutaneous vena cava filter for temporary or permanent use. Methods: The Dibie-Musset (DM) filter is a wire preformed into a double-spiral shape with a spring effect. The experiment was performed in 15 adult sheep and consisted of the insertion of 45 filters, clot trapping tests, and filter retrieval. Follow-up in all sheep consisted of radiologic (abdominal radiograph, inferior vena cavogram, abdominal computed tomography), macroscopic, and microscopic examinations between days 8 and 386 after filter placement. Results: Of the 45 filters implanted in 15 sheep, 29 were retrieved between day 0 and day 15. Filtration efficiency was 100% for clots 4 x 4 x 20 mm. No long-term (1 year) side-effects were detectable. Microscopic examination of the vein wall showed only a dense intimal fibrosis without signs of acute inflammation at 1 year. Conclusion: These results support the efficiency and safety of the DM filter in an animal model

  7. Geometrical variations of the canine superior vena cava: relationship between diameter, segment length and transmural venous pressure.

    Science.gov (United States)

    Minten, J; Van de Werf, F; De Geest, H

    1987-02-01

    The dimensional variations of the superior vena cava throughout the cardiac cycle were investigated by means of angiographic and ultrasonic techniques. Results obtained by both methods were largely in agreement. In frontal direction the diameter curve resembled the transmural pressure variations, the sagittal diameter curve was not related to the venous pressure variations during certain phases of the cardiac cycle and compressional and/or stretching forces exerted by respectively the distending aorta and/or pulmonary artery and the contracting heart may have been responsible. Also segment length variations occurred: during atrial contraction, ventricular systole and early diastole the vein elongated, indicating the varying longitudinal traction forces, possibly exerted by the rotational movement of the contracting heart. Assuming elliptical symmetry the vena caval cross-section could be reconstructed, and the cross-sectional area, perimeter and segmental volume could be calculated throughout the cardiac cycle. Despite the high venous distensibility, no extreme collapse of the vein was observed during the cardiac cycle at low transmural pressures. PMID:3562204

  8. The relationship between the longitudinal pressure gradient and the blood flow velocity in the canine superior vena cava.

    Science.gov (United States)

    Minten, J; Van de Werf, F; Aubert, A E; De Geest, H

    1986-09-01

    In the superior vena cava of anaesthetized open chest dogs the axial pressure gradient (delta P) was measured simultaneously with the blood flow velocity (V) under a variety of preload conditions. Both delta P and V curves showed distinct systolic and diastolic waves. Peak delta P ranged between 26 and 93 P/cm (0.2-0.7 mm Hg/cm) and V varied between 0.095 and 0.19 m/s. Peak systolic delta P, but not peak diastolic delta P was significantly linearly correlated to respectively peak systolic V and peak diastolic V. The shape of delta P and V curves corresponded fairly well but variations of delta P preceded the variations of V. Both the shape correspondence and the phase lag between delta P and V were evaluated by means of the normalized cross-correlation technique. During volume expansion the shape correspondence improved and the phase lag decreased. It is concluded that the transient vena caval blood velocity variations are directly related to the pulsatile axial pressure gradient. PMID:2434055

  9. Radiofrequency Ablation Of Typical Atrial Flutter Via Right Subclavian/jugular Vein Access In A Patient With Implanted Filter In The Inferior Vena Cava

    Directory of Open Access Journals (Sweden)

    Jorg Kynast

    2009-07-01

    Full Text Available Radiofrequency ablation of Cavotricuspid Isthmus-dependent Atrial Flutter (CTI AFL, a usual and safe therapeutic procedure in interventional electrophysiology with a high success rate, aiming to induce permanent block of conduction over CTI, is normally performed via the femoral access, which allows practical access to the CTI through the inferior vena cava (IVC. In rare cases of obstruction of IVC, ablation of CTI can be performed only through the superior vena cava (SVC access. We present a case with typical atrial flutter that was ablated through the right subclavian/jugular veins because of iatrogenic obstruction of the IVC due to a previously implanted thrombus filter. Furthermore we discuss about how we resolved access-related problems of instability during catheter ablation on CTI.

  10. Vena Caval Anomalies

    OpenAIRE

    Rajakulasingam, Ramyah; Francis, Rohin; Rajakulasingam, Ramanan

    2013-01-01

    Anomalous vena cavae can have significant implications for procedures on the right side of the heart. We report a rare anatomical configuration in a 44-year-old female, which to the best of our knowledge, is the first report of such an association. She had a bicuspid aortic valve in conjunction with a persistent left superior vena cava (PLSVC) draining into the coronary sinus, and a left-sided inferior vena cava (IVC) draining into a left superior vena cava via the hemiazygos vein. Comprehens...

  11. Long-Term Results of Cell-Free Biodegradable Scaffolds for In Situ Tissue-Engineering Vasculature: In a Canine Inferior Vena Cava Model

    OpenAIRE

    Matsumura, Goki; Nitta, Naotaka; Matsuda, Shojiro; Sakamoto, Yuki; Isayama, Noriko; Yamazaki, Kenji; Ikada, Yoshito

    2012-01-01

    We have developed a new biodegradable scaffold that does not require any cell seeding to create an in-situ tissue-engineering vasculature (iTEV). Animal experiments were conducted to test its characteristics and long-term efficacy. An 8-mm tubular biodegradable scaffold, consisting of polyglycolide knitted fibers and an L-lactide and ?-caprolactone copolymer sponge with outer glycolide and ?-caprolactone copolymer monofilament reinforcement, was implanted into the inferior vena cava (IVC) of ...

  12. Isolated central venous pressure elevation caused by hematoma formation compressing the superior vena cava following a Bentall operation: a case report

    OpenAIRE

    Song, Young; Sim, Jeesuk; Seo, Sai Ju; Choi, Seong Ah; Shim, Jae-Kwang

    2014-01-01

    We present a case of a patient exhibiting isolated elevation of the central venous pressure with minimal hemodynamic deterioration in an immediate postoperative period after Bentall operation requiring re-exploration. Isolated elevation of the central venous pressure usually alerts physicians of a volume overload or right ventricular dysfunction. However, even in the absence of significant hemodynamic deterioration, the development of loculated hematoma that compresses the superior vena cava ...

  13. The Comparison of Vena Cava Inferior Diameter Measurement and Hemoglobin Level Follow-Up for the Assessment of Traumatic Patient in Emergency Service

    Directory of Open Access Journals (Sweden)

    Mücahit Avcil

    2011-09-01

    Full Text Available Objective: In trauma patients determining and excluding occult bleeding is a difficult and error-prone work in emergency services. Material and Methods: The vena cava inferior diameters were measured by ultrasound at reference time, first hour and third hour, in sixty patients who were admitted to our university hospital and suffered multiple trauma. Their hemoglobin levels and vital signs were observed simultaneously. Follow-up results were compared to each other. Results: No serious bleeding was found in our patient population. The reference time vena cava inferior diameter mean value of our study group was 16.84±3.93 mms. This value was 16.79±3.74 mms for the first hour and 16.49±3.23 mms for the third hour. In the statistical evaluation of data there was no significant difference between the measurements (Pillai analyse p=0.29. In contrast, there was a decrease-mean of 0.68±0.91 mg/dl in hemoglobin values particularly between the reference and the third time and it was statistically significant (p=0.000. During this time a decrease in hemoglobin level was observed at gretaer than1 mg/dl and in 30% of patients. These changes in measuring hemoglobin levels were not correlated with fluid given to the patients. During all time intervals vena cava inferior measurement’s specivity was determined as approximately 95% and was 70% for hemoglobin level follow-up. Conclusion: Vena cava inferior serial measurements with ultrasound may be more beneficial to hemogram follow up for excluding occult bleeding in trauma patients.

  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. Right internal jugular vein distensibility appears to be a surrogate marker for inferior vena cava vein distensibility for evaluating fluid responsiveness

    Science.gov (United States)

    Broilo, Fabiano; Meregalli, Andre; Friedman, Gilberto

    2015-01-01

    Objective To investigate whether the respiratory variation of the inferior vena cava diameter (?DIVC) and right internal jugular vein diameter (?DRIJ) are correlated in mechanically ventilated patients. Methods This study was a prospective clinical analysis in an intensive care unit at a university hospital. Thirty-nine mechanically ventilated patients with hemodynamic instability were included. ?DIVC and ?DRIJ were assessed by echography. Vein distensibility was calculated as the ratio of (A) Dmax - Dmin/Dmin and (B) Dmax - Dmin/ mean of Dmax - Dmin and expressed as a percentage. Results ?DIVC and ?DRIJ were correlated by both methods: (A) r = 0.34, p = 0.04 and (B) r = 0.51, p = 0.001. Using 18% for ?DIVC, indicating fluid responsiveness by method (A), 16 patients were responders and 35 measurements showed agreement (weighted Kappa = 0.80). The area under the ROC curve was 0.951 (95%CI 0.830 - 0.993; cutoff = 18.92). Using 12% for ?DIVC, indicating fluid responsiveness by method (B), 14 patients were responders and 32 measurements showed agreement (weighted Kappa = 0.65). The area under the ROC curve was 0.903 (95%CI 0.765 - 0.973; cut-off value = 11.86). Conclusion The respiratory variation of the inferior vena cava and the right internal jugular veins are correlated and showed significant agreement. Evaluation of right internal jugular vein distensibility appears to be a surrogate marker for inferior vena cava vein distensibility for evaluating fluid responsiveness.

  16. 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

  17. 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.

  18. Budd-chiari syndrome by membranous obstruction of inferior vena cava: comparison of sonography and computed tomography

    International Nuclear Information System (INIS)

    Membranous obstruction of the hepatic inferior vena cava (MOVC) is one of the common causes of Budd-Chiari syndrome. The aim of this study is to ascertain and compare the characteristic sonographic and CT findings of Budd-Chiari syndrome caused by MOVC. We studied 10 patients of Budd-Chiari syndrome caused by MOVC thorough sonography and CT. MOVC was confirmed by operation and/or inferior vena cavography. The cases included 9 men and one woman. With sonography, IVC obstruction was diagnosed in 9 cases. The cause of IVC obstruction was web in 5 cases and fibrous cord in 3 cases. The cause was unspecified in one case. Obliteration of the hepatic veins and intrahepatic collateral vessels were delineated in 9 cases. With color doppler sonography, the directions of blood flow of the hepatic veins through the intervenous communication were fairly well demonstrated in all 5 cases. With CT, IVC obstruction was diagnosed in 7 cases. The obliteration of the hepatic segment of the IVC were segmental in 6 cases and diffuse in one case. CT demonstrated communicating vessels between the hepatic veins in 3 cases. Furthermore, systemic collateral vessels (azygos and hemiazygos veins, veins along the abdominal wall, and internal mammary veins) were demonstrated in all cases. Liver cirrhosis was combined in all cases and hepatoma developed in 4 cases. Sonography is useful to detect the MOVC and to demonstrate hepatic venous obstruction and intrahepatic collateral vessels. Color doppler sonography is easily performed to show the direction of the blood flow through interconnecting vessels. CT shows the obliterated segment of the IVC clearly and multiple prominent systemic collaterals. In conclusion, Budd-Chiari syndrome caused by MOVC is accurately diagnosed by combined color doppler sonography and CT

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

    International Nuclear Information System (INIS)

    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 reco8, 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)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 rec

  20. 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.

  1. 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: Paciente do sexo mas...

  2. 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.

  3. 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

    Scientific Electronic Library Online (English)

    Fábio Alves, Almeida; Carlos Augusto Cardoso, Pedra; Carlos Augusto de, Jesus; Simone Rolim Fernandes Fontes, Pedra; Valmir Fernandes, Fontes; Luís Carlos Bento de, Sousa.

    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 p [...] aciente 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. Abstract in english 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 uneventfu [...] lly, 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.

  4. 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

  5. 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

  6. Outpatient Use of Focused Cardiac Ultrasound to Assess the Inferior Vena Cava in Patients With Heart Failure.

    Science.gov (United States)

    Saha, Narayan M; Barbat, Julian J; Fedson, Savitri; Anderson, Allen; Rich, Jonathan D; Spencer, Kirk T

    2015-10-15

    Accurate assessment of volume status is critical in the management of patients with heart failure (HF). We studied the utility of a pocket-sized ultrasound device in an outpatient cardiology clinic as a tool to guide volume assessment. Inferior vena cava (IVC) size and collapsibility were assessed in 95 patients by residents briefly trained in focused cardiac ultrasound (FCU). Cardiologist assessment of volume status and changes in diuretic medication were also recorded. Patients were followed for occurrence of 30-day events. There was a 94% success rate of obtaining IVC size and collapsibility, and agreement between visual and calculated IVC parameters was excellent. Most patients were euvolemic by both FCU IVC and clinical bedside assessment (51%) and had no change in diuretic dose. Thirty-two percent had discrepant FCU IVC and clinical volume assessments. In clinically hypervolemic patients, the FCU evaluation of the IVC suggested that the wrong diuretic management plan might have been made 46% of the time. At 30 days, 14 events occurred. The incidence of events increased significantly with FCU IVC imaging categorization, from 11% to 23% to 36% in patients with normal, intermediate, and plethoric IVCs. By comparison, when grouped in a binary manner, there was no significant difference in event rates for patients who were deemed to be clinically volume overloaded. Assessment of volume status in an outpatient cardiology clinic using FCU imaging of the IVC is feasible in a high percentage of patients. A group of patients were identified with volume status discordant between FCU IVC and routine clinic assessment, suggesting that IVC parameters may provide a valuable supplement to the in-office physical examination. PMID:26279108

  7. 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.

  8. 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 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.

  9. 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.

  10. [Presurgical treatment of axitinib reduced operation risk by downsizing the vena cava tumor thrombus in advanced renal cell carcinomas: two case reports].

    Science.gov (United States)

    Hamada, Akihiro; Yamasaki, Toshinari; Negoro, Hiromitsu; Kobayashi, Takashi; Terada, Naoki; Sugino, Yoshio; Matsui, Yoshiyuki; Inoue, Takahiro; Kamba, Tomomi; Yoshimura, Koji; Ogawa, Osamu

    2014-12-01

    In cases of advanced renal cell carcinoma with inferior vena cava (IVC) thrombus, surgical resection of both tumor and thrombus contributes to the improvement of patient's prognosis, but the risk of perioperative complication is still high. We experienced two cases of advanced renal tumors with IVC tumor thrombus down-sized by presurgical treatment of axitinib. Axitinib treatment showed a marked tumor reduction effect without any severe adverse event. We could remove both tumor and thrombus without perioperative complications. In these two cases, downsizing of IVC thrombus enabled us to reduce the extent of the surgery. PMID:25602478

  11. 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

  12. Management of a Rare Complication of Epidural Analgesia in an Obese Laterally Positioned Parturient: Catheter Entrapment Next to the Inferior Vena Cava.

    Science.gov (United States)

    Amir, Alexander; Lash, Vynka; Moore, Albert; Rao, Pramod; Torres, Carlos; Kaufman, Ian

    2015-01-01

    Intravascular, subdural, intrathecal, and subcutaneous placement of epidural catheters are known complications and common causes of anesthesia and analgesia failure. Because the epidural space is located near the retroperitoneum and catheters are placed blindly, it is possible that misplacement could involve other structures, including the inferior vena cava, the aorta, and the lumbar plexus. We report a case of an obese laterally positioned parturient who presented with an epidural catheter lodged in the retroperitoneum. The catheter provided inadequate analgesia for labor, and postpartum computed tomography revealed it to be located in the retroperitoneal space just adjacent to the inferior vena cava. Conventional removal techniques were unsuccessful, and the catheter was finally removed after insertion of a guide wire under fluoroscopy. We conclude that obesity and lateral positioning are factors that increase the risk of epidural catheter misplacement, and a large distance from skin to loss of resistance is a potential sign of misplacement. We recommend ultrasound imaging to aid in the insertion of epidural catheters in high-risk patients. PMID:26469368

  13. 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.)

  14. 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

  15. Large cell non-Hodgkin's lymphoma masquerading as renal carcinoma with inferior vena cava thrombosis: a case report

    Directory of Open Access Journals (Sweden)

    Weissman Alan

    2011-06-01

    Full Text Available Abstract Introduction Many cancers are associated with inferior vena cava (IVC obstruction, but very few cancers have the ability to propagate within the lumen of the renal vein or the IVC. Renal cell carcinoma is the most common of these cancers. Renal cancer with IVC extension has a high rate of recurrence and a low five year survival rate. Case presentation A 62-year-old Caucasian woman previously in good health developed the sudden onset of severe reflux symptoms and right-sided abdominal pain that radiated around the right flank. A subsequent ultrasound and CT scan revealed a right upper pole renal mass with invasion of the right adrenal gland, liver, left renal vein and IVC. This appeared to be consistent with stage III renal cancer with IVC extension. Metastatic nodules were believed to be present in the right pericardial region; the superficial anterior abdominal wall; the left perirenal, abdominal and pelvic regions; and the left adrenal gland. The pattern of these metastases, as well as the invasion of the liver by the tumor, was thought to be atypical of renal cancer. A needle biopsy of a superficial abdominal wall mass revealed a surprising finding: The malignant cells were diagnostic of large-cell, B-cell non-Hodgkin's lymphoma. The lymphoma responded dramatically to systemic chemotherapy, which avoided the need for nephrectomy. Conclusion Lymphomas only rarely progress via intraluminal vascular extension. We have been able to identify only one other case report of renal lymphoma with renal vein and IVC extension. While renal cancer would have been treated with radical nephrectomy and tumor embolectomy, large-cell B-cell lymphomas are treated primarily with chemotherapy, and nephrectomy would have been detrimental. It is important to remember that, rarely, other types of cancer arise from the kidney which are not derived from the renal tubular epithelium. These may be suspected if an atypical pattern of metastases or unusual invasion of surrounding organs is present. A preoperative or intraoperative biopsy may be helpful in these cases.

  16. Suprarenal inferior vena cava filter placement prior to transcatheter arterial embolization (TAE) of a renal cell carcinoma with large renal vein tumor thrombus: Prevention of pulmonary tumor emboli after TAE

    International Nuclear Information System (INIS)

    To prevent embolization of necrotic renal vein tumor after transcatheter embolization of a left renal cell carcinoma, we placed a suprarenal Bird's nest inferior vena cava filter. The patient tolerated the procedure well and had extensive tumor infarction including the tumor thrombus on 6-month follow-up computed tomography

  17. Adrenocortical carcinoma with inferior vena cava, left renal vein and right atrium tumor thrombus extension

    Science.gov (United States)

    Annamaria, Pronio; Silvia, Piroli; Bernardo, Ciamberlano; Alessandro, De Luca; Antonino, Marullo; Antonio, Barretta; Giuseppe, Mazzesi; Massimo, Rossi; Montesani, Chiara

    2015-01-01

    Introduction Adrenocortical carcinoma (ACC) is a rare, but highly aggressive type of tumor with an annual incidence of 1–2 cases per million. The prognosis is poor with a five-year overall survival rate of ?35%. The poor prognosis may be related to the advanced stage at which the majority of ACCs are detected. Complete surgical resection remains the most effective treatment. Presentation of the case A 51-year-old female patient with recent onset of dyspepsia, ascites and peripheral edema was referred to our institution. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) displayed a 8 cm Ø right adrenal mass. Moreover a tumor thrombus jutted out into the IVC, left renal vein and right atrium. An echocardiographic evaluation confirmed the presence of the tumor thrombus in the right atrium. The patient underwent adrenalectomy with removal of its intravascular extension with the assistance of cardiopulmonary bypass and hypothermia. Discussion ACC is a rare malignancy and ACC with tumor thrombus extension is a rare presentation. Patients can present with a variety of sign and symptoms, depending on the extent of the tumor. CT scan of chest and abdomen represents the gold standard in ACC staging while magnetic resonance imaging (MRI) is preferred for tumor thrombus characterization. Complete surgical resection with a negative margin, R0 resection, is the only curative option for localized disease. Kidney sparing surgery should be performed when possible. Conclusion We present a rare case of Adrenocortical carcinoma with tumor thrombus extending into the IVC and right atrium. Complete resection with negative margins represents the best therapeutic chance for these patients. PMID:26355237

  18. 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.

  19. 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

  20. Cirugía con circulación extracorpórea e hipotermia en tumores con extensión a vena cava: 20 años de experiencia de la Clínica Universitaria de Navarra / Extracorporeal circulation and hypothermy surgery in tumors with vena cava extension: 20 years experience at the University Clinic Of Navarra

    Scientific Electronic Library Online (English)

    J., Rioja Zuazu; F., Rodríguez-Rubio Cortadellas; J.J., Zudaire Bergera; A., Saiz Sansi; D., Rosell Costa; J.E., Robles García; G., Rábago; J.M., Berián Polo.

    2008-04-01

    Full Text Available Objetivo: Presentamos 20 años de experiencia en pacientes con tumores con extensión a vena cava en los que se realizaron circulación extracorpórea, hipotermia, parada cardiaca y exanguinotransfusión (CEC-H-PC-E) para que junto con la resección tumoral se resecara el trombo tumoral en su totalidad. M [...] aterial y Métodos: Entre los años 1985 y 2005 se trataron 28 tumores retroperitoneales: 25 tumores renales, un tumor de Wilms, un rabdomiosarcoma paratesticular y un feocromocitoma. Todos ellos presentaban extensión en forma de trombo en la vena cava por encima de las venas suprahepáticas. A todos se les realizó CEC-H-PC-E para la extracción del trombo tumoral. Se realiza una descripción de la serie así como un análisis de la supervivencia de Kaplan-Meier. Resultados: Se presentaron complicaciones quirúrgicas en 10 pacientes (35%), con una mortalidad quirúrgica de dos pacientes (7%): intraoperatoria por embolismo pulmonar masivo en un paciente y al 4º día postquirúrgico por embolismo pulmonar. La supervivencia actuarial global fue de 29,1±10% a tres años y 17,5±8% a cinco años. Analizando por separado aquellos que tienen que no presentan lesiones metastásica ni ganglionares en el diagnóstico su supervivencia fue a tres años del 50,9±16,3% y del 38,2±16% a cinco años. Mientras aquellos que presentan algún tipo de lesión a distancia presentaron una supervivencia a tres y cinco años de 20,8±12% y 10,4±9% respectivamente. Conclusiones: La utilización de técnicas quirúrgicas con CEC-H-PC-E en patologías tumorales que se asocian a trombo en vena cava, esta justificada y su utilización no empeora la supervivencia; está indicada por sus resultados, permitiendo una resección tumoral de una manera segura y reproductible. Abstract in english Objective: We present our 20 years experience treating patients with vena cava extension in whom an extracorporeal circulation, hypothermia, cardio circulatory arrest (ECC-H-CCA) in order to perform, together with a tumoral resection, a thrombus resection. Material and Methods: From 1985 to 2005 a t [...] otal of 28 retroperitoneal tumor were treated: 25 renal cancers, a Wilms tumor, a paratesticular rabdomiosarcoma, and a pheocromocitoma. All of them had an extension by means of thrombus above the suprahepatics veins. All of them were treated by means of ECC-H-CCA for thrombus extraction. A descriptive study of the serie is performed as well as a Kaplan Meyer survival study. Results: Surgical complications were present within 10 patients (35%), with a surgical mortality of two patients (7%): one intra-operatively because a massive embolism of the lungs and the other because of a lung embolism on the 4th post-operative day. Global actuarial survival was 29.1±10% at three years and 17,5±8% at five years. Analyzing only who do not have metastatic lesions, nor lymph nodes at diagnosis their three year survival was 50,9±16,3% and 32,2±16% at five years. Mean while those who have any metastatic lesion at diagnosis their three and five years survival was 20,8±12% and 10,4±9% respectively. Conclusions: The employ of surgical techniques with ECC-H-CCA with in oncological pathology associated with vena cava thrombus is justified and its employment does not worsen the survival; it is indicated because its results, allowing a complete tumoral resection in a safe and reproducible fashion.

  1. The role of liver transplantation techniques in the surgical management of advanced renal urothelial carcinoma with or without inferior vena cava thrombus

    Directory of Open Access Journals (Sweden)

    Wolfgang H. Cerwinka

    2009-02-01

    Full Text Available Purpose: Standard radical nephrectomy for large masses is significantly facilitated by liver transplantation techniques, which have been successfully employed over the last ten years at our institution. Large and locally-advanced urothelial carcinoma of the kidney with or without extension into the inferior vena cava is rare. The purpose of this study was to present the surgical management of large and locally-advanced urothelial tumors arising from the renal pelvis using liver transplantation techniques and to evaluate patient outcome. Materials and Methods: Diagnostic work-up and surgical management of 4 patients with large and locally-advanced renal urothelial carcinoma were retrospectively reviewed. Two out of four patients with urothelial carcinoma presented with inferior vena cava thrombus. Mean tumor size was 11.6 cm. All patients underwent surgery, 2 patients with the presumed diagnosis of renal cell cancer. Liver transplantation techniques were an integral part in all radical nephrectomies. Results: No intraoperative complications and postoperative mortality occurred. Mean operative time was 7.5 hours, estimated blood loss was 1.5 L, and an average of 4.8 units of blood was transfused intraoperatively. Three patients succumbed to cancer recurrence at a mean postoperative time of 6.3 months; 1 patient is still alive 24 months after surgery. Conclusions: Large and locally-advanced renal masses of urothelial origin can be successfully removed by a combination of radical nephrectomy with liver transplantation techniques. Since long-term outcome of such patients has been poor, accurate preoperative diagnosis is essential to consider neoadjuvant treatment and to plan nephroureterectomy.

  2. The role of liver transplantation techniques in the surgical management of advanced renal urothelial carcinoma with or without inferior vena cava thrombus

    Scientific Electronic Library Online (English)

    Wolfgang H., Cerwinka; Murugesan, Manoharan; Mark S., Soloway; Gaetano, Ciancio.

    2009-02-01

    Full Text Available Purpose: Standard radical nephrectomy for large masses is significantly facilitated by liver transplantation techniques, which have been successfully employed over the last ten years at our institution. Large and locally-advanced urothelial carcinoma of the kidney with or without extension into the [...] inferior vena cava is rare. The purpose of this study was to present the surgical management of large and locally-advanced urothelial tumors arising from the renal pelvis using liver transplantation techniques and to evaluate patient outcome. Materials and Methods: Diagnostic work-up and surgical management of 4 patients with large and locally-advanced renal urothelial carcinoma were retrospectively reviewed. Two out of four patients with urothelial carcinoma presented with inferior vena cava thrombus. Mean tumor size was 11.6 cm. All patients underwent surgery, 2 patients with the presumed diagnosis of renal cell cancer. Liver transplantation techniques were an integral part in all radical nephrectomies. Results: No intraoperative complications and postoperative mortality occurred. Mean operative time was 7.5 hours, estimated blood loss was 1.5 L, and an average of 4.8 units of blood was transfused intraoperatively. Three patients succumbed to cancer recurrence at a mean postoperative time of 6.3 months; 1 patient is still alive 24 months after surgery. Conclusions: Large and locally-advanced renal masses of urothelial origin can be successfully removed by a combination of radical nephrectomy with liver transplantation techniques. Since long-term outcome of such patients has been poor, accurate preoperative diagnosis is essential to consider neoadjuvant treatment and to plan nephroureterectomy.

  3. 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.)

  4. 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.

  5. 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.

  6. 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.

  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. 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

  9. Long-term Outcomes of Percutaneous Venoplasty and Gianturco Stent Placement to Treat Obstruction of the Inferior Vena Cava Complicating Liver Transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Lorenz, Jonathan M., E-mail: jlorenz@radiology.bsd.uchicago.edu; Beek, Darren van; Funaki, Brian; Ha, Thuong G. Van; Zangan, Stephen; Navuluri, Rakesh; Leef, Jeffery A. [University of Chicago (United States)

    2013-05-11

    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.

  10. Real-time phase-contrast flow MRI of haemodynamic changes in the ascending aorta and superior vena cava during Mueller manoeuvre

    International Nuclear Information System (INIS)

    Aim: To evaluate the potential of real-time phase-contrast flow magnetic resonance imaging (MRI) at 40 ms resolution for the simultaneous determination of blood flow in the ascending aorta (AA) and superior vena cava (SVC) in response to reduced intrathoracic pressure (Mueller manoeuvre). Materials and methods: Through-plane flow was assessed in 20 healthy young subjects using real-time phase-contrast MRI based on highly undersampled radial fast low-angle shot (FLASH) with image reconstruction by regularized non-linear inversion. Haemodynamic alterations (three repetitions per subject = 60 events) were evaluated during normal breathing (10 s), inhalation with nearly closed epiglottis (10 s), and recovery (20 s). Results: Relative to normal breathing and despite interindividual differences, reduced intrathoracic pressure by at least 30 mmHg significantly decreased the initial peak mean velocity (averaged across the lumen) in the AA by ?24 ± 9% and increased the velocity in the SVC by +28 ± 25% (p < 0.0001, n = 23 successful events). Respective changes in flow volume per heartbeat were ?25 ± 9% in the AA and +49 ± 44% in the SVC (p < 0.0001, n = 23). Flow parameters returned to baseline during sustained pressure reduction, while the heart rate was elevated by 10% (p < 0.0001) after the start (n = 24) and end (n = 17) of the manoeuvre. Conclusions: Real-time flow MRI during low intrathoracic pressure non-invasively revealed quantitative haemodynamic adjustments in both the AA and SVC. - Highlights: • Direct monitoring of rapid haemodynamic adjustments can be achieved using real-time phase contrast MRI. • This technique allows for the simultaneous measurement of blood flow in multiple vessels. • It may improve our understanding of the cardiovascular consequences of sleep apnoea

  11. Follow-up Results of 71 Patients Undergoing Metallic Stent Placement for the Treatment of a Malignant Obstruction of the Superior Vena Cava

    International Nuclear Information System (INIS)

    Purpose. To retrospectively clarify the utility of metallic stent placement for the treatment of the malignant obstruction of the superior vena cava (SVC) in 71 patients with VC syndrome (SVCS) on the basis of long-term follow-up data. Materials and Methods. Seventy-one patients underwent stent placement and were followed until death. The applicability of the spiral Z-stent (S-Z-stent) mainly used the initial and follow-up results, stent placement for bilateral BCV obstruction and the value of concurrent anticancer therapy were studied. Results. The technical success rate was 100%, the initial clinical success rate was 87% (62/71), the primary clinical patency rate was 88% (57/65), and the secondary clinical patency rate was 95% (62/65). The obstruction rate of the stent was 12% (8/65), and an additional stent was useful for relief of recurrent SVCS. Survival of 57 patients in whom there was no recurrence of SVCS until death ranged from 1 week to 29 months (mean, 5.4 months and the S-Z-stent appeared to be suitable for the treatment of the malignant obstruction of SVC. Unilateral stent placement was effective for relief of SVCS with bilateral BCV obstruction. Patients who received concurrent anticancer therapy survived 2 months longer than those who did not. Conclusion. Stent placement is an effective treatment for SVCS. Further, the utility of S-Z-stent for SVCS, an additional stent for recurrence, unilateral stent for patients with bilateral BCV obstruction, and anticancer therapy after stent placement were verified

  12. Gradient echo sequences in the diagnosis of inferior vena cava obstruction. Les sequences d'echo de gradient dans le diagnostic de thrombose de la veine cave inferieure

    Energy Technology Data Exchange (ETDEWEB)

    Rahmouni, A.; Caseiro-Alves, J.; Mathieu, D.; Anglade, M.C.; Golli, M.; Berger, J.F.; Gheung, P.; Vasile, N. (Hopital Henri-Mondor, 94 - Creteil (FR))

    1991-11-01

    The capability for studying noninvasively vessels has been dramatically improved with the use of gradient echo sequences. Twenty-one patients presenting a suspected inferior vena cava obstruction on cavography underwent MR examination with axial, sagittal and coronal gradient echo images. Eighteen patients were also imaged with ultrasound and/or CT. Gradient echo sequences visualized a thrombus in 19 cases and a normal vein in the remaining 2 cases. The potential MR pitfalls are illustrated and the two cases of false positive on cavography are discussed. Gradient echo sequences allow a fast and performant examination of the vessels.

  13. 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 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

  14. 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.

  15. 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

  16. Avaliação de índices dopplerfluxométricos da veia cava inferior e do ducto venoso em fetos submetidos à transfusão intravascular / Inferior vena cava and ductus venosus doppler ultrasound index evaluation of fetuses undergoing intravascular transfusion

    Scientific Electronic Library Online (English)

    Ana Paula Brum Miranda, Lopes; Cézar de Alencar de Lima, Rezende; Antônio Carlos Vieira, Cabral; Henrique Vitor, Leite.

    2002-12-01

    Full Text Available OBJETIVO: avaliar os efeitos da transfusão intravascular nos índices dopplerfluxométricos do ducto venoso e da veia cava inferior (SV/CA) e relacionar essas alterações com o nível de hemoglobina pré-transfusão intravascular. MÉTODOS: trata-se de estudo transversal prospectivo. Foram realizadas 62 tr [...] ansfusões intravasculares em 27 fetos de gestações complicadas por isoimunização materno-fetal. Os 62 casos foram divididos em dois grupos: (A) fetos com níveis de hemoglobina pré-transfusão £10 g/dL, (B) fetos com níveis de hemoglobina pré-transfusão >10 g/dL. Os índices SV/CA e CA/SV foram medidos usando Doppler colorido 6 horas antes e 12 horas após a transfusão. Compararam-se os valores dos índices antes e após as transfusões em todos os 62 casos, e após a transfusão em cada grupo. O teste de Wilcoxon foi usado para comparação. Os resultados foram considerados estatisticamente significativos quando p£10 g/dL não foi observada diferença significativa nos valores de ambos os índices SV/CA e CA/SV, com p=0,061 e p=0,345, respectivamente. Após a transfusão intravascular houve aumento significativo do índice CA/SV em fetos com níveis de hemoglobina pré-transfusão >10 g/dL (p=0,049), mas o índice SV/CA não se alterou nesse grupo (p=0,086). CONCLUSÕES: o estudo por dopplervelocimetria venosa pode ser útil para a compreensão dos ajustes hemodinâmicos fetais após a transfusão intravascular. O aumento no índice SV/CA sem alteração no índice CA/SV após a transfusão em fetos anêmicos pode ser mecanismo compensatório importante em resposta ao aumento do volume intravascular. O aumento do índice CA/SV em fetos com hemoglobina pré-transfusão Abstract in english PURPOSE: to evaluate the effect of intravascular transfusion on ductus venosus and inferior vena cava Doppler ultrasound indexes (SV/CA) and to relate it to hemoglobin levels before transfusion. METHODS: this is a transversal prospective study. A total of 62 intravascular transfusions were performed [...] in 27 fetuses from pregnancies with red blood cell isoimmunization. The 62 cases were divided into two groups: (1) fetuses with hemoglobin levels before transfusion £10 g/dL and (2) fetuses with hemoglobin levels before transfusion >10 g/dL. The SV/CA and CA/SV indexes were measured using color Doppler ultrasound 6 h before and 12 h after intravascular transfusion. The index values before and after transfusion in all 62 cases were compared. Thereafter we compared these indexes before and after transfusion regarding each group. The Wilcoxon test was used and the results were considered statiscally significant when p£10 g/dL (p=0.061 and p=0.345, respectively). There was a significant increase in the CA/SV index after transfusion in fetuses with hemoglobin levels before transfusion >10 g/dL (p=0.049), but the SV/CA index did not change in this group (p=0.086). CONCLUSION: venous Doppler study may be useful to understand fetal hemodynamic adjustment after intravascular transfusion. An increase in SV/CA without change in CA/SV after transfusion in anemic fetuses may be an important compensatory mechanism to increase intravascular volume. The increase in CA/SV index in fetuses with hemoglobin levels before transfusion

  17. 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

  18. 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.

  19. 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.

  20. Transjugular liver biopsy: prospective evaluation of the angle formed between the hepatic veins and the vena cava main axis and modification of a semi-automated biopsy device in cases of an unfavorable angle

    International Nuclear Information System (INIS)

    In cases of transjugular liver biopsies, the venous angle formed between the chosen hepatic vein and the vena cava main axis in a frontal plane can be large, leading to technical difficulties. In a prospective study including 139 consecutive patients who underwent transjugular liver biopsy using the Quick-Core biopsy set, the mean venous angle was equal to 49.6 . For 21.1% of the patients, two attempts at hepatic venous catheterization failed because the venous angle was too large, with a mean of 69.7 . In all of these patients, manual reshaping of the distal curvature of the stiffening metallic cannula, by forming a new mean angle equal to 48 , allowed successful completion of the procedure in less than 10 min. (orig.)

  1. Assessment of left ventricular end-systolic pressure-volume relations with an impedance catheter and transient inferior vena cava occlusion: use of this system in the evaluation of the cardiotonic effects of dobutamine, milrinone, Posicor and epinephrine.

    Science.gov (United States)

    McKay, R G; Miller, M J; Ferguson, J J; Momomura, S; Sahagian, P; Grossman, W; Pasternak, R C

    1986-11-01

    The end-systolic pressure-volume relation has been postulated as a load-independent measure of cardiac contractility, but has been difficult to measure because of technical problems associated with the serial measurement of intracardiac volume over a physiologic range of ventricular loading conditions. Utilizing a multielectrode impedance catheter to assess continuous, on-line left ventricular relative volume during transient inferior vena cava occlusion, a method is described for determining the end-systolic pressure-volume relation and for assessing changes in this relation secondary to inotropic modulation. In particular, using this method, the relative inotropic properties were determined of four drugs: dobutamine, milrinone, epinephrine and an experimental cardiotonic agent (Ro 13-6438, Posicor). Left ventricular micromanometer pressure and impedance catheter volume were measured continuously in 10 open chest, anesthetized dogs and 14 pigs. Arterial pressure was altered over a range of 20 to 60 mm Hg by brief inferior vena cava constriction. A linear end-systolic pressure-volume relation was observed in pressure-volume diagrams constructed from on-line pressure and impedance catheter recordings. Administration of dobutamine, milrinone and epinephrine resulted in a leftward shift and an increase in the slope of the end-systolic pressure-volume relation as compared with baseline; Posicor did not alter the slope over a range of doses, despite an increase in the cardiac output secondary to arterial vasodilation. Volume changes as measured by the impedance method closely paralleled simultaneous changes in the ultrasonic crystal-determined segment length, and the impedance end-systolic pressure-volume relation slope was reproducible with repeated load-altering maneuvers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3760389

  2. 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.

  3. 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

  4. Polyphenol-Rich Fraction of Ecklonia cava Improves Nonalcoholic Fatty Liver Disease in High Fat Diet-Fed Mice

    Science.gov (United States)

    Park, Eun-Young; Choi, Hojung; Yoon, Ji-Young; Lee, In-Young; Seo, Youngwan; Moon, Hong-Seop; Hwang, Jong-Hee; Jun, Hee-Sook

    2015-01-01

    Ecklonia cava (E. cava; CA) is an edible brown alga with beneficial effects in diabetes via regulation of various metabolic processes such as lipogenesis, lipolysis, inflammation, and the antioxidant defense system in liver and adipose tissue. We investigated the effect of the polyphenol-rich fraction of E. cava produced from Gijang (G-CA) on nonalcoholic fatty liver disease (NAFLD) in high-fat diet (HFD)-fed mice. C57BL6 mice were fed a HFD for six weeks and then the HFD group was administered 300 mg/kg of G-CA extracts by oral intubation for 10 weeks. Body weight, fat mass, and serum biochemical parameters were reduced by G-CA extract treatment. MRI/MRS analysis showed that liver fat and liver volume in HFD-induced obese mice were reduced by G-CA extract treatment. Further, we analyzed hepatic gene expression related to inflammation and lipid metabolism. The mRNA expression levels of inflammatory cytokines and hepatic lipogenesis-related genes were decreased in G-CA-treated HFD mice. The mRNA expression levels of cholesterol 7 alpha-hydroxylase 1 (CYP7A1), the key enzyme in bile acid synthesis, were dramatically increased by G-CA treatment in HFD mice. We suggest that G-CA treatment ameliorated hepatic steatosis by inhibiting inflammation and improving lipid metabolism. PMID:26569269

  5. Polyphenol-Rich Fraction of Ecklonia cava Improves Nonalcoholic Fatty Liver Disease in High Fat Diet-Fed Mice

    Directory of Open Access Journals (Sweden)

    Eun-Young Park

    2015-11-01

    Full Text Available Ecklonia cava (E. cava; CA is an edible brown alga with beneficial effects in diabetes via regulation of various metabolic processes such as lipogenesis, lipolysis, inflammation, and the antioxidant defense system in liver and adipose tissue. We investigated the effect of the polyphenol-rich fraction of E. cava produced from Gijang (G-CA on nonalcoholic fatty liver disease (NAFLD in high-fat diet (HFD-fed mice. C57BL6 mice were fed a HFD for six weeks and then the HFD group was administered 300 mg/kg of G-CA extracts by oral intubation for 10 weeks. Body weight, fat mass, and serum biochemical parameters were reduced by G-CA extract treatment. MRI/MRS analysis showed that liver fat and liver volume in HFD-induced obese mice were reduced by G-CA extract treatment. Further, we analyzed hepatic gene expression related to inflammation and lipid metabolism. The mRNA expression levels of inflammatory cytokines and hepatic lipogenesis-related genes were decreased in G-CA-treated HFD mice. The mRNA expression levels of cholesterol 7 alpha-hydroxylase 1 (CYP7A1, the key enzyme in bile acid synthesis, were dramatically increased by G-CA treatment in HFD mice. We suggest that G-CA treatment ameliorated hepatic steatosis by inhibiting inflammation and improving lipid metabolism.

  6. The consensus among Chinese interventional experts on the standard of inferior vena cave filter insertion and retrieval

    International Nuclear Information System (INIS)

    This paper aims to propose the indications and contraindications of inferior vena cava filter insertion and retrieval through a careful review of its development history and a specific analysis of its current situation. The perioperative management, the manipulating procedure, the perioperative complications and preventions, etc. are summarized and illustrated. It is emphasized that temporary as well as retrievable inferior vena cava filters should be employed as far as possible in order to effectively reduce the occurrence of complications caused by long-term dwelling of the inferior vena cava filter. (authors)

  7. 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

  8. Percutaneous Stent Placement as Treatment of Renal Vein Obstruction Due to Inferior Vena Caval Thrombosis

    International Nuclear Information System (INIS)

    A patient who had undergone his third orthotopic liver transplantation nearly 9 years prior to presentation developed worsening hepatic and renal function, as well as severe bilateral lower extremity edema. Magnetic resonance imaging demonstrated vena caval thrombosis from the suprahepatic venous anastomosis to the infrarenal inferior vena cava, obstructing the renal veins. This was treated by percutaneous placement of metallic stents from the renal veins to the right atrium. At 16 months clinical follow-up, the patient continues to do well

  9. Transhepatic approach for catheter ablation of accessory pathway in a child with complex congenital heart disease

    OpenAIRE

    Sreeram, N; Emmel, M; Brockmeier, K.

    2004-01-01

    We report on a 22-month-old boy with drug-resistant atrioventricular reentrant tachycardia and complex structural heart disease consisting of right atrial isomerism, mirror image orientation of the intrathoracic veins, hemi-azygos continuation to the left superior vena cava, separate drainage of the hepatic veins into the left-sided atrium, congenitally corrected transposition, pulmonary atresia, and atrial and ventricular septal defects.

  10. 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)

  11. Medical image of the week: duplicate superior vena cava

    Directory of Open Access Journals (Sweden)

    L'Heureux D

    2013-04-01

    Full Text Available A persistent left SVC is the most common thoracic venous anomaly and usually opens into the right atrium via the coronary sinus. A central line inserted into the left SVC may be mistaken for placement in other sites such as the subclavian or carotid artery, the mediastinum, the pericardium or pleural space. A duplicate SVC may cause difficulty in introducing central venous catheters or pulmonary artery catheters because of the narrow opening of the coronary sinus to reach the right atrium. In addition, a duplicate SVC is associated with important cardiac conditions such as atrial septal defects and ventricular arrhythmias.

  12. Endovascular stenting in malignant obstruction of superior vena cava

    Directory of Open Access Journals (Sweden)

    Julian Hamzik

    2015-01-01

    Conclusion: Lymphomas are a common cause of SVCS in young age. HL may present as SVCS. Pathological confirmation of diagnosis should be done before initiating therapy while dealing with a case of SVCS. SVC stenting is effective and has few complications in patients with SVCS.

  13. 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.

  14. 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.

  15. 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.

  16. Characteristics of sublingual venae in primary liver cancer patients in different clinical stages

    OpenAIRE

    Liu, Qing

    2004-01-01

    Objective: To explore the characteristics of the sublingual venae in patients with primary liver cancer (PLC). Methods: The shape, color and the red, green and blue values of the sublingual venae were analyzed quantitatively for PLC patients in different clinical stages by analysis system for comprehensive information of tongue diagnosis. Results: With the aggravating of the disease, the patients' sublingual venae became wide and tortuous, and their color became blue and purple. The abnormali...

  17. 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.

  18. 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.

  19. First Magnetic Resonance Imaging-Guided Aortic Stenting and Cava Filter Placement Using a Polyetheretherketone-Based Magnetic Resonance Imaging-Compatible Guidewire in Swine: Proof of Concept

    International Nuclear Information System (INIS)

    The purpose of this study was to demonstrate feasibility of percutaneous transluminal aortic stenting and cava filter placement under magnetic resonance imaging (MRI) guidance exclusively using a polyetheretherketone (PEEK)-based MRI-compatible guidewire. Percutaneous transluminal aortic stenting and cava filter placement were performed in 3 domestic swine. Procedures were performed under MRI-guidance in an open-bore 1.5-T scanner. The applied 0.035-inch guidewire has a PEEK core reinforced by fibres, floppy tip, hydrophilic coating, and paramagnetic markings for passive visualization. Through an 11F sheath, the guidewire was advanced into the abdominal (swine 1) or thoracic aorta (swine 2), and the stents were deployed. The guidewire was advanced into the inferior vena cava (swine 3), and the cava filter was deployed. Postmortem autopsy was performed. Procedural success, guidewire visibility, pushability, and stent support were qualitatively assessed by consensus. Procedure times were documented. Guidewire guidance into the abdominal and thoracic aortas and the inferior vena cava was successful. Stent deployments were successful in the abdominal (swine 1) and thoracic (swine 2) segments of the descending aorta. Cava filter positioning and deployment was successful. Autopsy documented good stent and filter positioning. Guidewire visibility through applied markers was rated acceptable for aortic stenting and good for venous filter placement. Steerability, pushability, and device support were good. The PEEK-based guidewire allows either percutaneous MRI-guided aortic stenting in the thoracic and abdominal segments of the descending aorta and filter placement in the inferior vena cava with acceptable to good device visibility and offers good steerability, pushability, and device support.

  20. 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.

  1. 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

  2. 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.

  3. Virtual surgeries in patients with congenital heart disease: a multi-scale modelling test case.

    Science.gov (United States)

    Baretta, A; Corsini, C; Yang, W; Vignon-Clementel, I E; Marsden, A L; Feinstein, J A; Hsia, T-Y; Dubini, G; Migliavacca, F; Pennati, G

    2011-11-13

    The objective of this work is to perform a virtual planning of surgical repairs in patients with congenital heart diseases--to test the predictive capability of a closed-loop multi-scale model. As a first step, we reproduced the pre-operative state of a specific patient with a univentricular circulation and a bidirectional cavopulmonary anastomosis (BCPA), starting from the patient's clinical data. Namely, by adopting a closed-loop multi-scale approach, the boundary conditions at the inlet and outlet sections of the three-dimensional model were automatically calculated by a lumped parameter network. Successively, we simulated three alternative surgical designs of the total cavopulmonary connection (TCPC). In particular, a T-junction of the venae cavae to the pulmonary arteries (T-TCPC), a design with an offset between the venae cavae (O-TCPC) and a Y-graft design (Y-TCPC) were compared. A multi-scale closed-loop model consisting of a lumped parameter network representing the whole circulation and a patient-specific three-dimensional finite volume model of the BCPA with detailed pulmonary anatomy was built. The three TCPC alternatives were investigated in terms of energetics and haemodynamics. Effects of exercise were also investigated. Results showed that the pre-operative caval flows should not be used as boundary conditions in post-operative simulations owing to changes in the flow waveforms post-operatively. The multi-scale approach is a possible solution to overcome this incongruence. Power losses of the Y-TCPC were lower than all other TCPC models both at rest and under exercise conditions and it distributed the inferior vena cava flow evenly to both lungs. Further work is needed to correlate results from these simulations with clinical outcomes. PMID:21969678

  4. 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

    Scientific Electronic Library Online (English)

    Fernando Hintz, Greca; Lucia de, Noronha; Francisco Diniz Afonso da, Costa; Zacarias Alves de, Souza Filho; Andréa Thomaz, Soccol; André Néry, Feres; Jõao Ricardo, Duda; Eduardo, Adams.

    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 ident [...] ificada 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. Abstract in english 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.

  5. 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.

  6. Diagnostics of vascular diseases as a cause for acute abdomen

    International Nuclear Information System (INIS)

    Vascular pathologies are rare causes of an acute abdomen. If the cause is a vascular disease a rapid diagnosis is desired as vascular pathologies are associated with high mortality. A differentiation must be made between arterial and venous diseases. An occlusion of the superior mesenteric artery is the most common reason for acute mesenteric ischemia but intra-abdominal arterial bleeding is also of great importance. Venous pathologies include thrombotic occlusion of the portal vein, the mesenteric vein and the vena cava. Multi-detector computed tomography (MDCT) is predestined for the diagnostics of vascular diseases of the abdomen. Using multiphasic contrast protocols enables reliable imaging of the arterial and venous vessel tree and detection of disorders with high sensitivity and specificity. Although conventional angiography has been almost completely replaced by MDCT as a diagnostic tool, it is still of high importance for minimally invasive interventions, for example in the management of gastrointestinal bleeding. (orig.)

  7. 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.

  8. Physiological amyloid-beta clearance in the periphery and its therapeutic potential for Alzheimer's disease.

    Science.gov (United States)

    Xiang, Yang; Bu, Xian-Le; Liu, Yu-Hui; Zhu, Chi; Shen, Lin-Lin; Jiao, Shu-Sheng; Zhu, Xiao-Yan; Giunta, Brian; Tan, Jun; Song, Wei-Hong; Zhou, Hua-Dong; Zhou, Xin-Fu; Wang, Yan-Jiang

    2015-10-01

    Amyloid-beta (A?) plays a pivotal role in the pathogenesis of Alzheimer's disease (AD). The physiological capacity of peripheral tissues and organs in clearing brain-derived A? and its therapeutic potential for AD remains largely unknown. Here, we measured blood A? levels in different locations of the circulation in humans and mice, and used a parabiosis model to investigate the effect of peripheral A? catabolism on AD pathogenesis. We found that blood A? levels in the inferior/posterior vena cava were lower than that in the superior vena cava in both humans and mice. In addition, injected (125)I labeled A?40 was located mostly in the liver, kidney, gastrointestinal tract, and skin but very little in the brain; suggesting that A? derived from the brain can be cleared in the periphery. Parabiosis before and after A? deposition in the brain significantly reduced brain A? burden without alterations in the expression of amyloid precursor protein, A? generating and degrading enzymes, A? transport receptors, and AD-type pathologies including hyperphosphorylated tau, neuroinflammation, as well as neuronal degeneration and loss in the brains of parabiotic AD mice. Our study revealed that the peripheral system is potent in clearing brain A? and preventing AD pathogenesis. The present work suggests that peripheral A? clearance is a valid therapeutic approach for AD, and implies that deficits in the A? clearance in the periphery might also contribute to AD pathogenesis. PMID:26363791

  9. Isolated local recurrence of renal neoplasm with caval involvement 16 years after radical nephrectomy / Recurrencia local aislada de tumoración renal con afectación de cava 16 años después de la nefrectomía radical

    Scientific Electronic Library Online (English)

    L., D’Arrigo; M., Pennisi; P., Pepe; A., Scolaro; A., Lomeo; F., Aragona.

    2005-12-01

    Full Text Available OBJETIVOS: Presentar un caso de recurrencia local de tumor renal 16 años después de nefrectomía radical; analizar los datos de la literatura sobre tratamiento y pronóstico. MÉTODOS/RESULTADOS: Presentamos un caso de recurrencia local asociado con trombosis de la vena cava que fue intervenido mediant [...] e resección en bloque del tumor y la vena cava con sustitución por una prótesis PTFE. CONCLUSIONES: La recurrencia local después de nefrectomía radical es rara, siendo comunicada entre el 2-4% de los pacientes. Esta condición es incluso más rara después de diez años, especialmente si está asociada con trombosis de la vena cava. Se describe un caso de recurrencia local aislada de carcinoma de células renales con afectación de la cava 16 años después de nefrectomía radical. Pensamos que éste es el primer caso comunicado en la literatura. Este caso destaca la oportunidad de las revisiones periódicas de los pacientes sometidos a nefrectomía radical incluso muchos años después de cirugía. Abstract in english OBJECTIVE: To report a case of local recurrence 16 years after radical nephrectomy; to analyse literature data concerning, treatment and prognosis. METHODS/RESULTS: We report a case of local recurence associated with caval trombosis who was underwent an en-bloc resection of vena cava along with peri [...] caval lesion and caval replacement with PTFE prosthesis. The Authors reviewed and analysed literature data. CONCLUSIONS: Local recurrence after radical nephrectomy is rare as it is reported only in 2-4% of patients. This condition is even rarer beyond 10 years especially if associated with caval trombosis. A case of isolated local recurrence of renal cell carcinoma with caval involvement 16 years after radical nephrectomy is described herein. To the best of our knowledge, this is the first case reported in literature. This case highlights the opportunity of a periodic check-up of patients submitted to radical nephrectomy, even many years after surgery.

  10. 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.

  11. 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.

  12. A novel approach to an anatomical adapted stent design for the percutaneous therapy of tricuspid valve diseases: preliminary experiences from an engineering point of view.

    Science.gov (United States)

    Pott, Desiree; Malasa, Margarita; Urban, Ute; Kütting, Maximilian; Safi, Yara; Roggenkamp, Jan; Steinseifer, Ulrich; Hatam, Nima; Autschbach, Rüdiger; Spillner, Jan; Amerini, Andrea

    2012-01-01

    Tricuspid valve regurgitation mostly occurs as result of dilation of the right ventricle, secondary to left heart valve diseases. Until recently, little attention has been given to the development of percutaneous therapeutic tools exclusively designed for tricuspid valve disease. A new approach to the interventional therapy of tricuspid regurgitation, in particular, the design of a conceptual new valve-bearing, self-expansible stent, is presented here. A three-dimensional computer model of a right porcine heart was developed to gain a realistic anatomical geometry. The new design consists of two tubular stent elements, one inside the superior vena cava and the other inside the tricuspid valve annulus after being eventually equipped with a biological valve prosthesis, which are connected by struts. Anchoring to the heart structure is provided primarily by the vena cava stent, strengthened by the struts. The stents are designed to be cut from a 10 mm tube and later expanded to their designated diameter. Simulation software analyzing the expansion process with respect to the intended geometrical design is used in an iterative process. A validation of the anatomical geometry and function of the stent design inside a silicone model within in vitro tests and a random porcine heart shows an accurate anatomical fitting. PMID:22990286

  13. Aneurisma de la vena de Galeno Galen's vein aneurysm

    Directory of Open Access Journals (Sweden)

    Sergio Piloña Ruiz

    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 muy 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.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 depends 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.

  14. 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.

  15. A fatal case of Batch's disease with rare complications

    International Nuclear Information System (INIS)

    Behcet's disease (BD) may involve in any large or small artery, vein. We present a case of BD with multiple venous thromboses cardiac and pulmonary involvements, and renal failure. A 22-year-old admitted with progressive dyspnea and edema on his face and neck. He had the history of recurrent oral and genital ulcers, and pustular skin lesions for 4 years. Doppler ultrasonography revealed right internal jugular vein thrombosis. Transthoracic echocardiography showed a pericardial effusion, decreased left ventricular ejection fraction. While his symptoms were regressing moderately with a pulse cyclophosphamide, prednisolone, and low molecular weight heparin, treatment, new thrombosis occurred in vena cava inferior, and bilateral renal veins after the third and 7th dosage of pulse cyclophosamide. Creatinine levels increased progressively, which required hemodialysis. However, he died after the second session of hemodialysis. Patients with BD should be followed up for new developing thrombosis even during an immunosuppressive treatment. (author)

  16. 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.

  17. Enfermedad hidatídica diseminada con localización mediastinal como causa de síndrome de vena cava superior

    Scientific Electronic Library Online (English)

    José Luis, Pinto Valdivia; Yaneth, De Sosa; Oscar, Gayoso Cervantes; Javier, Díaz Urteaga; Omayra, Chincha.

    2001-10-01

    Full Text Available [...] Abstract in english Hydatidic illness is a frequent parasitic zoonosis in our country whose more frequent localization is the liver and the lungs. However other many sites have been described, depending their symptoms on the cyst’s size, localization and effect on next structures, being sometimes its evolution fatal. T [...] his is a 52 year-old female patient admitted at emergency room for dysfunction of sensory and neurological focalization. She had a previous history of surgery many years ago by abdominal tumor. We found a collateral circulation on right hemithorax and facial and arms edema at exam. The cerebral CT howed extensive left parietal parenchymal hemorrhage. Thoracoabdominal CT revealed multiple cystic masses of diverse sizes in the mediastinum, lungs, liver and other places. The patient’s evolution was torpid, the neurological compromise didn’t improve in spite of the treatment against the intracranial hypertension (EH), being also added a nosocomial pneumonia. The patient died after several days. Necropsy revealed presence of cystic lesions in mediastinum, heart’s great vessels, pericardium, lungs, liver, spleen and mentum, as well as intra and extraparenchymal hemorrhages of hypertensive cause in brain, not being cystic lesions in central nervous system. We concluded that it was disseminated hydatidic illness, cysts in the mediastinum caused compression of the heart’s great vessels, causing a superior cave vein syndrome. ( Rev Med Hered 2001; 12: 142-149 )

  18. Identifying diversion of inferior vena cava after repair of atrial septal defect.

    Science.gov (United States)

    Lee, Yi Wei; Lee, Wei Chieh; Chua, Sarah

    2015-10-01

    Inadvertent IVC diversion into left atrium is a rare morbidity following ASD repair. Reported risk factors included a large secundum, or low-lying ASD, or inferior sinus venosus defect, and anomalous pulmonary connection into the RA. In our case, transesophageal echocardiogram showed abnormal connection of IVC to LA, but could not be identified owing to limited window. Cardiac CT could offer better anatomic clarification. On contrast transesophageal echocardiogram with agitated saline injected via right femoral vein, an abnormal right-to-left shunt was demonstrated by transit of microbubbles from IVC into LA, while majority of rest entered into the RA. Therefore, we confirm the IVC diversion into LA. Detection of such unusual condition is a challenge due to the fact that special echocardiographic windows are often needed. PMID:26088264

  19. Adrenocortical carcinoma with inferior vena cava, left renal vein and right atrium tumor thrombus extension

    Directory of Open Access Journals (Sweden)

    Pronio Annamaria

    2015-01-01

    Conclusion: We present a rare case of Adrenocortical carcinoma with tumor thrombus extending into the IVC and right atrium. Complete resection with negative margins represents the best therapeutic chance for these patients.

  20. Saccular aneurysm of superior vena cava treated with percutaneous, transcatheter thrombin injection.

    Science.gov (United States)

    Jargiello, Tomasz; Durakiewicz, Marek; Sojka, Micha?; Czekajska-Chehab, Elzbieta; Szczerbo-Trojanowska, Malgorzata

    2014-04-01

    We report the case of successful endovascular treatment of large saccular aneurysm of SVC in a patient with vascular malformation of right hand and chest. Considering the high risk of surgery, the patient was referred for percutaneous intervention. Venography showed communication between the aneurysm and SVC, just below brachiocephalic confluence. That is why the decision of balloon-protected transcatheter thrombin injection was made. Selective catheter was placed in the aneurysm and balloon occlusion catheter in SVC. Both catheters were withdrawn right after thrombin injection. During follow-up, aneurysm slightly enlarged in early observation and after a year shrinkage was observed. PMID:23737024

  1. Non-surgical cannulation of the vena cava for chronic blood collection in mature swine.

    Science.gov (United States)

    Smith, C A; Ficken, M D

    1991-06-01

    A nonsurgical cannulation technique for blood collections from mature swine was evaluated. Primiparous Yorkshire-Landrace sows (n = 6) received an indwelling jugular vein cannulae for 7 days duration. Recannulation was performed at monthly intervals for a total of 14 months. During cannulation, sows were restrained in a standing position using a rope snout snare. A 12-gauge by 10 cm needle was inserted into the jugular vein. Sterilized polyvinyl chloride tubing was advanced through the needle into the vein and a blunted 18-gauge needle and attached intermittent injection hub was inserted into the free end of the tubing. Surgical tape was used to form a butterfly on the tubing by suturing the tape to the animals' skin. Foam padding, livestock cement, and elastic tape helped to keep the tubing in position. Problems with cannulae patency and maintenance were few. No behavioral problems or systemic signs of illness were noted and necropsy examinations performed after the final cannulation revealed few abnormalities associated with chronic intermittent cannulation. This technique provides a safe, quick, effective means for multiple and repeated cannulae placement for blood collection from mature swine with minimal effects on the animal and without the risks associated with surgical techniques. PMID:1658470

  2. Giant saphenous vein graft pseudoaneurysm to right posterior descending artery presenting with superior vena cava syndrome

    OpenAIRE

    Vargas-Estrada, Andres; Edwards, Dianna; Bashir, Mohammad; Rossen, James; Zahr, Firas

    2015-01-01

    Saphenous vein grafts (SVG) pseudoaneurysms, especially giant ones, are rare and occur as a late complication of coronary artery bypass grafting. This condition affects both genders and typically occurs within the sixth decade of life. The clinical presentation ranges from an asymptomatic incidental finding on imaging studies to new onset angina, dyspnea, myocardial infarction or symptoms related to compression of neighboring structures. An 82-year-old woman presented with acute onset back pa...

  3. Obstruction of Vena Cava and Collateral Flow after Abdominal Reconstruction for Gastroschisis

    Directory of Open Access Journals (Sweden)

    Wenceslao M. Calonge, MD

    2015-02-01

    Full Text Available 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.

  4. 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.

  5. 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.

  6. Cisterna chyli in patients with malignancy-Influence of cardiovascular disease on the prevalence of the cisterna

    International Nuclear Information System (INIS)

    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.

  7. 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 directly and rapidly into either a malleolar or a femoral vein while the patient lay supine under the 13.5' detector head of a scinticamera. Rapid sequential scintiphotos were manually taken at approximately 1 sec. interval for 20-30 sec. Thus iliac vein, I.V.C., cardiopulmonary zone in infants, aorta and the arterial phase were visualized. 48% of these subjets had an abnormal I.V.C. and the depictions were interestingly varied, indicating that different patients responded in a different manner even to grossly similar pathologies. It became evident that this soft walled vessel could be compressed by both fluids and neoplastic tissue; the long I.V.C. channel could also be segmentally pushed away by a mass inits vicinity. An abnormal arterial flush usually differentiated between benign and malignant lesions, even when the mass was extra-hepatic and retiroperitoneal. Such a systematic study of I.V.C. had not been possible earlier since the classical X-ray contrast inferior vena cavagram necessitates venous dissection, passage of a catheter, and the injection of large volume of fluid under an unphysiologically high pressure. The simplified radionuclide technique, however, permitted the study of neonates and critically ill subjects with massive ascites, while retaining a satisfactory reproducability. (orig.)

  8. Hemiazygos continuation of v.cava inferior: a case report

    International Nuclear Information System (INIS)

    Full text: A 78-year-old female patient was suffering from dyspnoea and tachypnoea in our hospital's orthopaedic clinic. Because she had an operation of right femoral mid-diaphizer fracture a week ago, we decided to perform a pulmonary computerized tomography angiography (CTA) examination with her clinicians in order to evaluate a possible pulmonary embolism and to make a further evaluation. In her CTA exam there were no pulmonary embolism was seen. There were some chronic changes in her lungs, bilateral pleural effusion and hilar lymphadenomagalies. A dilated and tortiozed vascular structure which was retrocrural and retroaortic placed at the level of the thorachoabdominal transition and joined to left brachiocephalic vein was seen. Then we realized that the liver was symmetrical and transverse localization the upper abdomen and the stomach and spleen was in the right upper quadrant. Because the cardiac apex was left-sided we decided that a kind of situs ambiguous. After that the patient was underwent a abdominal contrast enhanced CT which was including the both arterial and venous phases. In this examination the suprarenal part of the inferior vena cava (IVC) was interrupted and it was continuing as hemiazygos vein to the thorax something like the previous CT exam. The hepatic veins were drained into a short segment vein and then the right atrium. Multiple nodular parenchymal images which were enhanced like spleen in all phases were seen in right upper quadrant of the abdomen (polysplenia). And also partial agenesis of the pancreas and annular pancreas configuration was seen. Anomalies of the IVC occur rarely and the patient are usually asymptomatic. Non-invasive imaging modalities such as CT and MRI allow better identification of these anomalies. In these cases different organ anomalies accompanies the IVC anomalies

  9. Malformación de la vena de Galeno

    Scientific Electronic Library Online (English)

    Javier, González Ramos; Alejandro, Ceciliano; Graciela, Zuccaro.

    2006-12-01

    Full Text Available Objetivo: describir y analizar la embriología, anatomía, angioarquitectura y clínica de la malformación de la vena de Galeno. Método: revisión bibliográfica con actualización del tema. Resultados: la malformación de la vena de Galeno es una anormalidad congénita que representa el 30% de las lesiones [...] vasculares en los pacientes pediátricos. Se caracteriza por la persistencia de una vena embrionaria: la vena prosencefálica media, asociada a shunts arteriales por persistencia de una conexión fistulosa con arterias coroideas primitivas. La vena de Galeno se localiza en la región pineal, dentro de la cisterna cuadrigeminal. Se forma por la unión de las venas cerebrales internas y cursa posteriormente drenando hacia el seno recto. Su longitud varía de 3,1 a 25 mm. Las malformaciones de la vena de Galeno se clasifican en: 1) malformación aneurismática verdadera y 2) dilatación aneurismática. Basándose en la angioarquitectura el primer tipo se divide en 2 formas: mural y coroidea. La presentación clínica es variada y depende del tipo. El diagnóstico prenatal es posible con la ecografía y la resonancia magnética. El diagnóstico definitivo se logra con la angiografía digital. El éxito del tratamiento depende del reconocimiento de sus tipos y formas y, de un adecuado equipo de especialistas. Conclusión: el conocimiento de la embriología, anatomía y , tipos y formas de la malformación de la vena de Galeno, aseguran el éxito del diagnóstico y tratamiento. Abstract in english Objective: to describe and analyse the embryology, anatomy, angioarchitecture and clinical presentation of the vein of Galen malformation. Method: bibliographic review and up to date. Results: the vein of Galen malformation is a congenital anomaly that represents 30% of all the vascular lesions in t [...] he pediatric population. It is secondary to the persistence of an embrionary vein: the medial prosencephalic vein, associated with arterial shunts secondary to the persistence of a fistulous connection with the coroideal primitive arteries. The vein of Galen is localized at the pineal region, within the cuadrigeminal cistern. It is formed by the union of both internal cerebral veins and drains posteriorly into strait sinus. It has a length of 3.1 to 25 mm. They are classified in: 1) truth aneurismal malformation and 2) aneurismal dilatation. Based on its angioarchitecture the first type is divided into 2 forms: mural and coroidal. The clinical presentation is variable and depends on the type. Prenatal diagnosis is possible with ecography and magnetic resonance. Definitive diagnosis is performed with digital angiography. A successful treatment depends on the recognition of the different types and forms and on the presence of an appropriate team of specialists. Conclusion: the knowledge of the embryology, anatomy and, types and forms of the vein of Galen malformation assure the success of its diagnosis and treatment.

  10. Retrievable vena caval filter percutaneously introduced.

    Science.gov (United States)

    Lund, G; Rysavy, J; Hunter, D W; Castaneda-Zuniga, W R; Amplatz, K

    1985-06-01

    A vena caval filter than can be introduced percutaneously via the femoral vein is described. We placed these filters in five patients without complications. Experimental work in filter removal one to two weeks after insertion in dogs has been performed. PMID:4001390

  11. Corylucinine, a new Alkaloid from Corydalis cava (Fumariaceae), and its Cholinesterase Activity.

    Czech Academy of Sciences Publication Activity Database

    Novák, Z.; Chlebek, J.; Opletal, L.; Jiroš, Pavel; Macáková, K.; Kuneš, J.; Cahlíková, L.

    2012-01-01

    Ro?. 7, ?. 7 (2012), s. 859-860. ISSN 1934-578X Grant ostatní: SVV UK(CZ) 265002; SVV UK(CZ) 265001; FRVŠ(CZ) 664/2011; UNCE UK(CZ) 17/2012/ Institutional research plan: CEZ:AV0Z40550506 Keywords : Corydalis cava * corylucinine * 8-trichloromethyl-7,8-dihydropalmatine * acetylcholinesterase * butyrylcholinesterase * Alzheimer's disease Subject RIV: CC - Organic Chemistry Impact factor: 0.956, year: 2012

  12. Seminoma Presenting as Renal Mass, Inferior Vena Caval Thrombus, and Regressed Testicular Mass

    OpenAIRE

    Raup, Valary T; Michael H. Johnson; Weese, Jonathan R.; Hagemann, Ian S.; Marshall, Stephen D.; Brandes, Steven B.

    2015-01-01

    Testicular cancer is the most common malignancy of men aged 15–40. Metastatic spread classically begins with involvement of the retroperitoneal lymph nodes, with metastases to the liver, lung, bone, and brain representing advancing disease. Treatment is based on pathologic analysis of the excised testicle and presence of elevated tumor markers. We report a case of a 34-year-old male presenting with back pain who was found to have a right renal mass with tumor extension into the inferior vena ...

  13. Global Hepatic Uptake of {sup 99m}Tc-MAA During VQ Scintigraphy Secondary to Synchronous Superior and Inferior Vena Caval Obstruction: a Demonstraion of Trans-Portal Venous Collateral Pathways

    Energy Technology Data Exchange (ETDEWEB)

    Conway, Oliver; Lloyd, Simon; Gruening, Thomas [Derriford Hospital, Plymouth (United States)

    2013-12-15

    A 38-year-old woman underwent lung scintigraphy. Injection of technetium-99m macroaggregated albumin ({sup 99m}Tc-MAA) via the left antecubital fossa revealed global hepatic uptake. Review of contemporary computed tomography (CT) imaging demonstrated synchronous superior and inferior vena cava (SVC and IVC) obstruction, with formation of systemic-portal venous collateral pathways. Systemic-portal venous collateralisation can in rare circumstances lead to focal hepatic uptake of {sup 99m}Tc-MAA during lung scintigraphy. This case of global hepatic uptake, secondary to synchronous SVC and IVC obstruction, demonstrates the trans-portal venous collateral pathways leading to this unusual imaging outcome.

  14. Valor pronóstico de la afectación microscópica de la vena renal en el cáncer de células renales / Prognostic significance of the microscopic invasion of the renal vein wall in renal cell cancer

    Scientific Electronic Library Online (English)

    Gloria, Bocardo Fajardo; Ramón, Arellano Gañán; Lucía, González López; Inmaculada, Fernández González; Julia, Blanco González; Pablo, Garrido Abad; Almudena, Coloma del Peso; Ignacio, Pereira Sanz.

    2009-10-01

    Full Text Available Objetivo: En el carcinoma de células renales, la TNM define el estadio T3b como afectación macroscópica de la vena renal o cava infradiafragmática. El valor pronóstico de la invasión microscópica de la pared de la vena no se contempla. Analizamos la repercusión de ésta en la evolución de estos tumor [...] es, en estadios localizados y localmente avanzados. Métodos: De 257 carcinomas de células renales operados (Enero de 1989 / Julio de 2002), se analizan retrospectivamente 241 (excluímos los estadios IV y los casos con enfermedad de Von-Hippel-Lindau). El seguimiento mediano es de 50,96 meses. Tenemos datos de la histología de la vena en 216 casos. Comparamos el grupo con invasión microscópica de la pared (22 casos) frente al resto (n: 194). Resultado: En el grupo con afectación de la pared, la edad media es 65,02 años. El tamaño medio es 9 cm (significativamente superior, p Abstract in english Objectives: International TNM Staging System for renal cell carcinoma (RCC) classifies as T3b when "tumor grossly extends into the renal vein or its segmental branches, or vena cava below the diaphragm". The finding of microscopic invasion of the vein wall is not taken into account for TNM staging. [...] We analyse its prognostic significance in localized and locally advanced RCC. Methods: From January 1989 to July 2002, 257 RCC were surgically excised. Excluding Von Hippel-Lindau patients and stage IV (TNM 2002), 241 cases were studied in retrospect, with a median follow up of 50.96 months. Histopathological data from the renal vein were available in 216 specimens. There was renal vein wall invasion in 22. We compare the outcomes in this group vs. the group without microscopic involvement of the renal vein wall (n: 194). Results: Mean age for the group with renal vein invasion (RVI) was 65.02 years. Mean tumour size in the same group was 9 cm, larger than in control group (p

  15. Ressecção de metastáses hepáticas em dois estágios e reconstrução da veia cava suprarrenal Two-stage hepatectomy for hepatic metastasis and supra renal vena cava reconstruction

    Directory of Open Access Journals (Sweden)

    João Eduardo Nicoluzzi

    2012-12-01

    Full Text Available A hepatectomia em duas etapas utiliza a capacidade de regeneração do fígado, após uma primeira hepatectomia não curativa, para permitir uma segunda ressecção. Neste artigo relatamos os aspectos técnicos do manejo de uma doente de 37 anos de idade, com metástases colorretais sincrônicas, onde uma única hepatectomia não era suficiente para remover todas as lesões, mesmo em combinação com quimioterapia, embolização portal ou radiofrequência. Porém as metástases poderiam ser removidas por duas ressecções sequenciais.Two-stage hepatectomy uses compensatory liver regeneration after a first noncurative hepatectomy to enable a second curative resection. Herein we report the tecnical aspects of the management of a thirty-seven years-old woman with colorectal metastasis to the liver eligible because single resection could not achieve complete treatment, even in combination with chemotherapy, portal embolization, or radiofrequency, but tumors could be totally removed by two sequential resections.

  16. Ressecção de metastáses hepáticas em dois estágios e reconstrução da veia cava suprarrenal / Two-stage hepatectomy for hepatic metastasis and supra renal vena cava reconstruction

    Scientific Electronic Library Online (English)

    João Eduardo, Nicoluzzi.

    2012-12-01

    Full Text Available A hepatectomia em duas etapas utiliza a capacidade de regeneração do fígado, após uma primeira hepatectomia não curativa, para permitir uma segunda ressecção. Neste artigo relatamos os aspectos técnicos do manejo de uma doente de 37 anos de idade, com metástases colorretais sincrônicas, onde uma úni [...] ca hepatectomia não era suficiente para remover todas as lesões, mesmo em combinação com quimioterapia, embolização portal ou radiofrequência. Porém as metástases poderiam ser removidas por duas ressecções sequenciais. Abstract in english Two-stage hepatectomy uses compensatory liver regeneration after a first noncurative hepatectomy to enable a second curative resection. Herein we report the tecnical aspects of the management of a thirty-seven years-old woman with colorectal metastasis to the liver eligible because single resection [...] could not achieve complete treatment, even in combination with chemotherapy, portal embolization, or radiofrequency, but tumors could be totally removed by two sequential resections.

  17. 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

    OpenAIRE

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

    2009-01-01

    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 ...

  18. Use of the Frog Heart Preparation to Teach Students about the Spontaneous Mechanical Activity of the Vena Cava

    Science.gov (United States)

    Hill, Brent J. F.; Goodman, Ian; Moran, William M.

    2011-01-01

    Most undergraduate physiology texts describe veins simply as reservoirs for blood and conduits for return of blood to the heart. This article describes a laboratory exercise that can be performed by students to demonstrate that veins are much more than reservoirs and conduits for blood flow: they possess a dynamic rhythmic contraction. In this…

  19. Leiomiossarcoma da veia cava inferior: relato de caso

    Directory of Open Access Journals (Sweden)

    Rafael Lemos Nascif

    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 relação com a veia cava inferior. Realizou-se ressecção em bloco da massa e do segmento invadido da veia cava. A histologia revelou leiomiossarcoma.

  20. 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

    OpenAIRE

    Carolina Araya; Elizabeth Peña; Erika Salazar; Lisset Román; Claudia Medina; Roxana Mora; Agustín Aljaro; Inés-Marlene Rosales

    2011-01-01

    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 symptoml...

  1. Protective efficacy of an Ecklonia cava extract used to treat transient focal ischemia of the rat brain

    OpenAIRE

    Kim, Jeong Hwan; Lee, Nam Seob; Jeong, Yeong Gil; Lee, Je-Hun; Kim, Eun Ji; Han, Seung Yun

    2012-01-01

    Phlorotannins (marine algal polyphenols) have been reported to exhibit beneficial biological activities, serving as both antioxidants and anti-inflammatory agents. Among marine algae, Ecklonia cava, a member of the Laminariaceae, is a very popular food regarded as healthy in Korea and Japan. Recently, benefits afforded by phlorotannins in the treatment of various clinical conditions have been reported, but any therapeutic effects of such materials in the treatment of neurodegenerative disease...

  2. Improved sensitivity in diagnosing superior vena caval flow compromise through radionuclide ''phase'' imaging

    International Nuclear Information System (INIS)

    Usual scintiangiography for venous obstruction ignores the quantitative advantages of nuclear medicine. This failing denies patients timely therapy in such cases as gradual evolution of superior vena cava obstruction. This study prospectively examined venous flow in 116 patients using bilateral injections of Tc-99m pertechnetate. A gamma camera collected 60 images for 3 seconds each. The data was digitized, processed and displayed. A first harmonic Fourier ''phase'' image was generated for each study with a single cycle extending from the appearance of tracer in the axillary veins to its emergence from the right ventricle. Three sets of criteria were used: strict, requiring interrupted or collateral venous flow; sensitive, recognizing distortion or narrowing of venous channels; and phase. The latter used the colors in the phase image to encode the relative time when activity reached any given level. Abrupt color changes were interpreted as flow abnormalities. Angiography, performed on 25 patients, showed the best sensitivity (SENS) with phase criteria (100%). Phase criteria maintained the highest SENS when the venous obstruction was diagnosed by radiography alone or by radiography and clinical follow-up. The accuracy (ACC) of the phase criteria (64-78%) was almost equal to that of the strict (SENS, 36-40%; specificity (SPEC), 93-100%; ACC 64-89%) and sensitive (SEN 85-93%, SPEC 30-67%, ACC 66-76%) criteria. Quantitative radioangiography is recommended to sensitively and non-invasively screen patients with right upper lobe tumors to identify those who might benefit from timely therapeutic intervention for comprised venous flow

  3. Gunther Tulip Retrievable Inferior Vena Caval Filters: Indications, Efficacy, Retrieval, and Complications

    International Nuclear Information System (INIS)

    Purpose. We evaluated the Gunther Tulip (GT) retrievable inferior vena cava (IVC) filter with regard to indications, filtration efficacy, complications, retrieval window, and use of anticoagulation. Method. A retrospective study was performed of 147 patients (64 men, 83 women; mean age 58.8 years) who underwent retrievable GT filter insertion between 2001 and 2005. The indications for placement included a diagnosis of pulmonary embolism or deep venous thrombosis with a contraindication to anticoagulation (n = 68), pulmonary embolism or deep venous thrombosis while on anticoagulation (n = 49), prophylactic filter placement for high-risk surgical patients with a past history of pulmonary embolism or deep venous thrombosis (n = 20), and a high risk of pulmonary embolism or deep venous thrombosis (n = 10). Forty-nine of the 147 patients did not receive anticoagulation (33.7%) while 96 of 147 patients did, 82 of these receiving warfarin (56.5%), 11 receiving low-molecular weight heparins (7.58%), and 3 receiving antiplatelet agents alone (2.06%). Results. Filter placement was successful in 147 patients (100%). Two patients had two filters inserted. Of the 147 patients, filter deployment was on a permanent basis in 102 and with an intention to retrieve in 45 patients. There were 36 (80%) successful retrievals and 9 (20%) failed retrievals. The mean time to retrieval was 33.6 days. The reasons for failed retrieval included filter struts tightly adherent to the IVC wall (5/9), extreme filter tilt (2/9), and extensive filter thrombus (2/9). Complications included pneumothorax (n = 4), failure of filter expansion (n = 1), and breakthrough pulmonary embolism (n = 1). No IVC thrombotic episodes were recorded. Discussion. The Gunther Tulip retrievable filter can be used as a permanent or a retrievable filter. It is safe and efficacious. GT filters can be safely retrieved at a mean time interval of 33.6 days. The newly developed Celect filter may extend the retrieval interval

  4. A exposição do contorno lateral direito da veia cava inferior na cirurgia hepática

    OpenAIRE

    Tenório Nailton Jatobá; Goldenberg Alberto; Triviño Tarcísio

    2002-01-01

    O conhecimento da relação entre a veia cava inferior e o tecido hepático é fundamental para a sua abordagem durante a cirurgia hepática. Observa-se na literatura dados contraditórios. Objetivo: Pesquisar a sintopia da veia cava inferior, o número de veias confluentes para o contorno direito e a distância do segmento retro-hepático da veia cava inferior. Métodos: Foram estudados 38 fígados humanos, entre 13 e 98 anos de ambos sexos. Obtida a peça anatômica, era dissecada a veia cava inferior, ...

  5. Estudio electrofisiológico y ablación de actividad eléctrica anormal en venas pulmonares de pacientes con fibrilación auricular paroxística idiopática / Electrophysiologic study and ablation therapy in idiopathic paroxystic atrial fibrillation

    Scientific Electronic Library Online (English)

    Manlio F., Márquez; Pedro, Iturralde-Torres; Luis, Colín-Lizalde; Santiago, Nava-Townsend; Eric N, González -Aceves; J. Antonio G., Hermosillo; Marco A., Martínez-Ríos; Diana R., Victoria-Romero; Manuel, Cárdenas.

    2006-02-01

    Full Text Available Objetivo: Informar la ablación en las venas pulmonares (VPs) en pacientes con fibrilación auricular paroxística (FAP). Material y métodos: Catorce pacientes (38±12 años [intervalo 8-52, 11 hombres, 3 mujeres) con FAP idiopática, sintomática y refractarios a antiarrítmicos y con estudio electrofisiol [...] ógico. En 13 se encontró actividad eléctrica anormal (AEA) en VPs mediante catéteres especiales de cartografía y se realizó ablación. Resultados: Se identificó AEA en VP 's (13 pacientes, 86%) y en vena cava superior (un paciente, 6.6%). Un procedimiento fue suspendido por taquicardia ventricular. La ablación fue exitosa en 7 de los 12 pacientes restantes. Los cinco pacientes con ablación inicial fallida fueron llevados a un segundo procedimiento que fue exitoso en dos. En un paciente fue necesario un tercer procedimiento que resultó exitoso. Una paciente tuvo pericarditis con derrame ligero que no requirió drenaje. Conclusión: La ablación de FAP es un procedimiento seguro con una tasa de éxito combinada (con y sin antiarrítmicos) en esta población y a largo plazo, del 71%. Abstract in english Objective: To analyze the results of radiofrequency catheter ablation (RFCA) of the pulmonary veins (PV) in patients with paroxysmal atrial fibrillation (PAF). Material and methods: We describe 14 patients (38± 12 years, interval 8-52; 11 men) with symptomatic PAF, refractory to antiarrhythmic drugs [...] . Special mapping catheters were used and ablation was performed at the ostium/antrum of those veins with abnormal electrical activity (AEA). Results: AEA in one or more PV was identified in 13 patients (86%); in one patient AEA was also found in the superior vena cava (6.6%). One procedure was complicated by unstable ventricular tachycardia and was not finished. Success was accomplished in 10, in 5 after the first ablation, in 4 after the second, and in one after a third procedure. One patient had pericarditis with a small pericardial effusion that did not require intervention. Conclusions: RFCA is a useful and relatively safe procedure for the treatment of PAF and the only one with curative potential. The long-term rate of success (with or without antiarrhythmics) in this series was 71%. These results justify catheter ablation in selected patients with symptomatic PAF unresponsive to medical treatment.

  6. Estenosis de venas pulmonares post ablación por radiofrecuencia

    Directory of Open Access Journals (Sweden)

    Marcelo Guzzi

    2011-06-01

    Full Text Available Es importante estar atento ante la aparición de síntomas respiratorios luego de la realización de un procedimiento de ablación por radiofrecuencia en el tratamiento de la fibrilación auricular, pues la estenosis de venas pulmonares (EVP tiene una incidencia de entre 1 y 3% y puede aparecer hasta en los dos años posteriores al procedimiento1. Presentamos el caso de un paciente de 41 años de sexo masculino, que ingresó por un cuadro de hemoptisis y toracodinia de tres semanas de evolución, con antecedente de ablación por radiofrecuencia 6 meses antes de la admisión. La angiotomografía no evidenció tromboembolismo pulmonar (TEP y la angiorresonancia detectó hipoperfusión deI lóbulo superior del pulmón izquierdo (LSI. Debido a los antecedentes de ablación se solicitó angiotomografía de venas pulmonares, que evidenció estenosis de la vena del LSI. Se realizó estudio hemodinámico con dilatación y colocación de stent.

  7. Protective effect of dieckol isolated from Ecklonia cava against ethanol caused damage in vitro and in zebrafish model.

    Science.gov (United States)

    Kang, Min-Cheol; Kim, Kil-Nam; Kang, Sung-Myung; Yang, Xiudong; Kim, Eun-A; Song, Choon Bok; Nah, Jae-Woon; Jang, Mi-Kyeong; Lee, Jung-Suck; Jung, Won-Kyo; Jeon, You-Jin

    2013-11-01

    In the present study, the protective effects of phlorotannins isolated from Ecklonia cava against ethanol-induced cell damage and apoptosis were investigated both in vitro and in vivo. Three phlorotannin compounds, namely phloroglucinol, eckol and dieckol, were successively isolated and identified from the extract. Dieckol showed the strongest protective effect against ethanol-induced cell apoptosis in Chang liver cells, with the lowest cytotoxicity. It was observed that dieckol reduced cell apoptosis through activation of Bcl-xL and PARP, and down-regulation of Bax and caspase-3 in Western blot analyses. In the in vivo study, the protective effect of ethanol induced by dieckol was investigated in a zebrafish model. The dieckol treated group scavenged intracellural reactive oxygen species and prevented lipid peroxidation and ethanol induced cell death in the zebrafish embryo. In conclusion, dieckol isolated from E. cava might possess a potential protective effect against ethanol-induced liver diseases. PMID:24189014

  8. Behçet disease in association with Budd-Chiari syndrome and multiple thrombosis - Case report / Doenca de Behcet em associacao com Sindrome de Budd-Chiari e tromboses multiplas - Relato de caso

    Scientific Electronic Library Online (English)

    Maraya de Jesus Semblano, Bittencourt; Carolina Moraes, Dias; Thaiane Lima, Lage; Renata Silva, Barros; Otavio Augusto Gomes, Paz; Waldonio de Brito, Vieira.

    2013-06-01

    Full Text Available Doença de Behçet é uma doença inflamatória crônica de etiologia desconhecida, caracterizada clinicamente por ulcerações aftosas orais e genitais recorrentes, uveíte, lesões cutâneas e outras afecções multissistêmicas associadas à vasculite. Diferentes tipos de vasos, predominantemente veias, podem s [...] er afetados na doença de Behçet, causando tromboses venosas superficiais e profundas, aneurismas arteriais e oclusões, com uma frequência em torno de 7 a 29%. Síndrome de Budd-Chiari é uma rara e grave complicação da SB e implica trombose das veias hepáticas e/ou da veia cava inferior intra ou suprahepática. Nós reportamos um caso de paciente masculino com Doença de Behçet que apresentou Síndrome de Budd-Chiari e tromboses múltiplas, cujo diagnóstico foi favorecido pela correlação entre aspectos dermatológicos, histopatológicos, radiológicos e laboratoriais. Abstract in english Behçet's disease is a chronic inflammatory disease of unknown aetiology, characterized by recurrent oral and genital aphthous ulcerations, uveitis, skin lesions and other multisystem affections associated with vasculitis. Different types of vessels, predominantly veins, can be affected in Behçet's d [...] isease. The frequency of vascular lesions in Behçet's disease, such as superficial and deep venous thromboses, arterial aneurysms and occlusions, ranges between 7-29%. Budd-Chiari syndrome is a rare and serious complication of Behçet's disease and implies thrombosis of the hepatic veins and/or the intrahepatic or suprahepatic inferior vena cava. We report a case of a 25-year-old man with Behçet's disease that developed Budd-Chiari syndrome. The correlation of dermatological, pathological and imaging studies confirmed the diagnosis.

  9. Pure laparoscopic hepatectomy for hepatocellular carcinoma with chronic liver disease

    Directory of Open Access Journals (Sweden)

    Zenichi Morise

    2013-01-01

    Full Text Available Pure laparoscopic hepatectomy is a less invasive procedure than conventional open hepatectomy for the resection of hepatic lesions. Increases in experiences with the technique, in combination with advances in technology, have promoted the popularity of pure laparoscopic hepatectomy. However, indications for usage and potential contraindications of the procedure remain unresolved. The characteristics and specific advantages of the procedure, especially for hepatocellular carcinoma (HCC patients with chronic liver diseases, are reviewed and discussed in this paper. For cirrhotic patients with liver tumors, pure laparoscopic hepatectomy minimizes destruction of the collateral blood and lymphatic flow from laparotomy and mobilization, and mesenchymal injury from compression. Therefore, pure laparoscopic hepatectomy has the specific advantage of minimal postoperative ascites production that leads to lowering the risk of disturbance in water or electrolyte balance and hypoproteinemia. It minimizes complications that routinely trigger postoperative serious liver failure. Under adequate patient positioning and port arrangement, the partial resection of the liver in the area of subphrenic space, peri-inferior vena cava area or next to the attachment of retro-peritoneum is facilitated in pure laparoscopic surgery by providing good vision and manipulation in the small operative field. Furthermore, the features of reduced post-operative adhesion, good vision, and manipulation within the small area between the adhesions make this procedure safer in the context of repeat hepatectomy procedures. These improved features are especially advantageous for patients with liver cirrhosis and multicentric and/or metachronous HCCs.

  10. Clinical application of radionuclide cardiac study to the right heart diseases

    International Nuclear Information System (INIS)

    We experienced the four cases of rare right heart diseases: those are two-chambered right ventricle, ball thrombus in right ventricle, right ventricular hypertrophy and tricuspid valve regurgitation due to multiple pulmonary infarction, and right ventricular and right atrial infarction. The preoperative or ante mortem diagnosis of these diseases is difficult, especially by use of a noninvasive technique. This report shows the usefulness of radionuclide cardiac study for diagnosis of these cases. In the two-chambered right ventricle, abnormal muscle bundle was visualized by 201Tlcl and was observed as the filling defect by sup(99m)Tc-HSA radionuclide angiography. The ball thrombus showed the filling defect of sup(99m)Tc-HSA in the right ventricle but was not extracted by 201Tlcl in the site of the defect area. In the multiple pulmonary infarction, the right ventricular free wall was visualized by 201Tlcl, and during right ventricular systole, regurgitation from right atrium to inferior vena cava was noticed by means of sup(99m)Tc-HSA radionuclide angiography. These findings suggested right ventricular hypertrophy and tricuspid valve regurgitation. In the right ventricular and right atrial infarction, right ventricular ejection fraction and right atrial fractional emptying were lower than those of normal controls. (author)

  11. Unusual Case of an Ectopic Spleen

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Doo; Yoo, Hyung Sik; Park, Chang Yun [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1986-09-15

    Absence of spleen in its normal location on echocardiogram. Associated anomaly: Congenital heart disease of coexisting atrial and ventricular septal defect, right sided aorta, drainage of azygous vein into superior vena cava.

  12. Heart Transplant Procedure

    Medline Plus

    Full Text Available ... for other reasons and not necessarily end-stage heart disease. 00:18:21 DAVID D'ALESSANDRO, MD: So we're now separating the heart from its juncture with the inferior vena cava. ...

  13. Multiplanar and three-dimensional reconstruction techniques in CT: impact on chest diseases

    International Nuclear Information System (INIS)

    The purpose of this review is to capture the current state-of-the art of the technical aspects of multiplanar and three-dimensional (3D) images and their thoracic applications. Planimetric and volumetric analysis resulting from volumetric data acquisitions obviates the limitations of segmented transverse images. Among the 3D reconstruction techniques currently available, the most recently introduced technique, i. e., volume rendering, has to be evaluated in comparison with 3D shaded surface display and maximum or minimum intensity projection. Slabs are useful in detecting and localizing micronodular or microtubular patterns and in analyzing mild forms of uneven attenuation of the lungs. Three-dimensional angiography is helpful in the pretherapeutic evaluation and posttreatment follow-up of pulmonary arteriovenous malformations, in the comprehension of the postoperative reorientation of the pulmonary vessels, in the surgical planning of pulmonary tumors, and in the diagnosis of marginated thrombi. The systemic supply to the lung and superior vena cava syndromes are also relevant to these techniques. In acquired or congenital tracheobronchial diseases including stenosis, extraluminal air and complex airway anatomy, multiplanar and 3D reformations have a complementary role to both transaxial images and endoscopy. New developments are also expected in various topics such as 3D conformal radiation therapy, planning of intraluminal bronchoscopic therapy, virtual endoscopy, and functional imaging of the bronchial tree. Miscellaneous clinical applications are promising in the analysis of diaphragmatic morphology and pathophysiology, in the volumetric quantification of the lung parenchyma, and in the vascular components of the thoracic outlet syndromes. (orig.)

  14. Vena porta thrombosis in patient with inherited factor VII deficiency

    DEFF Research Database (Denmark)

    Klovaite, Jolanta; Friis-Hansen, Lennart Jan; Larsen, Fin S; Toffner-Clausen, Nielsaage; Bjerrum, Ole W

    2010-01-01

    Most clotting factor VII (FVII)-deficient patients suffer from bleeding episodes and occasionally thromboembolic complications after surgical interventions or replacement therapy. However, thromboses without apparent triggering factors may occur as well. We report a case of a pregnant woman with inherited FVII deficiency and chronic vena porta thrombosis. She presented at 32 weeks of gestation with spontaneously increased international normalized ratio, severe thrombocytopenia and very few unspe...

  15. Optional inferior vena caval filters: where are we now?

    LENUS (Irish Health Repository)

    Keeling, A N

    2008-08-01

    With the advent of newer optional\\/retrievable inferior vena caval filters, there has been a rise in the number of filters inserted globally. This review article examines the currently available approved optional filter models, outlines the clinical indications for filter insertion and examines the expanding indications. Additionally, the available evidence behind the use of optional filters is reviewed, the issue of anticoagulation is discussed and possible future filter developments are considered.

  16. Hemoperitoneo secundario a la rotura espontánea de la vena mesentérica

    Directory of Open Access Journals (Sweden)

    Mariano Garc\\u00EDa

    2006-01-01

    Full Text Available La cirrosis hepática es la principal causa de hipertensión portal y se asocia con el desarrollo de venas esplácnicas varicosas. La rotura de várices intraabdominales es una causa rara de hemoperitoneo. Se presenta el caso de hemoperitoneo espontáneo por rotura de vena mesentérica superior varicosa. Caso clínico: varón de 43 años con antecedentes de cirrosis alcohólica (estadio C de Child-Pugh y múltiples internaciones por hemorragia digestiva variceal. Consulta por episodios sincopales y distensión abdominal. Al examen físico se presento: vigil, orientado, hipotenso, con tilt test positivo, distensión abdominal, estigmas cutáneos de hepatopatía crónica. Laboratorio: anemia, plaquetopenia, prolongación de los tiempos de coagulación. TAC de abdomen: líquido libre en cavidad peritoneal. Laparotomía exploradora: se extraen tres litros de sangre de cavidad abdominal. Se visualiza vena mesentérica superior varicosa con una zona en forma de pezón que muestra punto de sangrado en jet, intermitente. No se evidenció daño de otro órgano. Se procedió a la rafia de la lesión lográndose hemostasia. El paciente evolucionó favorablemente abandonando el hospital 10 días después del ingreso. Objetivo: presentar un paciente con una causa poco común de hemoperitoneo y remarcar la buena evolución, ya que este tipo de patología suele tener alta mortalidad.

  17. Placement of the VenaTech LP Caval Filter in the Elderly: Feasibility and Clinical Benefits of Insertion Via the Arm

    International Nuclear Information System (INIS)

    Purpose. To evaluate routine use of access sites in the arm for percutaneous caval filter placement (PCFP) in elderly patients. Neck arthritis, patient anxiety, access site thrombosis or fecal/urinary incontinence complicating jugular or femoral access may require alternative access sites in this population. Methods. Access via the right arm was chosen for PCFP (VenaTech LP). The indication for PCFP was deep vein thrombosis, a history of pulmonary embolism, and a contraindication to anticoagulant therapy. Ultrasound-guided puncture was performed after diameter measurement of the arm veins (OAV). The filter was inserted with standard imaging procedures. Procedural difficulty was graded and compared with OAV and the angle from the arm vein to the superior vena cava (?AV/SVC). Results. Over 2 years, 16 patients (14 women, 2 men) with an average age of 90 years (range 79-97 years) were included in the study. The average OAV value of the basilic or brachial veins was 4.2 mm (range 3.0-5.1 mm). The minimal OAV for successful access was determined after the first 15 patients. No hematoma occurred at the puncture sites. The average ?AV/SVC value was 62 deg. (range 29 deg. - 90 deg.). Arm access was possible in 12 of 16 patients (75%) with OAV ? 3.5 mm and ?AV/SVC ? 29 deg. Every procedure via the arm was graded 'easy' by the operator, regardless of angulation values. Femoral access was used in one case due to the impossibility of traversing the heart (patient no. 2), and jugular access was used in 3 of 16 (19%) patients due to puncture failure (patient no. 4), small OAV (3 mm) (patient no. 6), and stenosis of the distal right subclavian vein (patient no.16), respectively. Conclusion. PCFP via the arm can be routinely accomplished in patients older than 75 years, provided OAV ? 3.5 mm, and ?AV/SVC ? 29 deg

  18. [Utility of Ultrasonography in Point of Care for Cardiovascular Disease].

    Science.gov (United States)

    Ishizu, Tomoko; Kawakami, Yasushi

    2015-06-01

    Echocardiography is a powerful noninvasive cardiovascular diagnostic tool. In the emergency room, an outpatient setting, and the intensive care unit, physician-performed point-of-care (POC) echocardiography is particularly important to understand the concurrent pathophysiology of unstable patients. In POC echocardiography, the purpose of examination should be clearly decided in advance by performing careful symptom assessment and physical examination, including heart and lung auscultation. In this article, heart failure, cardiac murmur-, ischemic heart disease, and acute pulmonary artery thromboembolism are selected and overviewed to assess the utility of POC cardiovascular ultrasound. In heart failure, visual assessments of the left ventricular ejection fraction, chamber size ratio, and inferior vena cava diameter are important. An ultrasound lung comet is a very useful finding, suggesting the presence of lung congestion. In patients with a cardiac murmur, the source of the abnormal sound can easily be confirmed by the color Doppler signal in conjunction with chamber size assessment. On the other hand, judgment of the severity of valvular heart disease should be reserved for detailed echocardiography. In acute coronary syndrome, POC echo is extremely important for prompt diagnosis and complication assessment. An understanding of the coronary artery territory and method to detect regional wall motion abnormality in ischemic heart disease is necessary. Papillary muscle rupture and ventricular septal perforation are both fatal complications of myocardial infarction, and they should be kept in mind and pan-systolic murmur should be detected before echocardiography. In acute pulmonary thromboembolism, the right heart size and characteristic wall motion abnormality should be focused on using echocardiography in addition to tricuspid regurgitant flow velocity measurement. Femoral vein ultrasonography with a compression test should be performed for all patients with acute pulmonary thromboembolism to search for potential embolic sources. PMID:26548235

  19. Vena porta thrombosis in patient with inherited factor VII deficiency

    DEFF Research Database (Denmark)

    Klovaite, Jolanta; Friis-Hansen, Lennart Jan

    2010-01-01

    Most clotting factor VII (FVII)-deficient patients suffer from bleeding episodes and occasionally thromboembolic complications after surgical interventions or replacement therapy. However, thromboses without apparent triggering factors may occur as well. We report a case of a pregnant woman with inherited FVII deficiency and chronic vena porta thrombosis. She presented at 32 weeks of gestation with spontaneously increased international normalized ratio, severe thrombocytopenia and very few unspecific symptoms. The extensive examination of the patient revealed cavernous transformation of the portal vein with well expressed portosystemic collaterals, heterozygosity for three common polymorphisms in FVII gene, associated with reduction in plasma FVII levels, and no other factors predisposing to thrombosis.

  20. A mediastinoscopia no diagnóstico de doenças intratorácicas Mediascopy in the diagnosis of intrathoracic diseases

    Directory of Open Access Journals (Sweden)

    Luiz Felippe Júdice

    1998-02-01

    Full Text Available A mediastinoscopia cervical, desenvolvida por Carlens em 1959, é usada principalmente para avaliação dos linfonodos mediastinais nos pacientes portadores de câncer do pulmão candidatos a tratamento cirúrgico. No entanto, a exploração desta região pode também identificar outras doenças como sarcoidose, tuberculose, micoses e doenças neoplásicas que envolvem o mediastino ântero-superior. Neste estudo analisamos o prontuário de 125 pacientes submetidos à mediastinoscopia com finalidade de diagnosticar doenças intratorácicas. A técnica utilizada foi: cervical em 103, anterior em 7, e cervical e anterior combinadas em 15 pacientes. Oitenta pacientes eram do sexo masculino e 45 do sexo feminino. A idade variou de 13 a 75 anos. O exame foi realizado com anestesia geral e intubação orotraqueal em todos os pacientes exceto em dois nos quais foi utilizada anestesia local, sedação e suplementação de oxigênio por máscara. O diagnóstico mais freqüente foi o de carcinoma (36,8%, seguido de linfoma (16% e sarcoidose (14,4%. Em nove pacientes, o exame foi inconclusivo, o que corresponde a um índice de falha do método de 7,2%. Onze pacientes portadores de síndrome de cava superior foram submetidos ao exame sem complicações adicionais, exceto um paciente que sofreu agravamento da síndrome. Conclui-se que a mediastinoscopia é um procedimento seguro e com baixo índice de complicações, e que pode ser utilizado com segurança nos pacientes portadores de massa mediastinal, ou linfonodomegalias, principalmente nas regiões paratraqueais.The cervical mediastinoscopy, developed by Carlens in 1959 is used primarily to evaluate, before thoracotomy, the status of mediastinal limph nodes in patients with lung cancer. However, exploration of the anterior mediastinum by these techniques can also identify other diseases processes such as sarcoidosis, tuberculosis, mycotic granulomatous infections and neoplastic diseases involving the mediastinum such as lymphoma. ln this study we analyze the medical reports of 125 patients in which mediastinoscopy was performed for the diagnosis of intrathoracic diseases. The procedure was performed with general anesthesia and orotracheal intubation in all patients out in two, submitted to mediastinoscopy with local anesthesia. The surgical approaches used were: cervical (n=103. anterior (n=7 and cervical + anterior (n=15. There were 80 male and 45 female patients. The age ranged from 13 to 75 years. Carcinoma was the most prevalent diagnosis obtained (36.8%, followed by lymphoma (16% and sarcoidosis (14.4%. In nine patients the exam was inconclusive, being responsible for a 7.2% failure index of the method. In eleven patients presenting superior vena cava syndrome, mediastinoscopy was performed without aditional complications, except in one case in which symptoms worsenned. We conclude that mediastinoscopy is a safe procedure and it is a valuable tool for the diagnosis of paratracheal mediastinal masses and lymphadenomegalies.

  1. First Evidence that Ecklonia cava-Derived Dieckol Attenuates MCF-7 Human Breast Carcinoma Cell Migration

    OpenAIRE

    Kim, Eun-Kyung; Tang, Yujiao; Kim, Yon-Suk; Hwang, Jin-Woo; Choi, Eun-Ju; Lee, Ji-Hyeok; Lee, Seung-Hong; Jeon, You-Jin; Park, Pyo-Jam

    2015-01-01

    We investigated the effect of Ecklonia cava (E. cava)-derived dieckol on movement behavior and the expression of migration-related genes in MCF-7 human breast cancer cell. Phlorotannins (e.g., dieckol, 6,6?-biecko, and 2,7?-phloroglucinol-6,6?-bieckol) were purified from E. cava by using centrifugal partition chromatography. Among the phlorotannins, we found that dieckol inhibited breast cancer cell the most and was selected for further study. Radius™-well was used to assess cell migration, a...

  2. Modified Senning Procedure for Correction of Atrioventricular Discordance With Total Anomalous Pulmonary Venous Return, Atrial Situs Inversus, Dextrocardia, and Bilateral Superior Venae Cavae.

    Science.gov (United States)

    Sebastian, Vinod A; Guleserian, Kristine J; Juraszek, Amy; Kane, Colin; Hamzeh, Rabih; Forbess, Joseph M

    2015-10-01

    The Senning and Mustard baffles remain important techniques for the treatment of congenitally corrected transposition (cc-TGA), isolated ventricular inversion, and D-transposition of the great arteries with delayed presentation. We describe the treatment of an 8-month old infant with atrioventricular discordance, ventriculoarterial concordance, and dextrocardia with atrial situs inversus. A modified Senning procedure was performed through the "left-sided" atrium. Modifications of the Senning and Mustard baffles remain important tools in the treatment of rare conditions like isolated ventricular inversion. PMID:26434442

  3. Avaliação dos resultados tardios da operação de derivação cavo-pulmonar bidirecional, no tratamento paliativo de cardiopatias congênitas com câmara ventricular única / Assessment of late results of bidirecional cavopulmonary shunt on paliative treatment of congenital heart disease with functional isolated ventricular chamber

    Scientific Electronic Library Online (English)

    Miguel Angel, Maluf; José carlos S, Andrade; Roberto, Catani; Antônio C, Carvalho; Nilce, Negrini; Ênio, Buffolo.

    1994-06-01

    Full Text Available No período de março de 1990 a janeiro de 1994, 17 pacientes com idades de 1 a 13 anos (média: 7 anos), portadores de cardiopatias congênitas com câmara ventricular única funcionante, foram submetidos a operação de derivação cavo-pulmonar bidirecional. Nove pacientes tinham atresia tricúspide (AT), 7 [...] do tipo lb, 1 tipo le e 1 tipo Mb. Cinco pacientes tinham dupla via de entrada ventricular tipo ventrículo direito (DVEVD); 2 com comunicação interventricular(CIV) múltipla+hipoplasiado VD; 1 com atresia pulmonar com septo interventricular íntegro (APc/SIVI). Nove (52,9%) pacientes tinham operações paliativas prévias. A operação foi realizada com auxílio da circulação extracorpórea (CEC) em 12 (70,5%) casos e mediante derivação do fluxo sangüíneo da veia cava superior (VCS) para o átrio direito (AD) em 5 (29,5%) casos. Em todos os casos a VCS foi anastomosada à artéria pulmonar direita (APD), interrompendo o fluxo sangüíneo para o pulmão, fechando a valva pulmonar e ligando a derivação de Blalock-Taussig pérvio. Houve 3 (17,6%) óbitos no pós-operatório imediato (POI) e 2 (14,2%) no pós-operatório tardio (POT). Doze (70,5%) pacientes estão em acompanhamento clínico, com um tempo de evolução de 2 a 46 meses. Um paciente foi submetido ao 2º tempo da operação, tunelizando a veia cava inferior (VCI) para a APD, com sucesso. A avaliação do fluxo da derivação cavo-pulmonar bidirecional está sendo realizada pela ecodopplercardiografia e ressonância nuclear magnética e a perfusão pulmonar mediante cintilografia radioisotópica. A indicação do 2º tempo da operação obedece à própria evolução clínica e avaliação da saturação arterial durante a cicioergometria. A derivação cavo-pulmonar bidirecional permite uma adaptação progressiva do fluxo venoso para o pulmão, diminuindo a sobrecarga de volume do ventrículo, preparando o paciente para a derivação venosa total. Abstract in english From March 1990 to January 1994, 17 patients 1 to 13 years old (mean 7 years), who had congenital heart disease with functional isolated ventricular chamber, were submitted to bidirectional cavopulmonary shunts. Nine cases had Tricuspid Atresia (TA) (7 type Ib, 1 type Ic and 1 type IIb). Five cases [...] had Double Inlet Right ventricle (Dl RV); two cases had multiple Ventricular Septal Defects (VSD) plus RV hypoplasia. One case had pulmonary atresia with Intact Ventricular septum (PA/IVS). Nine (52,9%) patients had been submitted, to previous paliative operations. The operations in 12 (70,5%) cases were with extracorporeal circulation (ECC) and in 5 (29,4%) cases with superior vena cava (SVC) to right atrio (RA) temporary shunt. In all cases the SVC was anastomosed to right pulmonary artery (RPA) closing the pulmonary valve (PV) or linking the Blalock-Taussig shunt to interrupt the pulmonary flow. There are three (17,6%) deaths in the immediate postoperative period and 2 (14,2%) late deaths. Twelve (70,5%) patients were followed-up for 2 to 46 months. One patient was submitted to the 2 nd operation, tunnelating the inferior vena cava (IVC) to RPA, with success. The assessment of bidirectional cavopulmonary flow was made with Doppler echocardiography and magnetic resonance and the pulmonary perfusion was made with radioisotopic cintilography. The indication tor the 2 nd, operation depended on the clinical evolution and assessment of arterial saturation during the cicloergometric test. The bidirectional cavo pulmonary shunt allows the progressive adaptation of the venous flow to lung and reduced ventricular volume load, preparing the patient to total venous shunt.

  4. Avaliação dos resultados tardios da operação de derivação cavo-pulmonar bidirecional, no tratamento paliativo de cardiopatias congênitas com câmara ventricular única Assessment of late results of bidirecional cavopulmonary shunt on paliative treatment of congenital heart disease with functional isolated ventricular chamber

    Directory of Open Access Journals (Sweden)

    Miguel Angel Maluf

    1994-06-01

    Full Text Available No período de março de 1990 a janeiro de 1994, 17 pacientes com idades de 1 a 13 anos (média: 7 anos, portadores de cardiopatias congênitas com câmara ventricular única funcionante, foram submetidos a operação de derivação cavo-pulmonar bidirecional. Nove pacientes tinham atresia tricúspide (AT, 7 do tipo lb, 1 tipo le e 1 tipo Mb. Cinco pacientes tinham dupla via de entrada ventricular tipo ventrículo direito (DVEVD; 2 com comunicação interventricular(CIV múltipla+hipoplasiado VD; 1 com atresia pulmonar com septo interventricular íntegro (APc/SIVI. Nove (52,9% pacientes tinham operações paliativas prévias. A operação foi realizada com auxílio da circulação extracorpórea (CEC em 12 (70,5% casos e mediante derivação do fluxo sangüíneo da veia cava superior (VCS para o átrio direito (AD em 5 (29,5% casos. Em todos os casos a VCS foi anastomosada à artéria pulmonar direita (APD, interrompendo o fluxo sangüíneo para o pulmão, fechando a valva pulmonar e ligando a derivação de Blalock-Taussig pérvio. Houve 3 (17,6% óbitos no pós-operatório imediato (POI e 2 (14,2% no pós-operatório tardio (POT. Doze (70,5% pacientes estão em acompanhamento clínico, com um tempo de evolução de 2 a 46 meses. Um paciente foi submetido ao 2º tempo da operação, tunelizando a veia cava inferior (VCI para a APD, com sucesso. A avaliação do fluxo da derivação cavo-pulmonar bidirecional está sendo realizada pela ecodopplercardiografia e ressonância nuclear magnética e a perfusão pulmonar mediante cintilografia radioisotópica. A indicação do 2º tempo da operação obedece à própria evolução clínica e avaliação da saturação arterial durante a cicioergometria. A derivação cavo-pulmonar bidirecional permite uma adaptação progressiva do fluxo venoso para o pulmão, diminuindo a sobrecarga de volume do ventrículo, preparando o paciente para a derivação venosa total.From March 1990 to January 1994, 17 patients 1 to 13 years old (mean 7 years, who had congenital heart disease with functional isolated ventricular chamber, were submitted to bidirectional cavopulmonary shunts. Nine cases had Tricuspid Atresia (TA (7 type Ib, 1 type Ic and 1 type IIb. Five cases had Double Inlet Right ventricle (Dl RV; two cases had multiple Ventricular Septal Defects (VSD plus RV hypoplasia. One case had pulmonary atresia with Intact Ventricular septum (PA/IVS. Nine (52,9% patients had been submitted, to previous paliative operations. The operations in 12 (70,5% cases were with extracorporeal circulation (ECC and in 5 (29,4% cases with superior vena cava (SVC to right atrio (RA temporary shunt. In all cases the SVC was anastomosed to right pulmonary artery (RPA closing the pulmonary valve (PV or linking the Blalock-Taussig shunt to interrupt the pulmonary flow. There are three (17,6% deaths in the immediate postoperative period and 2 (14,2% late deaths. Twelve (70,5% patients were followed-up for 2 to 46 months. One patient was submitted to the 2 nd operation, tunnelating the inferior vena cava (IVC to RPA, with success. The assessment of bidirectional cavopulmonary flow was made with Doppler echocardiography and magnetic resonance and the pulmonary perfusion was made with radioisotopic cintilography. The indication tor the 2 nd, operation depended on the clinical evolution and assessment of arterial saturation during the cicloergometric test. The bidirectional cavo pulmonary shunt allows the progressive adaptation of the venous flow to lung and reduced ventricular volume load, preparing the patient to total venous shunt.

  5. Alterações bioquímicas e morfológicas após anastomose porto-cava e hepatectomia parcial: estudo experimental em cães

    OpenAIRE

    Melo Valdinaldo Aragão de; Ceneviva Reginaldo; Godoy Álvaro Queiroz de; Santos José Ernesto dos; Melo Gustavo Barreto de

    2003-01-01

    OBJETIVO: Estudar os efeitos da anastomose porto-cava sobre a morfologia e bioquímica do fígado de cães. MÉTODOS: Vinte animais foram divididos em 2 grupos: o Grupo I foi submetido à hepatectomia parcial de 28,7% e o Grupo II, à hepatectomia parcial associada à derivação porto-cava. Os parâmetros analisados foram: peso corpóreo, colesterol e triglicérides plasmáticos, lipídios e glicogênio hepáticos e índice ponderal de regeneração hepática. Os dados foram analisados no pré-operatório e no 30...

  6. Alleviating Effects of Baechu Kimchi Added Ecklonia cava on Postprandial Hyperglycemia in Diabetic Mice

    OpenAIRE

    Lee, Hyun-ah; Song, Yeong-Ok; Jang, Mi-Soon; Han, Ji-Sook

    2013-01-01

    In this study, we investigated the inhibitory effects of Baechu kimchi added Ecklonia cava on the activities of ?-glucosidase and ?-amylase and its alleviating effect on the postprandial hyperglycemia in STZ-induced diabetic mice. Baechu kimchi added Ecklonia cava (BKE, 15%) was fermented at 5°C for 28 days. Optimum ripened BKE was used in this study as it showed the strongest inhibitory activities on ?-glucosidase and ?-amylase by fermentation time among the BKEs in our previous study. The B...

  7. Tratamiento de estenosis sintomática de venas pulmonares secundaria a ablación por radiofrecuencia

    Directory of Open Access Journals (Sweden)

    Adolfo Ferrero Guadagnoli

    2014-08-01

    Full Text Available El aislamiento de las venas pulmonares mediante la aplicación de radiofrecuencia es un tratamiento efectivo de la fibrilación auricular. Una de las complicaciones potenciales y de mayor compromiso clínico de esta técnica invasiva es la estenosis de una o varias venas pulmonares. Esta complicación puede ser tratada mediante angioplastia con o sin colocación de stent, logrando una adecuada mejoría clínica, aunque con un alto índice de recurrencia por re-estenosis.

  8. Variantes anatómicas vasculares halladas de manera incidental en estudios de tomografía computada / Incidental findings of vascular anatomic variants on computed tomography

    Scientific Electronic Library Online (English)

    Alejandro, Rodriguez; Ricardo, Cobeñas; Juan Cruz, Gallo; Alejandra, Salamida; Nebil, Larrañaga; Shigeru, Kozima.

    2013-03-01

    Full Text Available Introducción. El hallazgo de variantes anatómicas vasculares en estudios de tomografía computada (TC) puede generar confusiones, diagnósticos incorrectos e incluso la solicitud de nuevos estudios complementarios más invasivos. El conocimiento de estas variantes, además, es importante porque pueden e [...] star asociadas a otras anomalías, como cardiopatías, poliesplenia o síntomas como disfagia o disnea. Objetivo. El objetivo de esta publicación es describir las variantes anatómicas vasculares halladas incidentalmente en estudios de tomografía computada. Materiales y Métodos. Se revisaron 3586 estudios, realizados desde junio de 2010 hasta junio de 2011, con tomografía computada multicorte de 16 y 64 detectores. Entre los estudios analizados, se encontraron: arco aórtico derecho (AAD), subclavia derecha aberrante, vena cava superior izquierda, vena subclavia izquierda aberrante, vena cava inferior (VCI) izquierda, vena renal izquierda doble, vena cava inferior doble, vena renal circumaórtica, vena renal izquierda retroaórtica, vena subhepática e interrupción de la vena cava inferior con continuación en ácigos/hemiácigos. Conclusión. Las variantes anatómicas vasculares son hallazgos que se encuentran con relativa frecuencia en forma incidental en estudios solicitados por otras razones. Su conocimiento puede evitar confusiones y la realización de estudios complementarios innecesarios, así como también nos obliga a analizar la presencia de otras anomalías que podrían estar asociadas. Abstract in english Introduction. Incidental findings of vascular anatomic variants on computed tomography scans (CT) may cause confusion, misdiagnosis and lead to even more invasive complementary exams. The knowledge of these variants is also important because they can be associated with other anomalies such as heart [...] diseases or polysplenia, and symptoms like dysphagia or dyspnea. Purpose. The aim of this study is to describe the vascular anatomical variants incidentally found on computed tomography imaging. Materials and Methods. A total of 3586 scans were performed between June 2010 and June 2011 with 16-row and a 64-row Multidetector CT scanners. Findings included: right aortic arch, aberrant right subclavian artery, aberrant left subclavian vein, left superior vena cava, left inferior vena cava, double inferior vena cava, circumaortic renal vein, retroaortic left renal vein, subhepatic vein and azygous continuation of the inferior vena cava. Conclusion. Vascular anatomical variants are found with relative frequency on CT scans requested for other reasons. To be familiar with these anomalies may prevent confusions, diagnostic errors and unnecessary complementary exams and forces us to search for other associated anomalies.

  9. Effect of Dieckol, a Component of Ecklonia cava, on the Promotion of Hair Growth

    Directory of Open Access Journals (Sweden)

    Sang-Cheol Kim

    2012-05-01

    Full Text Available This study was conducted to evaluate the effect of Ecklonia cava, a marine alga native to Jeju Island in Korea, on the promotion of hair growth. When vibrissa follicles were cultured in the presence of E. cava enzymatic extract (which contains more than 35% of dieckol for 21 days, E. cava enzymatic extract increased hair-fiber length. In addition, after topical application of the 0.5% E. cava enzymatic extract onto the back of C57BL/6 mice, anagen progression of the hair-shaft was induced. The treatment with E. cava enzymatic extract resulted in the proliferation of immortalized vibrissa dermal papilla cells (DPC. Especially, dieckol, among the isolated compounds from the E. cava enzymatic extract, showed activity that increased the proliferation of DPC. When NIH3T3 fibroblasts were treated with the E. cava enzymatic extract and the isolated compounds from the E. cava enzymatic extract, the E. cava enzymatic extract increased the proliferation of NIH3T3 fibroblasts, but the isolated compounds such as eckol, dieckol, phloroglucinol and triphlorethol-A did not affect the proliferation of NIH3T3 fibroblasts. On the other hand, the E. cava enzymatic extract and dieckol significantly inhibited 5?-reductase activity. These results suggest that dieckol from E. cava can stimulate hair growth by the proliferation of DPC and/or the inhibition of 5?-reductase activity.

  10. Parotidectomía y vena facial Parotidectomy and facial vein

    Directory of Open Access Journals (Sweden)

    F. Hernández Altemir

    2009-10-01

    Full Text Available La cirugía de los tumores benignos de la parótida, es una cirugía de relaciones con estructuras fundamentalmente nerviosas cuyo daño, representa un gravísimo problema psicosomático por definirlo de una manera genérica. Para ayudar al manejo quirúrgico del nervio facial periférico, es por lo que en el presente artículo tratamos de enfatizar la importancia de la vena facial en la disección y conservación del nervio, precisamente donde su disección suele ser más comprometida, esto es en las ramas más caudales. El trabajo que vamos a desarrollar hay que verlo pues, como un ensalzamiento de las estructuras venosas en el seguimiento y control del nervio facial periférico y de porqué no, el nervio auricular mayor no siempre suficientemente valorado en la cirugía de la parótida al perder protagonismo con el facial.Benign parotid tumor surgery is related to fundamental nervous structures, defined simply: that when damaged cause great psychosomatic problems. In order to make peripheral facial nerve surgery easy to handle for the surgeon this article emphasizes the importance of the facial vein in the dissection and conservation of the nerve. Its dissection can be compromised if the caudal branches are damaged. The study that we develop should be seen as praise for the vein structures in the follow up and control of the peripheral facial nerve, and the main auricular nerve that is often undervalued when it is no longer the protagonist in the face.

  11. The Edible Brown Seaweed Ecklonia cava Reduces Hypersensitivity in Postoperative and Neuropathic Pain Models in Rats

    Directory of Open Access Journals (Sweden)

    Jae Goo Kim

    2014-06-01

    Full Text Available The current study was designed to investigate whether edible brown seaweed Ecklonia cava extracts exhibits analgesic effects in plantar incision and spared nerve injury (SNI rats. To evaluate pain-related behavior, we performed the mechanical withdrawal threshold (MWT and thermal hypersensitivity tests measured by von Frey filaments and a hot/cold plate analgesia meter. Pain-related behavior was also determined through analysis of ultrasonic vocalization. The results of experiments showed MWT values of the group that was treated with E. cava extracts by 300 mg/kg significantly increased; on the contrary, number of ultrasonic distress vocalization of the treated group was reduced at 6 h and 24 h after plantar incision operation (62.8%, p < 0.05. Moreover, E. cava 300 mg/kg treated group increased the paw withdrawal latency in hot-and cold-plate tests in the plantar incision rats. After 15 days of continuous treatment with E. cava extracts at 300 mg/kg, the treated group showed significantly alleviated SNI-induced hypersensitivity response by MWT compared with the control group. In conclusion, these results suggest that E. cava extracts have potential analgesic effects in the case of postoperative pain and neuropathic pain in rats.

  12. In Vivo Evaluation of Vena Caval Filters: Can Function Be Linked to Design Characteristics?

    International Nuclear Information System (INIS)

    Purpose: To compare the five vena caval filters marketed in the United States and one investigational vena caval filter and to determine whether there is an association between their design and their in vivo function.Methods: Four of each type of filter-Simon Nitinol (SN), Bird's Nest (BN), Vena Tech (VT), Greenfield stainless steel (PSGF), Greenfield titanium (TGF), and the investigational stent cone filter (NGF)-were studied for 60 days in 12 sheep. Radiographic and pathologic outcomes to be assessed included clot capture and resolution, vena caval penetration, position of the filter, thrombogenicity, and vessel wall reaction.Results: Filters differed with respect to the number of clot-trapping levels and the interdependence of the legs. All devices were successfully placed. Intentionally embolized clot was captured. One VT and two SN filters migrated in response to clot capture. Resolution of thrombus was variable, and related to the design of the device. Fibrin webbing was widely present with the VT, BN, and SN filters but limited in the others. The VT and NGF filters demonstrated the most stable filter base diameter.Conclusions: The performance of vena caval filters differs with respect to clot resolution and mechanical stability. Interdependent filter limbs and single-stage conical capture sites appear to result in more favorable performance in in vivo studies

  13. Protective efficacy of an Ecklonia cava extract used to treat transient focal ischemia of the rat brain.

    Science.gov (United States)

    Kim, Jeong Hwan; Lee, Nam Seob; Jeong, Yeong Gil; Lee, Je-Hun; Kim, Eun Ji; Han, Seung Yun

    2012-06-01

    Phlorotannins (marine algal polyphenols) have been reported to exhibit beneficial biological activities, serving as both antioxidants and anti-inflammatory agents. Among marine algae, Ecklonia cava, a member of the Laminariaceae, is a very popular food regarded as healthy in Korea and Japan. Recently, benefits afforded by phlorotannins in the treatment of various clinical conditions have been reported, but any therapeutic effects of such materials in the treatment of neurodegenerative diseases such as stroke remain unclear. Also, the mechanisms of action of the algal components remain poorly understood. In the present in vivo study, administration of Ecklonia cava polyphenols (ECP) at 10 mg/kg and 50 mg/kg intraperitoneally (i.p.) significantly decreased infarct size and the extent of brain edema in the rat after induction of transient focal ischemia via middle cerebral artery occlusion (MCAO). Further, terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) assay revealed dose-dependent blockage of neuronal apoptosis upon intravenous ECP treatment. Neurobehavioral tests performed over the 6 days after MCAO revealed a reduction in neurological motor performance in control animals, but administration of ECP (50 mg/kg i.p.) prevented this decline. In vitro, a significant neuroprotective effect of ECP was evident when cell viability was assayed after induction of H(2)O(2)-mediated oxidative stress, upon retinoic acid treatment, in the differentiated neuroblastoma cell line SH-SY5Y. Interestingly, ECP blocked the rise in cytosolic calcium, in a dose-dependent manner, in differentiated SH-SY5Y cells exposed to H(2)O(2). Together, the results suggest that ECP exerts neuroprotective effects in the focally ischemic brain by reducing Ca(2+)-mediated neurotoxicity. PMID:22822465

  14. Comparison of Venae Sectio vs. modified Seldinger Technique for Totally Implantable Access Ports; Portas-trial [ISRCTN:52368201

    Directory of Open Access Journals (Sweden)

    Luntz S

    2006-06-01

    Full Text Available Abstract Background The insertion of a Totally Implantable Access Port (TIAP is a routinely employed technique in patients who need a safe and permanent venous access. The number of TIAP implantations is increasing constantly mainly due to advanced treatment options for malignant diseases. Therefore it is important to identify the implantation technique which has the optimal benefit/risk ratio for the patient. Study design A single-centre, randomized, controlled superiority trial to compare two different TIAP implantation techniques. Sample size: 160 patients will be included and randomized intra-operatively. Eligibility criteria: Age equal or older than 18 years, patients scheduled for primary elective implantation of a TIAP in local anaesthesia and a signed informed consent. Primary endpoint: Primary success rate of the randomized technique. Intervention: Venae Sectio in combination with the Seldinger Technique (guide wire and a peel away sheath will be used to place a TIAP. Reference treatment: Conventional Venae Sectio will be used with a direct insertion of the TIAP without guide wire or peel away sheath. Duration of study: Approximately 20 months. Organisation/Responsibility The trial will be conducted in compliance with the protocol and in accordance with the moral, ethical, and scientific principles governing clinical research as set out in the Declaration of Helsinki (1989 and Good Clinical Practice (GCP. The trial will also be carried out in keeping with local and regulatory requirements. The Klinisches Studienzentrum Chirurgie (KSC – Centre of Clinical Trials in Surgery at the Department of Surgery, University Hospital Heidelberg is responsible for planning and conduction of the trial. Documentation of patient's data will be accomplished via electronical Case Report Files (eCRF with MACRO®-Software by the KSC. Randomization, data management, monitoring and biometry are provided by the independent Koordinierungszentrum für Klinische Studien (KKS – Coordination Centre for Clinical Trails at the University of Heidelberg.

  15. Trombosis de la vena yugular interna secundaria a faringoamigdalitis aguda / Thrombosis of the internal jugular vein secondary to acute pharyngotonsillitis

    Scientific Electronic Library Online (English)

    Giselle, Cuestas; Yesica, Lijdens; María Victoria, Demarchi; María Pía, Martínez Corvalán; Juan, Razetti; Carlos, Boccio.

    2014-12-01

    Full Text Available La faringoamigdalitis aguda es una de las enfermedades más comunes en niños y adolescentes. La etiología más frecuente es la viral, seguida por la bacteriana. Entre las causas bacterianas, el principal agente es el estreptococo beta hemolítico del grupo A. Una complicación infrecuente de los proceso [...] s infecciosos faríngeos es la tromboflebitis séptica de la vena yugular interna. El diagnóstico se sospecha ante la tumefacción laterocervical unilateral de carácter inflamatorio. Se confirma mediante tomografía computada con contraste. El tratamiento consiste en la administración prolongada de antibióticos; el uso de anticoagulantes es controvertido. El diagnóstico precoz y el tratamiento apropiado son esenciales para evitar la oclusión vascular persistente y la progresión del trombo, que puede ocasionar émbolos pulmonares. Presentamos a una adolescente con tromboflebitis de la vena yugular interna secundaria a faringoamigdalitis aguda estreptocócica, con el objetivo de describir las manifestaciones clínicas, los métodos diagnósticos y el tratamiento de esta rara complicación vascular. Abstract in english Acute pharyngotonsillitis is one of the most common diseases in children and adolescents. The most frequent etiology is virus, followed by bacteria. The main bacterial agent is beta hemolytic Streptococcus group A. A rare complication of pharyngeal infectious processes is septic thrombophlebitis of [...] the internal jugular vein. The diagnosis is suspected in the presence of an inflammatory unilateral neck swelling. The diagnosis is confirmed by contrast computed tomography. Treatment consists of prolonged administration of antibiotics, being the use of anticoagulants controversial. Early diagnosis and appropriate treatment are essential to prevent persistent vascular occlusion and progression of the thrombus, which can cause pulmonary emboli. In the present study, we present a teenager with thrombophlebitis of the internal jugular vein secondary to acute streptococcal pharyngotonsillitis. Clinical manifestations, diagnostic methods and treatment of this rare vascular complication are described herein.

  16. A CASE REPORT ON ABNORMAL COURSE OF VENA SAPHENA PARVA

    Directory of Open Access Journals (Sweden)

    D.Krupa Daniel

    2015-09-01

    Full Text Available Background: Great saphenous vein and short saphenous veins are the superficial veins of the lower limb. Variations in the superficial veins of the lowerlimb are uncommon. Our case report discusses anomalous course and its abnormal termination of short/small saphenous vein/Vena saphena parva. Materials and Methods: 80 Cadavers, Blade scalpel, Scissors, Forceps, Cotton, Other stationeries. Results: The short saphenous vein deviates the anatomical course without draining into popliteal vein, instead drains into deep femoral vein, femoral vein and Great saphenous vein. Discussion: During a routine dissection with 80 cadavers, an abnormal short saphenous vein was observed in the left lower limb of an aged male cadaver. The origin of small saphneous vein from the dorsum of the foot at the lateral end of the dorsal venous arch and continues behind the lateral malleolus and courses upward along the posterior side of the leg and has to end in popliteal vein but in our continuity of dissection the short saphenous vein has bifurcated into proper short saphenous vein and accessory saphenous vein at the junction of back of leg which drains into great saphenous vein. Conclusion: The knowledge of superficial veins of the lower limb is useful for clinicians during coronary bypass procedures, as these vessels are commonly used in such surgeries. It is therefore, essential for surgeons before harvesting the great saphenous vein to look for the abnormal drainage pattern of the short saphenous vein into the great saphenous vein either directly or through communication veins or with the presence of the Giacomini vein, Accessory saphenous vein.

  17. Peïra-Cava: itinéraire d’un lieu touristique dans la moyenne montagne niçoise

    Directory of Open Access Journals (Sweden)

    Christian Hélion

    2000-09-01

    Full Text Available A la fin du xixe siècle, la proximité et l’accessibilité de Peïra-Cava depuis Nice transforment en haut lieu touristique d’été et d’hiver un replat ouvert par l’armée frontalière dans la moyenne montagne azuréenne. L’itinéraire long et complexe de ce lieu aujourd’hui pratiquement en friche et le mythe de l’âge d’or qui s’y rattache, cachent la réalité de la dynamique territoriale: Peïra-Cava, annexe de Nice, ville d’hiver, s’inscrit désormais dans son aire de loisirs.

  18. Fístula aorto-cava: Caso clínico / Aortocaval Fistula: Case report

    Scientific Electronic Library Online (English)

    José Almeida, Lopes; Armando, Mansilha; José Fernando, Teixeira.

    2014-03-01

    Full Text Available As Fístulas Aorto-Cava (FAC) são complicações raras dos aneurismas da aorta abdominal (AAA) e estão frequentemente associadas a significativa mobi-mortalidade. Os autores apresentam o caso clínico de um doente que recorre ao nosso hospital e lhe é diagnosticado um AAA de 6,9 cm e uma FAC. Foi realiz [...] ada a sua correção cirurgica urgente por via clássica, tendo-se utilizado uma prótese tubular de Dacron® de 20 mm para a reconstrução aórtica. O internamento prolongou-se por 30 dias, desenvolveu gangrena do membro inferior direito com necessidade de realização de amputação major desse membro. O doente protetizou e 3 anos após esta cirurgia morre de neoplasia esofágica metastizada. É realizada uma revisão da literatura e é feita referência às várias hipóteses de tratamento. Abstract in english Aortocaval fistulas are rare complications of abdominal aortic aneurysms (AAA) and are often associated with significant mobi-mortality. The authors present a case report of a patient who comes to our hospital and an AAA of 6.9 cm and an associated aortocaval fistula were diagnosed. We performed its [...] urgent surgical correction by open repair, were a 20 mm tubular Dacron® graft was used for the aortic reconstruction. The hospitalization lasted for 30 days, during which developed gangrene of the right lower limb, requiring major amputation of this limb. The patient adapted well to a lower limb prosthesis and 3 years after this surgery dies of a metastic esophageal cancer. It is performed a literature review of the pathology in question and made reference to the various treatment options.

  19. Protocol of an expertise based randomized trial comparing surgical Venae Sectio versus radiological Puncture of Vena Subclavia for insertion of Totally Implantable Access Port in oncological patients

    OpenAIRE

    Radeleff Boris; Stampfl Ulrike; Lopez-Benitez Ruben; Cremonese Eva; Fischer Lars; Knebel Philip; Kauczor Hans-Ulrich; Büchler Markus W; Seiler Christoph M

    2008-01-01

    Abstract Background Totally Implantable Access Ports (TIAP) are being extensively used world-wide and can be expected to gain further importance with the introduction of new neoadjuvant and adjuvant treatments in oncology. Two different techniques for the implantation can be selected: A direct puncture of a central vein and the utilization of a Seldinger device or the surgical Venae sectio. It is still unclear which technique has the optimal benefit/risk ratio for the patient. Design A single...

  20. Correlación entre el diámetro de la vena porta, recuento plaquetario y tiempo de protrombina en el diagnóstico de várices esofágicas en pacientes con enfermedad hepática crónica del Hospital de Lídice durante el período Enero 2002- Marzo 2007

    Scientific Electronic Library Online (English)

    Solángel, Díaz; Gustavo, Fernández; Dorys, Suárez; Andrés, Ortiz; Natacha, Bastardo; Maria, Cruz; Lucy, Dagher; Jacobo, Dib Jr.

    2008-12-01

    Full Text Available Estudios recientes han reportado alternativas diagnósticas no invasivas para Várices Esofágicas (VE), identificando factores pronósticos como: bajo recuento plaquetario, esplenomegalia, diámetro de la vena porta aumentado, disminución de la actividad de protrombina (PT) y una clasificación avanzada [...] de Child-Pugh. Objetivo: determinar la relación entre diámetro de vena porta, recuento plaquetario y PT como valores predictivos negativos para la presencia de VE. Metodología: Se realizó un estudio retrospectivo de pacientes con enfermedad hepática crónica y diagnóstico endoscópico de várices esofágicas (VE), correlacionándolos con diámetro de la vena porta, recuento plaquetario y tiempo de protrombina (PT), en el Servicio de Gastroenterología del Hospital "Jesús Yerena" de Lídice; enero 2002 marzo 2007. Resultados: El diámetro de la vena porta osciló entre 8,00 y 20,00mm, recuento plaquetario entre 44,000 y 650,000 por mm? y el diferencial de PT se encontró entre 0,00 y 12,30 segundos. El diagnóstico endoscópico de VE mas frecuente fue el grado II con un 58,00%, relacionado con una media de diámetro de vena porta de 12,21mm, recuento plaquetario de 151,18mm? y PT de 1,36 segundos. Discusión: Se encontró una relación directamente proporcional entre el diámetro de vena porta y grado de VE, e inversamente proporcional con respecto al recuento plaquetario y PT. Abstract in english Recent studies have reported non invasive diagnostic alternatives for Esophageal Varices (EV), identifying prognostic factors such as: low platelet count, enlarged spleen, augmented portal vein diameter, diminished prothrombin activity level (PT), and an advanced Child-Pugh classification. Objective [...] s: to determine the relationship between portal vein diameter, platelet count and PT as negative predictors for the presence of EV. Methods: A retrospective study was carried out among patients with chronic hepatic disease and endoscopic diagnosis of EV, correlating portal vein diameter, platelet count and PT, at the Gastroenterology Service, Hospital of Lídice; between January 2002 and March 2007. Results: The diameter of the portal vein ranged from 8, 00 to 20, 00 mm; the platelet count between 44,000 and 650,000 mm? and the difference between the PT varied from 0, 00 secs and 12, 30 secs. The most frequent endoscopic diagnosis of EV was grade II (58%), related with a mean portal vein diameter of 12, 21 mm, platelet count of 151,18mm? and PT of 1, 36 secs. Discussion: we found a direct proportional relationship between portal vein diameter and the grade of EV, and an inversely proportional relationship with platelet count and PT.

  1. Correlación entre el diámetro de la vena porta, recuento plaquetario y tiempo de protrombina en el diagnóstico de várices esofágicas en pacientes con enfermedad hepática crónica del Hospital de Lídice durante el período Enero 2002- Marzo 2007

    Scientific Electronic Library Online (English)

    Solángel, Díaz; Gustavo, Fernández; Dorys, Suárez; Andrés, Ortiz; Natacha, Bastardo; Maria, Cruz; Lucy, Dagher; Jacobo, Dib Jr.

    2008-12-01

    Full Text Available Estudios recientes han reportado alternativas diagnósticas no invasivas para Várices Esofágicas (VE), identificando factores pronósticos como: bajo recuento plaquetario, esplenomegalia, diámetro de la vena porta aumentado, disminución de la actividad de protrombina (PT) y una clasificación avanzada [...] de Child-Pugh. Objetivo: determinar la relación entre diámetro de vena porta, recuento plaquetario y PT como valores predictivos negativos para la presencia de VE. Metodología: Se realizó un estudio retrospectivo de pacientes con enfermedad hepática crónica y diagnóstico endoscópico de várices esofágicas (VE), correlacionándolos con diámetro de la vena porta, recuento plaquetario y tiempo de protrombina (PT), en el Servicio de Gastroenterología del Hospital "Jesús Yerena" de Lídice; enero 2002 marzo 2007. Resultados: El diámetro de la vena porta osciló entre 8,00 y 20,00mm, recuento plaquetario entre 44,000 y 650,000 por mm y el diferencial de PT se encontró entre 0,00 y 12,30 segundos. El diagnóstico endoscópico de VE mas frecuente fue el grado II con un 58,00%, relacionado con una media de diámetro de vena porta de 12,21mm, recuento plaquetario de 151,18mm y PT de 1,36 segundos. Discusión: Se encontró una relación directamente proporcional entre el diámetro de vena porta y grado de VE, e inversamente proporcional con respecto al recuento plaquetario y PT. Abstract in english Recent studies have reported non invasive diagnostic alternatives for Esophageal Varices (EV), identifying prognostic factors such as: low platelet count, enlarged spleen, augmented portal vein diameter, diminished prothrombin activity level (PT), and an advanced Child-Pugh classification. Objective [...] s: to determine the relationship between portal vein diameter, platelet count and PT as negative predictors for the presence of EV. Methods: A retrospective study was carried out among patients with chronic hepatic disease and endoscopic diagnosis of EV, correlating portal vein diameter, platelet count and PT, at the Gastroenterology Service, Hospital of Lídice; between January 2002 and March 2007. Results: The diameter of the portal vein ranged from 8, 00 to 20, 00 mm; the platelet count between 44,000 and 650,000 mm and the difference between the PT varied from 0, 00 secs and 12, 30 secs. The most frequent endoscopic diagnosis of EV was grade II (58%), related with a mean portal vein diameter of 12, 21 mm, platelet count of 151,18mm and PT of 1, 36 secs. Discussion: we found a direct proportional relationship between portal vein diameter and the grade of EV, and an inversely proportional relationship with platelet count and PT.

  2. Electrophysiological Study and Catheter Ablation with 3D Mapping

    Medline Plus

    Full Text Available ... vena cava, which is one of the major vessels that feeds the heart. Okay, if you collect ... inferior vena cava, which is the other main vessel that feeds the heart. Okay. How’s that diagram ...

  3. Paracardioscopic Ex-Maze

    Medline Plus

    Full Text Available ... device, going through the right chest, through the transfer sinus, behind the superior vena cava, and be ... chest, behind the superior vena cava, through the transfer sinus, behind the left atrial appendage, and in ...

  4. Clinical Perspectives: 7-Year-Old Girl Has 6 Organs Removed and Retransplanted

    Medline Plus

    Full Text Available ... I'm sorry, infiltrated onto the vena cava wall. It was really not intravascular invasion but it ... to leave a little bit of vena cava wall onto the tumor site. Once this part is ...

  5. Giant superior vena caval aneurysm in a post-Glenn patient

    OpenAIRE

    Panduranga, Prashanth; Thomas, Eapen; Al-Maskari, Salim; Al-Farqani, Abdulla

    2012-01-01

    Aneurysms of mediastinal systemic veins are extremely rare, usually asymptomatic and incidentally diagnosed during chest radiography. We describe the case of a giant superior vena caval aneurysm in a 14-year old male following Glenn surgery and discuss its complications and management.

  6. Cholinesterasová a antioxida?ní aktivita isocholidinových tercialních alkaloid? Coridalis cava.

    Czech Academy of Sciences Publication Activity Database

    Chlebek, J.; Cahlíková, L.; Macáková, K.; Opletal, L.; Kurfürst, Milan

    Praha : ?eská spole?nost chemická, 2009, s. 954-955. ISSN 0009-2770. [Pokroky v organické, bioorganické a farmaceutické chemii /44./. Liblice (CZ), 27.11.2009-29.11.2009] Grant ostatní: GA UK(GB) 122309 Institutional research plan: CEZ:AV0Z40720504 Keywords : tertiary alkaloids * coridalis cava Subject RIV: CF - Physical ; Theoretical Chemistry

  7. Exploiting biological activities of brown seaweed Ecklonia cava for potential industrial applications: a review.

    Science.gov (United States)

    Wijesinghe, W A J P; Jeon, You-Jin

    2012-03-01

    Seaweeds are rich in vitamins, minerals, dietary fibres, proteins, polysaccharides and various functional polyphenols. Many researchers have focused on brown algae as a potential source of bioactive materials in the past few decades. Ecklonia cava is a brown seaweed that is abundant in the subtidal regions of Jeju Island in the Republic of Korea. This seaweed attracted extensive interest due to its multiple biological activities. E. cava has been identified as a potential producer of wide spectrum of natural substances such as carotenoids, fucoidans and phlorotannins showing different biological activities in vital industrial applications including pharmaceutical, nutraceutical, cosmeceutical and functional food. This review focuses on biological activities of the brown seaweed E. cava based on latest research results, including antioxidant, anticoagulative, antimicrobial, antihuman immunodeficiency virus, anti-inflammatory, immunomodulatory, antimutagenic, antitumour and anticancer effects. The facts summarized here may provide novel insights into the functions of E. cava and its derivatives and potentially enable their use as functional ingredients in potential industrial applications. PMID:21942760

  8. Vena Renal Izquierda Recurrente Retroaórtica: Reporte de una Rara Variación Recurrent Retroaortic Left Renal Vein: Report of an Uncommon Anomaly

    OpenAIRE

    Oscar Inzunza H; Martín Inzunza A; Guillermo Salgado A

    2011-01-01

    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...

  9. Infraclinical diagnosis of pulmonary embolism using indium 111 tropolonate labelled platelet scintigraphy. About one case

    International Nuclear Information System (INIS)

    An Indium 111 tropolonate autologous labeled platelet scintigraphy in a 24 year old man with a 2 year history of superior vena cava thrombosis of unknown etiology points out a significant hyperfixation at T3 hour on right iliac venous with extension of this hyperfixation to right femoral and vena cava at D1 and D2. Simultaneously at D2 an accumulation of labeled platelets was clearly detected in the left lung field. This pulmonary embolism was confirmed by a perfusion pulmonary scintigraphy using 99m Tc albumin microspheres which showed defects in the regions of Indium 111 hyperfixation. The old superior vena cava thrombosis was never detected by this isotopic study. So scintigraphy exam using Indium 111 tropolonate autologous labeled platelets detects acute thrombosis (active) and not old thrombosis (inactive), and points out that recurrent thrombo embolic disease would be due to persistant thrombotic evolution without clinical evidence

  10. Blood collection in the guinea pig (Cavia porcellus).

    Science.gov (United States)

    Williams, Wendy R; Kendall, Lon V

    2015-06-01

    Guinea pigs are useful animal models for the study of many human diseases including diabetes mellitus and infectious diseases. Often, these studies involve collecting blood samples of considerable volume. This column describes safe techniques for restraint and blood collection from the jugular vein and cranial vena cava from alert and anesthetized guinea pigs. PMID:25989552

  11. Rapid intra-hepatic dissemination of hepatocellular carcinoma with pulmonary metastases following combined loco-regional therapy

    Energy Technology Data Exchange (ETDEWEB)

    Pua, Uei [Dept. of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore (Singapore)

    2013-08-15

    This manuscript describes an unusual case of rapid intra-hepatic dissemination of hepatocellular carcinoma with pulmonary metastases occurring 1 month after combined chemoembolization and radiofrequency ablation. Inferior vena cava and portal vein invasion tumor thrombus was also detected, possibly accounting for the mechanism of disease dissemination route of disease.

  12. Antibacterial activity of the phlorotanninsdieckol and phlorofucofuroeckol-A from Ecklonia cava against Propionibacteriumacnes / Actividadantibacterial contra Propionibacterium acnes por florotaninos diecol yflorofucofuroecol-A producidos por Ecklonia cava

    Scientific Electronic Library Online (English)

    Jae-Suk, Choi; Kyungyong, Lee; Bo-Bae, Lee; Yang-Chun, Kim; Young Dae, Kim; Yong-Ki, Hong; Kwang Keun, Cho; In Soon, Choi.

    Full Text Available Se conoce que elextracto de metanol del alga parda marina Ecklonia cava presentaactividad antimicrobiana contra Propionibacterium acnes. Para identificarlos compuestos que confieren esta actividad antimicrobiana se fraccionóel extracto de metanol, usando cromatografía en columna de sílicagel, median [...] te el aumento de la polaridad del disolvente. La actividad antimicrobianade cada fracción se determinó en términos de laconcentración mínima inhibitoria. Las fracciones de hexano,éter dietílico, acetona, acetato de etilo, acetonitrilo, metanoly agua fueron producidas. La fracción de acetona presentó lamayor actividad antibacteriana (concentración mínima inhibitoria= 156 ?g/mL). Con base en este resultado, la fracción de acetona sepurificó por cromatografía en columna en LH-20 Sephadex y HPLC defase inversa usando una columna Alltima C18 con un gradiente lineal de H2O-MeOHde 30 a 100%. Dos picos se eluyeron a 18.1 (P1) y 23.8 (P2) min, ambos tuvieronactividad antibacteriana marcada (concentración mínimainhibitoria = 39 ?g/mL para ambos). La estructura de estos compuestos sedeterminó sobre la base de ¹H y 13C de resonanciamagnética nuclear y, mediante la comparación con valorespublicados, éstos pueden ser derivados de floroglucinol diecol (P1) yflorofucofuroecol-A (P2). Los resultados sugieren que florotaninos derivados deE. cava tienen actividad antimicrobiana frente a P. acnes, y porlo tanto, pueden ser útiles como aditivos naturales en loscosméticos anti-acné y los productos farmacéuticos. Abstract in english Methanol extract ofthe marine brown alga Ecklonia cava has been shown to exhibitantimicrobial activity against Propionibacterium acnes. To identify thecompounds conferring this antimicrobial activity, methanol extract wasfractionated using silica-gel column chromatography by increasing solventpolari [...] ty, and the antimicrobial activities of each fraction were determined interms of the minimum inhibitory concentration. Hexane, diethyl ether, acetone,ethyl acetate, acetonitrile, methanol, and water fractions were generated, withthe acetone fraction exhibiting the greatest antibacterial activity (minimuminhibitory concentration = 156 ?g/mL). The acetone fraction was further purifiedby Sephadex LH-20 column chromatography and reverse-phase HPLC using an AlltimaC18 column with an H2O-MeOH linear gradient from 30 to 100%. Twopeaks were eluted at 18.1 (P1) and 23.8 (P2) min, both of which exhibitedmarked antibacterial activity (minimum inhibitory concentration = 39 ?g/mL forboth). The structures of these compounds were determined on the basis of ¹Hand 13C nuclear magnetic resonance data and, through comparison withpublished data, can be phloroglucinol derivatives dieckol (P1) andphlorofucofuroeckol-A (P2). These results suggest that phlorotannins derivedfrom E. cava have antimicrobial activity against P. acnes, and somay be useful as natural additives in anti-acne cosmetics and pharmaceuticalproducts.

  13. Redução da água corporal de renais crônicos em diálise peritoneal se associa com melhor controle da hipertensão arterial / Total body water reduction in subjects with chronic kidney disease on peritoneal dialysis is associated with a better hypertension control

    Scientific Electronic Library Online (English)

    José Resende de, Castro Júnior; Natália, Fernandes; Thiago Bento de Paiva, Lacet; Fábio Simplício, Maia; Glauco Resende, Bonato; Cristianne, Nogueira; Sílvio Henrique, Barberato; Rogério Baumgratz de, Paula.

    2014-12-01

    Full Text Available Introdução: A hipertensão arterial tem alta prevalência em renais crônicos, sendo a hipervolemia um de seus fatores causais. Objetivo: Avaliar a influência da redução da volemia no controle pressórico e em parâmetros ecocardiográficos de pacientes renais crônicos em diálise peritoneal contínua. [...] Métodos: Doze renais crônicos sem sinais clínicos de hipervolemia foram submetidos à intensificação da diálise com o objetivo de reduzir o peso corporal em 5%. A volemia foi avaliada pela bioimpedância elétrica e pela ultrassonografia de veia cava inferior (VCI). Os voluntários foram submetidos à monitorização ambulatorial da pressão arterial e a exame ecocardiográfico no período basal e após 5 semanas de intervenção. Resultados: Após a intensificação da ultrafiltração, houve redução significativa do peso corporal, da água extracelular e do diâmetro inspiratório da VCI, enquanto o índice de colapsamento da VCI não alterou de modo significativo. A despeito da redução do número de anti-hipertensivos, a pressão sistólica do período de sono reduziu de 138,4 ± 18,6 para 126,7 ± 18,0 mmHg, o descenso pressórico do sono aumentou e o diâmetro sistólico final do ventrículo esquerdo reduziu significantemente. Conclusão: A redução da volemia de pacientes em diálise peritoneal, clinicamente euvolêmicos, se associou a melhor controle pressórico e à diminuição do diâmetro sistólico final do ventrículo esquerdo. Abstract in english Introduction: Hypertension is highly prevalent in patients with chronic kidney disease and hypervolemia is one of the principal causes. Objective: To evaluate the influence of the reduction of volemia on blood pressure as well as on echocardiographic parameters in patients on continuous ambulator [...] y peritoneal dialysis. Methods: Twelve patients with no clinical evidence of hypervolemia were submitted to an increase in the rate of the dialysis with the purpose of reducing body weight by 5%. The volemia was evaluated by electrical bioimpedance and by ultrasound of the inferior cava vena (ICV). Blood pressure was measured by ambulatory blood pressure monitoring and cardiac function was evaluated by echocardiography both at baseline and 5 weeks after the intervention period. Results: After the increase in the ultrafiltration, body weight, extracellular water and the inspiratory diameter of the ICV decreased significantly in parallel with a non-significant increase in the collapsing ICV index. Despite the reduction of anti-hypertensive drugs, systolic blood pressure during the sleep period decreased from 138.4 ± 18.6 to 126.7 ± 18.0 mmHg, the nocturnal blood pressure drop increased and the final systolic left ventricular diameter decreased significantly. Conclusion: Reduction of the volemia of patients on peritoneal dialysis, with no signs of hypervolemia, was associated with a better blood pressure control and with a decrease of the final systolic left ventricular diameter.

  14. Tratamiento de estenosis sintomática de venas pulmonares secundaria a ablación por radiofrecuencia

    Scientific Electronic Library Online (English)

    Adolfo, Ferrero Guadagnoli; Alejandro E, Contreras; Carlos R, Leonardi; Miguel A, Ballarino; Leonardo, Atea; Alejandro R, Peirone.

    2014-08-01

    Full Text Available El aislamiento de las venas pulmonares mediante la aplicación de radiofrecuencia es un tratamiento efectivo de la fibrilación auricular. Una de las complicaciones potenciales y de mayor compromiso clínico de esta técnica invasiva es la estenosis de una o varias venas pulmonares. Esta complicación pu [...] ede ser tratada mediante angioplastia con o sin colocación de stent, logrando una adecuada mejoría clínica, aunque con un alto índice de recurrencia por re-estenosis. Abstract in english Isolation of the pulmonary veins by applying radiofrequency is an effective treatment for atrial fibrillation. One of the potential complications with higher clinical compromise utilizing this invasive technique is the occurrence of stenosis of one or more pulmonary veins. This complication can be t [...] reated by angioplasty with or without stent implantation, with an adequate clinical improvement, but with a high rate of restenosis.

  15. Effect of phlorotannins isolated from Ecklonia cava on angiotensin I-converting enzyme (ACE) inhibitory activity

    OpenAIRE

    Wijesinghe, W.A.J.P.; Ko, Seok-Chun; Jeon, You-Jin

    2011-01-01

    Inhibition of angiotensin I-converting enzyme (ACE) activity is the most common mechanism underlying the lowering of blood pressure. In the present study, five organic extracts of a marine brown seaweed Ecklonia cava were prepared by using ethanol, ethyl acetate, chloroform, hexane, and diethyl ether as solvents, which were then tested for their potential ACE inhibitory activities. Ethanol extract showed the strongest ACE inhibitory activity with an IC50 value of 0.96 mg/ml. Five kinds of phl...

  16. SUBCUTANEOUS PHEOHYPHOMYCOSIS CAUSED BY Phoma cava: REPORT OF A CASE AND REVIEW OF THE LITERATURE

    OpenAIRE

    Clarisse ZAITZ; Elisabeth Maria HEINS-VACCARI; Freitas, Roseli Santos; ARRIAGADA Giovana Letícia Hernández; RUIZ Ligia; TOTOLI Silvia A.S.; Marques, Ana Cristina; Gisele G. REZZE; MÚLLER Helena; VALENTE Neuza Sakai; Carlos da Silva LACAZ

    1997-01-01

    We report a case of subcutaneous pheohyphomycosis observed in a male patient presenting pulmonary sarcoidosis and submitted to corticosteroid treatment. He presented nodular erythematous-violaceous skin lesions in the dorsum of the right hand. Histopathological examination of the biopsied lesion revealed dematiaceous hyphae and yeast-like cells, with a granulomatous tissual reaction. The isolated fungus was identified as Phoma cava. A review of the literature on fungal infection caused by dif...

  17. First evidence that Ecklonia cava-derived dieckol attenuates MCF-7 human breast carcinoma cell migration.

    Science.gov (United States)

    Kim, Eun-Kyung; Tang, Yujiao; Kim, Yon-Suk; Hwang, Jin-Woo; Choi, Eun-Ju; Lee, Ji-Hyeok; Lee, Seung-Hong; Jeon, You-Jin; Park, Pyo-Jam

    2015-04-01

    We investigated the effect of Ecklonia cava (E. cava)-derived dieckol on movement behavior and the expression of migration-related genes in MCF-7 human breast cancer cell. Phlorotannins (e.g., dieckol, 6,6'-biecko, and 2,7?-phloroglucinol-6,6'-bieckol) were purified from E. cava by using centrifugal partition chromatography. Among the phlorotannins, we found that dieckol inhibited breast cancer cell the most and was selected for further study. Radius™-well was used to assess cell migration, and dieckol (1-100 µM) was found to suppress breast cancer cell movement. Metastasis-related gene expressions were evaluated by RT-PCR and Western blot analysis. In addition, dieckol inhibited the expression of migration-related genes such as matrix metalloproteinase (MMP)-9 and vascular endothelial growth factor (VEGF). On the other hand, it stimulated the expression of tissue inhibitor of metalloproteinase (TIMP)-1 and TIMP-2. These results suggest that dieckol exerts anti-breast cancer activity via the regulation of the expressions of metastasis-related genes, and this is the first report on the anti-breast cancer effect of dieckol. PMID:25830682

  18. Effect of phlorotannins isolated from Ecklonia cava on angiotensin I-converting enzyme (ACE) inhibitory activity.

    Science.gov (United States)

    Wijesinghe, W A J P; Ko, Seok-Chun; Jeon, You-Jin

    2011-04-01

    Inhibition of angiotensin I-converting enzyme (ACE) activity is the most common mechanism underlying the lowering of blood pressure. In the present study, five organic extracts of a marine brown seaweed Ecklonia cava were prepared by using ethanol, ethyl acetate, chloroform, hexane, and diethyl ether as solvents, which were then tested for their potential ACE inhibitory activities. Ethanol extract showed the strongest ACE inhibitory activity with an IC(50) value of 0.96 mg/ml. Five kinds of phlorotannins, phloroglucinol, triphlorethol-A, eckol, dieckol, and eckstolonol, were isolated from ethanol extract of E. cava, which exhibited potential ACE inhibition. Dieckol was the most potent ACE inhibitor and was found to be a non-competitive inhibitor against ACE according to Lineweaver-Burk plots. Dieckol had an inducible effect on the production of NO in EAhy926 cells without having cytotoxic effect. The results of this study indicate that E. cava could be a potential source of phlorotannins with ACE inhibitory activity for utilization in production of functional foods. PMID:21556221

  19. First Evidence that Ecklonia cava-Derived Dieckol Attenuates MCF-7 Human Breast Carcinoma Cell Migration

    Directory of Open Access Journals (Sweden)

    Eun-Kyung Kim

    2015-03-01

    Full Text Available We investigated the effect of Ecklonia cava (E. cava-derived dieckol on movement behavior and the expression of migration-related genes in MCF-7 human breast cancer cell. Phlorotannins (e.g., dieckol, 6,6?-biecko, and 2,7?-phloroglucinol-6,6?-bieckol were purified from E. cava by using centrifugal partition chromatography. Among the phlorotannins, we found that dieckol inhibited breast cancer cell the most and was selected for further study. Radius™-well was used to assess cell migration, and dieckol (1–100 µM was found to suppress breast cancer cell movement. Metastasis-related gene expressions were evaluated by RT-PCR and Western blot analysis. In addition, dieckol inhibited the expression of migration-related genes such as matrix metalloproteinase (MMP-9 and vascular endothelial growth factor (VEGF. On the other hand, it stimulated the expression of tissue inhibitor of metalloproteinase (TIMP-1 and TIMP-2. These results suggest that dieckol exerts anti-breast cancer activity via the regulation of the expressions of metastasis-related genes, and this is the first report on the anti-breast cancer effect of dieckol.

  20. Comparison of Ecklonia cava, Ecklonia stolonifera and Eisenia bicyclis for phlorotannin extraction.

    Science.gov (United States)

    Chowdhury, Muhammad Tanvir Hossain; Bangoura, Issa; Kang, Ji-Young; Cho, Ji Young; Joo, Jin; Choi, Yoo Seong; Hwang, Dong Soo; Hong, Yong-Ki

    2014-07-01

    Phlorotannins are polyphenols of marine algae, particularly brown seaweed, having multiple biological activities. A reverse phase-high performance liquid chromatography method was developed for rapid and routine quantification of two major phlorotannins, dieckol and phlorofucofuroeckol-A (PFE-A), from boiling water- and organic solvent-extracts of brown seaweeds Ecklonia cava, E. stolonifera and Eisenia bicyclis. The regression equations for dieckol and PFE-A were as follows: the concentration (mg ml(-1)) = 16.56 x peak height (cm) + 0.44, and the concentration = 20.60 x peak height (cm) + 0.11, with correlation coefficients of 0.996 and 0.999, respectively. Compared to organic solvent extraction, the recovery yield of dieckol from boiling water extracts of E. cava, E. stolonifera and E. bicyclis was 86%, 93%, and 98%, respectively. The recovery yield of PFE-A was 74%, 86% and 62%, respectively. Antioxidant activity was detected in each E. bicyclis water extract (91%), followed by E. stolonifera (90%) and E. cava (74%). Dieckol and PFE-A showed almost 9- and 7-fold stronger antioxidant activity than the standard butylhydroxytoluene, and 6-and 4-fold greater than L-ascorbic acid in molar concentration, respectively. PMID:25004758

  1. Trombosis de la vena dorsal del pene (Flebitis de Mondor): Aportación de un nuevo caso / Trombosis of the dorsal penis vein (of Mondor’s Phlebitis): Presentation of a new case

    Scientific Electronic Library Online (English)

    O., Rodríguez-Faba; L., Parra-Muntaner; S.C., Gómez-Cisneros; J.L., Martín-Benito; S., Escaf-Barmadah.

    2006-01-01

    Full Text Available Objetivo: Presentamos un nuevo caso de trombosis de la vena dorsal superficial del pene o "flebitis de Mondor". Revisamos las características de la enfermedad y los métodos diagnósticos y terapéuticos actuales. Métodos: Revisamos el caso de un varón de 41 años que consultó por dolor e induración dor [...] sal del pene. Resultados: Después de realizar exploración física y Eco-doppler fue diagnosticado de Trombosis de la vena dorsal superficial o flebitis de Mondor. Recibió tratamiento con antiinflamatorios no esteroideos y antibióticos experimentando mejoría clínica. Conclusiones: La trombosis de la vena dorsal del pene es una rara entidad que cursa con dolor e induración dorsal, la etiología puede ser traumática, neoplásica, por excesiva actividad sexual o prolongada abstinencia. Puede cursar de forma aguda, subaguda o crónica. Es necesario realizar diagnóstico diferencial con la linfangitis esclerosante, el estudio de imagen ideal es el Eco-doppler y el tratamiento se basa en antiinflamatorios y antibióticos en caso de infección. Pueden ser útiles sustancias heparinizantes locales reservándose el manejo quirúrgico con trombectomía o resección de la vena dorsal para casos persistentes. Abstract in english Objective: We present a new case of trombosis of the superficial dorsal penis vein called Penile Mondor´s disease. The characteristics of the disease are reviewed and the most usual diagnostic and therapeutic methods. Methods: The case of a 41 year old man is reviewed who consulted for pain and indu [...] ration on the proximal part of the penis. Results: After phisical examination and Eco-doppler was made the diagnosis of Mondor´s disease. He receibed treatment with non steroidal antiinflamatories and antibiotics. Conclusions: The dorsal vein thrombosis is a rare disease with pain an induration of the dorsal part of the penis. The ethiology can be traumatic, neoplasic, excesive sexual activity or abstinence. Is necesary the diferencial diagnosis with esclerosant linphangitis and the most important imaging is the Eco-doppler. The treatment is based in non steroidal antiinflamatories and antibiotics wit infection. The local aplication of heparine can be useful and the surgery with thrombectomy and resection is for persistent cases.

  2. Protocol of an expertise based randomized trial comparing surgical Venae Sectio versus radiological Puncture of Vena Subclavia for insertion of Totally Implantable Access Port in oncological patients

    Directory of Open Access Journals (Sweden)

    Radeleff Boris

    2008-10-01

    Full Text Available Abstract Background Totally Implantable Access Ports (TIAP are being extensively used world-wide and can be expected to gain further importance with the introduction of new neoadjuvant and adjuvant treatments in oncology. Two different techniques for the implantation can be selected: A direct puncture of a central vein and the utilization of a Seldinger device or the surgical Venae sectio. It is still unclear which technique has the optimal benefit/risk ratio for the patient. Design A single-center, expertise based randomized, controlled superiority trial to compare two different TIAP implantation techniques. 100 patients will be included and randomized pre-operatively. All patients aged 18 years or older scheduled for primary elective implantation of a TIAP under local anesthesia who signed the informed consent will be included. The primary endpoint is the primary success rate of the randomized technique. Control Intervention: Venae Sectio will be employed to insert a TIAP by a surgeon; Experimental intervention: Punction of V. Subclavia will be used to place a TIAP by a radiologist. Duration of study: Approximately 10 months, follow up time: 90 days. Organisation/Responsibility The PORTAS 2 – Trial will be conducted in accordance with the protocol and in compliance with the moral, ethical, and scientific principles governing clinical research as set out in the Declaration of Helsinki (1989 and Good Clinical Practice (GCP. The Center of Clinical Trials at the Department of Surgery, University Hospital Heidelberg is responsible for design and conduct of the trial including randomization and documentation of patients' data. Data management and statistical analysis will be performed by the independent Institute for Medical Biometry and Informatics (IMBI, University of Heidelberg. Trial Registration The trial is registered at ClinicalTrials.gov (NCT00600444.

  3. Fibrosis mediastínica idiopática asociada a hipercoagulabilidad: A propósito de un caso / Idiopatic mediastinal fibrosis in association with hypercoagulability state: A case report

    Scientific Electronic Library Online (English)

    A., Bauzá Alonso; J. P., García Gómez; C., Abades Vázquez; N., García González; J., Prieto Valtueña.

    2001-12-01

    Full Text Available La fibrosis mediastínica es una entidad de baja frecuencia y de etiología desconocida en la mayor parte de los casos. Se caracteriza por la presencia de una masa fibrótica en el mediastino que puede invadir estructuras vecinas tales como el esófago, la tráquea, el nervio recurrente, la vena cava sup [...] erior etc. Solamente un 1-2% de pacientes con fibrosis mediastínica presentan un cuadro de obstrucción de vena cava superior, y esta es producida en casi todos los casos por compresión extrínseca por el magma fibrótico. Se presenta el caso de un paciente con un trastorno de hipercoagulabilidad asociado a fibrosis mediastínica con obstrucción de la vena cava superior por trombosis (mecanismo intrínseco) así como su evolución satisfactoria tras el tratamiento combinado con anticoagulación oral y tamoxifeno. Abstract in english Mediastinal fibrosis is a rare and unknown disease characterized by the presence of a fibrotic mass in the anterior mediastinum that can invade close structures as gullet, trachea, recurrent nerve, superior cava vein etc. Only 1-2% of patients with mediastinal fibrosis associate superior cava vein o [...] bstruction. When it appears, it is produced by extrinsic compression for fibrotic magma in almost all the cases. A case of hypercoagulability disorder associated with mediastinal fibrosis and superior cava vein obstruction by thrombosis (intrinsec mechanism), and the satisfactory evolution after the treatment with oral anticoagulation, corticosteroids and tamoxifen is presented.

  4. Estenosis de venas pulmonares post ablación por radiofrecuencia / Pulmonary vein stenosis after radio frequency ablation

    Scientific Electronic Library Online (English)

    Marcelo, Guzzi; Gabriel, Bouza; Raquel, Rodríguez; Jorge, Lantos; Sergio, Dubner; Jorge, Mrad.

    2011-06-01

    Full Text Available Es importante estar atento ante la aparición de síntomas respiratorios luego de la realización de un procedimiento de ablación por radiofrecuencia en el tratamiento de la fibrilación auricular, pues la estenosis de venas pulmonares (EVP) tiene una incidencia de entre 1 y 3% y puede aparecer hasta en [...] los dos años posteriores al procedimiento1. Presentamos el caso de un paciente de 41 años de sexo masculino, que ingresó por un cuadro de hemoptisis y toracodinia de tres semanas de evolución, con antecedente de ablación por radiofrecuencia 6 meses antes de la admisión. La angiotomografía no evidenció tromboembolismo pulmonar (TEP) y la angiorresonancia detectó hipoperfusión deI lóbulo superior del pulmón izquierdo (LSI). Debido a los antecedentes de ablación se solicitó angiotomografía de venas pulmonares, que evidenció estenosis de la vena del LSI. Se realizó estudio hemodinámico con dilatación y colocación de stent. Abstract in english Physicians should be alert to the occurrence of respiratory symptoms after radio frequency ablation for the treatment of atrial fibrillation. Pulmonary veins stenosis could appear with an incidence of between 1and 3% during the two years following the procedure. We present the case of a 41year-old-m [...] ale patient admitted with a three weeks old hemoptysis and thoracodinia and a prior history of a radiofrecuency ablation procedure performed six months earlier. The angiotomography was not compatible with the diagnosis of pulmonary embolism and the angio-MRI detected hypoperfusion of the left upper pulmonary lobe. Consequently pulmonary veins angiotomography was requested, showing upper pulmonary lobe vein stenosis. An hemodynamic study with vein expansion and stent placement was successfully performed.

  5. Estenosis de venas pulmonares post ablación por radiofrecuencia Pulmonary vein stenosis after radio frequency ablation

    Directory of Open Access Journals (Sweden)

    Marcelo Guzzi

    2011-06-01

    Full Text Available Es importante estar atento ante la aparición de síntomas respiratorios luego de la realización de un procedimiento de ablación por radiofrecuencia en el tratamiento de la fibrilación auricular, pues la estenosis de venas pulmonares (EVP tiene una incidencia de entre 1 y 3% y puede aparecer hasta en los dos años posteriores al procedimiento1. Presentamos el caso de un paciente de 41 años de sexo masculino, que ingresó por un cuadro de hemoptisis y toracodinia de tres semanas de evolución, con antecedente de ablación por radiofrecuencia 6 meses antes de la admisión. La angiotomografía no evidenció tromboembolismo pulmonar (TEP y la angiorresonancia detectó hipoperfusión deI lóbulo superior del pulmón izquierdo (LSI. Debido a los antecedentes de ablación se solicitó angiotomografía de venas pulmonares, que evidenció estenosis de la vena del LSI. Se realizó estudio hemodinámico con dilatación y colocación de stent.Physicians should be alert to the occurrence of respiratory symptoms after radio frequency ablation for the treatment of atrial fibrillation. Pulmonary veins stenosis could appear with an incidence of between 1and 3% during the two years following the procedure. We present the case of a 41year-old-male patient admitted with a three weeks old hemoptysis and thoracodinia and a prior history of a radiofrecuency ablation procedure performed six months earlier. The angiotomography was not compatible with the diagnosis of pulmonary embolism and the angio-MRI detected hypoperfusion of the left upper pulmonary lobe. Consequently pulmonary veins angiotomography was requested, showing upper pulmonary lobe vein stenosis. An hemodynamic study with vein expansion and stent placement was successfully performed.

  6. Estudo comparativo da biocompatibilidade da submucosa intestinal porcina e pericárdio bovino usados como enxertos na veia cava de cães

    OpenAIRE

    Greca Fernando Hintz; Noronha Lucia; Costa Francisco Diniz Afonso da; Souza Filho Zacarias Alves; Soccol Andréa Thomaz; Feres André Néry; Duda Jõao Ricardo; Adams Eduardo

    2005-01-01

    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 ...

  7. GPR utilizado na deteção da geometria de cavas usadas para disposição de resíduos de óleos lubrificantes

    Scientific Electronic Library Online (English)

    Welitom, Borges; Alexandre, Lago; Sergio, Fachin; Vagner, Elis; Ernande, Santos.

    2006-12-01

    Full Text Available Uma variedade de problemas ambientais ocorre devido à disposição inadequada de resíduos. Metodologias geofísicas aplicadas a estudos do meio físico mostram ótimos resultados na investigação de contaminantes. O georadar é um método geofísico prático e rápido nestas investigações, pois a resposta do s [...] inal eletromagnético auxilia na delimitação do contaminante em subsuperfície, direcionando técnicas diretas de investigação (furos e poços de monitoramento). Este estudo foi desenvolvido numa antiga área de disposição de resíduos de óleos lubrificantes (dense nonaqueous phase liquids - DNAPL) no município de Ribeirão Preto - SP, situada nos domínios geológicos dos derrames basálticos da Formação Serra Geral e arenitos da Formação Botucatu. A aquisição de seções GPR foi realizada dentro e próximo de 4 cavas de disposição de rejeitos, com antenas não-blindadas de 100 MHz, possibilitando uma profundidade de investigação máxima de 7 metros. Os limites laterais e as bases das cavas puderam ser identificados nas seções GPR, com exceção da cava 1, cuja base não é bem caracterizada pelo sinal GPR. Os resultados mostram que o sinal eletromagnético do GPR é bastante atenuado abaixo das cavas. Este fato pode ser resultado de uma atividade bacteriológica no resíduo ou aumento de sais dissolvidos no meio causado pelo pH ácido do resíduo. Abstract in english A variety of environmental problems occurs due to the inadequate disposition of residues. Applied geophysics methodologies to environmental studies show great results in the investigation of contaminating. GPR is a practical and fast geophysical method in such investigations, because the electromagn [...] etic signal assists in the delimitation of the contaminating, addressing direct techniques of investigation (boreholes and wells). This study was developed in an old disposition area to residues lubricants oils (dense nonaqueous phase liquids - DNAPL) in the municipal district of Ribeirão Preto, São Paulo State. This area is situated in the geological domains of the basaltic floods of the Serra Geral Formation and sandstones of the Botucatu Formation. GPR acquisition was carried out inside and next to 4 ditches of residues disposition, with 100 MHz unshielded antennas, enabling a maximum investigation depth of 7 meters. The limits and of the ditches base can be identify in the GPR sections, except in the ditch 1, which the base is not delineated by GPR. The results show that GPR signal is much attenuated below ditches. This fact could be result of a bacteriological activity in the residue or increase of dissolved salts in the soil caused by acid pH of the residue.

  8. Phlorotannins from Ecklonia cava (Phaeophyceae): biological activities and potential health benefits.

    Science.gov (United States)

    Wijesekara, Isuru; Yoon, Na Young; Kim, Se-Kwon

    2010-01-01

    The importance of bioactive derivatives as functional ingredients has been well recognized due to their valuable health beneficial effects. Therefore, isolation and characterization of novel functional ingredients with biological activities from seaweeds have gained much attention. Ecklonia cava Kjellman is an edible seaweed, which has been recognized as a rich source of bioactive derivatives mainly, phlorotannins. These phlorotannins exhibit various beneficial biological activities such as antioxidant, anticancer, antidiabetic, anti-human immunodeficiency virus, antihypertensive, matrix metalloproteinase enzyme inhibition, hyaluronidase enzyme inhibition, radioprotective, and antiallergic activities. This review focuses on biological activities of phlorotannins with potential health beneficial applications in functional foods, pharmaceuticals, and cosmeceuticals. PMID:20803523

  9. Preparative isolation and purification of phlorotannins from Ecklonia cava using centrifugal partition chromatography by one-step.

    Science.gov (United States)

    Lee, Ji-Hyeok; Ko, Ju-Young; Oh, Jae-Young; Kim, Chul-Young; Lee, Hee-Ju; Kim, Jaeil; Jeon, You-Jin

    2014-09-01

    Various bioactive phlorotannins of Ecklonia cava (e.g., dieckol, eckol, 6,6-bieckol, phloroglucinol, phloroeckol, and phlorofucofuroeckol-A) are reported. However, their isolation and purification are not easy. Centrifugal partition chromatography (CPC) can be used to efficiently purify the various bioactive-compounds efficiently from E. cava. Phlorotannins are successfully isolated from the ethyl acetate (EtOAc) fraction of E. cava by CPC with a two-phase solvent system comprising n-hexane:EtOAc:methanol:water (2:7:3:7, v/v) solution. The dieckol (fraction I, 40.2mg), phlorofucofuroeckol-A (fraction III, 31.1mg), and fraction II (34.1mg) with 2,7-phloroglucinol-6,6-bieckol and pyrogallol-phloroglucinol-6,6-bieckol are isolated from the crude extract (500 mg) by a one-step CPC system. The purities of the isolated dieckol and phlorofucofuroeckol-A are ?90% according to high performance liquid chromatography (HPLC) and electrospray ionization multi stage tandem mass spectrometry analyses. The purified 2,7-phloroglucinol-6,6-bieckol and pyrogallol-phloroglucinol-6,6-bieckol are collected from fraction II by recycle-HPLC. Thus, the CPC system is useful for easy and simple isolation of phlorotannins from E. cava. PMID:24731366

  10. DISEASES

    DEFF Research Database (Denmark)

    Pletscher-Frankild, Sune; Pallejà, Albert; Tsafou, Kalliopi; Binder, Janos X; Jensen, Lars Juhl

    2015-01-01

    Text mining is a flexible technology that can be applied to numerous different tasks in biology and medicine. We present a system for extracting disease-gene associations from biomedical abstracts. The system consists of a highly efficient dictionary-based tagger for named entity recognition of human genes and diseases, which we combine with a scoring scheme that takes into account co-occurrences both within and between sentences. We show that this approach is able to extract half of all manuall...

  11. Obstrucción de vena central de la retina en paciente femenino de 20 años de edad, asociada a síndrome antifosfolipídicos

    Scientific Electronic Library Online (English)

    MA, Ramírez; R, Padilla.

    Full Text Available Nuestro caso clínico se refiere a paciente femenina de 19 años de edad quien sufre obstrucción de vena central de la retina asociada a síndrome antifosfolipídicos, desde el punto de vista epidemiológico la presencia de estos sucesos se encuentran en la actualidad en personas normales aproximadamente [...] del 2-5%, sin embargo factores de riesgos como el uso de anticonceptivos orales, embarazos, LUPUS y otras enfermedades inmunológicas pueden conllevar a las complicaciones trombóticas más graves. Desde el punto de vista clínico el síndrome antifosfolipídicos puede presentarse como trombosis venosas que pueden incluir miembros inferiores, pulmón e inclusive a nivel ocular comprometiendo la visión. Son muchos los factores asociados en la patogenia de dicha enfermedad desde títulos elevados de anticuerpos antifosfolipídicos, hasta títulos de anticardiolipina, todos conllevan a la lesión básica de oclusión trombótica no inflamatoria de pequeños y grandes vasos. Desde el punto de vista terapéutico los anticoagulantes como la Warfarina y Heparina están indicados según el grado de trombosis asociado con este síndrome, de aquí la importancia de canalizarlo a tiempo para prevenir consecuencias mayores. Abstract in english Our clinical case refers to a 19-year-old feminine patient who suffers obstruction of central vein of the retina associated with syndrome "antifosfolipídicos", from the epidemiological point of view the presence of these events are present in normal persons approximately of 2-5% of them, nevertheles [...] s factors of risks as the use of contraceptive oral, pregnancies(embarrassments), LUPUS and other immunological diseases can bear to the complications "trombóticas" more serious. From the clinical point of view the syndrome "antifosfolipídicos" can appear like trombosis venous that low members can include, lung and inclusive to loose of ocular level vision. There are great factors associated in the "patogenia" of the above mentioned diseases from high titles(degrees) of antibodies "antifosfolipídicos", up to titles(degrees) of "anticardiolipina", bear all to the basic injury of occlusion "trombótica" not inflammatory of small and big glasses. From the therapeutic point of view the anticoagulants like the "Warfarina and Heparina" they are indicated according to the degree of "trombosis" associated by this syndrome, of here the importance of canalizing it in time to anticipate(prepare) major consequences.

  12. Evaluation of inhibitory effect of phlorotannins from Ecklonia cava on triglyceride accumulation in adipocyte.

    Science.gov (United States)

    Kim, Haejin; Kong, Chang-Suk; Lee, Jung Im; Kim, Hojun; Baek, Seungoh; Seo, Youngwan

    2013-09-11

    In the present study, a methanolic extract of Ecklonia cava and its solvent-partitioned fractions were evaluated for their antiadipogenic effect in 3T3-L1 adipocytes. One of them, the n-BuOH fraction, effectively reduced lipid accumulation and glucose consumption. In addition, the presence of the n-BuOH fraction in adipocytes suppressed the regulations of adipogenic transcription factors, PPAR? and SREBP1c, and adipogenic specific genes, FABP4, FABP1, FAS, LPL, HSL, and ACS1. Further purification of n-BuOH fractions led to the isolation of six phlorotannins (1-6). The six phlorotannins effectively suppressed triglyceride accumulation. Comparative analysis showed that lipid accumulation in adipocytes was dramatically attenuated in the presence of eckstolonol (4). PMID:23957842

  13. Avaliação econômica do minério remanescente nos taludes da cava final da Mina de Alegria

    Scientific Electronic Library Online (English)

    Adilson, Curi; Edson Rogério, Lage.

    2003-03-01

    Full Text Available Esse trabalho apresenta uma estimativa do benefício que pode ser auferido através da recuperação do minério remanescente nos taludes da cava final de uma mina a céu aberto através da aplicação de uma metodologia de lavra baseada no método de corte e enchimento. Para exemplificar o uso da metodologia [...] proposta, foi adotado o caso das minas de minério de ferro de Alegria de propriedade da Samarco Mineração S.A. A viabilidade econômica da recuperação do minério remanescente em taludes de cavas exauridas de minas a céu aberto envolve recursos que estarão diretamente ligadas ao valor de mercado do produto e ao custo operacional para sua recuperação. Na fase de exaustão de uma mina, tradicionalmente, considerada como de desembolso de capital, a geração de receitas adicionais é bem-vinda, pois implica ganhos econômicos não previstos na fase de fechamento de minas e até em minas já paralisadas, acrescendo-se também um ganho ambiental devido à não construção de pilhas de estéril. Abstract in english This paper introduces estimated benefits, obtainable by use of "cut and filling" mine-methodology extraction of ore remaining in slopes of the final pit in an open pit mining operation. The economic viability of this method considers product market value and operational costs. When terminating a min [...] ing operation, the generation of additional revenue is highly desired, since it implies unforeseen economical earnings. This also holds true for already-closed mines. When the method desribed in this study is used, there is also an environmental bonus since there is no waste pile construction.

  14. Avaliação econômica do minério remanescente nos taludes da cava final da Mina de Alegria

    Directory of Open Access Journals (Sweden)

    Adilson Curi

    2003-03-01

    Full Text Available Esse trabalho apresenta uma estimativa do benefício que pode ser auferido através da recuperação do minério remanescente nos taludes da cava final de uma mina a céu aberto através da aplicação de uma metodologia de lavra baseada no método de corte e enchimento. Para exemplificar o uso da metodologia proposta, foi adotado o caso das minas de minério de ferro de Alegria de propriedade da Samarco Mineração S.A. A viabilidade econômica da recuperação do minério remanescente em taludes de cavas exauridas de minas a céu aberto envolve recursos que estarão diretamente ligadas ao valor de mercado do produto e ao custo operacional para sua recuperação. Na fase de exaustão de uma mina, tradicionalmente, considerada como de desembolso de capital, a geração de receitas adicionais é bem-vinda, pois implica ganhos econômicos não previstos na fase de fechamento de minas e até em minas já paralisadas, acrescendo-se também um ganho ambiental devido à não construção de pilhas de estéril.This paper introduces estimated benefits, obtainable by use of "cut and filling" mine-methodology extraction of ore remaining in slopes of the final pit in an open pit mining operation. The economic viability of this method considers product market value and operational costs. When terminating a mining operation, the generation of additional revenue is highly desired, since it implies unforeseen economical earnings. This also holds true for already-closed mines. When the method desribed in this study is used, there is also an environmental bonus since there is no waste pile construction.

  15. Hepatoprotective effects of dieckol-rich phlorotannins from Ecklonia cava, a brown seaweed, against ethanol induced liver damage in BALB/c mice.

    Science.gov (United States)

    Kang, Min-Cheol; Ahn, Ginnae; Yang, Xiudong; Kim, Kil-Nam; Kang, Sung-Myung; Lee, Seung-Hong; Ko, Seok-Chun; Ko, Ju-Young; Kim, Daekyung; Kim, Yong-Tae; Jee, Youngheun; Park, Sun-Joo; Jeon, You-Jin

    2012-06-01

    Alcoholic liver disease, which is one of the most serious liver disorders, has been known to cause by ethanol intake. In the present study, in vivo hepatoprotective effects of dieckol-rich phlorotannins (DRP) from Ecklonia cava, a brown seaweed, on ethanol induced hepatic damage in BALB/c mice liver were investigated. After administration of 5 and 25mg/kg mouse of DRP and 4 g/kg mice ethanol, the body weights and survival rates were increased as compared to the control, which is ethanol-treated group without DRP. The glutamic oxaloacetic transaminase and glutamic pyruvic transaminase levels in the serum were lower than those of the control. DRP exhibited a reduction of the total cholesterol. The lower levels of SOD enzyme and a reduction of the formation of malondialdehyde were occurred in mice fed with 5 and 25mg/kg mouse of DRP. Finally the effect on improvement of fatty liver induced by ethanol was observed by taking out the liver immediately after dissecting the mouse. However, no significant difference was observed on hepatic histopathological changes. In conclusion, this study indicated that DRP could protect liver injury induced by ethanol in vivo. It suggested that DRP possesses the beneficial effect to human against ethanol-induced liver injury. PMID:22504843

  16. Influência das cavas de extração de areia no balanço hídrico do vale do Paraíba do Sul

    Directory of Open Access Journals (Sweden)

    Benedito Jorge dos Reis

    2006-12-01

    Full Text Available A crescente formação de lagos artificiais oriundos da atividade de extração de areia no Vale do Rio Paraíba do Sul é responsável por alterações ambientais significativas. Nesse trabalho, é investigada a evolução das áreas de cavas de extração de areia e sua influência no balanço hídrico regional. Para isso, foi desenvolvido um banco de dados georreferenciado, na plataforma SPRING, no qual foram inseridas imagens dos satélites Landsat 5 e 7, cenas 218/76 e 219/76, que foram analisadas para fornecer estimativas das áreas das cavas de areia em um período de 11 anos. Com dados da estação climatológica 83784 - UNITAU/INMET e a área total de lagos artificiais, foi possível estimar o volume de água evaporada para atmosfera a partir dos lagos resultantes dessa atividade. Observou-se um crescimento na área de lagos formados pela extração de areia de 591 ha, em 1993 para 1.726 ha, em 2003. A evaporação resultante aumentou em 203% e resultou na evaporação de 19.157.022 m³, no ano de 2003, equivalentes ao abastecimento de uma cidade com mais de 326.000 habitantes, considerando a média de consumo do Estado de São Paulo, que é superior à média Brasileira.The extraction of sand in the valley of the Paraíba do Sul River, carried out in a vulnerable environment, is responsible for significant environmental impacts. This work had the objective of investigating the increase of the total area of lakes created in the mining process for a period of 11 years and of verifying the influence of the evaporation from these lakes on the regional water balance. Thus, a Geographic Information System data basis was implemented using the GIS software package, SPRING, and Landsat imagery. Scenes 218/76 and 219/76 were used for the quantification of the mining areas and for the assessment of the evolution of the activity in the area for a period of 11 years. With data from a local climatological station (UNITAU/INMET-83784 integrated into the database and with the total area of artificial lakes resultant from sand mining activity, it was possible to estimate the increase of the evaporation rate due to this activity. An increase of 591 ha, in 1993 to 1,726 ha in 2003 in the area of lakes was observed. The resulting increase in the evaporating rate was 203% with 19,157,022 m³ evaporated in 2003 correspondent to the consumption of a city with more than 326,000 inhabitants, considering the average consumption for the State of São Paulo which is greater than the Brazilian average.

  17. Influência das cavas de extração de areia no balanço hídrico do vale do Paraíba do Sul

    Scientific Electronic Library Online (English)

    Benedito Jorge dos, Reis; Getulio Teixeira, Batista; Marcelo dos Santos, Targa; Celso de Souza, Catelani.

    2006-12-01

    Full Text Available A crescente formação de lagos artificiais oriundos da atividade de extração de areia no Vale do Rio Paraíba do Sul é responsável por alterações ambientais significativas. Nesse trabalho, é investigada a evolução das áreas de cavas de extração de areia e sua influência no balanço hídrico regional. Pa [...] ra isso, foi desenvolvido um banco de dados georreferenciado, na plataforma SPRING, no qual foram inseridas imagens dos satélites Landsat 5 e 7, cenas 218/76 e 219/76, que foram analisadas para fornecer estimativas das áreas das cavas de areia em um período de 11 anos. Com dados da estação climatológica 83784 - UNITAU/INMET e a área total de lagos artificiais, foi possível estimar o volume de água evaporada para atmosfera a partir dos lagos resultantes dessa atividade. Observou-se um crescimento na área de lagos formados pela extração de areia de 591 ha, em 1993 para 1.726 ha, em 2003. A evaporação resultante aumentou em 203% e resultou na evaporação de 19.157.022 m³, no ano de 2003, equivalentes ao abastecimento de uma cidade com mais de 326.000 habitantes, considerando a média de consumo do Estado de São Paulo, que é superior à média Brasileira. Abstract in english The extraction of sand in the valley of the Paraíba do Sul River, carried out in a vulnerable environment, is responsible for significant environmental impacts. This work had the objective of investigating the increase of the total area of lakes created in the mining process for a period of 11 years [...] and of verifying the influence of the evaporation from these lakes on the regional water balance. Thus, a Geographic Information System data basis was implemented using the GIS software package, SPRING, and Landsat imagery. Scenes 218/76 and 219/76 were used for the quantification of the mining areas and for the assessment of the evolution of the activity in the area for a period of 11 years. With data from a local climatological station (UNITAU/INMET-83784) integrated into the database and with the total area of artificial lakes resultant from sand mining activity, it was possible to estimate the increase of the evaporation rate due to this activity. An increase of 591 ha, in 1993 to 1,726 ha in 2003 in the area of lakes was observed. The resulting increase in the evaporating rate was 203% with 19,157,022 m³ evaporated in 2003 correspondent to the consumption of a city with more than 326,000 inhabitants, considering the average consumption for the State of São Paulo which is greater than the Brazilian average.

  18. Estrutura, ultraestrutura e morfometria da veia cava de paca (Cuniculus paca Linnaeus, 1766 criada em cativeiro

    Directory of Open Access Journals (Sweden)

    Sérgio Pinter Garcia Filho

    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, objetivou-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<0,05. Em relação à espessura das túnicas estudadas, comprovou-se que os valores da espessura das túnicas íntima, média e adventícia, para todos os animais, foram significativamente maiores no segmento cranial. As camadas das paredes dos vasos apresentaram variações entre si quanto à estrutura e espessura, supostamente devido a uma adaptação à exigência funcional.

  19. Desvios porta-jugular e cava-jugular passivos em cães: Investigação de pressões sangüíneas

    Directory of Open Access Journals (Sweden)

    Coelho Antônio Roberto Barros

    1999-01-01

    Full Text Available Os principais objetivos dos desvios veno-venosos durante o transplante ortotópico de fígado são: atenuação da estase venosa subdiafragmática, manutenção do retorno satisfatório de sangue ao coração e perfusão tissular eficiente. Investigações sobre PP, PVCIIH, PVC, PAM e PPR, bem como D PP e D PVCIIH foram conduzidas em seis cães, sob anestesia geral, com fígados perfundidos pela Artéria Hepática, submetidos a desvios porta-jugular e cava-jugular passivos durante 2 horas. Estes desvios não foram capazes de evitar estagnação de sangue na VP e VCIIH, acarretando estase e menor retorno sangüíneo ao coração, sugeridos por aumentos significativos de PP e PVCIIH e quedas significantes nos níveis de PVC. Os valores de PAM não apresentaram diferenças significativas em relação ao tempo T0, na maior parte dos tempos avaliados, enquanto que os valores de PPR foram significativamente menores que os verificados no tempo T0, na maioria dos tempos estudados. Tais pressões mantiveram-se, respectivamente, acima de 100 e 50 mm de Hg, atribuindo-se tais resultados, em parte, à vasoconstricção arteriolar generalizada. Incrementos de pressão na VP (D PP foram significativamente menos elevados que aqueles verificados na VCIIH (D PVCIIH, atribuindo-se tal diferença à complacência esplâncnica. Decréscimos ulteriores dos níveis de PP e PVCIIH sugerem queda do fluxo arterial para os territórios esplâncnico e sistêmico, decorrente de diminuição do retorno sangüíneo ao coração. Determinações de PP, PVCIIH, PVC, PAM e PPR podem constituir meio prático de avaliação hemodinâmica do desvio veno-venoso.

  20. Caval variations in neurologically diseased patients

    International Nuclear Information System (INIS)

    The import of the cavum variation and its prevalence rate in healthy individuals is still not clear, likewise in neurologically diseased patients. To evaluate the frequency and pattern of caval variations in neurologically diseased patients. The presence or absence of the cavum septum pellucidum (CSP), cavum vergae (CV), or cavum velum interpositum (CVI) was reviewed from successive cranial computerized tomography (CT) images of patients who were aged 6 months and above. Two hundred and seventeen cranial CT images were reviewed. At least a cavum variation was noted in 130 (59.9%) of the CT scan images reviewed. The CV, CVI, and CSP were noted in 86 (39.6%), 53 (24.4%), and 50 images (23%), respectively. Caval multiplicity was noted in 102 patients (47%). There was no significant difference in the rate of occurrence of cavum variations in patients with congenital brain diseases and acquired brain conditions (P = 0.484), neither was there a significant difference in the frequency of cavum variation in children aged older than 6 months compared to adults (P = 0.101). Cava variations are relatively common in neurological brain diseases. Patients with congenital brain diseases did not have a higher frequency of cava variation when compared with those that had acquired lesions. The most common type of cavum variation noted in this study was the vergae variety, while the CSP is the rarest

  1. Applied Anatomy of the Femoral Veins in Macaca fascicularis / Anatomía Aplicada de las Venas Femorales en Macaca fascicularis

    Scientific Electronic Library Online (English)

    Yong-Zhen, Zhang; Xi, Zhang; Shao-Hu, Xiong; Bing, Nie; Man-Ru, Shen; Zhen, Liu; Jian-Ming, Yuan; Rui-Shan, Dang; Chuan-Sen, Zhang.

    2012-12-01

    Full Text Available El objetivo fue comprender las características anatómicas de la válvula venosa en Macaca fascicularis y compararla con la de los humanos. Fueron disecados bilateralmente los miembros pélvicos (24 miembros de 12 animales) de cadáveres de Macaca fascicularis; las venas femorales (VF) fueron divididas [...] en secciones distal, media y proximal. Se midió el diámetro externo de las VFs en cada sección. Las válvulas venosas se observaron microscópicamente y se tiñeron con H-E y tricrómico. Los datos para describir la válvula venosa humana se obtuvieron desde la literatura. No se encontraron venas safenas magnas entre los 24 miembros inferiores. Los diámetros externos de las VFs en las secciones distal, media y proximal fueron 3,53±0,37 mm, 3,42 mm±0,55, y 3,37±0,54 mm, respectivamente. En la mayoría de los casos, hubo vena bivalva situada aproximadamente 0-2,71 mm debajo de la unión de la VF y la vena femoral profunda. El endotelio cubrió las superficies luminal y sinusal. Se observaron abundantes fibras de colágeno en las células endoteliales bajo la superficie luminal de las válvulas. Una red de fibras de elastina se encontró bajo la superficie del seno endotelial. Las células musculares lisas en las VFs se extiendían hasta el margen de la válvula. La válvula venosa del Macaca fascicularis es similar a la de los seres humanos, morfológica e histológicamente. Sin embargo, sólo hubo una vena bivalvular, y no se observaron venas safenas en Macaca fascicularis. Abstract in english The aim was to understand the anatomical features of the venous valve in Macaca fascicularis and to compare it with that of humans. The bilateral lower limbs (24 limbs from 12 animals) of Macaca fascicularis cadavers were dissected, and the femoral veins (FVs) were equally divided into distal, inter [...] mediate, and proximal sections. The external diameter of the FV in each section was measured. The venous valves were observed microscopically and stained with hematoxylin and eosin as well as trichrome. Data describing the human venous valve were collected from the current literature. No great saphenous veins were found among the 24 lower limbs from the Macaca fascicularis cadavers. The external diameters of the FVs in the distal, intermediate, and proximal sections were 3.53 ± 0.37 mm, 3.42 ± 0.55 mm, and 3.37 ± 0.54 mm, respectively. In most cases, there was one venous bivalve located in the FV approximately 0-2.71 mm below the junction of the FV and the deep femoral vein. Endothelium covered the luminal and sinusal surfaces of the leaflets. Abundant collagen fibers were found under the endothelial cells beneath the luminal surface of the leaflets. An elastin fiber network was located under the sinus endothelial surface. Smooth muscle cells in the FV extend to the edge of the valve. The venous valve of Macaca fascicularis is similar to that of humans, both morphologically and histologically. However, there is only one venous bivalve and no great saphenous vein in Macaca fascicularis.

  2. Applied Anatomy of the Femoral Veins in Macaca fascicularis Anatomía Aplicada de las Venas Femorales en Macaca fascicularis

    Directory of Open Access Journals (Sweden)

    Yong-Zhen Zhang

    2012-12-01

    Full Text Available The aim was to understand the anatomical features of the venous valve in Macaca fascicularis and to compare it with that of humans. The bilateral lower limbs (24 limbs from 12 animals of Macaca fascicularis cadavers were dissected, and the femoral veins (FVs were equally divided into distal, intermediate, and proximal sections. The external diameter of the FV in each section was measured. The venous valves were observed microscopically and stained with hematoxylin and eosin as well as trichrome. Data describing the human venous valve were collected from the current literature. No great saphenous veins were found among the 24 lower limbs from the Macaca fascicularis cadavers. The external diameters of the FVs in the distal, intermediate, and proximal sections were 3.53 ± 0.37 mm, 3.42 ± 0.55 mm, and 3.37 ± 0.54 mm, respectively. In most cases, there was one venous bivalve located in the FV approximately 0-2.71 mm below the junction of the FV and the deep femoral vein. Endothelium covered the luminal and sinusal surfaces of the leaflets. Abundant collagen fibers were found under the endothelial cells beneath the luminal surface of the leaflets. An elastin fiber network was located under the sinus endothelial surface. Smooth muscle cells in the FV extend to the edge of the valve. The venous valve of Macaca fascicularis is similar to that of humans, both morphologically and histologically. However, there is only one venous bivalve and no great saphenous vein in Macaca fascicularis.El objetivo fue comprender las características anatómicas de la válvula venosa en Macaca fascicularis y compararla con la de los humanos. Fueron disecados bilateralmente los miembros pélvicos (24 miembros de 12 animales de cadáveres de Macaca fascicularis; las venas femorales (VF fueron divididas en secciones distal, media y proximal. Se midió el diámetro externo de las VFs en cada sección. Las válvulas venosas se observaron microscópicamente y se tiñeron con H-E y tricrómico. Los datos para describir la válvula venosa humana se obtuvieron desde la literatura. No se encontraron venas safenas magnas entre los 24 miembros inferiores. Los diámetros externos de las VFs en las secciones distal, media y proximal fueron 3,53±0,37 mm, 3,42 mm±0,55, y 3,37±0,54 mm, respectivamente. En la mayoría de los casos, hubo vena bivalva situada aproximadamente 0-2,71 mm debajo de la unión de la VF y la vena femoral profunda. El endotelio cubrió las superficies luminal y sinusal. Se observaron abundantes fibras de colágeno en las células endoteliales bajo la superficie luminal de las válvulas. Una red de fibras de elastina se encontró bajo la superficie del seno endotelial. Las células musculares lisas en las VFs se extiendían hasta el margen de la válvula. La válvula venosa del Macaca fascicularis es similar a la de los seres humanos, morfológica e histológicamente. Sin embargo, sólo hubo una vena bivalvular, y no se observaron venas safenas en Macaca fascicularis.

  3. Self-Expanding Metal Stents for Palliative Treatment of Superior Vena Caval Syndrome

    International Nuclear Information System (INIS)

    Purpose: Two stent types (a new Wallstent and a Z-stent) were investigated in 30 patients with recurrent malignant superior vena caval syndrome (SVCS). Methods: Eligibility requirements were that the patient had recurrent symptoms after appropriate radiation therapy, chemotherapy, or both; ?75% of the vessel was occluded; and there was collateral flow. Because of the limited availability of stents, it was not possible to perform a prospectively randomized study. Results: In the Z-stent group (17 patients), occlusion of the stent due to acute thrombosis occurred within 12 hr in 4 patients (24%), but in the other 13 patients (76%) symptoms disappeared completely. After 2 weeks the cavogram in these patients showed no signs of thrombosis, and 12 (71%) of the patients remained symptom-free. There was partial occlusion in 5 patients (29%), without relevant clinical symptoms. Of the 13 patients who received Wallstents, only 1 had an acute immediate thrombosis (8%). Symptoms disappeared completely in the other 12 patients and no signs of thrombosis were seen. However, after 2 weeks complete stent occlusion with SVCS was found in 3 patients (23%) and partial occlusion with minor clinical symptoms in 6 (46%). Only 3 patients (23%) had complete relief of their SVCS. The difference between the rates of occlusion of the two stents after 2 weeks was highly significant (p= 0.008). Conclusions: The overall clinical success rate for long-term patency was 100% for the Z-stents and 69% for the new Wallstent. These results suggest that when used for this purpose, the new Wallstent is more thrombogenic at 2 weeks than the Z-stent

  4. Superior mesenteric venous thrombosis: a retrospective study of thirteen cases Trombosis de vena mesentérica superior: estudio retrospectivo de trece casos

    Directory of Open Access Journals (Sweden)

    S. Muñoz

    2004-06-01

    Full Text Available Objective: to analyze the epidemiology, associated risk factors, clinical presentation, diagnostic methods, treatment, and evolution of patients diagnosed with superior mesenteric venous thrombosis (SMVT at an university hospital in Madrid. Experimental design: retrospective and descriptive study. We review the medical records of patients with this diagnosis in our hospital from January 1998 to December 2002. Data were processed by using the SPSS vs. 11 software. Patients: all thirteen subjects diagnosed with SMVT in that period were included. Results: associated risk factors included tumoral conditions (5 patients, acute abdominal pathology (2, polyglobulia (1, prothrombin gene mutation (1, and anticardiolipin antibodies (1. No predisposing factor was found in 3 patients. Clinical presentation for all patients was abdominal pain, with nausea and vomiting being the second symptom in frequency (7. The diagnosis was reached by abdominal CT (9, arteriography (2, ultrasounds (1, and histology after intestinal resection (1. Treatment with only anticoagulation was initiated in 4 patients, whereas anticoagulation and surgery were performed in 5 cases. In 4 subjects no specific treatment was prescribed and only palliative measures were established due to a baseline end-stage condition. Five patients died, and four of them had a neoplasic condition as associated risk factor. Mortality in our series was 38.5%. Conclusions: SMVT is a very rare disease that is often associated with neoplasic pathology, which influences its high mortality. Due to non specific symptoms, imaging is essential for the diagnosis and the detection of associated risk factors. In our series, computed tomography imaging was the most profitable test.Objetivo: analizar la epidemiología, factores de riesgo asociados, presentación clínica, métodos diagnósticos, tratamiento y evolución en pacientes diagnosticados de trombosis de vena mesentérica superior (TVMS en un hospital universitario de Madrid. Diseño experimental: estudio retrospectivo descriptivo. Se revisaron las historias clínicas de los pacientes ingresados en nuestro hospital entre enero de 1998 y diciembre de 2002 con este diagnóstico. Los datos fueron procesados mediante el programa informático SPSS vs. 11. Pacientes: los trece pacientes diagnosticados de TVMS en ese periodo fueron incluidos. Resultados: los factores de riesgo asociados fueron patología tumoral (5, patología aguda intraabdominal (2, poliglobulia (1, mutación del gen de la protrombina (1 y anticuerpos anticardiolipina (1. En 3 pacientes no se encontró factor predisponente. La presentación clínica de todos los pacientes fue dolor abdominal, siendo las náuseas y vómitos el segundo síntoma en frecuencia (7. El diagnóstico se obtuvo por TC abdominal (9, arteriografía (2, ecografía (1 y por histología tras resección intestinal (1. Se realizó anticoagulación aislada en 4 pacientes y anticoagulación más cirugía en 5 casos. En 4 no se realizó tratamiento específico por tratarse de pacientes paliativos debido a la patología de base. Cinco pacientes fallecieron, cuatro de ellos presentaban neoplasia como factor asociado. La mortalidad fue de 38,5%. Conclusiones: la TVMS es una entidad muy poco frecuente, asociada en muchos casos patología neoplásica, lo que influye en su elevada mortalidad. Por la inespecificidad de los síntomas las pruebas de imagen son esenciales para el diagnóstico y para detectar factores asociados. En nuestra serie el TC fue la prueba más rentable.

  5. Trasplante hepático en pacientes con trombosis de la vena porta Liver transplantation in patients with portal vein thrombosis

    Directory of Open Access Journals (Sweden)

    Mauricio Gabrielli N

    2013-04-01

    Full Text Available La trombosis de la vena porta (TP es una complicación grave de la enfermedad hepática crónica terminal. La factibilidad y pronóstico del trasplante hepático (TH dependen de su extensión en el eje porto-mesentérico. Objetivo: Analizar los resultados del trasplante hepático en pacientes con TP. Material y Método: Estudio de cohorte no concurrente a partir de los registros clínicos de los pacientes adultos con TP sometidos a un TH entre marzo de 1994 y marzo de 2010. Las TP fueron clasificadas en cuatro grados según Yerdel y Mc Master. Resultados: De 109 TH en 105 pacientes, 13 (12,4% tuvieron una TP; en 6 de ellos el diagnóstico fue preoperatorio (46,2%. En tres se indicó tratamiento anticoagulante vía sistêmica (TACO. En el intraoperatorio se encontró TP en 10 pacientes. La trombosis fue grado I, II, III y IV en 2, 3, 4 y 1 pacientes, respectivamente. Los 3 casos tratados con TACO tenían trombosis grado I y II; en ellos no se encontró trombosis durante el trasplante. Se realizó trombectomía simple en 1 paciente, trombectomía por eversión en 7 y un puente mesentérico-portal en 2 casos. No hubo re-trombosis. Dos pacientes (15,4% fallecieron de complicaciones médicas con injerto funcionante. La sobrevida al año de seguimiento año fue de un 69% vs 79% en los sin TP (p = 0,476. Conclusiones: El TH en pacientes con TP no se asoció a mayor mortalidad en relación a los pacientes trasplantados sin TP. El tratamiento anticoagulante en pacientes con TP puede indicarse mientras se espera el trasplante.Portal vein thrombosis (PVT is a serious complication of end-stage liver disease, representing a challenge for the liver transplantation (LT team. The aim of this study was to analyze the results of LT in patients with PVT. Methods: All adult patients who underwent a LT from a cadaveric donor between March 1994 and March 2010 were included. PVT was categorized using the classification of Yerdel and McMaster. Results: A total of 109 LT were performed in 105 patients. PVT was found in 13 cases (12.4%. In 6 of them (46.2%, thrombosis was found preoperatively by transplant routine work up. Pre-transplant systemic anticoagulation was indicated in 3 cases. At the time of surgery, only 10 patients had persistent PVT. Grade I, II, III and IV PVT was found on 2, 3, 4 and 1 patient respectively. In the 3 cases treated with systemic anticoagulation preo-peratively, grade I (1 case and grade II (2 cases no thrombus was evident intraoperatively. Endovenectomy was performed in 7 cases; simple thrombectomy in one and a mesenteric vein graft was required in 2 cases. No thrombus recurrence was detected on postoperative follow-up. In-hospital mortality occurred in 2 cases with PTV grade III and IV due to medical complications. One-year patient and graft survival was 69% vs 79% in patients without PVT (p = 0,476. Conclusion: Liver transplant in patients with PVT thrombosis was not associated with a significant increased risk of mortality. Systemic anticoagulation seems to be warranted while waiting for liver transplantation.

  6. Trasplante hepático en pacientes con trombosis de la vena porta / Liver transplantation in patients with portal vein thrombosis

    Scientific Electronic Library Online (English)

    Mauricio, Gabrielli N; José Luis, Galindo R; Eduardo, Figueroa R; Fabrizio, Moisan P; Marco, Arrese J; Carlos, Benítez; Alejandro, Soza R; Pilar, Domínguez B; Rosa María, Pérez A; Juan Francisco, Guerra C; Nicolás, Jarufe C; Jorge, Martínez C.

    2013-04-01

    Full Text Available La trombosis de la vena porta (TP) es una complicación grave de la enfermedad hepática crónica terminal. La factibilidad y pronóstico del trasplante hepático (TH) dependen de su extensión en el eje porto-mesentérico. Objetivo: Analizar los resultados del trasplante hepático en pacientes con TP. Mate [...] rial y Método: Estudio de cohorte no concurrente a partir de los registros clínicos de los pacientes adultos con TP sometidos a un TH entre marzo de 1994 y marzo de 2010. Las TP fueron clasificadas en cuatro grados según Yerdel y Mc Master. Resultados: De 109 TH en 105 pacientes, 13 (12,4%) tuvieron una TP; en 6 de ellos el diagnóstico fue preoperatorio (46,2%). En tres se indicó tratamiento anticoagulante vía sistêmica (TACO). En el intraoperatorio se encontró TP en 10 pacientes. La trombosis fue grado I, II, III y IV en 2, 3, 4 y 1 pacientes, respectivamente. Los 3 casos tratados con TACO tenían trombosis grado I y II; en ellos no se encontró trombosis durante el trasplante. Se realizó trombectomía simple en 1 paciente, trombectomía por eversión en 7 y un puente mesentérico-portal en 2 casos. No hubo re-trombosis. Dos pacientes (15,4%) fallecieron de complicaciones médicas con injerto funcionante. La sobrevida al año de seguimiento año fue de un 69% vs 79% en los sin TP (p = 0,476). Conclusiones: El TH en pacientes con TP no se asoció a mayor mortalidad en relación a los pacientes trasplantados sin TP. El tratamiento anticoagulante en pacientes con TP puede indicarse mientras se espera el trasplante. Abstract in english Portal vein thrombosis (PVT) is a serious complication of end-stage liver disease, representing a challenge for the liver transplantation (LT) team. The aim of this study was to analyze the results of LT in patients with PVT. Methods: All adult patients who underwent a LT from a cadaveric donor betw [...] een March 1994 and March 2010 were included. PVT was categorized using the classification of Yerdel and McMaster. Results: A total of 109 LT were performed in 105 patients. PVT was found in 13 cases (12.4%). In 6 of them (46.2%), thrombosis was found preoperatively by transplant routine work up. Pre-transplant systemic anticoagulation was indicated in 3 cases. At the time of surgery, only 10 patients had persistent PVT. Grade I, II, III and IV PVT was found on 2, 3, 4 and 1 patient respectively. In the 3 cases treated with systemic anticoagulation preo-peratively, grade I (1 case) and grade II (2 cases) no thrombus was evident intraoperatively. Endovenectomy was performed in 7 cases; simple thrombectomy in one and a mesenteric vein graft was required in 2 cases. No thrombus recurrence was detected on postoperative follow-up. In-hospital mortality occurred in 2 cases with PTV grade III and IV due to medical complications. One-year patient and graft survival was 69% vs 79% in patients without PVT (p = 0,476). Conclusion: Liver transplant in patients with PVT thrombosis was not associated with a significant increased risk of mortality. Systemic anticoagulation seems to be warranted while waiting for liver transplantation.

  7. In vitro antiviral activity of phlorotannins isolated from Ecklonia cava against porcine epidemic diarrhea coronavirus infection and hemagglutination.

    Science.gov (United States)

    Kwon, Hyung-Jun; Ryu, Young Bae; Kim, Young-Min; Song, Naaleum; Kim, Cha Young; Rho, Mun-Chual; Jeong, Jae-Ho; Cho, Kyoung-Oh; Lee, Woo Song; Park, Su-Jin

    2013-08-01

    Despite the prepdominat agent causing severe entero-pathogenic diarrhea in swine, there are no effective therapeutical treatment of porcine epidemic diarrhea virus (PEDV). In this study, we evaluated the antiviral activity of five phlorotannins isolated from Ecklonia cava (E. cava) against PEDV. In vitro antiviral activity was tested using two different assay strategies: (1) blockage of the binding of virus to cells (simultaneous-treatment assay) and (2) inhibition of viral replication (post-treatment assay). In simultaneous-treatment assay, compounds 2-5 except compound 1 exhibited antiviral activities of a 50% inhibitory concentration (IC??) with the ranging from 10.8 ± 1.4 to 22.5 ± 2.2 ?M against PEDV. Compounds 1-5 were completely blocked binding of viral spike protein to sialic acids at less than 36.6 ?M concentrations by hemagglutination inhibition. Moreover, compounds 4 and 5 of five phlorotannins inhibited viral replication with IC?? values of 12.2 ± 2.8 and 14.6 ± 1.3 ?M in the post-treatment assay, respectively. During virus replication steps, compounds 4 and 5 exhibited stronger inhibition of viral RNA and viral protein synthesis in late stages (18 and 24 h) than in early stages (6 and 12 h). Interestingly, compounds 4 and 5 inhibited both viral entry by hemagglutination inhibition and viral replication by inhibition of viral RNA and viral protein synthesis, but not viral protease. These results suggest that compounds isolated from E. cava have strong antiviral activity against PEDV, inhibiting viral entry and/or viral replication, and may be developed into natural therapeutic drugs against coronavirus infection. PMID:23746631

  8. Triphlorethol-A from Ecklonia cava Up-Regulates the Oxidant Sensitive 8-Oxoguanine DNA Glycosylase 1

    OpenAIRE

    Ki Cheon Kim; In Kyung Lee; Kyoung Ah Kang; Mei Jing Piao; Min Ju Ryu; Jeong Mi Kim; Nam Ho Lee; Jin Won Hyun

    2014-01-01

    This study investigated the protective mechanisms of triphlorethol-A, isolated from Ecklonia cava, against oxidative stress-induced DNA base damage, especially 8-oxoguanine (8-oxoG), in Chinese hamster lung fibroblast V79-4 cells. 8-Oxoguanine DNA glycosylase-1 (OGG1) plays an important role in the removal of 8-oxoG during the cellular response to DNA base damage. Triphlorethol-A significantly decreased the levels of 8-oxoG induced by H2O2, and this correlated with increases in OGG1 mRNA and...

  9. Influence of temperature during the second fermentation and aging of sparkling wine (Cava on the properties of the foam

    Directory of Open Access Journals (Sweden)

    Esteruelas Mireia

    2015-01-01

    Full Text Available The aim of this study was to determine the influence of temperature during the second fermentation and aging of spar- kling wines (AOC Cava on their foam properties. The results indicate that sparkling wines elaborated at 12?°C have a maximum height (HM and a stable height (HS of the foam significantly higher than the corresponding ones produced at 16?°C. This better foam properties observed in sparkling wines obtained at low temperature are probably related with their higher protein and oligosaccharide concentration.

  10. Hallazgos ultraestructurales en lesiones foliares asociadas a 'vena roja' en helecho hoja de cuero / Ultrastructural findings in foliar lesions associated with 'red vein' in leather leaf fern

    Scientific Electronic Library Online (English)

    María del Milagro, Granados-Montero; Ethel, Sánchez-Chacón; Maribel, Vargas-Montero; Cinthya, Barboza-Aguilar.

    2014-02-01

    Full Text Available La vena roja del helecho hoja de cuero (Rumorah adiantiformis) se cataloga como una enfermedad de etiología desconocida, ya que no se conoce cuál es su agente o factor causal. Ésta alteración, al igual que el síndrome de Sterloff (SS), se ha venido presentando desde hace varios años en Costa Rica, l [...] o que ha producido situaciones económicas desfavorables, reduciendo el área sembrada en 60% y provocando una disminución en los puestos de trabajo 70%. Se registra muy poca investigación a nivel mundial que caracterice ambas patologías, por lo que es imposible realizar una estrategia de manejo apropiada, lo que conlleva al aumento del costo económico, social y ambiental del cultivo. Con el fin de describir ultraestructuralmente los síntomas de la enfermedad, se colectó tejido foliar por un período de dos años (2007 y 2008) en Poás de Alajuela, Costa Rica, y se realizaron observaciones mediante microscopia electrónica de barrido y transmisión. Los tejidos con síntomas revelaron la presencia de cristales laminados en las células del mesófilo esponjoso y acumulaciones cristalinas amorfas en el parénquima del haz vascular, así como gran cantidad de cristales en las vacuolas del mesófilo esponjoso. Éstos cristales, aparentemente, están compuestos por oxalato de calcio, no se evidenció presencia de cristales en tejidos asintomáticos. Este artículo describe los hallazgos ultraestructurales en follaje con y sin síntomas de vena roja en plantas de helecho y menciona como una posibilidad de la causa condiciones de estrés por desbalances nutricionales. Abstract in english The red vein leather leaf fern (Rumorah adiantiformis) is classified as a disease of unknown etiology, and it is not known what his agent or causal factor. This alteration, like Sterloff syndrome (SS) has been presenting for several years in Costa Rica, which has produced unfavorable economic condit [...] ions, reducing the area planted in 60% and causing a decrease in jobs 70%. Very little is recorded worldwide research that characterizes both conditions, so it is impossible to make an appropriate management strategy, which leads to increased economic costs, social and environmental dimensions of culture. In order to describe ultrastructural symptoms of the disease, leaf tissue was collected for a period of two years (2007 and 2008) in Poas, Alajuela, Costa Rica, and observations were made by scanning electron microscopy and transmission. Tissues with symptoms revealed the presence of laminated glass in spongy mesophyll cells and amorphous crystalline accumulations in the parenchyma of the vascular bundle, as well as lots of crystals in the spongy mesophyll vacuoles. These crystals are apparently calcium oxalate compounds, no evidence of crystals in the presence of asymptomatic tissues. This article describes the ultrastructural findings foliage with and without symptoms of red vein fern plants and mentioned as a possible cause stress conditions nutritional imbalances.

  11. Two Rare Anatomical Variations of External Jugular Vein: an Embryological Overview / Dos Raras Variaciones Anatómicas de la Vena Yugular Externa: una Visión Embriológica

    Scientific Electronic Library Online (English)

    Susmita, Ghosh; Lopamudra, Mandal; Sanchita, Roy; Manimay, Bandyopadhyay.

    2012-09-01

    Full Text Available La anatomía humana tiene un sin fin de variaciones y sus misterios se han develado desde el inicio de los tiempos. El conocimiento de las variaciones anatómicas de las venas superficiales de la cabeza y del cuello es fundamental para llevar a cabo con éxito los procedimientos quirúrgicos. Durante un [...] a disección de rutina de cabeza y cuello encontramos una arquitectura venosa interesante en dos cadáveres de hombres de mediana edad en el Departamento de Anatomía de la Facultad de Medicina Nacional Calcuta, Calcuta, India. En el lado izquierdo del cuello de ambos cadáveres, la vena retromandibular no se encontraba dividida, y se unía a la vena facial en un ángulo agudo, para formar un tronco venoso común a una distancia variable desde el ángulo de la mandíbula. Ese tronco finalmente drenaba en la vena subclavia izquierda. Esto podría ser el resultado de la desaparición de la parte cefálica de la vena yugular externa y la formación de una comunicación adicional entre la vena facial común y la vena yugular externa en la vida fetal. En un caso, también se encontró con una comunicación adicional transversal entre ese tronco común y la vena yugular interna. Se realiza una descripción en detalle de los casos junto a una explicación embriológica. Abstract in english Human anatomy is an ocean of unending variations and its mysteries are being unravelled since ages. Knowledge of variations in the superficial veins of head and neck is essential to carry out successful surgical procedures. During routine dissection of head and neck of two middle aged male cadavers, [...] in the Department of Anatomy, Calcutta National Medical College, Kolkata, India, we came out with some interesting venous architecture. The retromandibular vein on the left side of both the cadavers was found to be undivided and joined with the facial vein in the neck at an acute angle to form a common venous trunk at variable distances from the angle of the mandible. That trunk ultimately drained into the left subclavian vein. This might be the result of disappearance of the cephalic part of the external jugular vein and formation of an additional communication between common facial vein and the external jugular vein in foetal life. In one case, we also came across an extra transverse communication between that common trunk and the internal jugular vein. A detail of those cases with embryological explanation is attempted.

  12. Influenza virus neuraminidase inhibitory activity of phlorotannins from the edible brown alga Ecklonia cava.

    Science.gov (United States)

    Ryu, Young Bae; Jeong, Hyung Jae; Yoon, So Young; Park, Ji-Young; Kim, Young Min; Park, Su-Jin; Rho, Mun-Chual; Kim, Se-Jae; Lee, Woo Song

    2011-06-22

    Influenza A virus infections continue to pose a major threat to humans and several animal species. Neuraminidase (NA) is one of the most promising targets for the development of drugs against influenza viruses because of its critical role in the viral life cycle. During the course of a search for NA inhibitors from edible natural sources, we found that the ethyl acetate layer of ethanol extracts of Ecklonia cava showed extremely high NA-inhibitory activity (72.1% inhibition at 30 ?g/mL). Bioactivity-guided fractionation of the ethyl acetate layer yielded five phlorotannins, identified as phloroglucinol (1), eckol (2), 7-phloroeckol (3), phlorofucofuroeckol (4), and dieckol (5). The inhibitory activities of these compounds (1-5) against NAs from group-1 (A/Bervig_Mission/1/18 [H1N1], A/PR/8/34 [H1N1]) and group-2 (A/Hong Kong/8/68 [H3N2], A/Chicken/Korea/MS96/96 [H9N2]) influenza A were evaluated to determine potencies and kinetic behavior. Analyses using various in vitro influenza A virus NA assays showed that all five phlorotannin derivatives were selective NA inhibitors. Of the phlorotannins, phlorofucofuroeckol (4) exhibited the most potent inhibitory activities toward group-1 NAs (IC?? values, 4.5 and 14.7 ?M), whereas dieckol (5) potently inhibited group-2 NAs. Kinetic analyses indicated that compounds 1-5 were all noncompetitive. Notably, these noncompetitive inhibitors synergized with oseltamivir to enhance the NA-inhibitory effects of oseltamivir. PMID:21585204

  13. Flavobacterium jejuensis sp. nov., isolated from marine brown alga Ecklonia cava.

    Science.gov (United States)

    Park, So-Hyun; Kim, Ji-Young; Kim, Young-Ju; Heo, Moon-Soo

    2015-11-01

    A bacterial strain, designated EC11(T) was isolated from brown alga Ecklonia cava collected from Jeju Island, Korea. EC11(T) was identified as a Gram-negative, rod-shaped and yellowpigmented bacterial strain. The strain EC11(T) grew over a temperature range of 10°C to 30°C (optimally at 25°C), and a pH range of 6.0-10.5 (optimally at pH 7.5). Phylogenetic analysis based on 16S rRNA gene sequences showed that strain EC11(T) belongs to the genus Flavobacterium. Strain EC11(T) shared close similarity with Flavobacterium jumunjinense HME7102(T) (96.4%), Flavobacterium dongtanense LW30(T) (95.8%), Flavobacterium haoranii LQY-7(T) (95.3%), and Flavobacterium urocaniciphilum (95.1%). The major fatty acids (> 5%) were iso-C17:0 3-OH (22.4%), iso-C15:0 3-OH (19.0%), C15:0 (12.4%), summed feature 3 (comprising C16:1 ?7c/ C16:1 ?6c; 9.78%), iso-C15:1 G (9.6%), and iso-C16:0 3-OH (9.0%). The DNA G+C content was 28.1 mol% and the strain contained MK-6 as the predominant menaquinone. The major polar lipids were phosphatidylethanolamine, two unknown aminolipids and three unknown polar lipids. Based on phenotypic, chemotaxonomic and phylogenetic analysis, strain EC11T represents a novel species of the Flavobacterium genus, for which the name Flavobacterium jejuensis sp. nov. is proposed. The type strain of F. jejuensis is EC11(T) (=KCTC 42149(T) = JCM 30735(T)). PMID:26502959

  14. Trombosis de la vena ovárica: Factores de riesgo, diagnóstico y tratamiento / Ovarian vein thrombosis: risk factors, diagnosis and treatment

    Scientific Electronic Library Online (English)

    Eduardo, González-Bosquet.

    2009-06-01

    Full Text Available La trombosis de la vena ovárica es una complicación muy poco frecuente (0.002-0.05%), que se observa en mujeres que presentan un incremento en los factores de coagulación. La principal situación en la que es posible detectar esta complicación es el embarazo, aunque no es la única. Se describe el cas [...] o de una mujer de 31 años de edad, gestante de 16 semanas, que presenta un aborto espontáneo séptico complicado con una trombosis de la vena ovárica. Se aprovecha el caso clínico para revisar en la literatura los factores de riesgo, el diagnóstico y el tratamiento de esta inusual patología. Abstract in english Ovarian vein thrombosis is an uncommon complication (0.002-0.05%) related to hypercoagulated status of women. The most frequent condition associated to ovarian vein thrombosis is pregnancy, but there are other possible causes. We present a case of a 31 year old pregnant woman at 16th week of gestati [...] on who had spontaneuos septic abortion complicated with an ovarian vein thrombosis. A discussion of risk factors, diagnostic and treatment options of ovarian vein thrombosis are presented.

  15. Trombosis de la vena ovárica: Factores de riesgo, diagnóstico y tratamiento Ovarian vein thrombosis: risk factors, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Eduardo González-Bosquet

    2009-06-01

    Full Text Available La trombosis de la vena ovárica es una complicación muy poco frecuente (0.002-0.05%, que se observa en mujeres que presentan un incremento en los factores de coagulación. La principal situación en la que es posible detectar esta complicación es el embarazo, aunque no es la única. Se describe el caso de una mujer de 31 años de edad, gestante de 16 semanas, que presenta un aborto espontáneo séptico complicado con una trombosis de la vena ovárica. Se aprovecha el caso clínico para revisar en la literatura los factores de riesgo, el diagnóstico y el tratamiento de esta inusual patología.Ovarian vein thrombosis is an uncommon complication (0.002-0.05% related to hypercoagulated status of women. The most frequent condition associated to ovarian vein thrombosis is pregnancy, but there are other possible causes. We present a case of a 31 year old pregnant woman at 16th week of gestation who had spontaneuos septic abortion complicated with an ovarian vein thrombosis. A discussion of risk factors, diagnostic and treatment options of ovarian vein thrombosis are presented.

  16. Un análisis retrospectivo de cavernomatosis de la vena porta en Chile: II. Hemorragia, tratamiento y pronóstico

    Directory of Open Access Journals (Sweden)

    Paul Harris D.

    1999-07-01

    Full Text Available Objetivo: El tratamiento de la hipertensión portal de origen prehepático en niños es motivo de controversia. El objetivo de este estudio retrospectivo fue analizar la evolución, tratamiento y morbimortalidad de 34 niños con cavermomatosis de la vena porta. Pacientes y método: Se analizó la evolución antropométrica y hematológica, las características del sangramiento digestivo, el tratamiento médico, endoscópico y quirúrgico, y la morbimortalidad. Resultados: El 74% de los niños presentó uno o más episodios de sangramiento. El 56% de los niños recibió propanolol como profilaxis y el 38% fue sometido a escleroterapia de várices esofágicas. Sólo seis niños requirieron de cirugía derivativa. La mortalidad fue del 5,6% y el seguimiento fue de 3,6 años por niño. Conclusión: Aun cuando la hemorragia digestiva alta por ruptura de las várices esofágicas fue la complicación más frecuente de la cavernomatosis de la porta en esta serie, el éxito del tratamiento médico y endoscópico en evitar un nuevo episodio de sangramiento sugieren que a futuro un número menor de pacientes requerirá de cirugía derivativa portosistémicaObjective: the treatment of prehepatic portal hypertension in children is controversial. The object of this retrospective study was to analise the evolution, treatment, morbidity and mortality in 34 children with portal vein cavernomatosis. Patients and methods: we analised the anthropomorphic and hae-matological evolution, the caracteristics of gastrointestinal (GI bleeding, the medical, endoscopic and surgical treatment and the morbidity and mortality. Results: 74% presented with one or more episodes of GI bleeding, 56% received propanolol as prophylaxis and 38% had sclerotherapy of their oesphageal varices. Only six children needed surgery for porto-systemic shunts. The mortality was 5.6% with a follow-up of 3.6 years. Conclusions: Although upper GI bleeding from ruptured oesphageal varices was the most frequent complication of portal vein cavernomatosis in this series, the success of medical and endoscopic treatment to avoid rebleeding suggests that in the future a smaller number of patients will require surgery for porto-systemic shunts

  17. Right heart thrombus causing syncope in an elderly patient.

    Science.gov (United States)

    Papadimitraki, Eva D; Papadopoulos, Dimitrios; Zerva, Kanella; Bassoulis, Dimitrios; Chatzigheorgiou, Evangelos; Barbetseas, John

    2015-09-01

    Pulmonary embolism and thromboembolic disease carry a high mortality if not recognised and managed appropriately. Herein we illustrate the case of a dehydrated elderly female patient with recurrent syncope who proved to have high risk pulmonary embolism and a free floating right heart thrombus. The echocardiographic findings of right heart thrombus and possible thrombi 'in transit' within a low flow inferior vena cava, guided a life-saving treatment in this frail elderly patient. PMID:26220987

  18. Stent placement in VCI, in Budd Chiari syndrome

    International Nuclear Information System (INIS)

    The portal decompression in patients with acute form of Budd Chiari syndrome (absence of extensive fibrosis or cirrhosis and short time evolution of the disease) is mandatory, because the risk of shunt thrombosis is lower and the studies show good long-term results. With percutaneous technique, we expanded the inferior vena cava placing Gianturco stents, and simultaneous venoplasty of suprahepatic vein. The patient had a satisfactory evolution and no complications during procedure

  19. Palliative Procedures in Lung Cancer

    OpenAIRE

    Masuda, Emi; Sista, Akhilesh K.; Pua, Bradley B.; Madoff, David C.

    2013-01-01

    Palliative care aims to optimize comfort and function when cure is not possible. Image-guided interventions for palliative treatment of lung cancer is aimed at local control of advanced disease in the affected lung, adjacent mediastinal structures, or distant metastatic sites. These procedures include endovascular therapy for superior vena cava syndrome, bronchial artery embolization for hemoptysis associated with lung cancer, and ablation of osseous metastasis. Pathophysiology, clinical pres...

  20. Renal vein thrombosis and adrenal hemorrhage in the newborn: ultrasound evaluation of 4 cases.

    Science.gov (United States)

    Orazi, C; Fariello, G; Malena, S; Schingo, P; Ferro, F; Bagolan, P

    1993-01-01

    Renal vein thrombosis and adrenal hemorrhage can both be encountered in the neonatal period and they may occur at the same time. Inferior vena cava thrombosis can complicate some cases. These diseases can be easily diagnosed by means of ultrasound. The authors present 4 cases in which newborns were affected by renal vein thrombosis associated with adrenal hemorrhage and caval thrombosis, evaluated by means of ultrasound. The echographic aspect of renal, adrenal and caval involvement is described. PMID:8382217

  1. Biliary atresia

    OpenAIRE

    Sinha C; Davenport Mark

    2008-01-01

    Biliary atresia (BA) is a cholangiodestructive disease affecting biliary tract, which ultimately leads to cirrhosis, liver failure and death if not treated. The incidence is higher in Asian countries than in Europe. Up to 10% of cases have other congenital anomalies, such as polysplenia, asplenia, situs inversus, absence of inferior vena cava and pre-duodenal portal vein, for which we have coined the term Biliary Atresia Splenic Malformation (BASM) syndrome. For these infants the aetio...

  2. Pseudodefect on /sup 99m/Tc sulfur colloid liver scan caused by hepatodiaphragmatic interposition

    International Nuclear Information System (INIS)

    Factors causing pseudodefects in liver scans are classified as follows: foreign objects; normal structures and variations such as embedded gall bladder with or without stone, inferior vena cava, and prominent rib cage; and extrahepatic disease processes such as emphysema and ascites. Awareness of these causes for false defect in /sup 99m/Tc sulfur colloid liver scan will significantly reduce false positive scan interpretations

  3. Hydatid Cysts of Liver and Portal Hypertension

    OpenAIRE

    Emre, Ali; Ario?ul, Orhan; Alper, Aydin; Ökten, Attilâ; Uras, Ali; Yalçin, Süleyman

    1990-01-01

    Two cases of portal hypertension due to hydatid cysts of the liver are reported. In one of the patients, symptoms were secondary to obstruction of inferior vena cava and hepatic outflow tract. The other patient was operated on with a diagnosis of extrahepatic presinusoidal portal hypertension caused by extrinsic compression of the liver by an hydatid cyst. Although hydatidosis is a benign disease, it can produce serious complications as in these reported cases. Therefore hydatidos...

  4. Communication of the External and Internal Jugular Veins: A Case Report Comunicación entre las Venas Yugulares Externa e Interna: Reporte de Caso

    Directory of Open Access Journals (Sweden)

    Rekha Lalwani

    2006-12-01

    Full Text Available The external jugular vein, which traverses the sternocleidomastoid muscle superficially, is known to exhibit variations in its formation and course. There are less reports on the communication of the external and internal jugular vein. During routine cadaveric dissection, we detected an abnormal communication of the external jugular vein and the internal jugular vein, in a 45 year male cadaver. The knowledge of both normal and abnormal anatomy of the superficial veins of the neck may be important for clinicians performing catheterization and surgeons operating in the region of the neck. The presence of such anomalous communications may also be important for radiologists performing angiographic and sonographic studiesLa vena yugular externa, cruza transversal y superficialmente al músculo esternocleidomastoideo presentando variaciones en su curso y formación, existiendo algunos repórters en las comunicaciones entre ambas venas yugulares externa e interna. Durante ua disección de rutina, detectamos una anormal comunicación entre ambas venas, en una cadáver de sexo masculino de 45 años. El conocimiento de la anatomía normal y de las variaciones de las venas superficiales del cuello es importante en los procedimientos de cateterización tanto para clínicos como para cirujanos que operan en esta región. La presencia de estas variaciones de comunicación venosa es importante además, para imagenólogos y estudios sonográficos

  5. 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

    OpenAIRE

    Fernando Hintz Greca; Lucia de Noronha; Francisco Diniz Afonso da Costa; Zacarias Alves Souza Filho; Andréa Thomaz Soccol; André Néry Feres; Jõao Ricardo Duda; Eduardo Adams

    2005-01-01

    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 ...

  6. Hallazgos ecocardiográficos en la esclerodermia sin antecedentes cardiovasculares / Echocardiographic Findings in Scleroderma without Histor