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The superior vena cava syndrome caused by malignant disease  

International Nuclear Information System (INIS)

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

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[Superior vena cava syndrome].  

Science.gov (United States)

Superior vena cava(SVC)syndrome is one of the complication of malignant neoplasia, which often occurs in clinical practice. It is caused by obstruction of the SVC by invasion, extrinsic compression by adjacent pathologic processes, or by internal thrombus. They sometimes coexist. The increased venous pressure in the upper body caused by this syndrome results in edema of the head, neck, and arms, which is visually striking but generally of little clinical consequence. But edema may cause a functional compromise of the larynx or pharynx, causing dyspnea, stridor, cough, hoarseness, and dysphagia. Cerebral edema may lead to cerebral ischemia, confusion, coma, and possibly death. We therefore recognize the SVC syndrome as an oncologic emergency. The most common malignant cause of this disease is lung cancer. It is necessary to plan a management strategy after consideration of staging and the histopathologic diagnosis. The most useful imaging study for this disease is CT scanning of the chest with administration of contrast material. Management of the SVC syndrome associated with malignant disease includes both treatment of the cancer and relief of the symptoms of obstruction. Major therapeutic modalities are supportive care and medical management, including chemotherapy, radiotherapy, placement of intravascular stent, and surgery. The presence of the SVC syndrome does not reduce the likelihood ofa cure for the underlying malignant condition, and should not compromise the choice of appropriate therapy. PMID:21498977

Taguchi, Jun; Kinoshita, Ichiro; Akita, Hirotoshi

2011-04-01

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

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

Yamelic Bernal

2011-01-01

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

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

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

2003-11-01

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

International Nuclear Information System (INIS)

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

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

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

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

2006-03-01

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

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

Otacílio Figueiredo da Silva Júnior

2006-03-01

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

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

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

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Vena cava superior izquierda persistente / Persistent left superior vena cava  

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Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish 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.

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

2014-04-01

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A persistent left superior vena cava.  

Science.gov (United States)

Persistent left superior vena cava is the most common form of anomalous venous drainage involving the superior vena cava, and represents persistence of the left horn of the embryonic sinus venosus, which normally involutes during normal development to become the coronary sinus. Almost always, a persistent left superior vena cava enters the right atrium through the orifice of an enlarged coronary sinus. In this case report of a 60-year-old male cadaver, we describe a persistent left superior vena cava and discuss its embryology and clinical significance. PMID:17342280

Paval, J; Nayak, S

2007-03-01

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Roentgenoendovaskular prosthetics of vena cava for compression  

International Nuclear Information System (INIS)

The paper discusses the experience of transcatheteral intravascular application of endoprosthesis into superior vena cava for compression in a patient suffering Hodgkin disease. The patient had failed to respond to 3 cycles of combination chemotherapy and 46 Gy of radiation to the mediastinum. Application of the procedure brought the vascular lumen and blood flow to normal which led to regression of compression syndrome. The self-fixing endoprosthesis dilates and forms an interior frame for the vessel thus preventing relapse of compression

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Roentgenologic appearance of left-sided inferior vena cava  

International Nuclear Information System (INIS)

2 Cases of left-sided inferior vena cava, and 2 cases of left-sided inferior vena cava with azygos and hemiazygos continuation were evaluated with computed tomography and other roentgenologic procedures and discussed thier clinical and radiological significance. Left-sided inferior vena cava with azygos (hemiazygos) continuation is often associated with cyanotic or acyanotic congenital heart disease and abnormalities of cardiovascular position, abdominal situs and polysplenia. But, single left-sided inferior vena cavas have little tendency having associated anomalies. Both venous anomalies also shuld be embryologically differentiated, namely, failure of development of the lower portion of the supracardinal veins results in infrahepatic interruption of inferior vena cava with azygos continuation, persistence of the left cardinal system and atrophy of the right system lead to the left-side inferior vena cava. Knowledge of inferior vena cava anomalies is important to the radiologist in order to differentiate between venous anomalies and an enlarged lymph nodes in a patient with malignant tumor. (author)

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Sarcoma de vena cava inferior Sarcoma of the vena cava inferior  

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Full Text Available Se presentó un caso infrecuente de una paciente con tumor abdominal y gran circulación colateral superficial tipo cava-cava, el ultrasonido abdominal, el ecocardiograma trans-torácico y transesofágico y la tomografía axial computarizada identificaron un tumor de la vena cava inferior. La citología aspirativa con aguja fina de la lesión confirmó que se trataba de un sarcoma fusopleomórfico de alto grado de malignidad primario de la vena cava inferior.Authors present an infrequent case of a female patient with abdominal tumor a great superficial collateral circulation type cava-cava, the abdominal ultrasound, the transthoracic and transesophageal echocardiogram and the computerized axial tomography (CAT identified a tumor of the vena cava inferior. The fine-needle aspiration cytology of lesion confirmed the presence of primary fusopleomorphous sarcoma of high degree of malignancy of vena cava inferior.

Jorge Luis León Álvarez

2010-12-01

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Vena cava ?nvasion by adrenal leiomyosarcoma  

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Full Text Available Primary adrenal mesenchymal tumors are extremely rare. These tumors are hard to diagnose, and similar to certain adrenal tumors, as they do not produce hormones, and they can only manifest themselves when the tumor reaches an advanced size. These tumors are generally detected incidentally. This study reports a rare case of primary leiomyosarcoma of the right adrenal gland with vena cava invasion, in a 70-year-old woman who presented with right flank pain. Computerized tomography showed an adrenal mass with a diameter of 78 mm, which exerted pressure on the vena cava inferior. The invasive part was excised by using adrenalectomy and cavatomy. Tumor invasion was determined on the wall of the vena cava. Histopathological examination on 10× magnification showed 8-10 mitotic events. Immunohistochemical staining showed that the cells were SMA (+, desmin (+, cytokera- tin (-, and Bcl-2 (-. The Ki67 proliferation index was 70%. Widespread metastasis develo- ped six months after the adrenalectomy.

Hakan Öztürk

2014-05-01

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Endovascular treatment of superior vena cava syndrome  

DEFF Research Database (Denmark)

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.

Duvnjak, Stevo; Andersen, Poul Erik

2011-01-01

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Experience with three percutaneous vena cava filters  

International Nuclear Information System (INIS)

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

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

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Full Text Available SciELO Chile | Language: Spanish Abstract in spanish 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.

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

2014-02-01

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish 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.

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

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Vena cava air embolism after traumatic Foley catheter placement.  

Science.gov (United States)

We report a case of traumatic Foley catheter placement and manipulation that resulted in a large, symptomatic, vena cava air embolism confirmed on computed tomography. To the best of our knowledge, our report represents the first case of a large, symptomatic, vena cava air embolism as a direct result of Foley catheter trauma. The included computed tomography images are unique in that they simultaneously show an improperly positioned Foley catheter and a large vena cava air embolism. PMID:19118872

Chavez, Anthony H; Reilly, T Philip; Bird, Erin T

2009-04-01

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Leiomyosarcoma of the Inferior Vena Cava  

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Vascular leiomyosarcoma (LMS) are unique. The inferior vena cava (IVC) is the most affected organ (about 38% cases). We report the observation of a 50-year old woman who consulted for right upper quadrant pain. Imaging studies revealed a retroperitoneal mass that mimic a LMS of the IVC. The patient was operated. A resection of the IVC along with the tumor was performed without reconstruction. The management of LMS is surgical and depends upon the location and tumor characteristics. PMID:24765501

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

2013-01-01

 
 
 
 
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Leiomyosarcoma of the inferior vena cava  

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Full Text Available Vascular leiomyosarcoma (LMS are unique. The inferior vena cava (IVC is the most affected organ (about 38% cases. We report the observation of a 50-year old woman who consulted for right upper quadrant pain. Imaging studies revealed a retroperitoneal mass that mimic a LMS of the IVC. The patient was operated. A resection of the IVC along with the tumor was performed without reconstruction. The management of LMS is surgical and depends upon the location and tumor characteristics.

Ben Abid Sadri

2013-01-01

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Bilateral absence of superior vena cava.  

Science.gov (United States)

The absence of a right superior vena cava (SVC) in situs solitus is very rare, and even then it is usually associated with left SVC. There have been few case reports in the literature of isolated bilateral absence of SVC. Bilateral absent SVC can have clinical implication, including pacemaker placements, central venous line placement, monitoring, and occasionally associated anomalies. We describe a case detected on fetal echocardiogram with bilateral absent SVC and structurally normal heart. PMID:22580777

Bansal, Manish; Strainic, James; Ashwath, Ravi

2013-04-01

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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

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Inferior Vena Cava Index in Edematous Patients  

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Full Text Available Introduction: To find a relation between extracellular over fluid and inferior vena cava index as a noninvasive, cost effective and accessible method .Methods: In a cross sectional study 54 cases (no edema 30, mild and moderate 13 and significant edema 11 cases entered to study. Inferior vena cava index (IVCi measured by difference of inspiration to expiration divided to maximum size multiply by 100, we also find delta ratio as difference of maximum to minimum size of inferior vena cava. All data expressed by rate and ratio, relation of edema severity to IVCi or delta ratio performed by mann whitney and regression test, P less than 0.05 was significant.Results: IVCi in 30 cases with no edema ,13 cases with mild to moderate and 11 cases with significant edema were %46±16 , %42±16 , %38±17, there is a reverse relation of IVCi and edema severity but these relations were not significant (P>0.05 .Averaged Delta ratio(millimeter decreased in severe edema but it was not significant(3.7mm±2 vs. 2.8mm±1.6. Conclusion: In edematous conditions IVCi and delta ratio decrease but these changes are not significant for edema severity estimation.

Shamsi Ghaffari

2012-09-01

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Superior Vena Cava Thrombosis in a Case of Lung Adenocarcinoma  

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Full Text Available Superior vena cava syndrome is a common presentation of bronchogenic carcinoma. The mechanism of obstruction is by compression of superior vena cava by the bronchogenic tumor itself or enlarged mediastinal lymph nodes. However obstruction due to intravascular thrombosis is extremely uncommon. Here, we report a rare case of a 65-year-old male smoker who presented with superior vena cava syndrome and bilateral pleural and pericardial effusion with thrombotic occlusion of the superior vena cava in adenocarcinoma of the lung. He was given chemotherapy with carboplatin and gemcitabine with anticoagulant therapy.

Santanu Ghosh

2013-01-01

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

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

Roxana Dronca

2013-07-01

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish [...] 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

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.

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Ultrasound Detection of Superior Vena Cava Thrombus  

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Full Text Available Superior vena cava (SVC syndrome is most commonly the insidious result of decreased vascular flow through the SVC due to malignancy, spontaneous thrombus, infections, and iatrogenic etiologies. Clinical suspicion usually leads to computed tomography to confirm the diagnosis. However, when a patient in respiratory distress requires emergent airway management, travel outside the emergency department is not ideal. With the growing implementation of point-of-care ultrasound (POCUS, clinicians may make critical diagnoses rapidly and safely. We present a case of SVC syndrome due to extensive thrombosis of the deep venous system cephalad to the SVC diagnosed by POCUS. [West J Emerg Med. 2014;15(6:715-718

Aaron Birch

2014-09-01

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A new design of the retrievable vena cava filter.  

Science.gov (United States)

Retrievable vena cava filters are invented to minimize surgical traumas to patients. However, in reality the deployed filter may firmly adhere to the vena cava due to tissue in-growth into the filter, which will breach the original concept of retrieving the filter by minimal invasive surgery. We hypothesize that if we can invent a filter with a part of supporting feet that is made of biodegradable materials and can be detached from the main body of the filter during the filter retrieval, the retrieval damage problem to the vena cava might be solved. PMID:22922057

Chen, Zengsheng; Zhang, Xiwen; Deng, Xiaoyan

2012-11-01

30

Right superior vena cava draining into the left atrium  

International Nuclear Information System (INIS)

The right superior vena cava draining into the left atrium is a rare malformation causing cyanosis and clubbing in patients in whom no other signs of congenital heart defect are present. Diagnosis may be difficult as cyanosis may be mild and the anomaly is not always easily detectable by echocardiography. For this reason we report a 13-month-old male in whom we confirmed the clinical and echocardiographic suspicion of anomalous drainage of the right superior vena cava using multidetector CT. This allowed successful surgical reconnection of the right superior vena cava to the right atrium. (orig.)

31

Radiological evaluation of inferior vena cava obstruction: pictorial essay  

International Nuclear Information System (INIS)

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

32

Radiological evaluation of inferior vena cava obstruction: pictorial essay  

Energy Technology Data Exchange (ETDEWEB)

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

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

1999-12-01

33

Traumatismos de veia cava inferior / Inferior vena cava injuries  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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 Abstract in english 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

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

34

Traumatismos de veia cava inferior / Inferior vena cava injuries  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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 Abstract in english 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

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

2005-10-01

35

Congenital anomalies of the inferior vena cava  

Energy Technology Data Exchange (ETDEWEB)

Congenital anomalies of the inferior vena cava (IVC) and its tributaries are increasingly recognized in asymptomatic patients due to the more frequent use of cross-sectional imaging and computed tomography (CT) in particular. IVC development is a complex process involving formation of anastomoses between three pairs of embryonic veins in the 4th to 8th week of gestation. Various permutations occur in the basic venous plan of the abdomen and pelvis resulting in variants such as isolated left IVC, double IVC, and retroaortic left renal vein. The majority of these anomalies are asymptomatic but occasionally present clinically with thromboembolic complications. However, awareness of their existence is important to avoid important diagnostic pitfalls and in preoperative surgical and interventional radiological planning.

Malaki, M., E-mail: mbmv@doctors.org.uk [Department of Clinical Radiology, Queen Elizabeth Hospital, Birmingham (United Kingdom); Willis, A.P.; Jones, R.G. [Department of Clinical Radiology, Queen Elizabeth Hospital, Birmingham (United Kingdom)

2012-02-15

36

Radiation therapy for superior vena cava syndrome  

International Nuclear Information System (INIS)

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%, ? 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

37

Radiation therapy for superior vena cava syndrome  

Energy Technology Data Exchange (ETDEWEB)

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.

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

2005-06-15

38

Neoplasms of the inferior vena cava - pictorial essay  

International Nuclear Information System (INIS)

This pictorial essay reviews common and rare neoplasms affecting the inferior vena cava (IVC, Table 1), with a particular emphasis on the clinical implications and the role and efficacy of the various imaging techniques. (author)

39

Injuries of the retrohepatic inferior vena cava and the liver  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 ...

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

2008-01-01

40

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish [...] 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)

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

 
 
 
 
41

Traumatismos de veia cava inferior Inferior vena cava injuries  

Directory of Open Access Journals (Sweden)

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

Cleinaldo de Almeida Costa

2005-10-01

42

Multicentric pheochromocytoma and involvement of the inferior vena cava  

Scientific Electronic Library Online (English)

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

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

43

Leiomyosarcoma of the inferior vena cava.  

Science.gov (United States)

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

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

2014-05-01

44

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

International Nuclear Information System (INIS)

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.)

45

Congenitally corrected transposition of the great arteries with anomalous inferior vena cava drainage: multimodality imaging.  

Science.gov (United States)

Atrioventricular discordance with ventricular-arterial discordance is a rare cardiac anomaly known as congenitally corrected transposition of the great arteries (CCTGA). This malformation has a prevalence of 0.4-0.6% of all congenital heart disease cases. Complete heart block develops in up to 30% of patients with CCTGA. We present the case of a 62-year-old woman diagnosed with CCTGA who, on echocardiography, had anomalous venous drainage where the inferior vena cava (IVC) bypassed the right atrium and drained into the azygos system. Complementary images with magnetic resonance imaging demonstrated the unique anatomical relationship between the IVC, azygos venous system, and the superior vena cava.? PMID:21967326

Paterick, Timothy E; Schmidt, Matthew; Jan, M Fuad; Kramer, Christopher; Umland, Matt M; Bloomgarden, Daniel; Tajik, A Jamil

2012-01-01

46

Pediatric child abuse victim with posttraumatic inferior vena cava thrombosis.  

Science.gov (United States)

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

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

2014-05-01

47

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)

48

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

LENUS (Irish Health Repository)

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.

Leong, S

2010-06-19

49

Retrieval of Cement Embolus from Inferior Vena Cava After Percutaneous Vertebroplasty  

International Nuclear Information System (INIS)

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

50

[Resection of leiomyosarcoma of the inferior vena cava].  

Science.gov (United States)

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

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

2013-01-01

51

Injuries of the retrohepatic inferior vena cava and the liver  

Directory of Open Access Journals (Sweden)

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

Koprivica Radenko

2008-01-01

52

Advanced Techniques for Removal of Retrievable Inferior Vena Cava Filters  

Energy Technology Data Exchange (ETDEWEB)

Inferior vena cava (IVC) filters have proven valuable for the prevention of primary or recurrent pulmonary embolism in selected patients with or at high risk for venous thromboembolic disease. Their use has become commonplace, and the numbers implanted increase annually. During the last 3 years, in the United States, the percentage of annually placed optional filters, i.e., filters than can remain as permanent filters or potentially be retrieved, has consistently exceeded that of permanent filters. In parallel, the complications of long- or short-term filtration have become increasingly evident to physicians, regulatory agencies, and the public. Most filter removals are uneventful, with a high degree of success. When routine filter-retrieval techniques prove unsuccessful, progressively more advanced tools and skill sets must be used to enhance filter-retrieval success. These techniques should be used with caution to avoid damage to the filter or cava during IVC retrieval. This review describes the complex techniques for filter retrieval, including use of additional snares, guidewires, angioplasty balloons, and mechanical and thermal approaches as well as illustrates their specific application.

Iliescu, Bogdan; Haskal, Ziv J., E-mail: ziv2@mac.com [University of Maryland School of Medicine, Division of Vascular and Interventional Radiology (United States)

2012-08-15

53

Detection by means of CT of inferior vena cava filters  

International Nuclear Information System (INIS)

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

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

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

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

2012-08-01

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Excision of a permanent inferior vena cava filter with multiple vena caval perforations.  

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Perforation of an inferior vena cava filter by one the filter device hooks is a recognized possible complication of this device. We describe a case of surgical excision of a permanent inferior vena cava filter associated with multiple perforations of surrounding structures by each of the 6 hooks of the device. Structures affected include the third lumbar vertebral body, transverse mesocolon, the infrarenal aorta, the duodenum, and the psoas muscle. A thorough understanding of the filter design and adequate preoperative imaging were vital in planning the safe surgical excision of this device. PMID:24084266

Georg, Yannick; Khalife, Theresa; Alomran, Faris; Gaudric, Julien; Chiche, Laurent; Koskas, Fabien

2014-01-01

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Radiographic evaluation of caudal vena cava size in dogs  

International Nuclear Information System (INIS)

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

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

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

Miriam Davis G.

2005-10-01

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

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Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Introducción: Un niño con cáncer puede presentar durante su enfermedad una emergencia, ya sea como manifestación inicial, en la fase de diagnóstico, durante la evolución o en el periodo terminal. Objetivo: Presentar nuestra experiencia en el manejo del síndrome de Vena Cava Superior en niños con 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

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

2005-10-01

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Introducción: Un niño con cáncer puede presentar durante su enfermedad una emergencia, ya sea como manifestación inicial, en la fase de diagnóstico, durante la evolución o en el periodo terminal. Objetivo: Presentar nuestra experiencia en el manejo del síndrome de Vena Cava Superior en niños con 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

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

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Modeling Flow Past a Tilted Vena Cava Filter  

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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.

Singer, M A; Wang, S L

2009-06-29

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

Science.gov (United States)

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

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

2012-01-01

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Resection of the inferior vena cava for hepatic malignancy.  

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Involvement of the inferior vena cava (IVC) by hepatic tumors, although uncommon, is considered to be unresectable by standard surgical techniques. Recent advances in hepatic surgery have made combined hepatic and vena caval resection possible. The purpose of this study is to describe the surgical techniques and early results of combined resection of the liver and IVC. From 1997 to 2000, 11 patients underwent resection of the IVC along with four to seven liver segments. Resections were carried out for hepatocellular carcinoma (four); colorectal metastases (four); and hepatoblastoma, gastrointestinal stromal tumor metastases, and squamous cell carcinoma in one patient each. Ex vivo procedures were performed twice, and total vascular isolation was used in the nine other cases. The IVC was reconstructed with ringed Gore-Tex tube graft (five), primarily (five), or with Gore-Tex patches (one). There were two early deaths: one from liver failure at 3 weeks and one from sepsis secondary to a perforated segment of small bowel 4 months postresection. One patient with a gastrointestinal stromal tumor died at 32 months of recurrent tumor and one patient with hepatocellular carcinoma is alive with recurrent tumor at 16 months. The remaining patients are alive and disease free with follow-up ranging from 3 to 40 months without evidence of IVC occlusion. Combined resection of the liver and IVC is a formidable undertaking with substantial surgical risk. However, this aggressive surgical approach offers a chance for cure in patients with tumors involving the IVC that would otherwise have a dismal prognosis. PMID:11730225

Hemming, A W; Langham, M R; Reed, A I; van der Werf, W J; Howard, R J

2001-11-01

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Malignant epithelioid angiomyolipoma invading the inferior vena cava: Using a temporary vena cava filter to prevent tumour emboli during nephrectomy  

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Angiomyolipoma (AML) is generally considered to be benign and malignant angiomyolipoma is rare. This paper presents an extremely rare case of epithelioid AML with tumour thrombus invading inferior vena cava (IVC). We present the case of a 36-year-old woman with epithelioid AML with tumour thrombus invading inferior vena cava who underwent radical nephrectomy and IVC thrombectomy. As an adjunctive procedure, a temporary IVC filter was placed in suprarenal position before operation. One week after surgery, the temporary IVC filter was retrieved by femoral approach. Three months postoperatively, a computed tomography scan and abdominal ultrasonogaphy showed no evidence of thrombus in IVC or renal vein and no sign of tumour recurrence. Epithelioid AML is extremely rare and can be malignant, with invasion of the IVC or renal vein. Implanting temporary filter can prevent fatal pulmonary complication and avoid potential the side effects of permanent filter.

Li, Xiang; Liu, Runming; He, Dalin

2014-01-01

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

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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.

Alberto Miranda Bravo

2010-09-01

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

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish 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.

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

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Experimental study of domestic inferior vena cava filter comparative to Antheor temporary vena cava filter in vitro  

International Nuclear Information System (INIS)

Objective: To evaluate clot capturing efficacy and stability of a new domestic designed inferior vena cava filter (DDIVCF) by comparing with Anthem temporary vena cava filter in vitro. Methods: (1)The DDIVCF and Antheor filter were tested in a flow model simulated the inferior vena cava (IVC) with 20 mm and 25 mm in diameter. The swine clots of four sizes were used: 3 mm x 20 mm, 3 mm x 30 mm, 6 mm x 20 mm, 6 mm x 30 mm. The clot capturing capacity was observed in horizontal position. (2) The stability was observed by measuring the comparative moving distance of 6 mm x 30 mm clots after clot trapping. Results: (1) DDIVCF capture rates were 34%, 56%, 82%, 94% and 26%, 38%, 56%, 86% for the 20 mm and 25 mm IVC models of four different sizes clots respectively, comparing with 54%, 64%, 86%, 96% and 38%, 44%, 68%, 90% respectively of Anthem temporary vena cava filter. The capture rates of DDIVCF and Antheor filter showed no significant differences of 3 mm x 30 mm, 6mm x 20 mm and 6 mm x 30 mm clots in 20 mm and 25 mm IVC models (P>0.05). (2) There was a few caudal migration with no significant difference (P>0.05). The filter migration distances were (0.6±0.3) cm and (1.0±0.1) cm respectively in the 20 mm and 25 mm IVC models with most clots of 6 mm x 30 mm were captured, comparing with (0.4±0.1) cm and (0.8 ±0.3) cm respectively for Antheor filter. Conclusions: DDIVCF is a stable and effective filter in an in-vitro model experiment but application in vivo would rather be further evaluated through more animal experiments. (authors)

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

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish El síndrome de vena cava superior es una complicación grave de una amplia variedad de procesos (el más frecuente es el cáncer de pulmón) que obstruyen el flujo de la vena cava superior y provocan la aparición de manifestaciones clínicas características, por el aumento de presión en el territorio 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.

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

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Morphofunctional characterization of decellularized vena cava as tissue engineering scaffolds.  

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Clinical experience for peripheral arterial disease treatment shows poor results when synthetic grafts are used to approach infrapopliteal arterial segments. However, tissue engineering may be an option to yield surrogate biocompatible neovessels. Thus, biological decellularized scaffolds could provide natural tissue architecture to use in tissue engineering, when the absence of ideal autologous veins reduces surgical options. The goal of this study was to evaluate different chemical induced decellularization protocols of the inferior vena cava of rabbits. They were decellularized with Triton X100 (TX100), sodium dodecyl sulfate (SDS) or sodium deoxycholate (DS). Afterwards, we assessed the remaining extracellular matrix (ECM) integrity, residual toxicity and the biomechanical resistance of the scaffolds. Our results showed that TX100 was not effective to remove the cells, while protocols using SDS 1% for 2h and DS 2% for 1h, efficiently removed the cells and were better characterized. These scaffolds preserved the original organization of ECM. In addition, the residual toxicity assessment did not reveal statistically significant changes while decellularized scaffolds retained the equivalent biomechanical properties when compared with the control. Our results concluded that protocols using SDS and DS were effective at obtaining decellularized scaffolds, which may be useful for blood vessel tissue engineering. PMID:24929113

Bertanha, Matheus; Moroz, Andrei; Jaldin, Rodrigo G; Silva, Regina A M; Rinaldi, Jaqueline C; Golim, Márjorie A; Felisbino, Sérgio L; Domingues, Maria A C; Sobreira, Marcone L; Reis, Patricia P; Deffune, Elenice

2014-08-01

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

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

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

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Ressonância magnética cardiovascular em veia cava inferior interrompida não prevista Cardiovascular magnetic resonance in unsuspected interrupted inferior vena cava Cardiovascular magnetic resonance in unsuspected interrupted inferior vena cava  

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Full Text Available A Veia Cava Inferior (VCI interrompida é uma anomalia rara. As anomalias da VCI são clinicamente importantes para os cardiologistas e radiologistas que pretendem intervir na cavidade cardíaca direita. Descrevemos três casos de interrupção da VCI diagnosticados por meio de estudo imaginológico de ressonância magnética cardíaca.La Vena Cava Inferior (VCI, interrumpida es una anomalía rara. Las anomalías de la VCI son clínicamente importantes para los cardiólogos y radiólogos que pretenden intervenir en la cavidad cardíaca derecha. Aquí describimos tres casos de interrupción de la VCI diagnosticados por medio de un estudio imaginológico de resonancia magnética cardíaca.Interrupted inferior vena cava (IVC is a rare anomaly. Anomalies of IVC are clinically important for cardiologists and radiologists who plan to intervene in the right heart. We describe three cases of IVC interruption diagnosed by cardiac magnetic resonance imaging study.

Andre Mauricio Fernandes

2012-02-01

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Ressonância magnética cardiovascular em veia cava inferior interrompida não prevista / Cardiovascular magnetic resonance in unsuspected interrupted inferior vena cava / Cardiovascular magnetic resonance in unsuspected interrupted inferior vena cava  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A Veia Cava Inferior (VCI) interrompida é uma anomalia rara. As anomalias da VCI são clinicamente importantes para os cardiologistas e radiologistas que pretendem intervir na cavidade cardíaca direita. Descrevemos três casos de interrupção da VCI diagnosticados por meio de estudo imaginológico de re [...] ssonância magnética cardíaca. Abstract in spanish La Vena Cava Inferior (VCI), interrumpida es una anomalía rara. Las anomalías de la VCI son clínicamente importantes para los cardiólogos y radiólogos que pretenden intervenir en la cavidad cardíaca derecha. Aquí describimos tres casos de interrupción de la VCI diagnosticados por medio de un estudio [...] imaginológico de resonancia magnética cardíaca. Abstract in english Interrupted inferior vena cava (IVC) is a rare anomaly. Anomalies of IVC are clinically important for cardiologists and radiologists who plan to intervene in the right heart. We describe three cases of IVC interruption diagnosed by cardiac magnetic resonance imaging study. [...

Andre Mauricio, Fernandes; Vikas, Rathi; June, Yamrozik; Ronald, Willians; Robert W., Biederman.

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The initial experience of transjugular retrieval of Geunther Tulip inferior vena cava filters  

International Nuclear Information System (INIS)

Objective: To explore the indications and technical procedures of transjugular retrieval of Geunther Tulip inferior vena cava filters. Methods: Seventy-four patients (40 males and 34 females with a mean age of 45.8 years) with acute lower extremity deep venous thrombosis encountered in our hospital from September 2007 to Mar 2009 were involved in this study. The onset of the disease was from one day to 14 days. Clinical symptoms included swelling, pain, cyanosis or pallescence of the affected limb with higher or normal skin temperature. Thirty-one patients who complicated with pulmonary embolism suffered from dyspnoea, chest pain, hemoptysis, etc. Implantation of Geunther Tulip retrievable inferior vena cava filters through femoral or right internal jugular vein was carried out, which was followed by intravenous transcatheter thrombolysis. Vascular ultrasound and angiography showed no fresh or free thrombus in 12-80 days after initial treatment, then the Geunther Tulip filter was taken out from right internal jugular vein, and inferior vena cavography was performed again. All patients accepted anticoagulation and antibiotic treatment for 3-5 days after operation. A follow-up lasting for 4-12 months was made. Results: Successful implantation of Geunther Tulip retrievable inferior vena cava filter with only one session was obtained in all 74 patients. During implantation procedure one filter became tilted 25 degrees. Successful removal of Geunther Tulip retrievable inferior vena cava filter was achieved in 40 patients in 41.3 days (12-80 days) after the filter was delivered, and the procedure cost only 5.8 minutes (1-115 minutes) with a successful rate of 97.6% (40/41). Failure of retrieval of IVC filter due to compact adhesion of the filter to IVC wall happened in one patient. Inferior vena cavography again confirmed that there was no any sign of vascular perforation or rupture. Retrieval of IVC filter was not performed in other 33 patients and no clinical manifestations of pulmonary embolism or inferior vena cava occlusion emerged during follow-up period. Conclusion: For the treatment of acute lower extremity deep venous thrombosis, interventional transjugular retrieval of Geunther Tulip IVC Filters has some advantages, including retrievable time, i.e. a long time window for thrombolysis therapy, high successful rate of retrieval and satisfactory clinical efficacy. (authors)

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Portal and mesenteric vein and inferior vena cava thrombosis associated with antiphospholipid syndrome.  

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We report a 48-year-old man with thrombosis of the portal and superior mesenteric vein and inferior vena cava associated with primary antiphospholipid syndrome (APS). Primary APS was diagnosed by a positive reaction with anticardiolipin antibody (aCL) and the absence of any evidence suggesting the presence of other disease states known to be associated with aCL. A coeliac angiography showed obstruction of the portal and superior mesenteric vein with prominent collaterals and cavernous transformation. Femoral vein angiography showed total obstruction of the external iliac vein and inferior vena cava, and dilation of the pelvic veins, with contrast medium in the lumbar vein. This case is noteworthy as a report of primary APS accompanied by extensive abdominal and pelvic venous thrombosis. PMID:11813853

Higa, M; Kojima, M; Ohnuma, S; Hamanaka, S; Yamamuro, W; Sugiura, H; Sato, M

2001-12-01

74

Roentgenologic diagnosis of pulmonary veins pathologically inflowing into vena cava inferior  

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

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Multidetector row computed tomography and ultrasound characteristics of caudal vena cava duplication in dogs.  

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Caudal vena cava duplication has been rarely reported in small animals. The purpose of this retrospective study was to describe characteristics of duplicated caudal vena cava in a large group of dogs. Computed tomography (CT) and ultrasound databases from two hospitals were searched for canine reports having the diagnosis "double caudal vena cava." One observer reviewed CT images for 71 dogs and two observers reviewed ultrasound images for 21 dogs. In all CT cases, the duplication comprised two vessels that were bilaterally symmetrical and approximately the same calibre (similar to Type I complete duplication in humans). In all ultrasound cases, the duplicated caudal vena cava appeared as a distinct vessel running on the left side of the abdominal segment of the descending aorta and extending from the left common iliac vein to the left renal vein. The prevalence of caudal vena cava duplication was 0.46% for canine ultrasound studies and 2.08% for canine CT studies performed at these hospitals. Median body weight for affected dogs was significantly lower than that of unaffected dogs (P Breeds with increased risk for duplicated caudal vena cava were Yorkshire Terrier (odds ratio [OR] = 6.41), Poodle (OR = 7.46), West Highland White Terrier (OR = 6.33), and Maltese (OR = 3.87). Presence of a duplicated caudal vena cava was significantly associated with presence of extrahepatic portosystemic shunt(s) (P dogs, caudal vena cava duplication should be differentiated from other vascular anomalies when planning surgeries and for avoiding misdiagnoses. PMID:24832756

Bertolini, Giovanna; Diana, Alessia; Cipone, Mario; Drigo, Michele; Caldin, Marco

2014-01-01

76

Azygos continuation of the caudal vena cava in a dog: radiographic and ultrasonographic diagnosis  

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Azygos continuation of the caudal vena cava was identified via ultrasonography and angiography in a 7 month old female boxer. Azygos continuation of the caudal vena cava is a rare vascular anomaly that results from failure of anastomosis between the caudal cardinal system and the right vitelline vein during embryogenesis. This anomaly has also been described in association with portoazygos shunt

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Sturge-Weber and Klippel-Trenaunay syndromes with absence of inferior vena cava.  

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A baby girl born at 33 weeks' gestation weighing 2250 g presented with Sturge-Weber syndrome, features of the Klippel-Trenaunay syndrome, and absence of the inferior vena cava. We suggest that aplasia of the vena cava may be a feature of Klippel-Trenaunay syndrome when the capillary malformation affects the trunk.

Stewart, G.; Farmer, G.

1990-01-01

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

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Full Text Available SciELO Portugal | Language: Portuguese Abstract in portuguese 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.

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

2014-03-01

79

The Result of Radiation Therapy of superior Vena Cava Syndrome  

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To access the result of radiation therapy for 8 years experiences, 21 patients who were treated with superior vena cava syndrome had been analysed according to dose fractionation and total dose. The results are as follows; 1. In high fractionate dose group, six of eleven patients (54.5%) exhibited relief of symptoms in 1-2 days, and additional three patients of nine (81.7%) within 3-4 days, while standard fractionated dose treatment is not effective to achieve initial relief of symptoms. 2. Graded response by total dose was correlated with total dose rather than dose fractionation. 3. Overall one year survival rate with superior vana cava syndrome was 9.1% and mean survival was 4.2 months

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Budd-Chiari syndrome: puncturing occlusion of inferior vena cava with blunt wire  

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Objective: To explore the safety of puncturing occlusion of inferior vena cava with blunt wire for Budd-Chiari syndrome. Methods: Under the fluoroscopic guidance, occlusions of inferior vena cava were punctured with blunt wire for 63 patients with membranous occlusion of inferior vena cava and 33 with segmental occlusion of the inferior vena cava; including 15 patients with hepatic vein stenosis or occlusion. Results: 96 patients with Budd-Chiari syndrome were operated successfully. All occlusions of inferior vena cava were punctured with patent rate of 100% and no serious complications occurred. Conclusion: Puncturing occlusion of IVC with blunt guide wire is safe, efficient, no serious complication and simple economic method, worthy to be recommended. (authors)

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

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

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

2005-02-01

82

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

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

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

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

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

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

84

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

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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.

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

85

Left sided inferior vena cava duplication and venous thromboembolism: case report and review of literature  

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Full Text Available Abstract The etiology of venous thromboembolism in young patients is frequently associated with hereditary coagulation abnormalities, immunologic diseases, and neoplasia. The advent of radiological advances, namely Computed Tomography (CT scans and venography has identified vena cava malformations as a new etiologic factor worthy of consideration. In this case report, we describe the unusual occurrence of venous thromboembolism in association with a duplicated inferior vena cava. Duplications of the inferior vena cava (IVC are seen with an incidence of 0.2% to 3.0% in the general population. Embryogenesis of the IVC is a complex process involving the intricate formation and regression of numerous anastomoses, potentially leading to various anomalies. We present a 23-year-old Caucasian woman with IVC duplication who developed a deep venous thrombosis and multiple pulmonary emboli. Anomaly of the IVC is a rare example of a congenital condition that predisposes to thromboembolism, presumably by favoring venous stasis. This diagnosis should be considered in patients under the age of 30 with spontaneous occurrence of blood clots.

Butera James N

2008-12-01

86

Percutaneous treatment of superior vena cava syndrome using metallic stents  

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

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

2003-04-01

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Percutaneous treatment of superior vena cava syndrome using metallic stents  

International Nuclear Information System (INIS)

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

88

A Rare Retroperitoneal Mass: Leiomyosarcoma of the Inferior Vena Cava  

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Full Text Available Leiomyosarcoma of the inferior vena cava (IVC is a rare soft tissue tumor, mesenchymal in origin that arises from smooth muscles of tunica media; it accounts for about 0.5% of all soft tissue sarcomas, and it is the commonest vascular leiomyosarcoma. The tumor progression is slow, and it is asymptomatic until advanced stage in which involvement of surrounding structures even when the symptoms present are nonspecific. Presentation of Case: A 60 years old lady presented with upper abdominal pain for 3 months duration. Past surgical history was significant for Hysterectomy 15 years ago. On examination: soft abdomen, palpable non pulsating right hypochondrial mass. Ultrasound of the abdomen showed tumor of the head of pancreas. CT scan showed large retroperitoneal tumor extending from the head of pancreas to IVC. Trans abdominal CT guided FNAC showed retroperitoneal sarcoma while Immunohistochemistry (IHC was proved to be Leiomyosarcoma of the IVC. Discussion: Leiomyosarcoma of inferior vena cava (IVC is a rare soft tissue tumor, mesenchymal in origin that arises from smooth muscles of tunica media; it accounts for about 0.5% of all soft tissue sarcomas, and it is the commonest vascular leiomyosarcoma. The type of surgical management is a matter of debate and includes resection alone, primary repair/cavoplasty, or replacement with a graft. Reconstruction of the IVC is not always required especially in chronic occlusions. Conclusion: Despite all the advanced modalities, surgery remains the most effective method for treatment of Leiomyosarcoma.

Aram Baram

2014-04-01

89

Retrocaval ureter and anomalies of inferior vena cava  

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

90

Primary research on direct multi-slice spiral CT venography in inferior vena cava  

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Objective: To investigate the superiority of direct multi-slice spiral CT venography in inferior vena cava. Methods: Twenty-eight patients performed MSCT venography in inferior vena cava, including 2 cases with both indirect and direct venography, 10 cases with indirect venography, 20 cases with direct venography through unilateral or bilateral lower extremity venous injection. The image quality and enhancement degree of the inferior vena cava were compared in double-blind method. Results: Of 10 cases with indirect venography of inferior vena cava, 1 case was failed due to mild enhancement in inferior vena cava. Image quality was good in 2 cases, poor in 7 cases, no excellent case. Of 20 cases with direct venography of inferior vena cava, the enhancement degree was scored 1, 2 degree in 16, 4 cases respectively and no case was scored 3 degree, the image quality was excellent, good in 16, 4 cases and no case was bad. The success rate was 100%. Conclusion: The image quality of direct MSCT venography in inferior vena cava is better than that of indirect method. (authors)

91

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

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

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

2007-06-15

92

A case of mediastinal seminoma presenting as superior vena cava syndrome.  

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Primary mediastinal seminoma is a rare tumor usually with nonspecific symptoms such as chest pain, dyspnea and hoarseness, but superior vena cava syndrome (SVCS) is an extremely uncommon syndrome. We report a 25-year-old man who presented with superior vena cava syndrome for 1 month and a 1-week history of retrosternal chest pain. Thorax computerized tomography demonstrated a soft tissue mass in the anterior mediastinum with stippled calcifications compressing the superior vena cava and other major vessels. Transthoracic biopsy showed primary seminoma of the anterior mediastinum. Combined chemoradiotherapy was performed and the patient was considered to have a partial response to treatment. PMID:22687803

Xu, Xue; Sun, Chengtao; Zhang, Lei; Liang, Jiangjiu

2012-01-01

93

Ultrasonic detection of renal tubular carcinoma extending into the inferior vena cava.  

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Extension of renal tubular carcinoma into the ipsilateral renal vein and vena cava has been reported to occur in about 5 per cent of the cases. In those patients without demonstrable metastases the 5-year survival rate with aggressive surgical management is 50 per cent. The preoperative diagnosis of tumor extension into the vena cava is important when planning a surgical procedure. A high degree of clinical suspicion, coupled with invasive preoperative roentgenographic evaluation has been the mainstay of diagnosis. We report a case in which gray scale ultrasonography proved to be an important diagnostic test for delineating the extent of a vena cava tumor thrombus. PMID:7420599

Crawford, E D; Rogers, H C; Mettler, F A; Klimach, W

1980-10-01

94

Treatment of Superior Vena Cava (SVC) Syndrome and Inferior Vena Cava (IVC) Thrombosis in a Patient with Colorectal Cancer: Combination of SVC Stenting and IVC Filter Placement to Palliate Symptoms and Pave the Way for Port Implantation  

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Thrombosis of the inferior vena cava is a life-threatening complication in cancer patients leading to pulmonary embolism. These patients can also be affected by superior vena cava syndrome causing dyspnea followed by trunk or extremity swelling. We report the case of a 61-year-old female suffering from an extended colorectal tumor who became affected by both of the mentioned complications. Due to thrombus formation within the right vena jugularis interna, thrombosis of the inferior vena cava, and superior vena cava syndrome, a combined interventional procedure via a left jugular access with stenting of the superior vena cava and filter placement into the inferior vena cava was performed As a consequence, relief of the patient's symptoms, prevention of pulmonary embolism, and paving of the way for further venous chemotherapy were achieved.

95

Combined resection of the pancreas and inferior vena cava for pancreatic metastasis from renal cell carcinoma.  

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Indications for pancreatic resections for metastatic disease have not yet been defined to date, and few guidelines exist for the management of these lesions. However, most authors recommend surgery as the treatment of choice for pancreatic metastasis (PM). Resection of the inferior vena cava (IVC) is rarely done during removal of peripancreatic cancer. This report presents the first case of metachronous PM from renal cell carcinoma (RCC) with IVC involvement successfully treated by en-bloc resection in a 70-year-old asymptomatic woman. The abdominal computed tomography (CT) scan showed a 4.0-cm mass in the tail and a 5.0-cm mass in the head of the pancreas with a suspected involvement of vena cava. An en-bloc total pancreatectomy was performed with excision of the involved portion of the cava vein. Histology confirmed the presence of two metastases from RCC with neoplastic infiltration of the IVC and without lymph node involvement. All surgical margins were tumor-free. At most recent follow-up 12 months after pancreatectomy, the patient has no evidence of disease. We believe that a multidisciplinary approach and careful evaluation and treatment of these patients is a mandatory component for patient selection. IVC resection should be performed only when a margin-negative resection is expected to be achieved. PMID:17805935

Tuech, J J; Lefebure, B; Bridoux, V; Albouy, B; Lermite, E; Le Pessot, F; Le Blanc-Louvry, I; Michot, F

2008-03-01

96

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

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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.

Elton Correia Alves

2010-12-01

97

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

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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.

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

98

Rapid evaluation by lung-cardiac-inferior vena cava (LCI integrated ultrasound for differentiating heart failure from pulmonary disease as the cause of acute dyspnea in the emergency setting  

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Full Text Available Abstract Background Rapid and accurate diagnosis and management can be lifesaving for patients with acute dyspnea. However, making a differential diagnosis and selecting early treatment for patients with acute dyspnea in the emergency setting is a clinical challenge that requires complex decision-making in order to achieve hemodynamic balance, improve functional capacity, and decrease mortality. In the present study, we examined the screening potential of rapid evaluation by lung-cardiac-inferior vena cava (LCI integrated ultrasound for differentiating acute heart failure syndromes (AHFS from primary pulmonary disease in patients with acute dyspnea in the emergency setting. Methods Between March 2011 and March 2012, 90 consecutive patients (45 women, 78.1?±?9.9?years admitted to the emergency room of our hospital for acute dyspnea were enrolled. Within 30?minutes of admission, all patients underwent conventional physical examination, rapid ultrasound (lung-cardiac-inferior vena cava [LCI] integrated ultrasound examination with a hand-held device, routine laboratory tests, measurement of brain natriuretic peptide, and chest X-ray in the emergency room. Results The final diagnosis was acute dyspnea due to AHFS in 53 patients, acute dyspnea due to pulmonary disease despite a history of heart failure in 18 patients, and acute dyspnea due to pulmonary disease in 19 patients. Lung ultrasound alone showed a sensitivity, specificity, negative predictive value, and positive predictive value of 96.2, 54.0, 90.9, and 75.0%, respectively, for differentiating AHFS from pulmonary disease. On the other hand, LCI integrated ultrasound had a sensitivity, specificity, negative predictive value, and positive predictive value of 94.3, 91.9, 91.9, and 94.3%, respectively. Conclusions Our study demonstrated that rapid evaluation by LCI integrated ultrasound is extremely accurate for differentiating acute dyspnea due to AHFS from that caused by primary pulmonary disease in the emergency setting.

Kajimoto Katsuya

2012-12-01

99

Superior vena cava thrombosis with peripartum dilated cardiomyopathy.  

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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. PMID:24613121

Munir, Rubab; Hussain, Sajjad; Kayani, Azhar Mahmood

2014-03-01

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Indications, Management, and Complications of Temporary Inferior Vena Cava Filters  

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

 
 
 
 
101

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

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

102

Clinical Sequelae of Thrombus in an Inferior Vena Cava Filter  

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

103

Temporary vena cava filter for the thrombolytic treatment of venous thrombosis  

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Objective: To study the value of the temporary vena cava filter in the prevention of ectopic embolism formation in cases with thrombolytic therapy of venous thrombosis. Methods: Of 11 patients, 10 suffered from venous thrombosis of lower limb and 1 from thrombosis of right internal jugular vein with persistent truncus arteriosus were treated by inserting permanent or temporary vena cava filter via median vein. Results: In all 11 case control of symptoms followed this treatment occurred 7 to 15 days, thrombi were completely or partly dissolute, the blood vessels re-canalized, and finally removed the temporary vena cava filter. There were no complication and ectopic emboli related to thrombolytic therapy. Conclusions: The observation indicated that temporary vena cava filter insertion is safe and effective to prevent ectopic embolism in thrombolytic therapy of venous thrombosis

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Coronary Sinus Mapping through a Persistent Left Superior Vena Cava in Wolff-Parkinson-White Syndrome  

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Persistent left superior vena cava is not an uncommon finding in patients undergoing evaluation for preexcitation syndromes. In such patients, this anatomical configuration might be used advantageously for mapping and ablation of a left-sided accessory pathway during electrophysiologic studies. We successfully used this mapping approach in a 16-year-old boy undergoing evaluation for Wolff-Parkinson-White syndrome. The patient was found to have a persistent left superior vena cava confluent wi...

Perin, Emerson; Petersen, Fernando; Rizo-patron, Carlos; Massumi, Ali

1991-01-01

105

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

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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'.

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

106

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

International Nuclear Information System (INIS)

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'.

107

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

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

108

125I brachytherapy seeds implantation for inoperable low-grade leiomyosarcoma of inferior vena cava  

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A 60-year-old female presented with abdominal pain and tenderness of five-day duration. Contrast enhanced CT showed a mass of 9 x 6 x 5.5 cm in size with almost complete obliteration of the inferior vena cava and massive extension to the extravascular space. CT-guided biopsy demonstrated a low-grade leiomyosarcoma. The patient underwent 125Iodine seeds implantation in two sessions, and another balloon cavoplasty. Abdominal pain and tenderness gradually improved and the patient continues to remain as disease free state for three years after the procedures.

109

[Long-term survival following resection of a leiomyosarcoma originating from the inferior vena cava].  

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We describe the case of a 46-year-old woman in which a large intra-abdominal tumor was detected using computed tomography. It was a low-density, homogeneous, 7 cm tumor, adjacent to the inferior vena cava (IVC). The tumor, along with a portion of the anterior wall of the IVC, was surgically resected. The tumor originated from the IVC wall, and histopathological examination revealed a diagnosis of leiomyosarcoma. The patient is alive without recurrence 10 years after surgery. Although this disease is rare and typically has a poor prognosis, complete resection with long-term survival is achievable. PMID:25100353

Yamamoto, Takehito; Yagi, Shintaro; Hashida, Hiroki; Ichikawa, Chihiro; Yamashita, Daisuke; Imai, Yukihiro; Hosotani, Ryo

2014-08-01

110

Vena cava filter insertion and the general surgery armamentarium: a 13-year experience.  

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The prevention of pulmonary emboli has a long surgical history. Through the development of percutaneous technologies, vena cava filters (VCFs) are now commonly inserted by interventional radiologists. This study reviews our experience with VCFs inserted by general surgeons. We retrospectively reviewed data from our VCF performance improvement database, which is a prospective collection of the VCF experience of the Department of General Surgery from February 1996 to May 2009. Demographics, procedural information, and complications were recorded. Eight hundred fifty-five VCFs were inserted in 853 patients. The mean age was 42.0 years (range, 14 to 90 years). One hundred ninety-seven VCFs were placed in the operating room, and 658 were placed in the intensive care unit. Twelve VCFs were intentionally inserted in a suprarenal position, and four were placed in the superior vena cava. Two patients received both superior vena cava and inferior vena cava filters. Complications included deep vein thrombosis at the insertion site (n=16), vena cava thrombosis (n=9), post-VCF pulmonary embolism (n=2), and a ventricle perforation requiring operative repair (n=1). No deaths were attributed to the presence of a VCF. Overall insertion success was 99.8 per cent. In two patients, an inferior VCF could not be placed as a result of inferior vena cava occlusion with no safe "landing zone" for deployment. The placement of VCFs is a vital skill in the general surgery armamentarium. Our experience demonstrates that general surgeons can safely insert VCFs with minimal perioperative complications. PMID:20698376

Sing, Ronald F; Nguyen, Phuong H; Christmas, A Britton; Jacobs, David G; Heniford, B Todd

2010-07-01

111

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

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

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

112

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

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

Leopoldo Mariné M

2008-12-01

113

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

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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.)

114

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

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

115

Successful removal of a Gunther tulip vena cava filter with wall-embedded hook and migration during a retrieval attempt  

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Retrieval of a Gunther tulip vena cava filter implanted in a patient with inferior vena cava and right common iliac vein thrombosis was attempted by the standard method. Because the filter was tilted, the hook became attached to the vena cava wall and could not be snared. During attempts at removal by an alternative method, the filter migrated toward the right atrium. However, it was finally successfully removed. PMID:23986855

Yamagami, Takuji; Yoshimatsu, Rika; Matsumoto, Tomohiro; Nishimura, Tsunehiko

2013-01-01

116

Percutaneous placement of bird's nest inferior vena cava filter  

International Nuclear Information System (INIS)

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

117

Inferior vena cava filters: What radiologists need to know  

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

118

Evaluation of Retrievability of the Gunther Tulip Vena Cava Filter  

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Purpose. To evaluate the feasibility and safety of withdrawal of a Gunther tulip retrievable vena cava filter (GTF). Methods. Between June 2001 and December 2005, at our institution 86 GTFs were implanted for temporary caval filtration in 59 patients (37 women, 22 men; mean age 59.3 years, range 18-87 years). For GTFs retrieved thereafter, we retrospectively reviewed the following parameters: rate of success in retrieval, degree of trapped thrombus in the filter, and complications during retrieval. Results. Worsening of or new development of pulmonary embolism after filter implantation did not occur in any patient. Of the 86 GTFs implanted, retrieval of 80 was attempted. Among those 80 filters, 77 (96%) were successfully retrieved (with the standard method, n = 72; with the modified method, n = 5) without any complication. The period of implantation of the retrieved filters was 13.4 ± 4.2 days. In the 5 filters that were filled to a height of ? 1/4 with trapped thrombus, retrieval was performed after attempts were made to decrease trapped thrombi. In addition, a temporary filter or another GTF was temporarily placed at the cephalad level of the GTF during this removal procedure. Conclusion. GTFs can be retrieved in the majority of cases. Even when encountering situations in which the filter could not be removed using the standard method, withdrawal was possible in a high frequency of cases through various trials using modified methods methods

119

Mesoaortic entrapment of a left inferior vena cava  

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

Gupta Ashish

2010-01-01

120

Superior vena cava thrombosis causing respiratory obstruction successfully resolved by stenting in a small bowel transplant candidate.  

Science.gov (United States)

A 4 year old child was referred for small bowel transplantation. He had superior vena cava obstruction secondary to numerous central venous line placements; alternative routes for long term central venous access were compromised by extensive venous occlusive disease. Patency for the superior vena cava was re-established with stenting, which allowed for radiological placement of another central venous line. Long term survival in infants and young children with intestinal failure is dependent on adequate central venous access for the administration of parenteral nutrition. Line sepsis and physical damage to the catheter often necessitates multiple central venous catheter placements during their early life and these children are at risk of catheter related veno-occlusive disease. Recurrent sepsis and the loss of satisfactory venous access for the administration of parenteral nutrition is life threatening and is an indication for intestinal transplantation in up to 41% of patients reported by the small bowel registry. PMID:10906028

Peters, M; Beath, S V; Puntis, J W; John, P

2000-08-01

 
 
 
 
121

Role of irradiation in the management of superior vena cava syndrome.  

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The records of 125 patients treated for superior vena cava syndrome secondary to malignant disease were reviewed retrospectively. The mean age of patients was 55 years. Bronchogenic carcinoma was the cause of the syndrome in 79% of cases, malignant lymphoma 18%, and other tumors 6%. Approximately 80% of the patients obtained good to excellent symptomatic relief. High initial dose radiation therapy (300-400 cGy daily for three fractions) yielded good symptomatic relief in less than 2 weeks in 70% of patients; conventional dose radiation therapy (200 cGy daily, five weekly fractions) yielded the same response in 56% of patients (p = 0.09). Lymphoma patients displayed a 1 year survival of 41%, small cell carcinoma 24%, and other types of bronchogenic carcinoma 17%. Combination of radiation and chemotherapy did not improve response rate, degree of symptomatic relief or long-term survival. Patients exhibiting symptomatic relief within 30 days had a significantly better survival rate than those who did not (p = 0.002). Thirteen percent of patients showed a recurrence of superior vena cava syndrome. There was no correlation between tumor regression and symptomatic relief. Side effects of therapy were minimal; dysphagia was the most common complaint (26% of patients). PMID:3558044

Armstrong, B A; Perez, C A; Simpson, J R; Hederman, M A

1987-04-01

122

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

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Full Text Available SciELO Venezuela | Language: Spanish Abstract in spanish 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.

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

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

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

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

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

ANTÔNIO S. ANDRADE-FILHO

1998-09-01

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

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

Dolou Paraskevi

2010-06-01

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Sonographic Measurement of the Inferior Vena Cava as A Marker of Blood Loss  

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Full Text Available Background and Objective: Detecting and monitoring blood loss is always a challenging dilemma in emer-gency settings. Measuring diameter of inferior vena cava in trauma patients may be useful in this regard. This has been classically done with CT; however do-ing it with Ultrasound as a bedside easily available modality is a novel approach. Materials and Methods: Between January 2006 and March 2006, 88 injured patients referred to Namazee Hospital, were investigated. The patients were di-vided in to two groups: a shock group (n=11, 12.5% and a control group (n=77, 87.5% who were trauma patients with normal blood pressure. The maximum antero-posterior diameter of inferior vena cava was measured ultrasonographically both in inspiration and expiration by M-Mode in subxyphoid area. Sta-tistical analysis included tests for normality and cor-relation analysis. Results: The average diameter of inferior vena cava in the control group was 11.2 mm and 9.5mm in expira-tion and inspiration respectively. In contrast the above values were 5.6 and 4.3 mm in shock group. Correlation analysis revealed a negative correlation between the diameter of inferior vena cava and the presence of shock (r=0.61. Conclusion: The diameter of inferior vena cava was found to correlate with shock in trauma patients. This measurement can be added to FAST sonography of trauma patient with minimum additional time.

A. Sefidbakht

2007-05-01

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

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

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Computed tomographic characteristics of collateral venous pathways in dogs with caudal vena cava obstruction.  

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Collateral venous pathways develop in dogs with obstruction or increased blood flow resistance at any level of the caudal vena cava in order to maintain venous drainage to the right atrium. The purpose of this retrospective study was to describe the sites, causes of obstruction, and configurations of venous collateral pathways for a group of dogs with caudal vena cava obstruction. Computed tomography databases from two veterinary hospitals were searched for dogs with a diagnosis of caudal vena cava obstruction and multidetector row computed tomographic angiographic (CTA) scans that included the entire caudal vena cava. Images for each included dog were retrieved and collateral venous pathways were characterized using image postprocessing and a classification system previously reported for humans. A total of nine dogs met inclusion criteria and four major collateral venous pathways were identified: deep (n = 2), portal (n = 2), intermediate (n = 7), and superficial (n = 5). More than one collateral venous pathway was present in 5 dogs. An alternative pathway consisting of renal subcapsular collateral veins, arising mainly from the caudal pole of both kidneys, was found in three dogs. In conclusion, findings indicated that collateral venous pathway patterns similar to those described in humans are also present in dogs with caudal vena cava obstruction. These collateral pathways need to be distinguished from other vascular anomalies in dogs. Postprocessing of multidetector-row CTA images allowed delineation of the course of these complicated venous pathways and may be a helpful adjunct for treatment planning in future cases. PMID:24762097

Specchi, Swan; d'Anjou, Marc-André; Carmel, Eric Norman; Bertolini, Giovanna

2014-09-01

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

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

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

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

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

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

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The decision to implant vena cava filters, either temporary or permanent, is difficult in young patients. We present the case of a young man with pulmonary embolism in whom temporary and permanent inferior vena cava filters were implanted. The decision process is discussed in relation to the current literature. PMID:14753313

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

2003-01-01

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

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

Fernando Viñals L.

2002-01-01

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

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

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

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Successful implantation of a biventricular pacing and defibrillator device via a persistent left superior vena cava  

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Full Text Available Introduction. Persistent left superior vena cava is the most common thoracic venous abnormality which is usually asymptomatic, found incidentally during pacemaker implantation. The main problem is related to reaching the appropriate pacing site and ensuring stable lead placement. Case report. We reported a successful implantation of a biventricular pacing and defibrillator device (CRT-D via a persistent left superior vena cava in a 55-year-old man with dilated cardiomyopathy and severe heart failure. A persistent left superior vena cava was detected during CRT-D implantation. We managed to position electrodes in the right ventricular outflow tract, a posterior branch of the coronary sinus and in the right atrium. Conclusion. Congenital anomalies of thoracic veins may complicate lead placement on the appropriate and stable position. The presented case demonstrates a successful biventricular pacing and defibrillator therapy device implantation in a patient with dilated cardiomyopathy and severe heart failure.

Vukmirovi? Mihailo

2013-01-01

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Congenital anomalies of the inferior vena cava: importance of multiplanar imaging methods: an iconographic essay  

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The inferior vena cava is the result of a complex embryologic process which takes place between 6 and 8 weeks of intra-uterine life. Several variations can occur during this process, and a defective embryogenesis of this vessel may lead to the development of anatomic variants. Although many of these variants are asymptomatic, the radiologist should be aware of them and of the potential medico-legal issues involved, especially in cases in which abdominal surgery or hemodynamic procedures are contemplated. In this paper, the major congenital anomalies involving the inferior vena cava are reviewed under the form of a pictorial essay, highlighting the role of the multiplanar imaging methods (volumetric computed tomography and magnetic resonance imaging) in their diagnosis. Keywords: Congenital variations; Inferior vena cava; Renal veins; Computed tomography; Magnetic resonance imaging. author)

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

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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

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

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An eight-year-old, male castrated basset hound presenting with a three-month history of lethargy was examined. Diagnostic tests including radiography and ultrasonography showed a right-sided renal mass. A 99mTc diethylenetriamine penta-acetic acid scan demonstrated that this kidney was non-functional. At surgery, invasion of the caudal vena cava was found, and the renal segment of the vena cava and the right kidney were resected. The left renal vein was anastomosed to the more proximal vena cava using a polytetrafluoroethylene graft, and the dog recovered well. Two days postsurgery, the dog suffered an acute episode of aspiration pneumonia and was euthanased. The renal mass was diagnosed as lymphoma on histopathology. PMID:12653330

Lascelles, B D X; Monnet, E; Liptak, J M; Johnson, J; Dernell, W S

2003-03-01

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

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

Park, Ji Eun; Moon, Sung Kyoung; Lim, Joo Won; Park, Seong Jin [Kyung Hee Univ. Hospital/College of Medicine/Kyung Hee Univ. Seoul (Korea, Republic of)

2012-09-15

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

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

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Retro-aortic left renal vein with left suprarenal vein draining into inferior vena cava  

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Full Text Available During a routine undergraduate dissection of abdomen of a 50-year-old male cadaver, a variant pattern of left renal and suprarenal veins was encountered. The left renal vein coursed behind the aorta to drain into inferior vena cava at the level of lower pole of left kidney. The left suprarenal vein coursed in front of aorta to drain directly into inferior vena cava instead of left renal vein. A knowledge of such patterns is important for renal surgeons operating for renal transplantation, renal trauma and nephrectomy. Further the ontogenic basis and clinical implications of the anomalies are discussed in the detail.

Singla RK

2010-08-01

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

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Scimitar syndrome is a rare congenital cardiopulmonary malformation characterized by hypoplasia of the right lung and drainage of the right pulmonary veins into the vena cava inferior. It may also be associated with cardiac dextroversion and anomalies of the tracheobronchial system, cardiovascular system, and diaphragm. Some cases are asymptomatic with others diagnosed in early-childhood period with pulmonary hypoplasia and other associated malformations. We present here a patient whose venous return of the middle and lower lobes of the right lung is into the superior vena cava, which is a very unusual finding for this disorder. PMID:20157730

Demir, Esen; A?kin, Memnune; Midyat, Levent; Gülen, Figen; Ulger, Zülal; Tanaç, Remziye; Bayraktaro?lu, Selen

2010-10-01

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

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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.)

143

MRI diagnosis of congenital anomalies of the vena cavae and pulmonary veins  

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Imaging of congenital venous anomalies in children or adults includes chest radiograph, angiography, echocardiography, CT scan and MRI. ECG gated MRI of the chest is a noninvasive examination for diagnosis of pulmonary or systemic congenital venous anomalies and it should replace angiography in many cases. The authors describe MR aspects of left superior vena cava, azygos continuation of inferior vena cava and anomalous pulmonary venous returns (total and partial types). MRI provides anatomical data, and gradient echo sequences with flow compensation assess the vascular nature of the anomalous structures. (authors). 44 refs., 6 figs

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Persistent left superior vena cava draining to the left atrium: A case report and review of the literature  

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Summary Background: Persistent left superior vena cava is a rare but important congenital vascular anomaly. However, PLSVC with absent RSVC (isolated PLSVC) is a very rare venous malformation We report on a rare case of persistent left superior vena cava (PLSVC) with absent right superior vena cava (RSVC). Case Report: This venous malformation was identified incidentally in a 69-year-old woman during chest multi-detector computed tomography (MDCT). On chest MDCT, the SVC was noted on the left side. A bridging vein drained the right jugular and right subclavian veins and joined the left brachiocephalic vein in order to form the PLSVC, which descended on the left side of the mediastinum and drained into the left atrium (LA). The patient had no additional cardiac anomaly. Conclusions: Isolated PLSVC is usually asymptomatic but it can pose difficulties for establishing central venous access, pacemaker implantation and cardiothoracic surgery. This condition is also associated with an increased incidence of congenital heart disease, arrhythmias and conduction disturbances. A wide spectrum of clinicians should be aware of this anomaly, its variations and possible complications. PMID:23269940

Duymus, Mahmut; Yesilkaya, Yakup; Orman, Gunes; Bozkurt, Alper; Yilmaz, Omer

2012-01-01

145

[Vena cava filter for prevention of pulmonary embolism].  

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Vena caval filters in the prevention of pulmonary embolism All currently available caval filters can be implanted percutaneously in local anaesthesia. In the USA the FDA has approved the stainless steel Greenfield filter, the Titanium Greenfield filter, the Bird's Nest filter, the LGM or VenaTech filter and the Simon Nitinol filter. Some other caval filters are commercially available in Europe, but there exist only few clinical trials about them. The Greenfield filter is implanted since the early seventies and the greatest amount of data has been published about it. Standard indications for filter placement are recurrent pulmonary embolism despite adequate anticoagulation, in patients after pulmonary embolectomy, when there is a contraindication to anticoagulation (e.g. fresh surgical wound, active gastrointestinal bleeding, recent haemorrhagic stroke, major trauma,...) and when serious complications occur after thrombolysis or anticoagulation. In patients who suffer from severe cardiopulmonary disease both a caval filter and anticoagulation may be required. Follow-up investigations include plain abdominal radiography and duplex ultrasound, in special cases computed tomography, cavography, magnetic resonance imaging in newer filter types, and intravascular ultrasound. Complications include recurrent pulmonary embolism, caval obstruction, migration, fracture and perforation of filter struts. As clinically relevant complications are rare, in diligently selected cases the patient will benefit from implantation of a caval filter. PMID:10611842

Winkler, W B; Slany, J

1999-11-01

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Tumor renal con trombo en la vena cava inferior: Manejo quirúrgico y pronóstico / Renal tumor with inferior vena cava thrombus: Surgical approach and prognosis  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivos: el objetivo del presente estudio fue evaluar las estrategias usadas para el manejo quirúrgico del cáncer de renal con extensión de trombo a la vena cava inferior y evaluar el pronóstico del paciente. Métodos: Quince pacientes con cáncer renal y trombo en la vena cava inferior fueron somet [...] idos a una nefrectomía radical y trombectomía y fueron evaluados de forma retrospectiva. Los pacientes fueron seguidos desde 0 a 36 meses (media de 9,5 meses). La tomografía computada con reconstrucción tridimensional fue usada para definir el nivel del trombo. Resultados: La edad media fue de 54 años, con un rango de entre 16 y 79 años. El trombo fue clasificado como de nivel I (13,5%), nivel II (40%), nivel III (26,5%) y nivel IV (20%). La cirugía fue llevada a cabo mediante by pass cardiopulmonar en seis casos, tres de los cuales sin esternotomía. Hubo una muerte intraoperatoria (13%) en un paciente que presentaba enfermedad metastásica con un trombo que alcanzaba la aurícula derecha. Los pacientes con ganglios positivos o enfermedad metastásica como presentación inicial tenían peor supervivencia global en la curva de Kaplan-Meier. Ambos, estadiaje tumoral (p = 0,380), y extensión del trombo (p = 0,174) no tuvieron relación con la supervivencia. Conclusiones: A pesar de su morbilidad y mortalidad, la nefrectomía radical y la trombectomía deberían ser llevadas a cabo en casos de carcinoma renal con trombo tumoral, porque puede ofrecer la posibilidad de control local de la enfermedad. Los pacientes con ganglios linfáticos y enfermedad metastásica tienen peor pronóstico. Abstract in english Objectives: The aim of this study was to evaluate strategies used for surgical management of renal cell carcinoma with tumoral thrombus extension in the inferior vena cava (IVC) and evaluate patient's prognosis. Metods: Fifteen patients with renal tumor and IVC thrombus, underwent radical nephrectom [...] y and thrombectomy, and were retrospectively evaluated. Patients were followed for 0 to 36 months (mean of 9.5 months). Computed tomography (CT) scan with three-dimensional reconstruction was used to define IVC thrombus level. Results: The mean age was 54 years, range from 16 to 79. The thrombus was classified as level I - 13.5%, level II - 40%, level III - 26.5% and level IV - 20%. Surgery was performed with cardiopulmonary bypass (CPB) in six (40%) cases, three (50%) without sternotomy. There was one (13%) death during the intraoperative period; this patient presented extensive metastatic tumor, with the thrombus reaching the right atrium. Patients with lymph node or metastatic disease at initial presentation had poorer overall survival in Kaplan-Meier curve. Both, tumor stage (p = 0.380), and thrombus extension (p = 0.174) were not related to survival. Conclusions: Despite its morbidity and mortality, radical nephrectomy with thrombectomy should be performed in case of renal cell carcinoma with tumoral thrombus, because it can offers the possibility of local control. Patients with lymph node and distant metastatic disease have poor prognoses.

Fernandes, Denardi; Leonardo, Oliveira Reis; Ricardo Reges M., Oliveira; Fábio, Ferreira; Ubirajara, Ferreira.

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

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

João Carlos Coelho Filiio

1989-12-01

148

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

Scientific Electronic Library Online (English)

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

João Carlos, Coelho Filiio; Jorge, Pereira; Álvaro, Rabello Júnior.

149

Recurrent intravenous leiomyosarcoma of the uterus in the retrohepatic vena cava.  

Science.gov (United States)

Although intravenous extension of uterine leiomyosarcomas has been described, extension into the inferior vena cava (IVC) and right atrium, so-called 'intravenous leiomyosarcomatosis (IVLS)', is rare. To our knowledge only a few cases have been described in the literature. We describe a case of recurrent uterine leiomyosarcoma to the retrohepatic IVC. The patient was initially treated with total abdominal hysterectomy. Follow-up computed tomography a year later showed an extensive intravascular and intracardiac soft tissue mass treated with tumor extraction using cardiac bypass. Five years later she presented to our institution with a new retrohepatic caval mass treated with surgical resection and caval grafting. IVLS is a rare disease that is best treated with surgical resection even in the recurrent setting. The role of adjuvant therapy remains unclear. PMID:25204766

Mckenna, Logan R; Jones, Edward L; Jones, Teresa S; Nydam, Trevor; Gajdos, Csaba

2014-01-01

150

Total right pulmonary venous return to the inferior vena cava: a rare variant of Scimitar syndrome.  

Science.gov (United States)

Scimitar syndrome is a rare congenital disorder characterized by a partial, or rarely total, unilateral anomalous pulmonary venous return to the inferior vena cava. This anomaly has a distinctive bimodal presentation with the infantile form having a higher incidence, severity and mortality than the adult form, which is usually asymptomatic on diagnosis. We present the case of a 36-year-old-male transferred to our institution due to incidental anomalous vascular findings on contrast enhanced chest tomography while being evaluated for dyspnea on exertion. Patient underwent right and left heart catheterization with evidence of left-to-right shunt secondary to complete anomalous right pulmonary venous return. Patient was referred to a cardiovascular surgeon with expertise in congenital heart disease for definitive surgical correction. PMID:22737830

Marmorato-Rivera, Rossella; Banchs-Pieretti, Hector; Parrilla-Quinones, Francisco; Altieri-Nieto, Pablo; Carrion, Enrique; Quintana-Rodríguez, Cid; Maldonado-Vargas, Jose

2011-01-01

151

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

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

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

2009-12-03

152

Long-term follow-up of protection efficacy of vena cava filters in the prevention of pulmonary embolism  

International Nuclear Information System (INIS)

Objective: To analyze the protection efficacy of the vena cava filter from pulmonary thromboembolism and report the problems and complications after filter placement. Methods: Fifty-five Vena Tech-LGM filters (VTF) and 6 Titanium-Greenfield filters (TGF) were placed in 61 patients. Follow-up was obtained by means of duplex sonography of the inferior vena cava and abdominal radiography in 38 patients, and by means of computed tomography in 11 patients. Results: One case of pulmonary embolism was seen following filter placement. Filter thrombosis occurred in 9 cases. There had been 1 case of incomplete filter opening and one case of filter tilting. Filter migration was noted in 1 case. Conclusion: This experience suggests that vena cava filter is safe and effective for the prevention of pulmonary embolism. A vena cava filter should only be inserted in a patient when there is strict proof of the indication

153

POTS due to excessive venous pooling in an enlarged inferior vena cava.  

Science.gov (United States)

Postural tachycardia syndrome (POTS) is a form of orthostatic intolerance characterized by a marked increase in heart rate within the first 10 min of head-up tilt (HUT). We present a patient whose enlarged inferior vena cava that appears to be a contributing mechanism to her POTS and presyncopal symptoms. PMID:22314777

Gaw, Christopher E; Shields, Robert W; Mayuga, Kenneth A; Gornik, Heather L; Fouad-Tarazi, Fetnat

2012-08-01

154

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

International Nuclear Information System (INIS)

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

155

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

LENUS (Irish Health Repository)

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.

Klop, B

2011-01-01

156

Deep venous thrombosis and agenesis of the intrahepatic segment of inferior vena cava  

International Nuclear Information System (INIS)

We present a case of agenesis of the intrahepatic segment of inferior vena cava (IVC) with drainage through the azygos and hemiazygos systems. The presenting sign was deep venous thrombosis (DVT) in both lower extremities. The different imaging studies led to the diagnosis of both the congenital and acquired venous abnormalities, which are discussed. (Author) 14 refs

157

[The angioplasty of a postsurgical obstruction of the superior vena cava].  

Science.gov (United States)

A case of superior vena cava obstruction secondary to surgical repair of partial anomalous pulmonary venous drainage was successfully treated with balloon angioplasty in a double procedure. Dilatation was effective with a significant clinical benefit and patient remains symptoms free at mid-term. PMID:8184172

Alcibar, J; Oñate, A; Cabrera, A; Pastor, E; Galdeano, J; Inguanzo, R; Peña, N; Arriola, J

1994-03-01

158

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

International Nuclear Information System (INIS)

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

159

Endovascular treatment of iatrogenic injury to the retrohepatic inferior vena cava.  

Science.gov (United States)

Iatrogenic injury of the inferior vena cava (IVC) is a rare event with potentially devastating sequelae. Only a handful of case reports are available in the literature describing successful endovascular techniques to manage this complication. We present the case of a patient with injury to the retrohepatic IVC resulting in life-threatening hemorrhage which was controlled with endovascular stent grafts. PMID:24858590

Briggs, Charles S; Morcos, Omar C; Moriera, Carla C; Gupta, NavYash

2014-10-01

160

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

DEFF Research Database (Denmark)

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

Juhl-Olsen, Peter; Vistisen, Simon T

2013-01-01

 
 
 
 
161

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

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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.

Lipp Rainer W

2010-07-01

162

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

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

Gustavo J. Ventura Couto

2008-03-01

163

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)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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.

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

164

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)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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.

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.

165

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)

166

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

International Nuclear Information System (INIS)

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

167

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

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

G. Lacuey

2009-04-01

168

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)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish 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.

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

2009-04-01

169

Dialysis Catheter-Related Superior Vena Cava Syndrome with Patent Vena Cava: Long Term Efficacy of Unilateral Viatorr Stent-Graft Avoiding Catheter Manipulation  

Science.gov (United States)

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. PMID:24843241

Galli, Franco; Moramarco, Lorenzo Paolo; Corti, Riccardo; Leati, Giovanni; Fiorina, Ilaria; Maestri, Marcello

2014-01-01

170

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

Energy Technology Data Exchange (ETDEWEB)

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)

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

171

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

International Nuclear Information System (INIS)

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)

172

Gianturco expandable wire stents for treatment of superior vena cava syndrome secondary to lung carcinoma  

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Two patients with superior vena cava syndrome (SVCS) secondary to lung carcinoma which recurred after maximum-dose radiation therapy were treated with placement of modified Gianturco expandable wire stents constructed in the authors' research laboratory. Symptoms of SVCS disappeared in 24 hours after stent placement, and the patients remained asymptomatic to their last follow-up, 2 1/2 months after the procedure (to the submission of this abstract). Both stents were widely patent at that time on superior vena cavograms and draining well the head, neck, and upper extremity circulation to the right atrium

173

Budd-Chiari syndrome: the study of pathological features of inferior vena cava obstruction by biopsy  

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Objective: To investigate the pathogenesis of inferior vena cava obstruction for Budd-Chiari syndrome (BCS) patients. Methods: Forceps biopsy was carried out at the obstructed site of inferior vena cava (IVC) in 13 patients with BCS. The specimens were then studied under light microscopy. Results: The technical successful rate of forceps biopsy reached 100%(13/13), with sensitivity of 92.3%(12/13). One of them showed simple mixed thrombus; 11 demonstrated proliferation of fibrous connective tissue, with hyalinization or mucoid degeneration under light microscopy, including thrombi formation in 3 and inflammatory cells infiltration in 8. Conclusion: IVC obstruction in BCS probably may due to gradual fibrous organization of thrombi induced by local inflammatory change. (authors)

174

Agenesis of Ductus Venosus Presenting with Dilated Inferior Vena Cava with Favorable Outcome  

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Full Text Available The ductus venosus regulates the distribution of oxygen and placental nutrients by restricting the centralization of blood flow in fetal circulation. The ductus venosus is a small vein transmitting oxygen-rich blood from the umbilical vein to the fetal heart.. Increasing numbers of case reports are being published about ductus venosus agenesis with cardiac structural abnormalities, other malformations, chromosomal abnormalities, and stillbirth. Heart failure, hydrops and unexplained polyhydramnios could also be associated with ductus venosus agenesis. In the follow-up of fetuses with ductus venosus agenesis, care must be taken to examine for hydrops and heart failure. The agenesis of ductus venosus is often only found in fetuses by coincidentally. Herein we discuss the prenatal diagnosis of isolated agenesis of the ductus venosus presenting with a dilated inferior vena cava and without any disturbance of fetal hemodynamics and any other malformation. In conclusion a dilated inferior vena cava can be a sign of ductus venosus agenesia.

Omer Dai

2014-04-01

175

Internal thoracic vein draining into the extrapericardial part of the superior vena cava: a case report  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese As veias torácicas internas são veias comitantes de cada artéria torácica interna drenando o território suprido por ela e geralmente se unem em frente à terceira cartilagem costal. Esta única veia entra na veia braquicefálica correspondente. Apresentamos uma variação da veia mamária interna direita [...] drenando para a veia cava superior em um cadáver masculino de 45 anos. O provável desenvolvimento e a significância clínica da veia são discutidos. Abstract in english The internal thoracic veins are venae comitantes of each internal thoracic artery draining the territory supplied by it and usually unite opposite the third costal cartilage. This single vein enters the corresponding brachiocephalic vein. We present a variation of right internal mammary vein drainin [...] g into superior vena cava in a 45-year-old male cadaver. Likely development and clinical significance of the vein are discussed.

Venkata Ramana, Vollala; Narendra, Pamidi; Bhagath Kumar, Potu.

176

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

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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.

177

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

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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.

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

178

A case of absent right and persistent left superior vena cava  

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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.

Nagy Endre

2006-01-01

179

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

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

180

Case Presentation of Preureteral Vena Cava and Review of the Literature  

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Full Text Available Retrocaval ureter, terms are anatomically descriptive but misleading in regard to development and results from altered vascular development. This anomaly is relatively uncommon, although it has clinical relevance. The ureter typically deviates medially behind the inferior vena cava, winding about and crossing in front of it from a medial to a lateral direction, to resume a normal course, distally, to the bladder. The renal pelvis and upper ureter typically appear elongated and dilated in a “J” or fishhook shape before passing behind the vena cava. Diagnoses were confirmed with intravenous urography and patient had an open surgical repair of the anomaly. The anomaly predominantly involves the right ureter, as was observed in these reported cases. Treatment is surgical allowing for correction of the anomaly with resolution of symptoms

Nexhmi Hyseni

2013-08-01

 
 
 
 
181

Recurrent deep venous thrombosis in a patient with agenesis of inferior vena cava  

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Full Text Available William Nseir1, Mahmud Mahamid1, Zuhair Abu-Rahmeh2, Arieh Markel3,41Department of Internal Medicine, 2Radiology Department, Holy Family Hospital, Nazareth, Israel; 3Department of Internal Medicine A, Haemek Medical Center, Afula, Israel; 4Technion, Faculty of Medicine, Haifa, IsraelBackground: Agenesis of the inferior vena cava (IVC as a cause of recurrent deep vein thrombosis (DVT is uncommon.Case: A 33-year-old male with no family history of thrombophilia, who had experienced multiple recurrent episodes of DVT over a 15-year period of unknown cause, was admitted into our hospital because of cellulitis in the right leg. Computer tomography with contrast of the abdomen showed an absence of IVC.Conclusion: Congenital absence of the IVC could be a rare risk factor for idiopathic DVT, especially in young individuals.Keywords: deep vein thrombosis, agenesis, inferior vena cava

Nseir W

2011-06-01

182

Internal thoracic vein draining into the extrapericardial part of the superior vena cava: a case report  

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Full Text Available The internal thoracic veins are venae comitantes of each internal thoracic artery draining the territory supplied by it and usually unite opposite the third costal cartilage. This single vein enters the corresponding brachiocephalic vein. We present a variation of right internal mammary vein draining into superior vena cava in a 45-year-old male cadaver. Likely development and clinical significance of the vein are discussed.As veias torácicas internas são veias comitantes de cada artéria torácica interna drenando o território suprido por ela e geralmente se unem em frente à terceira cartilagem costal. Esta única veia entra na veia braquicefálica correspondente. Apresentamos uma variação da veia mamária interna direita drenando para a veia cava superior em um cadáver masculino de 45 anos. O provável desenvolvimento e a significância clínica da veia são discutidos.

Venkata Ramana Vollala

2008-03-01

183

A caval homograft for Budd-Chiari syndrome due to inferior vena cava obstruction  

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Full Text Available Transjugular intrahepatic portosystemic shunt (TIPS is the standard treatment of Budd-Chiari syndrome (BCS non responsive to medical therapy. However, patients with inferior vena cava (IVC obstruction proximal to the atrium do not benefit from TIPS and a surgical approach is mandatory. We report the case of BCS due to intrapericardial IVC obstruction. We describe a novel surgical approach using a fresh caval homograft. An attempt to balloon dilatation of the IVC obstruction was complicated by right atrial disruption with tamponade and ventricular fibrillation. Lately, the patient successfully underwent a reconstruction of the cavo-atrial continuity by the interposition of a fresh caval homograft, a novel surgical approach never described before for BCS. Further follow-up revealed progressive reduction and resolution of ascites, and overall clinical improvement. IVC obstruction near to the atrium can be surgically approached with a new technique consisting in inferior vena cava resection and replacement with a caval homograft.

Andrea Mancuso

2013-01-01

184

Leiomyosarcoma of the inferior vena cava: a clinicopathologic review and report of four cases  

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AIM: This article describes four cases of leiomyosarcoma treated in the University Hospital of Turin and reviews current understanding of the biological behavior of the tumor, together with essential diagnostic procedures and established approaches to treatment. METHODS: Between February 2004 and December 2005, four patients (two men and two women; mean age 57.5 years) with leiomyosarcoma of the interior vena cava (IVC) were treated at the Vascular Surgery Unit. Resection and excision of the ...

Rispoli, Pietro; Varetto, Gianfranco; Bitossi, Giorgio Ovidio

2008-01-01

185

The Value of Pre-Operative Embolisation in Primary Inferior Vena Cava Paraganglioma  

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We report a case of a 13-year-old boy who complained of progressive abdominal distension and symptoms of anaemia. Radiological investigations revealed that the child had a hypervascular tumour of the inferior vena cava (IVC). Unfortunately, the child presented with acute lower gastrointestinal bleed soon after the investigation. He underwent an urgent pre-operative embolisation, aimed to reduce the tumour vascularity. A total resection of the tumour, right nephrectomy, and partial duodenal re...

Zaki, Faizah Mohd; Osman, Syazarina Sharis; Abdul Manaf, Zaleha; Mahadevan, Jeyaledchumy; Yahya, Mazri

2011-01-01

186

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

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

187

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

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

188

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

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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.

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

189

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

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

190

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

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La trombosis de la vena cava inferior supone alrededor del 15 % del total de los casos de trombosis venosa profunda. Se presenta un caso de una puérpera primigesta con parto por cesárea que presentó una trombosis con inicio en la vena ovárica derecha y extensión hasta la cava inferior. Fue tratada con heparina de bajo peso molecular en dosis anticoagulantes, reposo con extremidades elevadas y elastocompresión. Tras la evolución satisfactoria del proceso, con lisis parcial del trombo, s...

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

2011-01-01

191

Gastric varices without portal hypertension: role of left inferior vena cava?  

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A variant vascular anatomy was detected during regular analysis of multidetector computed tomography angiography of the abdomen in a 70 year-old female patient, referred to the department of surgery for laparoscopic right colectomy for colon cancer. The anomalous vessel was located left to the aorta, and was consistent with a persistent left inferior vena cava. It was connected by two retroaortic rootlets to the dorsal surface of the regular right inferior vena cava and had four notable tributaries - an anastomosis with the iliolumbar trunk, ovarian vein, renal vein and the inferior phrenic vein. In the upper abdomen, the left inferior vena cava took a tortuous course, passing at first between the spleen and the diaphragm, then curving below the inferior splenic border and terminating in an irregular network in the posterior region of gastric fundus and cardia, close to the splenic hilum, without supradiaphragmatic continuation. Despite this extraordinary termination, there were no signs of portal hypertension or data on previous occurrence of this condition. PMID:23198370

Stimec, B V; Grønvold, L A B; Ignjatovic, D; Fasel, J H D

2012-01-01

192

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

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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

193

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

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

194

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

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

Wang Quan

2012-06-01

195

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

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

196

Bedside insertion of the inferior vena cava filter in the intensive care unit.  

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Historically, inferior vena cava (IVC) filters have been inserted in the Radiology Department or the Operating Room. When initially designed, vena cava filters required surgical cut down of the internal jugular vein to insert a large (24 French) introducer and it was therefore necessary to perform this procedure in the operating room. Percutaneous methods (e.g., the Seldinger technique) with smaller profile sheath-dilator devices (6 to 12 French) have made IVC filter insertion a much easier procedure. Furthermore, the remaining equipment is simple, portable, and readily available throughout most hospitals (e.g., C-arm, contrast, sterile drapes, gowns, gloves, catheters, etc.). These factors have made it easy to "bring the procedure to the patient." This is particularly advantageous in critically ill ICU patients. Complication rates of "road trips" for critically ill patients from the ICU to other parts of the hospital (i.e., radiology department or operating room) can result in a mishap rate of 5-30. Secondary benefits of bedside insertion of vena cava filters include cost-effectiveness. PMID:12953822

Sing, Ronald F; Heniford, B Todd

2003-08-01

197

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

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

198

Surgical management of clear cell sarcoma of the kidney with tumor thrombus in the inferior vena cava and lung metastasis  

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Full Text Available Clear cell sarcoma of the kidney (CCSK is a rare renal neoplasm of childhood. While CCSK is more common in children, it is extremely rare in adults. In CCSK, a tumor thrombus is sometimes formed in the inferior vena cava. Herein, we describe a rare case of an 18-year-old female with CCSK with vascular tumor thrombus extending to the inferior vena cava that was managed successfully by excision of the renal mass and vena caval thrombus, and pulmonary metastasectomy using cardiopulmonary bypass without cardiac arrest.

Yunus Nazl?

2014-06-01

199

Estimation of Right Atrial Pressure from the Inspiratory Collapse of the Inferior Vena Cava in Pediatric Patients  

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Full Text Available Objective:Paucity of data exists between mean right atrial pressure (RAP and inferior vena cava (IVC size and collapsibility in pediatric patients with congenital heart disease.Methods:In a prospective study, fifty consecutive pediatric patients with different congenital heart diseases who had right side cardiac catheterization were studied, comparing right atrial pressure with simultaneous M-mode echocardiographic measurement of inferior vena cava diameter. Mean age of the patients was 4.96?4.05 years (30 male and 20 female. Patients were categorized into two groups according to their right atrial pressure (RAP as measured by cardiac catheterization: Group 1 (40 patients were those with mean RAP 8 mmHg when IVC diameter in inspiration was >3.6 (sensitivity of 100%, specificity of 47.5%, +LR=1.9 or if IVC diameter was >6mm in expiration (sensitivity of 70%, specificity of 87%, +LR=4.67.Conclusion:This study showed that measurement of IVC size in inspiration and expiration can be used as a reliable method for estimation of mean right atrial pressure.

Hamid Amoozgar

2010-06-01

200

Estimation of Right Atrial Pressure from the Inspiratory Collapse of the Inferior Vena cava in Pediatric Patients  

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Full Text Available Objective: Paucity of data exists between mean right atrial pressure (RAP and inferior vena cava (IVC size and collapsibility in pediatric patients with congenital heart disease.Methods: In a prospective study, fifty consecutive pediatric patients with different congenital heart diseases who had right side cardiac catheterization were studied, comparing right atrial pressure with simultaneous M-mode echocardiographic measurement of inferior vena cava diameter. Mean age of the patients was 4.96±4.05 years (30 male and 20 female. Patients were categorized into two groups according to their right atrial pressure (RAP as measured by cardiac catheterization: Group 1 (40 patients were those with mean RAP 8 mmHg when IVC diameter in inspiration was >3.6 (sensitivity of 100%, specificity of 47.5%, +LR=1.9 or if IVC diameter was >6mm in expiration (sensitivity of 70%, specificity of 87%, +LR=4.67.Conclusion: This study showed that measurement of IVC size in inspiration and expiration can be used as a reliable method for estimation of mean right atrial pressure.

Gholamhossein Ajami

2010-06-01

 
 
 
 
201

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

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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.

202

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)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish 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.

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

203

Optimizing the use of inferior vena cava filters in oncology patients: are all filters created equally?  

Science.gov (United States)

Many studies have supported the efficacy of inferior vena cava filters (IVCF) in the setting of venous thromboembolic disease, particularly in oncologic patients who are at increased risk. The advent of retrievable IVCF designs has prompted dramatically expanded use for patients with widely accepted indications but also disproportionately so in patients with so-called extended indications. At the same time, an alarming increase in filter-related complications has been reported both in the literature and through regulatory agencies, leading to government agency-issued warnings. The synergistic effect of these two interconnected phenomena is explained through a careful review of the evolution of IVCF device design. Critical differences exist when comparing retrievable IVCF and permanent IVCF. IVCF utilization can be optimized by prospectively identifying which patients are best served by a specific IVCF device. Careful follow-up strategies are also needed to ensure that all IVCFs are removed as soon as they are no longer needed. Finally, adjunctive techniques for removing "difficult" filters help maximize the number of IVCF removed and minimize IVCF left implanted needlessly. PMID:24610401

Ryu, Robert K; Lewandowski, Robert J

2014-04-01

204

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

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Full Text Available We examined the relationship between microscopic hematuria and inferior vena cava (IVC reflux. Transabdominal color Doppler ultrasonography of the IVC was performed in the supine position with the convex probe positioned perpendicular to the upper abdominal wall, and the extent of reflux into the IVC with each heart beat was examined near the diaphragm. A total of 171 patients were studied who had no diseases that could cause hematuria, and no symptomatic gross hematuria. The relationship between the existence and severity of IVC reflux and urine occult blood was examined. The 98 males included 50 subjects without IVC reflux and 48 with reflux, while the 73 females included 24 without IVC reflux and 49 with IVC reflux, respectively. The occurrence of IVC reflux was unrelated to age, but the prevalence of reflux was significantly higher in females than males. As the grade of IVC reflux increased, there was an increase in the prevalence and the severity of hematuria in both males and females. In conclusion, IVC reflux could be related to the occurrence of microscopic hematuria. Renal or urinary tract congestion secondary to IVC reflux may be one of the factors contributing to hematuria.

Kimio Sugaya

2013-12-01

205

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

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

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

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

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

David Ibáñez Muñoz

2011-09-01

207

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

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

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

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

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Full Text Available Abstract Standard treatment of patients with coexisting cardiac and non-cardiac diseases includes two separate operations. We report a case of 55-year-old man with combined valvular heart disease and renal carcinoma infiltrating inferior caval vein, who underwent one-stage cardio-urologic procedure. In the first step, mitral and tricuspid valvuloplasty were performed by cardiac surgeons. Then, urologists performed radical nephrectomy and thrombectomy. The postoperative course was uneventful. In twelve months follow-up the patient shows no signs of reccurrence and he had no symptoms of cardiac disease. To the best of our knowledge such a case has never been reported before in the literature.

Zapala Lukasz

2010-07-01

209

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

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

Jorge García Egea

2011-03-01

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

Scientific Electronic Library Online (English)

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

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

211

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

Scientific Electronic Library Online (English)

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

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

212

The Analysis of Postoperative Complications after Thrombectomy from Inferior Vena Cava in Renal Cell Carcinoma  

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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.

P.I. Rykhtik

2012-05-01

213

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

International Nuclear Information System (INIS)

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

214

The characteristics of the spectra of superior venae cavae in patients with right heart failure  

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Full Text Available Abstract Background Aimed to elucidate the characteristics of the spectra of superior venae cavae (SVC in respiratory cycles in patients with right heart failure. Methods The spectra of SVC of 30 patients with right heart failure and 30 paired healthy subjects were recorded through right supraclavicular fossa view. The profiles of spectra of superior venae cavae were observed, and peak velocity and velocity time integral (VTI of every wave of SVC under spontaneous respiration were measured for statistical analysis. Results In healthy subjects, the peak velocities and VTI of S wave and D wave increased in inspiratory phase and diminished in expiratory phase, and which of S wave were larger than which of D wave in whole respiratory cycle. In patients with right heart failure, spectral variations of SVC could be classified into three patterns: Pattern I: peak velocities and VTI of S wave were larger than that of D wave in early inspiratory phase, but peak velocities and VTI of D wave were larger than those of S wave in late inspiratory phase and early expiratory phase [Pattern I-1], even in whole respiratory cycle [Pattern I-2]; Pattern II: the S wave disappeared and was substituted by inverse wave with low amplitude in whole respiratory cycle. Pattern III: the profiles of the spectra of SVC in patients were similar to those of healthy subjects. In the whole, the respiratory variation ratios of peak velocities and VTI of S wave and D wave were diminished in patients compared with those in healthy subjects. Conclusion The spectra of superior venae cavae in patients with right heart failure were abnormal, and these characteristics could be used as signs in evaluating right heart failure.

Yuan Li-Jun

2006-04-01

215

Minimally invasive approach to the supradiaphragmatic inferior vena cava: total thoracoscopic caval isolation.  

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Minimally invasive techniques for cardiac operations have evolved in safety and popularity. To our knowledge, a thoracoscopic technique for control of the inferior vena cava (IVC) has not been previously described. We report a case of a right renal cell cancer with tumor extension into the IVC. Total thoracoscopic isolation and occlusion of the IVC were performed. Intraoperative real-time transesophageal echocardiography confirmed complete cessation of caval flow upon cinching the Rummel tourniquet. As extensive intra-abdominal operations are more often being attempted laparoscopically or robotically, video-assisted thoracoscopic IVC occlusion for proximal control for tumors extending into the cava can be achieved to offer a minimally invasive thoracic approach. PMID:24758947

Hui, Dawn S; Gill, Inderbir S; Cunningham, Mark J

2014-01-01

216

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  

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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

Alexander Alves da Silva

2009-12-01

217

Sequential Venoplasty for Treatment of Inferior Vena Cava Stenosis Following Liver Transplant  

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Obstruction of the inferior vena cava (IVC) is a rare complication of liver transplantation with significant consequences including intractable ascites and hepatic dysfunction. Although venoplasty and stenting are effective in many cases, patients who fail first-line treatment may require surgical intervention or re-transplantation. Scheduled sequential balloon dilation, an approach frequently used to treat fibrotic, benign biliary strictures, but less commonly vascular lesions, may avert the need for such high-risk alternatives while achieving favorable clinical and angiographic response. Herein, we report the case of a 36-year-old woman with transplant-related, initially angioplasty-resistant IVC stenosis that was successfully treated with sequential balloon dilation.

Parvinian, Ahmad; Gaba, Ron Charles

2014-01-01

218

Antegrade balloon occlusion of inferior vena cava during thrombectomy for renal cell carcinoma  

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Nephrectomy with inferior vena cava (IVC) thrombectomy for advanced renal cell carcinoma (RCC) is a challenging and morbid surgical case. We describe the use of a simple endoluminal technique to occlude the suprahepatic IVC during thrombectomy. A 60-year-old male presented with a large right-sided RCC and IVC tumour thrombus. The tip of the thrombus, which was non-adherent to the caval wall, extended to the level of the hepatic veins. After complete dissection of the kidney, we obtained supra...

Metcalfe, Charles; Chang-kit, Laura; Dumitru, Ioana; Macdonald, Shaun; Black, Peter

2010-01-01

219

Femoral vein patency after percutaneous Greenfield inferior vena cava filter placement  

International Nuclear Information System (INIS)

Compared to jugular vein or cutdown approaches, percutaneous right femoral vein puncture affords straightforward venous access and minimal risk of air embolism for Greenfield inferior vena cava filter placement. Concern about possible femoral vein thrombosis after 24-French catheter dilation prompted the authors to examine right femoral vein patency after 12 consecutive filter placements. Doppler evaluation in 11 patients and venography in one showed normal flow characteristics 4-45 days (mean, 16) after the procedure. The authors' results indicate that the risk of femoral vein thrombosis after dilation to a size 24-French catheter is low

220

Severe low back pain as the initial symptom of venous thrombosis of the inferior vena cava.  

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A 45-year-old previously well male truck driver presented to the emergency department with severe low back pain; lumbosacral X-ray was normal and he was given analgaesics and discharged. The following day, he presented to the emergency department again, his pain had not responded to the analgaesics; this time he also presented with massive bilateral swelling of lower limbs and left testicle that started 3?h earlier. The pain was severe, dull and interfered with the patient's ability to walk. An urgent workup revealed extensive thrombosis of the inferior vena cava. PMID:25155491

Tabatabai, Mohsen Abdul Wahab; Butros, Victor Mikhaeel; Mahdi, Shihab Ahmed; Ahmad, Mohammad Javad

2014-01-01

 
 
 
 
221

Seminoma with bronchial involvement and superior vena cava syndrome: a rare combination.  

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We describe the case of a 45-year-old male who was admitted with clinical signs of superior vena cava syndrome (SVCS). Physical examination showed collar of Stokes and extensive collateral circulation in the neck and anterosuperior thoracic region, as well as a large testicular mass. Fibrobronchoscopy revealed an endobronchial tumour, histopathologically diagnosed as seminoma, with the same characteristics as the testicular biopsy. Treatment was initiated with surgery, chemotherapy and radiotherapy, resulting in a major clinical improvement. We indicate the importance of considering SVCS as an entity related with less common neoplasms such as germ cell tumours. PMID:24064342

Landete, Pedro; Chiner, Eusebi; Sancho-Chust, José N; Sánchez-Valverde, M Dolores; Pérez-Ferrer, Patricia; Bravo-Fernández, Rodrigo

2014-05-01

222

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

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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.

223

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

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Duplication of the superior vena cava (SVC), associated with an aberrant left hepatic vein (LHV), was found in one of the 58 dissected specimens. The right SVC virtually showed a typical appearance. The persistent left SVC, which drained into the right atrium via the enlarged coronary sinus, was formed by the persistence of the left anterior cardinal vein. The LHV opened into the right atrium, due to the persistent left hepatocardiac channel. The left common carotid artery arose from the brachiocephalic trunk as a consequence of a regression of the embryonic aortic sac. The revealed venous and arterial variations seem to be the first reported vascular combination of this type. PMID:22865421

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

2013-10-01

224

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

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

Pelta, A.M.; Jorgensen, M.

2008-01-01

225

Permanent Pacemaker-Induced Superior Vena Cava Syndrome: Successful Treatment by Endovascular Stent  

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The use of metallic stents in the management of benign and malignant superior vena cava syndrome (SVCS) is well documented. Symptomatic stenosis or occlusion of the SVC is a rare complication of a transvenous permanent pacemaker implant. Suggested treatments have included anticoagulation therapy, thrombolysis, balloon angioplasty and surgery. More recently, endovascular stenting has evolved as an attractive alternative but the data available in the literature are limited. We describe a case in which venous stenting with a Wallstent endoprosthesis was used successfully. The patient remains symptom free and with normal pacemaker function 36 months later

226

Successful Thrombolysis of Occluded Inferior Vena Cava Filter withIVC Syndrome  

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Full Text Available Thrombosis of Inferior Vena Cava (IVC following filter insertion can occur in up to 30% of the cases. The optimal management of such cases is unknown. We describe a simple and less expensive method of achieving successful recanalization of the IVC in a 40 year old hypertensive man who developed recurrent pulmonary embolism after his orthopedic treatment. An IVC filter was inserted, which developed extensive thrombosis of the whole IVC and venous system of the lower limbs. Catheter directed thrombolysis using a multiple side-hole multipurpose catheter and balloon angioplasty was carried out in order to “crush and lyse” the IVC thrombi.

BC Srinivas

2012-10-01

227

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

International Nuclear Information System (INIS)

s could be set free with all the filters turning into venous stents. Postmortem displayed retroperitoneal hemorrhage and caval thrombosis. The barbs of the filters penetrated over the caval adventitial coat. Under electron microscope, a thin layer of neointima already covered the braiding net of VCSFs at 2 weeks after the deployment. The tunica intima became slightly thick at 3-4 weeks and with moderate proliferation at 5-6 weeks. Conclusions: The self-made vena cava stent-filter possesses rather long indwelling period according to the necessity of treatment with simultaneously keeping patent caval flow, stability of the position and easy for displacement and retrieval. (authors)

228

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

DEFF Research Database (Denmark)

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

Pelta, A.M.; JØrgensen, Maja

2008-01-01

229

[Vena cava cement embolism after percutaneous kyphoplasty. Interventional radiological recovery in metastasized urothelial cancer].  

Science.gov (United States)

For patients suffering from vertebral metastases vertebroplasty and kyphoplasty offer two relatively new treatment options for the stabilization of vertebral compression fractures. This can help to reduce the fracture-associated symptoms and can improve the quality of life. Cement extravasation is a specific complication of this therapy. This article reports a case of multiple cement paravasations in the paravertebral veins, the vena cava inferior and peripheral segmental and subsegmental pumonary arteries after kyphoplasty of an extensive pathological vertebral body fracture in a 64-year-old man suffering from metastatic urothelial cancer. PMID:24113993

Schmid, R; Efinger, K; Schulz, C; Sparwasser, C; Martinschek, A

2014-01-01

230

Open surgery repair for superior vena cava syndrome after failed endovascular stenting.  

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Thrombosis is a rare cause of superior vena cava (SVC) syndrome. We report a 37-year-old man hospitalized because of swelling of the face and neck. A computed tomography angiography showed a thrombotic obstruction of SVC. The patient was treated by percutaneous transluminal balloon angioplasty of the SVC and placement of a stent. The symptoms disappeared, but the patient was hospitalized again after 3 months for the same complaints. Computed tomography angiography showed thrombosis in the stent in the SVC. The SVC was replaced with a prosthetic blood vessel. The patient's postoperative recovery was uneventful, and SVC syndrome did not occur during 2 years of postoperative follow-up. PMID:24694429

Li, Huadong; Jiang, Xionggang; Sun, Tucheng

2014-04-01

231

Superior vena cava syndrome caused by a swollen absorbable haemostat after repair of ischaemic mitral regurgitation.  

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Surgicel, an absorbable haemostat, is widely used in cardiovascular surgery. An 81-year-old woman, who was diagnosed with ischaemic mitral regurgitation, underwent mitral valve plasty and coronary artery bypass grafting. On postoperative day two, her superior vena cava (SVC) pressure gradually rose to 38 mmHg and she developed low output syndrome. Emergent surgery revealed that the cause of SVC syndrome was external compression from a haematoma at the posterior surface of the SVC, which formed around the Surgicel. PMID:24387601

Eto, Koki; Matsumoto, Mitsuaki; Kubo, Yoji; Kemmochi, Reiko

2014-01-01

232

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

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

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

2013-02-01

233

Wolff-Parkinson-White syndrome with an unroofed coronary sinus without persistent left superior vena cava treated with catheter cryoablation  

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Full Text Available Coronary sinus anomalies are rare congenital defects which are usually coexistent with a persistent left superior vena cava and may be associated with cardiac arrhythmias. We report an unroofed coronary sinus without persistent left superior vena cava diagnosed during a catheter ablation procedure for Wolff-Parkinson-White syndrome. Diagnostic and therapeutic options and outcomes are discussed. This condition is of relevance to electrophysiologists performing catheter-based procedures, as well as cardiologists implanting coronary sinus pacing leads, who may encounter this anomaly in their practice.

Andrei Catanchin

2008-08-01

234

Combined Anomaly of the Right Hepatic Lobe Agenesis and Absence of the Inferior Vena Cava: a Case Report  

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The absence of the inferior vena cava is an uncommon congenital anomaly that has recently been identified as an important risk factor contributing to the development of deep venous thrombosis. Congenital agenesis of the right hepatic lobe is a rare anomaly which is found incidentally in radiologic examinations. We present a case of a congenital absence of the infrarenal inferior vena cava, combined with agenesis of the right hepatic lobe in a 62-year-old man presented with symptoms of deep venous thrombosis

Suh, Hee Jung; Kim, Wan Tae; Kim, Mi Young; Cho, Yun Ku [Seoul Veterans Hospital, Seoul (Korea, Republic of)

2008-07-15

235

Combined Anomaly of the Right Hepatic Lobe Agenesis and Absence of the Inferior Vena Cava: a Case Report  

International Nuclear Information System (INIS)

The absence of the inferior vena cava is an uncommon congenital anomaly that has recently been identified as an important risk factor contributing to the development of deep venous thrombosis. Congenital agenesis of the right hepatic lobe is a rare anomaly which is found incidentally in radiologic examinations. We present a case of a congenital absence of the infrarenal inferior vena cava, combined with agenesis of the right hepatic lobe in a 62-year-old man presented with symptoms of deep venous thrombosis

236

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

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

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

2008-01-15

237

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

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

Vu?i?evi?-Trobok Jadranka

2002-01-01

238

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

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

Hikmat Abdel-Razeq

2011-03-01

239

[Reconstruction of the Superior Vena Cava for Invasive Thymoma under Monitoring of Regional Cerebral Saturation of Oxygen].  

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A 63-year-old man was referred to our department for surgical resection of invasive thymoma (type B3)after 2 courses of chemo-therapy resulted in stable disease. Resection of the tumor was done through a median sternotomy under monitoring of regional cerebral saturation of oxygen (rSo2) using near-infrared spectroscopy (NIRS). The tumor invaded to the right upper lobe (S3), the right phrenic nerve, the superior vena cava (SVC), and the bilateral brachiocephalic vein (BCV). Although bilateral clamping of the BCVs induced significant decrease in rSo2, unilateral clamping of the BCV did not. Therefore, reconstruction of the SVC by sequential reconstruction of BCVs was carried out, and the tumor was successfully and safely excised with the SVC and a part of the right upper lobe. PMID:25201361

Umeda, Yukio; Matsumoto, Shinsuke; Mori, Yoshio; Takiya, Hiroshi

2014-09-01

240

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

International Nuclear Information System (INIS)

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

 
 
 
 
241

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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.

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

2014-04-01

242

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

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

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

2014-01-01

243

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

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

Mitov Vladimir

2010-01-01

244

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

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

245

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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.

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

246

Leiomyosarcoma of the inferior vena cava: Radical surgery and vascular reconstruction  

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Full Text Available Abstract Background Vascular leiomyosarcoma are rare tumors typically originating from the inferior vena cava (IVC. Due to nonspecific clinical signs most tumors are diagnosed at advanced stages. Complete surgical resection remains the only potential curative therapeutic option. Surgical strategy is particularly influenced by the level of the IVC affected. Due to the topographic relation to the renal veins level-II involvement of the IVC raises special surgical challenges with respect to the maintenance of venous outflow. Case presentation We herein report two cases of leiomyosarcoma of the IVC with successful en bloc resection and individualized caval reconstruction. One patient presented with a large intramural and intraluminal mass and received a complete circumferential resection. Reconstruction was performed by graft replacement of the caval segment affected. The other patient displayed a predominantly extraluminal tumor growth and underwent semicircumferential resection of the IVC including the confluence of the left renal vein. In this case vascular reconstruction was performed by cavoplasty and reinsertion of the left renal vein into the proximal portion of the IVC. Resection margins of both patients were tumor free and no clinical signs of venous insufficiency of the lower extremity occurred. Conclusion This paper presents two cases of successfully managed leiomyosarcomas of the vena cava and exemplifies two different options for vascular reconstruction in level II sarcomas and includes a thorough review of the literature.

Knoefel Wolfram T

2009-06-01

247

Pancreatic and multiorgan resection with inferior vena cava reconstruction for retroperitoneal leiomyosarcoma  

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Full Text Available Abstract Background Inferior vena cava (IVC leiomyosarcoma is a rare tumor of smooth muscle origin. It is often large by the time of diagnosis and may involve adjacent organs. A margin-free resection may be curative, but the resection must involve the tumor en bloc with the affected segment of vena cava and locally involved organs. IVC resection often requires vascular reconstruction, which can be done with prosthetic graft. Case presentation We describe a 39-year-old man with an IVC leiomyosarcoma that involved the adrenal gland, distal pancreas, and blood supply to the spleen and left kidney. Tumor excision involved en bloc resection of all involved organs with reimplantation of the right renal vein and reconstruction of the IVC with a polytetrafluoroethylene graft. The patient recovered without renal insufficiency, graft infection, or other complications. Follow-up abdominal imaging at 1 year showed a patent IVC graft and no locally recurrent tumor. Prosthetic graft provides a sufficient diameter and length for replacement conduit in extensive resection of IVC leiomyosarcoma. Conclusion To our knowledge, this is the first case of resection of an IVC sarcoma with prosthetic graft reconstruction in combination with pancreatic resection. Aggressive surgical resection including vascular reconstruction is warranted for select IVC tumors to achieve a potentially curative outcome.

Nakhleh Raouf E

2009-01-01

248

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  

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

Renan Roque Onzi

2007-06-01

249

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

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

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

250

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

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

Singh Sandeep

2008-01-01

251

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

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

Jose C. Baptista-Silva

2005-12-01

252

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

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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.

253

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  

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

Luiz Guilherme Cintra Vidal Reys

2012-01-01

254

Optease Vena Cava Filter Optimal Indwelling Time and Retrievability  

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

255

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

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

256

Quantitative assessment of average velocity in the inferior vena cava by phase display MR imaging  

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The authors quantified flow velocity in the inferior vena cava (IVC) by using MR imaging. Fifteen healthy volunteers underwent both MR imaging and pulsed Doppler US. MR phase display flow imaging methods included the following: 15 gated paramedian sagittal zebra-stripe images of the IVC (10-mm section thickness), acquired with fast imaging technique (TE = 14 msec, TR < ECG RR interval). Mean velocities through the cardiac cycle were quantitatively determined by measuring the distance between two stripes and the stripe displacement in the IVC plane. The results ranged from 20 to 40 cm/sec, which correlates well with results obtained on pulsed Doppler US. Thus this study shows the potential of phase display MR imaging as a noninvasive means of assessing local laminar flow in large vessels

257

The value of pre-operative embolisation in primary inferior vena cava paraganglioma.  

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We report a case of a 13-year-old boy who complained of progressive abdominal distension and symptoms of anaemia. Radiological investigations revealed that the child had a hypervascular tumour of the inferior vena cava (IVC). Unfortunately, the child presented with acute lower gastrointestinal bleed soon after the investigation. He underwent an urgent pre-operative embolisation, aimed to reduce the tumour vascularity. A total resection of the tumour, right nephrectomy, and partial duodenal resection were done within 24 hours post-embolisation. The child was stable postoperatively. The histopathological examination revealed chromogranin-positive paraganglioma originating from the IVC. We highlight the radiological findings of rare primary IVC paraganglioma and the role of embolisation prior to surgical removal of the tumour. PMID:22135590

Zaki, Faizah Mohd; Osman, Syazarina Sharis; Abdul Manaf, Zaleha; Mahadevan, Jeyaledchumy; Yahya, Mazri

2011-04-01

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Agenesia de vena cava inferior y traumatismo abdominal cerrado / Inferior caval agenesis and renal trauma  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Presentamos el caso de un varón de 16 años, con agenesia de vena cava inferior que sufre una caída, resultando de la misma un severo traumatismo de la unidad renal izquierda. Revisamos las recomendaciones de actuación frente a traumatismos de alto grado y, valoramos, si existen en pacientes con esta [...] anomalía, factores que predispongan a aumentar la severidad de las lesiones frente a traumatismos. Abstract in english We are publishing a case of sixteen years old male, with inferior caval agenesis suffering a fall, and having a serious trauma over the left renal unit. We review the recommendations of intervention in front of high grade renal trauma and we too study the existing knowledge on the literature in orde [...] r to get a posible higher incidence of this kind of trauma in patients with these anomaly.

A., Barbagelata López; E., Fernández Rosado; J.L., Ponce Díaz-Reixa; E., Romero Selas; I., Rodríguez Gómez; M., González Martín.

259

Successful Venous Angioplasty of Superior Vena Cava Syndrome after Heart Transplantation  

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Introduction. For patients with terminal heart failure, heart transplantation (HTX) has become an established therapy. Before transplantation there are many repeated measurements with a pulmonary artery catheter (PAC) via the superior vena cava (SVC) necessary. After transplantation, endomyocardial biopsy (EMB) is recommended for routine surveillance of heart transplant rejection again through the SVC. Case Presentation. In this report, we present a HTX patient who developed a SVC syndrome as a possible complication of all these procedures via the SVC. This 35-year-old Caucasian male could be successfully treated by balloon dilatation/angioplasty. Conclusion. The SVC syndrome can lead to pressure increase in the venous system such as edema in the head and the upper part of the body and further serious complications like cerebral bleeding and ischemia, or respiratory problems. Balloon angioplasty and stent implantation are valid methods to treat stenoses of the SVC successfully. PMID:25161772

Strecker, Thomas; Zimmermann, Iris; Heinz, Marco; Rosch, Johannes; Agaimy, Abbas; Weyand, Michael

2014-01-01

260

Dermatofibrosarcoma protuberans on the right neck with superior vena cava syndrome: case report and literature review.  

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Dermatofibrosarcoma protuberans (DFSP) is an uncommon dermal soft tissue tumour of intermediate malignancy. A 44-year-old man presented to the hospital with a large lesion on the right upper chest and neck. Despite eight previous surgical excisions, the tumour had continued to recur. Contrast-enhanced computed tomography showed recurrence of the tumour, associated with superior vena cava (SVC) syndrome. He declined radical surgical resection of the recurrent tumour, which may have required right upper limb amputation. Targeted therapy with sunitinib malate was therefore introduced. This case demonstrates the recurrent nature of DFSP and the association of this lesion on the upper chest/neck with SVC syndrome. Primary wide radical resection is essential for better local control and to avoid the development of SVC syndrome. PMID:23535006

Ong, H S; Ji, T; Wang, L Z; Yu, Z W; Zhang, C P

2013-06-01

 
 
 
 
261

Passing sheaths and electrode catheters through inferior vena cava filters: safer than we think?  

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Inferior vena cava (IVC) filters are being inserted with increasing frequency for the prevention of pulmonary embolus. Previous case reports have documented the passage of up to three electrode catheters or an individual long sheath through an IVC filter. The current report expands on prior series with regard to the number of devices used. We describe our experience in 10 patients in whom up to five electrode catheters and/or sheaths were placed through an IVC filter using a transfemoral approach under fluoroscopic guidance without routine venography. Devices were successfully introduced and withdrawn in each case without filter dislodgment. Our series illustrates the feasibility and safety of passing multiple electrode catheters and long sheaths through an IVC filter. Evidence is accumulating to suggest that an IVC filter should not be considered an absolute contraindication to performing diagnostic or therapeutic procedures. PMID:19642198

Kanjwal, Yousuf; John, Jerry M; Burket, Mark W

2009-11-15

262

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

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

263

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

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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

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

2007-11-01

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

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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)

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

2002-06-01

265

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

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

Qing Ji

2010-01-01

266

Transfemoral approach through inferior vena cava filters for complex cardiac interventions: expanding the limits.  

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Performing complex cardiac interventions that need atrial septal crossing in patients with a previously implanted inferior vena cava filter (ICVF) has proven difficult. Accordingly, some authors have chosen accesses different from the traditional femoral vein approach. Here, we report two cases of complex cardiac procedures performed via the femoral vein and through an IVCF. In the first case, a percutaneous mitral valvuloplasty was performed in an elderly woman after crossing the IVCF with a large sheath. In the second case, simultaneous left atrial appendage and patent foramen ovale closures were performed. In both experiences, the key step was to secure the access by positioning a long sheath with its tip above the IVCF and not removing it until the procedure had finished. These cases further support the use of traditional femoral vein access in patients with IVCF and confirm the possibility of performing complex cardiac interventions in these scenarios. PMID:23468455

Martínez, Gonzalo; Lindefjeld, Dante; Martínez, Alejandro

2013-03-01

267

Superior vena cava injury after central venous catheterization: a case report  

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Full Text Available "nBackground: Central venous catheters are useful instruments in monitoring of critical patients and are important roots for total parentral nutrition. The catheters are widely used in general wards and intensive care units. Their use may be associated with serious and rare complications. "n"nCase presentation: We reported a 24 years old woman that admitted to Ghaem hospital Mashhad University of Medical Science, in Mashhad, Iran, because of penetrating chest wall injury and surgical exploration indicated due to massive hemorrhage. Central vein (right jugular vein was canulated for resuscitation and monitoring. Superior vena cava was injured after canulation and presented with delay massive mediastinal hematoma. "n"nConclusion: We aim to introduce this rare complication and its management. This management could be conservative or surgical intervention according to severity of the vein damage.

Bagheri R

2010-08-01

268

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

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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

269

Interventional therapy for inferior vena cava obstruction caused by hepatic cancer  

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Objective: To study the method and effectiveness of interventional therapy for the stenotic or obstructive inferior vena cava (IVC) caused by hepatic cancer. Methods: All together 6 patients were enrolled, 4 males and 2 females, with age of 45 to 58 years, average 53 years. The main symptoms including abdominal distension, varices on abdominal walls and edema in lower extremities were caused by compression or involvement of IVC with right hepatic lobe lesion. The authors performed thrombolysis first and follower by balloon dilation and stent placement. Results: IVC were recanalized in all 6 patients with free patent blood flow. The postal venous pressure dropped from 4.4 kPa to 2.1 kPa without major complication. Conclusions: Treating the IVC stenosis and obstruction caused by primary liver cancer with interventional method is safe and effective together with improvement of life quality and prolongation of survival time. (authors)

270

Sclerosing epithelioid fibrosarcoma of the liver infiltrating the inferior vena cava  

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Full Text Available Sclerosing epithelioid fibrosarcoma (SEF is a rare and distinct variant of fibrosarcoma, composed of epithelioid tumor cells arranged in strands, nests, cords, or sheets embedded within a sclerotic collagenous matrix. We report a 39-year-old man with SEF of the liver, which infiltrated the inferior vena cava (IVC. The SEF of the liver was successfully resected, and the infiltrated IVC was also removed together with the liver tumor. Histopathological examination of the tumor showed typical histopathology of SEF. Immunohistochemically, the tumor was positive for vimentin. Recurrence was noted 7 mo after surgery. After chemotherapy, the recurrent tumor was resected surgically, and histopathological examination showed similar findings to those of the primary tumor. To our knowledge, this is the first report of SEF of the liver with tumor invasion of the IVC.

Yoshito Tomimaru, Hiroaki Nagano, Shigeru Marubashi, Shogo Kobayashi, Hidetoshi Eguchi, Yutaka Takeda, Masahiro Tanemura, Toru Kitagawa, Koji Umeshita, Nobuyuki Hashimoto, Hideki Yoshikawa, Kenichi Wakasa, Yuichiro Doki, Masaki Mori

2009-09-01

271

Complex radiodiagnosis and surgical treatment of the patients with thrombosis of inferior vena cava system  

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Full Text Available Despite of much effort, taken to improve diagnosis technologies, examination and development of the tactics for treatment of patients with acute inferior vena cava (IVC thrombosis remain to be insufficiently understood. In period from 2003 there were examined and treated 572 patients with thrombosis of the IVC system. Thrombectomy was conducted in 62 (39.7% cases, only clipping or placation without thrombectomy was made in 94(60.3% of cases. After operation all patients showed regress of LEDVT clinical symptoms. In the postoperative period there were no PATE events. All patients were discharged from hospital in satisfactory condition. On the basis of this clinical material we may suggest that choice of the technique of PATE surgical prophylaxis depends on the character and spreading of thrombus, functional-anatomic peculiarities of the IVC system.

Amet Seydaliev

2011-03-01

272

Persistent left superior vena cava: a case report and review of literature  

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Full Text Available Abstract Persistent left superior vena cava is rare but important congenital vascular anomaly. It results when the left superior cardinal vein caudal to the innominate vein fails to regress. It is most commonly observed in isolation but can be associated with other cardiovascular abnormalities including atrial septal defect, bicuspid aortic valve, coarctation of aorta, coronary sinus ostial atresia, and cor triatriatum. The presence of PLSVC can render access to the right side of heart challenging via the left subclavian approach, which is a common site of access utilized when placing pacemakers and Swan-Ganz catheters. Incidental notation of a dilated coronary sinus on echocardiography should raise the suspicion of PLSVC. The diagnosis should be confirmed by saline contrast echocardiography.

Verma Gita

2008-10-01

273

Obstruction of the superior vena cava or subclavian veins: Sonographic diagnosis  

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The normal subclavian vein shows a respiratory rhythmicity on sonograms and responds to a sudden sniff maneuver by collapsing in a rapid, transient manner secondary to the sudden decrease in intrathoracic pressure. Of 11 patients studied using ultrasound (US) for possible superior vena cava (SVC) obstruction, five patients with proved SVC obstruction had no response of the enlarged subclavian veins to respiratory maneuvers. One patient with a partial obstruction had a minimal response on one side. Two patients with isolated subclavian vein obstructions had no response on the affected side and a normal response on the contralateral side. Three patients proved not to have SVC obstruction had normal responses. Sonography of the subclavian veins may be an effective, indirect screening technique for the presence of SVC obstruction and can also be used to evaluate the patency of the subclavian vein, although the the sensitivity and specificity of the method remain to be determined from a larger, prospective study

274

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

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

275

Ultrasound measurement of inferior vena cava diameters by emergency department nurses.  

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Sonographic measurement of the inferior vena cava (IVC) diameter is a potentially important noninvasive estimate of fluid status. We researched whether nurses without prior ultrasonography experience could accurately obtain vena cava diameter measurements on models and subjects in comparison with those obtained by an expert sonographer. The design was a prospective educational study using a pre- and posttest of knowledge and a comparison of imaging performance between a subject and an expert sonographer. The setting was an urban teaching medical center with emergency nurses and a convenience sample of volunteer patients selected from the emergency department (ED). Nurses completed a written survey and a pretest to document prior training and experience in ultrasonography and assess baseline knowledge. A structured training program (3.5 hr in length) was provided over three sessions. Training consisted of didactic presentations, practice on phantoms (manikin models designed to provide the sonographic image of the human body when scanned by a trainee) and classmates, and one volunteer patient in the ED. Each nurse then measured IVC diameters on three different volunteer patients in transverse and longitudinal orientations using frozen images. An expert sonographer, blinded to subject results, performed the same examination. Correlations were determined, and a posttraining written examination was completed and results compared with the pretest using a pair-wise t test. Fourteen nurses, with a mean of 8 years' nursing experience (range = 2-18 years), participated. Nurse-expert R value correlation for the longitudinal orientation was 0.68 (95% confidence interval [CI] [0.35, 0.76]) and 0.59 (95% CI [0.47, 0.81]) for the transverse orientation. Posttest scores improved 8.2 percentage points (95% CI [4.0, 12.4]) from 83.3% to 91.5%. Following a brief training course, nurses with no prior sonography experience show moderately good correlation measuring the IVC diameter as compared with expert measurements, with better performance demonstrated in the longitudinal orientation. PMID:25076402

De Lorenzo, Robert A; Holbrook-Emmons, Victoria L

2014-01-01

276

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

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

Iqbal Javaid

2008-02-01

277

The Need for Anticoagulation Following Inferior Vena Cava Filter Placement: Systematic Review  

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Purpose. To perform a systemic review to determine the effect of anticoagulation on the rates of venous thromboembolism (pulmonary embolus, deep venous thrombosis, inferior vena cava (IVC) filter thrombosis) following placement of an IVC filter. Methods. A comprehensive computerized literature search was performed to identify relevant articles. Data were abstracted by two reviewers. Studies were included if it could be determined whether or not subjects received anticoagulation following filter placement, and if follow-up data were presented. A meta-analysis of patients from all included studies was performed. A total of 14 articles were included in the final analysis, but the data from only nine articles could be used in the meta-analysis; five studies were excluded because they did not present raw data which could be analyzed in the meta-analysis. A total of 1,369 subjects were included in the final meta-analysis. Results. The summary odds ratio for the effect of anticoagulation on venous thromboembolism rates following filter deployment was 0.639 (95% CI 0.351 to 1.159, p = 0.141). There was significant heterogeneity in the results from different studies [Q statistic of 15.95 (p = 0.043)]. Following the meta-analysis, there was a trend toward decreased venous thromboembolism rates in patients with post-filter anticoagulation (12.3% vs. 15.8%), but the result failed to reach statistical significance. Conclusion. Inferior vena cava filters can be placed in patients who cannot receive concomitant anticoagulation without placing them at significantly higher risk of development of venous thromboembolism

278

Inferior vena cava filter placement for the prevention of pulmonary embolism and the complications related to the filter placement  

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Objective: To investigate the effects of inferior vena cava (IVC) filter placement for the prevention of fatal pulmonary embolism and to discuss the management of complications related to the filter placement. Methods: Seventy patients with proved deep vein thrombosis of lower extremity underwent inferior vena cava filter placement.A total of 72 IVC filters were implanted,which included 20 Trap Ease filters, 31 Vena Tech filters, 13 retrievable OptEaseTM filters and 8 Tempo II filters. One filter was deployed above the orifice of renal vein and the remaining 71 were deployed below the orifice of renal vein. Results: All the patients were followed up for 8-72 months after the procedure. During the follow-up period no fatal pulmonary embolism occurred except that some complications related to the filter placement occurred in 6 cases. Conclusion: Inferior vena cava filter placement can effectively prevent the occurrence of pulmonary embolism. Of course, this treatment should be strictly applied according to the indications. (authors)

279

Superior vena cava obstruction presenting with epistaxis, haemoptysis and gastro-intestinal haemorrhage in two men receiving haemodialysis with central venous catheters: two case reports  

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Full Text Available Abstract Introduction Superior vena cava (SVC obstruction secondary to central venous catheterization is an increasingly recognized complication. Case presentation We present two cases of superior vena cava obstruction secondary to indwelling central venous catheters used for haemodialysis access. One of the patients developed the unusual complications of torrential epistaxis and haemoptysis, which has been reported only once so far in the literature. The other patient developed melaena secondary to downhill oesophageal varices. We briefly discuss the pathophysiology, symptoms and signs, investigations and management of superior vena cava obstruction and thrombosis. Conclusion Increasing use of central venous access for haemodialysis will increase the incidence of central venous stenosis, thrombosis and exhaustion. Superior vena cava obstruction is likely to be an increasingly recognised complication of vascular access in the future.

Gopaluni Seerapani

2009-05-01

280

[Symmetrical phlebothrombosis of lower extremities resulting from congenital malformation of vena cava inferior].  

Science.gov (United States)

Agenesis/atresia ofvena cava inferior is a rare congenital anomaly, caused by an aberrance of embryonal venous system development. This is in most cases asymptomatic, because of well developed collateral venous circulation. However, in some cases, it can be manifested with occurence of deep thrombosis in area of pelvis and lower limbs. In this case report, we repon a 21 year old male with painful swelling of both lower limbs. Ultrasonographic examination revealed a bilateral thrombosis in deep venous system of lower limbs and pelvis. Subsequent CT angiography showed atresia ofinfrarenal segment ofvena cava inferior. According to the CT image thrombotic proces affected also collateral venous system, that joined mostly to vena azygos and hemiazygos. Examination of coagulation system didn't reveal a procuring cause ofthrombotic occurrence. We realized a systemic trombolysis with streptokinase during 5 days. Starting from the fifth day we administered a low molecular weight heparin in anticoagulant dose. This treatment showed a good clinical effect. Pacient was discharged with a long-term oral warfarin therapy in combination with acetylsalicylic acid. In next four months of taking recommended therapy no relapse of thrombotic process nor evolvement of bleeding complication was observed. PMID:20070035

Halcín, A; Kovácová, E; Mikla, F; Reptová, A; Bedeová, J

2009-12-01

 
 
 
 
281

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

2008-02-04

282

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2000-11-01

283

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

International Nuclear Information System (INIS)

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

284

Interrupted inferior vena cava and partial anomalous pulmonary venous return with atrial septal defect in a 38-year-old adult: a case report  

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We present a woman having congenital anomalies of the inferior vena cava and partial anomalous pulmonary venous return from the right lung with atrial septal defect in a 38-year-old. Congenital anomalies of inferior vena cava are rare. They are seen more often in young males. If there are not other anomalies, they are latent for a long time. Peripheral venous thrombosis, chronic venous insufficiency, dyspnea and fatigue are often the first symptoms of these anomalies. Surgical repair of atria...

Colak, Mehmet Cengiz; Rahman, Ali; Kocaturk, Hasan; Bayram, Ednan; Kocakoc, Ercan

2009-01-01

285

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  

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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, sien...

Juan Bahamondes, C. S.; Pablo Sandoval, M.; He?ctor Losada, M.; Gustavo Merin?o, S.; Juan Salman, A.; Abelardo Silva, V.; Javier Mora, P.

2010-01-01

286

Living donor liver transplantation for Budd-Chiari syndrome with hepatic inferior vena cava obstruction after open pericardial procedures.  

Science.gov (United States)

Living donor liver transplantation (LDLT) for Budd-Chiari syndrome (BCS) presents a unique challenge as it does not involve replacement of the hepatic inferior vena cava (IVC). We report a case of successful LDLT in a patient with BCS associated with occlusion of the hepatic veins as well as the IVC. A 34-year-old woman with a history of two open pericardial procedures had decompensated liver failure and portal hypertension. Venography showed complete obstruction of the hepatic IVC and well-developed collateral vessels. We performed LDLT via sternotomy and laparotomy, with an end-to-end anastomosis between the left hepatic vein of the donor and the patient's suprahepatic vena cava in the pericardium. The patient recovered uneventfully and has been doing well for 5 years. LDLT without caval replacement for BCS in a patient with hepatic IVC obstruction is feasible if the patient has good functional collaterals before liver transplantation. PMID:23188387

Fukuda, Akinari; Ogura, Yasuhiro; Kanazawa, Hiroyuki; Mori, Akira; Kawaguchi, Michiya; Takada, Yasutsugu; Uemoto, Shinji

2013-10-01

287

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)

288

Angiomiolipoma renal causante de trombo en cava y síndrome de Budd-Chiari secundario / Renal angiomyolipoma causing inferior vena cava thrombus and secondary Budd-Chiari´s syndrome  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Se aporta un caso de angiomiolipoma renal con tres peculiaridades: origen en seno renal, trombo en cava hasta ostium de aurícula derecha y presentación clínica en forma de síndrome de Budd-Chiari. Métodos: Se realiza una presentación y comentarios de las características del caso clínico. R [...] esultados/Conclusiones: El angiomiolipoma renal es un tumor benigno mesenquimal, poco frecuente (2-6.4% de los tumores renales), de predominio en el sexo femenino. Habitualmente surge en el parénquima renal, siendo infrecuente su origen en el seno renal. Puede afectar a estructuras venosas formando trombo tumoral en vena renal y en vena cava inferior, llegando incluso a aurícula derecha. Habitualmente es asintomático, constituyendo un hallazgo incidental en técnicas diagnósticas de imagen, pero su presentación clínica varía desde el dolor en flanco (lo más frecuente) hasta el TEP fatal, siendo excepcional su presentación como síndrome de Budd-Chiari. Debido al riesgo de TEP y muerte, el tratamiento quirúrgico (nefrectomía radical y trombectomía) del AML con trombo en cava está indicado aún cuando sea asintomático. Abstract in english Objective: We report one case of renal angiomyolipoma with three characteristics: renal sinus origin, inferior vena cava tumor thrombus reaching the right atrium and Budd-Chiari syndrome. Methods: The characteristics of the case are presented and discussed. Results/Conclusions: Renal angiomyolipoma [...] is a benign mesenchymal tumor. It is an uncommon tumor (2-6.4% of all kidney tumors), with a female predominance. Angiomyolipoma most often originate from the renal parenchyma but they can rarely originate from the renal sinus. They can involve the renal vein, the inferior vena cava and even the right atrium as a tumor thrombus. Angiomyolipoma commonly present as an incidental finding on radiographic studies, but the clinical presentation varies from flank pain to fatal pulmonary tumor embolism. The Budd-Chiari syndrome is an extremely rare presentation. Because of the risk of potentially fatal cardiopulmonary embolism and death, surgical treatment (radical nephrectomy plus tumor thrombectomy) of these lesions is indicated even when they are asymptomatic.

Cristina, Quicios Dorado; Antonio, Allona Almagro.

289

Angiomiolipoma renal causante de trombo en cava y síndrome de Budd-Chiari secundario / Renal angiomyolipoma causing inferior vena cava thrombus and secondary Budd-Chiari´s syndrome  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Se aporta un caso de angiomiolipoma renal con tres peculiaridades: origen en seno renal, trombo en cava hasta ostium de aurícula derecha y presentación clínica en forma de síndrome de Budd-Chiari. Métodos: Se realiza una presentación y comentarios de las características del caso clínico. R [...] esultados/Conclusiones: El angiomiolipoma renal es un tumor benigno mesenquimal, poco frecuente (2-6.4% de los tumores renales), de predominio en el sexo femenino. Habitualmente surge en el parénquima renal, siendo infrecuente su origen en el seno renal. Puede afectar a estructuras venosas formando trombo tumoral en vena renal y en vena cava inferior, llegando incluso a aurícula derecha. Habitualmente es asintomático, constituyendo un hallazgo incidental en técnicas diagnósticas de imagen, pero su presentación clínica varía desde el dolor en flanco (lo más frecuente) hasta el TEP fatal, siendo excepcional su presentación como síndrome de Budd-Chiari. Debido al riesgo de TEP y muerte, el tratamiento quirúrgico (nefrectomía radical y trombectomía) del AML con trombo en cava está indicado aún cuando sea asintomático. Abstract in english Objective: We report one case of renal angiomyolipoma with three characteristics: renal sinus origin, inferior vena cava tumor thrombus reaching the right atrium and Budd-Chiari syndrome. Methods: The characteristics of the case are presented and discussed. Results/Conclusions: Renal angiomyolipoma [...] is a benign mesenchymal tumor. It is an uncommon tumor (2-6.4% of all kidney tumors), with a female predominance. Angiomyolipoma most often originate from the renal parenchyma but they can rarely originate from the renal sinus. They can involve the renal vein, the inferior vena cava and even the right atrium as a tumor thrombus. Angiomyolipoma commonly present as an incidental finding on radiographic studies, but the clinical presentation varies from flank pain to fatal pulmonary tumor embolism. The Budd-Chiari syndrome is an extremely rare presentation. Because of the risk of potentially fatal cardiopulmonary embolism and death, surgical treatment (radical nephrectomy plus tumor thrombectomy) of these lesions is indicated even when they are asymptomatic.

Cristina, Quicios Dorado; Antonio, Allona Almagro.

2008-04-01

290

Blocking of the Hepatic Vein Outflow by Neointima Covering a Wallstent Across a Membranous Stenosis of the Inferior Vena Cava  

International Nuclear Information System (INIS)

A 31-year-old man presented with idiopathic membranous obstruction of the suprahepatic inferior vena cava (IVC) and was treated by balloon dilation and placement of a Wallstent. The patient improved markedly. However, he developed obstruction of the hepatic vein outflow secondary to neointima formation over the stent that covered the hepatic vein ostia. The patient died of liver failure and septicemia. We believe that this is the first report of such a serious complication

291

Blocking of the hepatic vein outflow by neointima covering a wallstent across a membranous stenosis of the inferior vena cava  

International Nuclear Information System (INIS)

A 31-year-old man presented with idiopathic membranous obstruction of the suprahepatic inferior vena cava (IVC) and was treated by balloon dilation and placement of a Wallstent. The patient improved markedly. However, he developed obstruction of the hepatic vein outflow secondary to neointima formation over the stent that covered the hepatic vein ostia. The patient died of liver failure and septicemia. We believe that this is the first report of such a serious complication.

292

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

Directory of Open Access Journals (Sweden)

Full Text Available We report and describe the presentation, pathological diagnosis with immunostaining and management of a rare case of capsular renal leiomyosarcoma encasing the inferior vena cava (IVC. We have reviewed and tabulated other such similar cases. The present case was successfully managed by radical nephrectomy and adjuvant radio-chemotherapy. Immunostaining should be freely used to define the histological type of renal sarcoma in order to accurately counsel and deliver a prognosis for patients with renal leiomyosarcomas with a poor prognosis.

Singh Iqbal

2010-01-01

293

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

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Abstract Background We present a case of Xanthogranulomatous pyelonephritis (XGPN) in a male child with renal vein thrombus extending into the inferior vena cava. This is a rare presentation. XGPN is a rare type of renal infection characterised by granulomatous inflammation with giant cells and foamy histiocytes. The peak incidence is in the sixth to seventh decade with a female predominance. XGPN is rare in children. Case presentation An 11 year old male child ...

Kotasthane Vaishali D; Kotasthane Dhananjay S; Singh Reecha; Gupta Geetanjali; Kumar Shailesh

2010-01-01

294

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

Energy Technology Data Exchange (ETDEWEB)

EKG-gated cardiac CT revealed a variant vein in a 44-year-old man that was misinterpreted as a mass on echocardiography. The variant vein was an extension of the confluence of the left internal jugular vein and left subclavian vein and coursed anterior to the right ventricle. It connected to the right atrium directly at the inferior surface of the heart. The variant vein was likely a persistent left superior vena cava, a variant that has never been reported.

Lee, You Kyung; Lee, Whal; Park, Eun Ah; Kang, Mi Jin; Chung, Jin Wook; Park, Jae Hyung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

2008-12-15

295

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

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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.

Farzanah I. Ismail

2014-05-01

296

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

Directory of Open Access Journals (Sweden)

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.

Patel Nehal

2009-01-01

297

Persistent Left Superior Vena Cava and Partial Anomalous Pulmonary Venous Return in an Old Asymptomatic Female Patient  

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Persistent left superior vena cava is a rare congenital venous anomaly. It results from failure of closure of the left anterior cardinal vein during cardiac development. It is usually asymptomatic but can be associated with other congenital cardiac defects including atrial septal defects, ventricular septal defects, endocardial cushion defects, tetralogy of Fallot and rhythm disturbances. PLSVC should be considered in the presence of a dilated coronary sinus on transthoracic echocardiography....

Tayfun Sahin; Teoman Kilic; Umut Celikyurt; Ulas Bildirici; Dilek Ural

2009-01-01

298

Magnetic resonance imaging of renal carcinoma with extension into the vena cava: staging accuracy and recent advances.  

Science.gov (United States)

In 16 patients with surgical confirmation of inferior vena cava thrombi from renal carcinoma, magnetic resonance imaging (MRI) and computed tomography (CT) were compared to assess the ability of non-invasive, cross-sectional imaging techniques to detect tumour thrombus, the level of its extension, and vessel wall invasion. MRI accurately detected tumour thrombus in the inferior vena cava in all 16 cases (CT in 14) and demonstrated the cephalad extent of tumour thrombi in 15 of 16 (CT in 11). The level of extension was more easily seen on MRI, as was the presence of extension into the hepatic veins--a finding not detected by CT. Tumour invasion of the wall of the inferior vena cava was correctly demonstrated in 7 cases on MRI and in 1 case on CT. In 8 of 16 patients, gradient recall acquisition in steady state (GRASS imaging) was performed in addition to conventional spin echo sequences and it correctly identified the composition of thrombus in all: tumour in 6 patients, blood clot in 1 and both tumour and blood clot in the remaining patient. MRI and CT are excellent for detection of tumour but MRI is superior in the evaluation of vascular extension. In addition, the use of GRASS imaging allows differentiation of tumour from blood thrombus. PMID:1773285

Myneni, L; Hricak, H; Carroll, P R

1991-12-01

299

Life-Saving Super-Urgent Liver Transplantation with Replacement of Retrohepatic Vena Cava by Dacron Graft  

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Full Text Available We describe a modified technique of side-to-side cavo-cavostomy by Dacron interposition prosthesis during a super urgent liver transplantation. A liver graft from a deceased donor was immediately requested on a top priority basis as a consequence of massive bleeding during extended left hepatectomy for a huge hepatic haemangioma arising from the caudate lobe. Veno-venous bypass was employed during anhepatic phase but it was disconnected due to severe fibrinolysis and hypothermia. A porto-caval shunt was performed and the inferior vena cava outflow was restored by a Dacron interposition prosthesis. A liver graft from a deceased donor was available 16 hours later. Due to the shortness of the vena cava of the donor liver graft, the removal of the Dacron graft was impossible and a modified side-to-side cavo-cavostomy between the Dacron interposition graft and the vena cava of the donor liver was than performed. Liver transplantation was uneventful and the patient is doing well 25 months after the surgical procedure. Although the use of synthetic vascular prosthesis should usually be discouraged during organ transplantation, its exceptional use during liver transplantation is possible with long-term good results.

Paolo Aseni

2010-01-01

300

Experimental evaluation of a new retrievable inferior vena cava filter for protection from acute pulmonary embolism in canine  

International Nuclear Information System (INIS)

Objective: To evaluate the validity, safety and feasibility of a new retrieval inferior vena cava filter for the prevention of pulmonary embolism in an animal model. Methods: The model of deep iliofemoral venous thrombosis was established in 12 experimental dogs. In control group(6 experimental dogs), the deep venous thrombosis was made to fall off directly. In experimental group (6 experimental dogs), the deep venous thrombosis was made to fall off with an implanted filter in inferior vena cava. The filter's thrombus-trapping efficacy was evaluated by angiography of pulmonary artery, measurement of the mean pressure of pulmonary artery and arterial oxygen saturation before and after the deep venous thrombus falling off. Results: All filters implanted in the experimental dogs could successfully capture clot coming from deep venous thrombosis. There was no case of pulmonary embolism in experimental groups. On the other hand, pulmonary embolism occurred following the fall of deep venous thrombus in all dogs of control group. Conclusion: The retrievable inferior vena cava filter can effectively prevent from the pulmonary embolism due to falling off of the emboli from deep venous thrombosis. The process of implantation and retrieval is relatively simple and easy. (authors)

 
 
 
 
301

The design and application of retrieval stent for Budd-Chiari syndrome with inferior vena cava thrombosis  

International Nuclear Information System (INIS)

Objective: To design the retrieval stent and study the preliminary treatment effect for Budd-Chiari syndrome (BCS) complicated with inferior vena cava thrombosis. Methods: The retrieval stent was designed on the basis of the characteristics of BCS complicated with thrombosis. Four patients with BCS complicated with thrombosis were involved, including recanalization of inferior vena cava through blunt wire penetration after anticoagulation and thrombolytic therapy, then followed by dilation with smaller balloon, and retrievable stent placement, and finally ending by dilation of IVC with larger balloon. All retrieval stents were taken out through internal jugular vein after disappearance of thrombi. Z stent and a retrievable stent were placed at same time for IVC segmental occlusion. Doppler US monitored the course of follow up. Results: Technical success was achieved in 4 patients without pulmonary infarction and other complications during and after the procedure. After all thrombi completely disappeared, all retrievable stents were taken out uneventfully. 3 months follow up with color Doppler did not find thrombus formation, wall thickening and local restenosis at the sites of stent placement. Conclusion: Treatment of BCS complicated with inferior vena cava thrombosis by retrievable stent is a safe and effective method, without complications on vascular wall, probably could take the place of permanent endovascular stent placement. (authors)

302

Correlation of natriuretic peptides and inferior vena cava size in patients with congestive heart failure  

Directory of Open Access Journals (Sweden)

Full Text Available Virginia Hebl, Marina Y Zakharova, Mariana Canoniero, Daniel Duprez, Santiago GarciaDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Minnesota, Minneapolis, MN, USABackground: The inferior vena cava (IVC diameter and degree of inspiratory collapse are used as echocardiographic indices in the estimation of right atrial pressure. Brain-natriuretic peptides (BNPs are established biomarkers of myocardial wall stress. There is no information available regarding the association between the IVC diameter and BNPs in patients with heart failure and various degrees of systolic performance. The purpose of this investigation is to quantify the degree to which natriuretic peptides (BNP and N-terminal pro-B natriuretic peptide [NT-ProBNP] and echocardiographic-derived indices of right atrial pressure correlate in this patient population.Methods: We examined 77 patients (mean age 61 ± 17 years, 44% male with decompensated heart failure who underwent transthoracic echocardiography and, within a timeframe of 24 hours, determination of BNP and NT-ProBNP levels in venous blood. BNP and NT-ProBNP were analyzed after log transformation. The degree of association was measured by the correlation coefficient using the Pearson's method.Results: The mean ejection fraction was 50% ± 20%, and 33% of the study cohort had a remote history of heart failure. The mean IVC diameter was 1.85 cm ± 0.5, the mean BNP was 274 pg/mL, the confidence interval (CI was 95% (95% CI: 197–382, and the mean NT-ProBNP was 1994 pg/mL (95% CI: 1331–2989. There was a positive, albeit small, association between IVC diameter and BNP (r = 0.24, 95% CI: 0.01–0.44; P = 0.03 and NT-ProBNP (r = 0.27, 95% CI: 0.05–0.47; P = 0.01. Among patients with different degrees of IVC collapse in response to inspiration, values for BNP and NT-ProBNP did not differ substantially (P = 0.36 and 0.46 for BNP and NT-ProBNP, respectively.Conclusion: Natriuretic peptides correlate weakly with IVC size and do not predict changes in response to intrathoracic pressure.Keywords: heart failure, inferior vena cava, natriuretic peptides

Duprez D

2012-04-01

303

Derivación portocava transitoria en el trasplante hepático con preservación de la cava / Temporary portocaval shunt in the liver transplant with vena cava preservation  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish INTRODUCCIÓN. La preservación de la vena cava durante el trasplante hepático ortotópico ha ganado adeptos, pero son aún polémicos los beneficios de la derivación portocava transitoria durante la técnica de preservación de la vena cava o piggyback. Este estudio persiguió el objetivo de evaluar los be [...] neficios de la derivación portocava transitoria durante el trasplante hepático con preservación de la vena cava. MÉTODOS. Se realizó un estudio prospectivo aleatorio con 34 pacientes que recibieron trasplante hepático en el Hospital «Hermanos Ameijeiras» en un período de 4 años. Los pacientes fueron distribuidos en dos grupos: Grupo A) con derivación portocava transitoria (n = 16) y Grupo B) sin ella (n = 18). En todos los pacientes se utilizó técnica de piggyback y se midieron variables hemodinámicas y bioquímicas. RESULTADOS. Los datos preoperatorios fueron similares. El tiempo quirúrgico fue también similar (403 ± 77 min y 387 ± 56 min; p = 0,3). Los requerimientos de glóbulos fueron menores en el grupo A (3,3 ± 2,5 unidades frente a 4,2 ± 2,9 unidades), aunque no hubo diferencias significativas. Durante la fase anhepática la disminución del índice cardíaco fue menor en el Grupo A (- 6,8 % frente a - 27,3 %; p = 0,05), y la diuresis durante la fase anhepática fue también mayor en este grupo (3,6 ± 2,97 en comparación con 2,1 ± 1,38 mL/(kg · h); p = 0,005). No hubo diferencias en los parámetros bioquímicos en los tres primeros días después del trasplante, aunque los valores de creatinina fueron mayores en el Grupo B. CONCLUSIONES. El uso de la derivación portocava durante el trasplante hepático ortotópico mejora la hemodinámica, puede contribuir a reducir los requerimientos de glóbulos y protege la función renal, aunque incrementa moderadamente el tiempo quirúrgico Abstract in english INTRODUCTION. The preservation of the vena cava during the orthotopic liver transplantation has won followers, but the benefits of the temporary portocaval shunt during the technique of preservation of the vena cava or piggyback are still polemical. This study was aimed at evaluating the benefits of [...] temporary portocaval shunt during liver transplantation with preservation of the vena cava. METHODS. A prospective randomized study was undertaken with 34 patients that received liver transplantation in "Hermanos Ameijeiras" Hospital during 4 years. The patients were divided into 2 groups: A) with temporary portocaval shunt (n = 16) and, B) without it (n = 18). The piggyback technique was used in all the patients, and the hemodynamic and biochemical variables were measured. RESULTS. The preoperative data were similar. Surgical time was also similar (403 ± 77 min y 387 ± 56 min; p = 0.3). The requirements of red blood cells were lower in group A (3.3 ± 2.5 units versus 4.2 ± 2.9 units), although there were no significant differences. During the anhepatic phase, the reduction of the heart rate was lower in group A (- 6.8 % versus - 27.3 %; p = 0,05). Diuresis during this phase was higher in this group (3.6 ± 2.97 compared with 2.1 ± 1.38 mL/(kg · h); p = 0.005). No differences were found in the biochemical parameters in the first three days after transplantation, even though the values of creatinine were higher in group B. CONCLUSIONS. The use of the portocaval shunt during the liver orthotopic transplantation improves the hemodynamics, contributes to reduce the requirements of red blood cells and and protects the renal function, although it moderately increases the surgical time

Boris L, Gala López; Lucas, Cordoví de Armas; José A, Copo Jorge; Fernando, González Castillo; Orlando, Clausell Wong; Reginaldo, Sarría Duvergel.

304

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  

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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.

JUAN C BAHAMONDES S

2010-04-01

305

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  

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

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

306

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  

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

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

2010-04-01

307

Implante profilático e temporário de filtro de veia cava inferior no trauma / Prophylactic and temporary inferior vena cava filter implant in trauma  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O tromboembolismo pulmonar (TEP) é importante causa de óbito no trauma e esse, na maioria das vezes, contraindica a principal farmacoterapia na prevenção e no tratamento do TEP: a anticoagulação. Relatamos um caso de paciente politraumatizado, com risco elevado de embolia pulmonar, submetido ao impl [...] ante preventivo e temporário de filtro de veia cava inferior (FVC). Abstract in english Pulmonary embolism (PE) is a major cause of death in trauma and that, on most cases, the main contraindication for pharmacotherapy in the prevention and treatment of PE: the anticoagulation. We report a case of multiple trauma patient at high risk of pulmonary embolism, preventive and implant subjec [...] ted to temporary inferior vena cava filter (VCF).

Fábio Augusto Cypreste, Oliveira; Carlos Eduardo de Sousa, Amorelli; Fábio Lemos, Campedelli; Juliana Caetano, Barreto; Mariana Caetano, Barreto; Philippe Moreira da, Silva; Fernanda Lauar Sampaio, Meirelles.

2013-03-01

308

Ausência parcial de veia cava inferior associada à malformação intestinal Partial absence of the inferior vena cava associated with bowel malformation  

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Full Text Available Criança de 6 anos de idade, sexo feminino, procurou serviço médico devido a mal-formação gastrointestinal. Durante o acompanhamento médico, foi diagnosticada ausência parcial de veia cava inferior, alteração congênita rara que envolve a drenagem vascular do segmento inferior do corpo. Realizados exames de imagem, os quais contribuíram para avaliação e descrição do caso. Mantido tratamento conservador com anticoagulante oral. Paciente apresenta boa evolução após longo tempo de acompanhamento cardiovascular.A 6-year-old female child sought medical service due to a gastrointestinal malformation. During a medical follow-up a partial absence of the inferior vena cava was diagnosed, which is a rare congenital alteration, involving the vascular drainage from the inferior segment of the body. Imaging exams were performed, which contributed to evaluation and description of the case. Conservative treatment with an oral anticoagulant was maintained. The patient presents good evolution after a long-term cardiovascular follow-up.

Marcello Laneza Felicio

2007-09-01

309

Implante profilático e temporário de filtro de veia cava inferior no trauma / Prophylactic and temporary inferior vena cava filter implant in trauma  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O tromboembolismo pulmonar (TEP) é importante causa de óbito no trauma e esse, na maioria das vezes, contraindica a principal farmacoterapia na prevenção e no tratamento do TEP: a anticoagulação. Relatamos um caso de paciente politraumatizado, com risco elevado de embolia pulmonar, submetido ao impl [...] ante preventivo e temporário de filtro de veia cava inferior (FVC). Abstract in english Pulmonary embolism (PE) is a major cause of death in trauma and that, on most cases, the main contraindication for pharmacotherapy in the prevention and treatment of PE: the anticoagulation. We report a case of multiple trauma patient at high risk of pulmonary embolism, preventive and implant subjec [...] ted to temporary inferior vena cava filter (VCF).

Fábio Augusto Cypreste, Oliveira; Carlos Eduardo de Sousa, Amorelli; Fábio Lemos, Campedelli; Juliana Caetano, Barreto; Mariana Caetano, Barreto; Philippe Moreira da, Silva; Fernanda Lauar Sampaio, Meirelles.

310

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

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Full Text Available Paciente do sexo masculino, branco, 57 anos, portador de síndrome da veia cava superior havia 3 meses, devido a timoma invasivo em mediastino médio e anterior, levando a comprometimento da veia cava superior intrínseca e extrinsecamente. Após avaliação por tomografia computadorizada e angiorressonância magnética de tórax, o paciente foi submetido à ressecção radical do timoma - derivação venosa da veia subclávia esquerda para átrio direito, com tubo de PTFE (politetrafluoroetileno. Relevante caso de timoma invasivo ocasionando a oclusão da veia cava superior. A evolução clínica, após 7 meses, foi considerada satisfatória.We report on a case of a 57 years-old white male, patient, who presented superior vena cava syndrome (SVC for 3 months, derived from an invasive thymoma in the medium and anterior mediastinum, compromising intrinsic and extrinsic to the SVC. After evaluation by computed tomography and magnetic angioresonance of the thorax, the patient underwent radical resection of the thymoma - bypass from left subclavian vein to right atrium, using polytetrafluoroethylene tube. Relevant case of invasive thymoma causing the occlusion of SVC. The clinic evolution of the patient after 7 months was considered satisfactory.

George Ronald Soncini da Rosa

2010-06-01

311

Inferior vena cava bypass for the treatment of obliterative hepatocavopathy with five-year follow-up.  

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Inferior vena cava (IVC) thrombosis at its hepatic portion (also known as obliterative hepatocavopathy [OH]), in the absence of systemic or local diseases such as vasculitis, coagulopathy, infection and malignancy, is a rare event. We report the case of a 25-year-old woman with progressive abdominal pain and leg edema after exercise. Imaging showed congestive liver and IVC occlusion at the intrahepatic portion. A liver biopsy demonstrated portal congestion without evidence of fibrosis; after unsuccessful percutaneous attempts for recanalization, consideration was given to liver transplantation with IVC reconstruction versus IVC bypass. Due to the presence of preserved liver function, an externally supported 16-mm ringed polytetrafluoroethylene graft was used to bypass from the suprarenal IVC to the suprahepatic IVC. At five years, she remains symptom-free, with normal liver function and a patent graft on systemic anticoagulation. This report highlights the successful surgical management of a patient with OH with a thick membrane. It supports other published proposals that this entity differs significantly from classic Budd-Chiari syndrome with thrombosis that affects only the hepatic veins and, thus, OH should be approached and managed differently. PMID:21917743

Anaya-Ayala, Javier E; Johnson, Brett A; Smolock, Christopher J; Davies, Mark G; Peden, Eric K

2011-10-01

312

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

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Full Text Available Abstract Background An unusual sequence of post operative events heralded by hemodynamic deterioration followed by dyspnea and rapidly progressive dilatation of superficial neck and facial veins, resembling a superior vena cava syndrome, two days post surgical resection of filamentous aortic valve masses, closure of a patent foramen ovale, and performance of a modified Maze procedure for atrial fibrillation in a patient that presented with transient neurologic findings is presented. Case Presentation Although both clinical findings and hemodynamic derangements completely resolved following tricuspid valve repair aimed to correct the new onset severe tricuspid regurgitation noted post operatively; a clear mechanism was not readily obvious and diagnostic testing data somewhat conflictive. We present a careful retrospective examination of all clinical data and review possible clinical entities that could have been implicated in this particular case and recognize that transesophageal echocardiographic findings were most useful in identifying the best course of action. Conclusion After reviewing all clinical data and despite the inconclusive nature of test results; the retrospective examination of transesophageal echocardiographic findings proved to be most useful in identifying the best course of action. We postulate that in our case, resolution of the suspected pulmonary embolism with anticoagulation and reestablishment of a normal right ventricular geometry with tricuspid valve repair worked in unison in restoring normal hemodynamics and resolving both dyspnea and venous dilatation.

Pellegrini Ronald

2005-10-01

313

Endovascular treatment of stenoses in the superior vena cava syndrome caused by non-tumoral lesions  

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We report our experience in percutaneous treatment of non-tumoral superior vena cava syndrome (SVCS) between December 1998 and July 2001. During a period of 2.5 years, 9 patients (age range 27-84 years, mean age 50 years) were treated percutaneously for significant non-tumoral SVCS. Symptomatic SVCS were due to dialysis catheters (7), central line (1) and radiation therapy (1). In thrombotic occlusions and severe stenosis, a preliminary in situ thrombolysis was achieved before angioplasty. Patients were followed by echo-Doppler, computed tomography angiography (CTA), magnetic resonance angiography (MRA), or phlebography. Complete recanalization of the veins and immediate resolution of symptomatic SVCS were obtained in all patients, with no procedure-related complication. Thirteen stents were placed in 9 patients with a mean clinical follow-up of 9.1 months (range 2-23 months). One hundred percent patency at 6 months was obtained. Two patients recurred twice and were treated with new stent placement. At 12 months the patency was 67% and assisted patency was 100%. Stent placement in benign symptomatic SVCS is a safe and minimally invasive procedure, with no technical and clinical complications in our experience. It allowed immediate relief of symptoms, and in dialysed patients could provide continued use of hemodialysis access. Close clinical surveillance is mandatory to assess stent patency. (orig.)

314

Mediastinal seminoma presenting as superior vena cava syndrome and tracheal obstruction.  

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Malignant germ cell tumours of the mediastinum are rare, presenting mostly in young males. These are bulky tumours, mostly intrathoracic, infiltrating into adjacent structures early in the growth process. Patients may present with symptoms of compression. Occasionally, mediastinal adenopathy and superior vena cava (SVC) syndrome may occur. We discuss a case of a 19 year old boy with six weeks history of progressively worsening shortness of breath and mid-sternal chest heaviness and one month history of swelling of the face and upper limbs. The entire face and upper extremities were grossly oedematous with engorged veins suggesting SVC syndrome. CT scan chest showed a large mediastinal mass 18 x 24 cm extending from the superior mediastinum to the mid pericardial area. The trachea was extrinsically compressed to almost 80% at its distal portion. Mass was resected completely. Post operative course was unremarkable. The final histopathology showed a fibrotic mass with no viable tumour. Surgery followed by radiation therapy has been the usual initial treatment with multimodal chemotherapy showing remarkable results. PMID:21381621

Fatimi, Saulat Hasnain; Shahid, Basma; Hanif, Hashim Muhammad; Muzaffar, Marium

2010-10-01

315

Pulmonary hilar lymph node metastasis of breast cancer induced bronchopleural fistula and superior vena cava syndrome.  

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Background It is extremely rare for pulmonary hilar lymph node metastasis (PHLNM) of a cancer to be independently lethal. Here, we report an exceedingly rare case of cavitation in PHLNM from breast cancer triggering broncho-pleural fistula and empyema (BPFE), complicated with superior vena cava syndrome (SVCS). Case Report A 56-year-old woman who had undergone left segmental mastectomy and axillary lymph node dissection due to left breast cancer was then treated for 1 year with postoperative adjuvant chemotherapy. Recurrence of right PHLNM was observed 2 years after the operation, for which 3 courses of bevacizumab (BEV) and paclitaxel combination chemotherapy were administered. The woman had dyspnea and fever during the washout period, and CT examination revealed fistula formation between the right PHLNM cavitation and right main bronchus, so she was admitted for further treatment. This fistula rapidly progressed to BPFE, and contralateral aspiration was observed to cause pneumonia of the left lung. In addition, edema of both upper limbs and head and neck were observed, and CT examination revealed SVCS caused by re-enlargement of PHLNM. Active treatment was performed, but the recommencement of chemotherapy was not possible, and she died on Day 150 of admission. Conclusions We think that PHLNM deteriorated to central necrosis due to chemotherapy with BEV taking effect, leading to formation of BPFE. The case was also made more difficult due to the complication of SVCS caused by the re-enlarged PHLNM. PMID:25399335

Nishinari, Yutaka; Kashiwaba, Masahiro; Umemura, Akira; Komatsu, Hideaki; Sasaki, Akira; Wakabayashi, Go

2014-01-01

316

Fulminate intracardiac thrombosis associated with Budd-Chiari-syndrome and inferior vena cava thrombosis.  

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The most common cause of edema of the legs and dyspnea is congestive heart failure. Further differential diagnosis such as renal or hepatic failure have to be considered. We report the case of a previous healthy 65-year-old woman who developed dyspnea and massive edema of the legs followed by acute hepatic and renal failure. Imaging studies showed a thrombosis of the inferior vena cava (IVC) caused by a tumor between the right kidney and the IVC. Histological examination revealed a leiomyosarcoma of the IVC. Hepatic failure due to venous outflow obstruction (Budd-Chiari syndrome, BCS) was diagnosed. Coagulation profile showed a complex disorder due to acute hepatic failure. Factor V Leiden and prothrombin gene mutation G20210A could be excluded. The thrombosis extended from the femoral veins up to the right atrium. After 11 days of anticoagulation with heparin platelet counts decreased by more than 50%. Suspecting a heparin-induced thrombocytopenia the patient was placed on recombinant hirudin (lepirudin) for anticoagulation. Hepatic venogram showed a thrombosis of the hepatic vein orifices but not of the hepatic veins. The tumor and the thrombi were removed surgically. When the cardiopulmonary bypass was terminated new intracardiac thrombi occurred. Despite immediate surgical intervention the patient finally died due to right ventricular failure caused by the fulminate intracardiac thrombosis. In conclusion, thrombosis of the IVC may mimic congestive heart failure and may cause BCS. Neoplasms and coagulation disorders may cause thrombosis of the IVC. PMID:11951701

Eckel, F; Huber, W; Heidecke, C D; Moessmer, G; Berger, H; Holper, K; Dietrich, W; Lersch, C; Siewert, J R

2002-02-01

317

MitraClip® via direct right atrial access in case of a missing inferior vena cava.  

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The presence of mitral regurgitation (MR) in patients with heart failure represents an independent predictor of mortality. Until now, the standard therapy for severe MR has been cardiac surgery in order to perform mitral valve replacement or mitral valve repair. With the introduction of the MitraClip® system (Abbott Vascular - Structural Heart, Menlo Park, CA, USA) in 2008, there is now an alternative percutaneous treatment option available for high-risk patients. We report on an 84-year-old male patient who was admitted to the emergency room with increasing shortness of breath due to severe functional MR, at stage NYHA III. In the following days the patient developed cardiogenic shock due to failure of the diuretic medication. The case first described here demonstrates an alternative transseptal route of access via a direct atrial puncture of the RA in a patient with absent inferior vena cava. This approach was successfully used to perform a MitraClip® procedure in this patient with functional MR and cardiogenic shock. It was possible to treat mitral regurgitation and the consecutive cardiogenic shock by implanting two MitraClips®. PMID:23482326

Frerker, Christian; Meincke, Felix; Seibert, Hans-Peter; Alessandrini, Hannes; Kreidel, Felix; Caspary, Michael; Busse, Cord; Schäfer, Ulrich; Kuck, Karl-Heinz

2013-09-01

318

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

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Aim: To evaluate the cross-sectional radiological appearances and to review the clinical presentation and outcome of patients with leiomyosarcomas of the inferior vena cava (IVC LMS). These are rare aggressive tumours that present late with non-specific symptoms and have a poor prognosis. Materials and Methods: From January 2002 to December 2008, the radiological images of 23 sequential patients with pathologically proven IVC LMS were independently reviewed by two experienced radiologists. The clinical presentation, treatment including surgical details, and outcome were recorded. Results: There were 19 females and four males with a mean age of 53 years. CT typically demonstrated a large, lobulate, non-calcified heterogeneous mass with peripheral enhancement. T1-weighted magnetic resonance imaging (MRI) images demonstrated a mass with a low signal intensity and T2-weighted MRI images demonstrated a mass with a high signal intensity. Clinical presentation included leg oedema, back and abdominal pain with almost 50% of patients presenting with metastases. Eleven patients underwent ablative surgery. The mean survival time of all patients in the study was 34 months and that of the 11 post-surgical patients was 56 months. Conclusion: There are a variety of diagnostic features on both computed tomography (CT) and MRI which aid the diagnosis of this unusual vascular neoplasm. CT is vital in determining the location of the tumour within the IVC and MRI accurately depicts its extent and the potential for surgical resectability, which offers the only chance of survival.

319

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

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

Masato Katagiri

2012-07-01

320

A young testicular cancer case presenting with an inferior vena cava thrombosis and bilateral pulmonary embolisms  

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Full Text Available The increased risk of thromboembolic events is well known in patients with cancer. We aimed to highlight this relationship in a case of testicular cancer. A 25-year-old young man was admitted to our hospital with complaints of sudden onset chest pain and dyspnea. Physical examination revealed a respiratory rate of 30/min and a blood pressure of 110/70 mmHg. A partial reduction of breath sounds in the basal posterior of the right lung was present on lung auscultation. Posteroanterior chest radiography was interpreted as normal. Echocardiographic evaluation revealed severe dilatation and hypertrophy of the right heart, and the pulmonary arterial pressure was 75 mmHg. Multi-detector computed tomography showed a submassive pulmonary embolism and inferior vena cava thrombosis. The level of serum alpha-fetoprotein was slightly higher than normal. A right testicular mass was found upon physical examination. A right orchiectomy operation was performed. Pathological investigation revealed a malignant mixed germinal tumor of the testicle. In conclusion, in cases of thromboembolism in young males, physicians should consider the possibility of testicular cancer.

Bünyamin Serto?ullar?ndan

2012-03-01

 
 
 
 
321

Percutaneous Greenfield inferior vena cava filter placement: Experience in 50 cases  

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Although several alternatives exist for interruption of the inferior vena cava, the Greenfield filter is the only one currently approved for percutaneous intravascular use. The authors describe their experience in our first 50 consecutive placements with a follow-up of 4-28 months. After serial dilation procedures the filters were inserted, via a 24-French sheath, into the right femoral vein (n = 37), right internal jugular vein (n = 12), and left femoral vein (n = 1). Early and delayed CT and US examinations of the entry site in 20 patients revealed no postplacement thromboses. Only one complication occurred, secondary to severe scarring due to previous surgery at the entry site in a patient with impaired hemostasis. The authors therefore advocate percutaneous Greenfield filter placement as a safe and fast procedure, using the right femoral or internal jugular approach as dictated by the angiographer's experience, the presence of thrombus, and the ease of access to the vein in question. Caveats in patient selection and methods of introduction based on our experience are presented

322

The Guenther temporary inferior vena cava filter for short-term protection against pulmonary embolism  

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Purpose. To evaluate clinically the Guenther temporary inferior vena cava (IVC) filter. Methods. Eleven IVC filters were placed in 10 patients. Indications for filter placement were surgical pulmonary embolectomy in seven patients, pulmonary embolism in two patients, and free-floating iliofemoral thrombus in one patient. Eight filters were inserted from the right femoral approach, three filters from the left. Follow-up was by plain abdominal radiographs, cavography, and duplex ultrasound (US). Eight patients received systemic heparinization. Follow-up, during 4-60 months after filter removal was by clinical assessment, and imaging of the lungs was performed when pulmonary embolism (PE) was suspected. Patients received anticoagulation therapy for at least 6 months. Results. Ten filters were removed without complications 7-14 days (mean 10 days) after placement. One restless patient pulled the filter back into the common femoral vein, and a permanent filter was placed. In two patients a permanent filter was placed prior to removal. One patient developed sepsis, and one an infection at the insertion site. Clinically no recurrent PE developed with the filter in place or during removal. One patient had recurrent PE 7 months after filter removal. Conclusion. The Guenther temporary IVC filter can be safely placed for short-term protection against PE. The use of this filter is not appropriate in agitated or immunocompromised patients

323

Histology of Tissue Adherent to OptEase Inferior Vena Cava Filters Regarding Indwelling Time  

International Nuclear Information System (INIS)

The purpose of this paper is to report on the histology of tissues found on retrieved filters with regard to indwelling time. Between February 2006 and January 2007, 28 Optease inferior vena cava filters (Cordis Europa, Roden, The Netherlands) were retrieved from 27 patients. Twenty-two filters were inserted prophylactically for trauma patients and six for patients with venous thromboembolism. Cavography was performed both before and after filter removal to evaluate the presence of thrombi or wall damage. Filters were retrieved with the snare and sheath method. All material adherents to the filters were examined histologically.The mean indwelling time of the filters was 24.9 days (range, 6-69 days). Red tissue fragments were seen on all the filters, consistent microscopically with clots and fibrin. On five filters (18%; mean indwelling time, 45.4 days) white tissue consistent with vascular intima was found. All postprocedure cavographies were normal. We conclude that most material adherent to the retrieved filters is thrombi, while vascular intima can be found in the minority of filters with a longer indwelling time.

324

A computational method for predicting inferior vena cava filter performance on a patient-specific basis.  

Science.gov (United States)

A computational methodology for simulating virtual inferior vena cava (IVC) filter placement and IVC hemodynamics was developed and demonstrated in two patient-specific IVC geometries: a left-sided IVC and an IVC with a retroaortic left renal vein. An inverse analysis was performed to obtain the approximate in vivo stress state for each patient vein using nonlinear finite element analysis (FEA). Contact modeling was then used to simulate IVC filter placement. Contact area, contact normal force, and maximum vein displacements were higher in the retroaortic IVC than in the left-sided IVC (144 mm(2), 0.47 N, and 1.49 mm versus 68 mm(2), 0.22 N, and 1.01 mm, respectively). Hemodynamics were simulated using computational fluid dynamics (CFD), with four cases for each patient-specific vein: (1) IVC only, (2) IVC with a placed filter, (3) IVC with a placed filter and model embolus, all at resting flow conditions, and (4) IVC with a placed filter and model embolus at exercise flow conditions. Significant hemodynamic differences were observed between the two patient IVCs, with the development of a right-sided jet, larger flow recirculation regions, and lower maximum flow velocities in the left-sided IVC. These results support further investigation of IVC filter placement and hemodynamics on a patient-specific basis. PMID:24805200

Aycock, Kenneth I; Campbell, Robert L; Manning, Keefe B; Sastry, Shankar P; Shontz, Suzanne M; Lynch, Frank C; Craven, Brent A

2014-08-01

325

Prognostic significance of dilated inferior vena cava in advanced decompensated heart failure.  

Science.gov (United States)

Dilated inferior vena cava (IVC) is prevalent among patients with heart failure (HF), but whether its presence predicts worsening renal function (WRF) or adverse outcomes is unclear. This cohort study analyzed patients with left ventricular ejection fraction IVC diameter was the most powerful predictor for the development of WRF (area under the curve = 0.795, cut-off value = 20.5 mm). During the 2-year follow-up, 36 patients (49 %) were re-hospitalized for HF and 14 patients (19 %) died. The event rates were significantly greater in the WRF group than in the non-WRF group (71 vs. 30 %, P IVC >21 mm, and WRF. When adjusted for confounding factors, IVC >21 mm [hazard ratio (HR) 3.73, 95 % confidence interval (CI) 1.66-8.34] and WRF (HR 2.68, 95 % CI 1.07-6.75) were significant predictors for adverse outcomes. In patients with advanced decompensated HF, dilated IVC (>21 mm) predicted the development of WRF and could be a predictor for adverse outcomes. PMID:24939288

Lee, Hsin-Fu; Hsu, Lung-An; Chang, Chi-Jen; Chan, Yi-Hsin; Wang, Chun-Li; Ho, Wan-Jing; Chu, Pao-Hsien

2014-10-01

326

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

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Aim: To evaluate the cross-sectional radiological appearances and to review the clinical presentation and outcome of patients with leiomyosarcomas of the inferior vena cava (IVC LMS). These are rare aggressive tumours that present late with non-specific symptoms and have a poor prognosis. Materials and Methods: From January 2002 to December 2008, the radiological images of 23 sequential patients with pathologically proven IVC LMS were independently reviewed by two experienced radiologists. The clinical presentation, treatment including surgical details, and outcome were recorded. Results: There were 19 females and four males with a mean age of 53 years. CT typically demonstrated a large, lobulate, non-calcified heterogeneous mass with peripheral enhancement. T1-weighted magnetic resonance imaging (MRI) images demonstrated a mass with a low signal intensity and T2-weighted MRI images demonstrated a mass with a high signal intensity. Clinical presentation included leg oedema, back and abdominal pain with almost 50% of patients presenting with metastases. Eleven patients underwent ablative surgery. The mean survival time of all patients in the study was 34 months and that of the 11 post-surgical patients was 56 months. Conclusion: There are a variety of diagnostic features on both computed tomography (CT) and MRI which aid the diagnosis of this unusual vascular neoplasm. CT is vital in determining the location of the tumour within the IVC and MRI accurately depicts its extent and the potential for surgical resectability, which offers the only chance of survival.

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

2011-01-15

327

The relationship between Doppler indices from inferior vena cava and hepatic veins in normal human fetuses.  

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Full Text Available This study was conducted to determine the gestational age-related reference range of the preload index [peak velocity during atrial contraction (A/peak velocity during ventricular systole (S] for the inferior vena cava (IVC, the right hepatic vein, the middle hepatic vein and the left hepatic vein. The slope and the intercept of the regression line for each preload index were compared among the 4 veins using analysis of covariance. Doppler measurements were obtained for the 4 veins of 316 normal fetuses at 22-40 weeks of gestation. A and S values were measured from the recorded flow velocity waveform of each vein and the A/S ratio was calculated as the preload index. The regression lines for the preload index of the 4 veins decreased gradually throughout gestation. Analysis of covariance revealed no significant differences in the slopes of the regression lines for the 4 veins. However, the intercepts of the regression lines for all hepatic veins were significantly higher than that of the regression line for the IVC (P<0.0001, with the difference ranging from 0.024 to 0.033. There were no significant differences among the intercepts of the regression lines for different hepatic veins. We concluded that the relationship between the preload index and the duration of gestation was statistically similar for all hepatic veins, and strongly resembled that for the IVC.

Okura I

2003-04-01

328

The Use of Inferior Vena Cava Filters in Pediatric Patients for Pulmonary Embolus Prophylaxis  

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Purpose: To report our experience with inferior vena cava (IVC) filters in pediatric patients. Methods: Over a 19-month period, eight low-profile percutaneously introducible IVC filters were placed in four male and four female patients aged 6-16 years (mean 11 years). Indications were contraindication to heparin in six patients, anticoagulation failure in one, and idiopathic infrarenal IVC thrombosis in one. Six of the eight devices placed were titanium Greenfield filters. One LGM and one Bird's Nest filter were also placed. Two of the filters were introduced via the right internal jugular vein by cutdown, and the remainder were placed percutaneously via the right internal jugular vein or the right common femoral vein. Patients received follow-up abdominal radiographs from 2 to 13 months after IVC filter placement. Results: All filters were inserted successfully without complication. Three of the patients died during the follow-up period: two due to underlying brain tumors at 2 and 12 months and a third at 6 weeks due to progressive idiopathic renal vein and IVC thrombosis. The remaining five patients were all alive and well at follow-up without evidence of IVC thrombosis, pulmonary emboli, or filter migration. Conclusion: IVC filter placement using available devices for percutaneous delivery is technically feasible, safe, and effective in children

329

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

DEFF Research Database (Denmark)

During an 18-month period, 82 consecutive patients (37 women and 45 men), with a mean age of 50 yr (range 15 to 74), underwent hemodialysis with 91 polyurethane double-lumen subclavian superior vena cava catheters inserted via the right subclavian vein. Upon catheter removal, venograms were performed in 53 which revealed thrombosis in 13. Autopsy performed in 13 other patients revealed thrombosis in three. Mean catheter duration was 27 days (range 1 to 138). Catheter duration was significantly (p less than .01) longer in the 16 cases complicated by thrombosis. There was no significant difference in the frequency of thrombosis between men and women. Two patients developed symptoms of subclavian vein occlusion after the creation of an arteriovenous fistula on the same side as a previous hemodialysis catheter. Overall, thrombosis was found in 23% and increased with longer catheter duration. We recommend phlebography to exclude thrombosis before creating an arteriovenous fistula on the same side as the previous hemodialysis catheter. There was no case of clinical discernible pulmonary embolism.

Wanscher, Maria RØrbæk; Frifelt, J J

1988-01-01

330

Primary hepatic carcinoma with tumor thrombus in inferior vena cava: treated by transcatheter chemoembolization  

International Nuclear Information System (INIS)

Objective: To evaluate the efficacy and the safety of the interventional radiology treatment for primary hepatic carcinoma (PHC) combined with tumor thrombus in inferior vena cava (IVC). Methods: Transcatheter chemoembolization were performed on 9 cases of PHC with tumor thrombus in IVC. The diagnosis was established by puncture biopsy, including single lesion in 3 cases, 2-3 lesions in 4 cases, more than 3 lesions in 2 cases. The tumors ranged in maximum diameter from 3.5-8.6 cm with a mean of (5.6 ± 1.7) cm. All the patients were treated with the chemotherapeutics-lipiodol mixture and the treated arterials included the hepatic arterial, the right inferior phrenic arterial and the left gastric arterial. Follow-up was performed by upper abdomen CT, lung CT and laboratory examination, and follow-up time ranged from 7 to 38 months with a mean of (14.9 ± 9.9) months. Results: Seventeen interventional procedures were performed on 9 patients and all operations were successful without significant complications. The average survival time of 9 cases was (14.9 ± 9.9) months (ranged from 7 months to 38 months), and the longest survival time was 38 months. Conclusions: Transcatheter chemoembolization can be safely performed on the cases of PHC combined with tumor thrombus in IVC. Interventional treatment can prolong the survival time and promote the quality of life. (authors)

331

The application of GxA8xB9nther Tulip retrievable inferior vena cava filter in interventional treatment for acute deep venous thrombosis of lower extremity  

International Nuclear Information System (INIS)

Objective: To discuss the therapeutic efficacy and manipulation skill of Gunther Tulip retrievable inferior vena cava filter in interventional treatment for acute deep venous thrombosis of lower extremity. Methods: From September 2007 to April 2008, a total of 36 patients with acute deep venous thrombosis of lower extremity were treated in our hospital. The time of the onset of disease ranged from 1 day to 12 days. The precipitation causes included prolonged lying in bed due to surgery or bone fracture (n = 18) and postpartum (n = 5), while no obvious precipitation causes could be found in 13 patients. Pulmonary embolism was coexisted in 12 cases. Clinically, the affected limb was swelling and painful, the skin was cyan-purple or pale in color with higher skin temperature. The circumferential length of the affected thigh was 3-10 cm longer than that of normal side. Patients with coexisted pulmonary embolism had the clinical presentation of dyspnea, chest pain, hemoptysis, etc. Gunther Tulip retrievable inferior vena cava filter was implanted via femoral venous access or via right internal jugular venous access, which was followed by intravenous transcatheter thrombolysis. Vascular ultrasonography and angiography were performed 45-75 days after the treatment to confirm that there was no fresh or free thrombus in the veins of lower limb or in the pulmonary arteries. When it was confirmed, Gunther Tulip retrievable inferior vena cava filter was taken out via right internal jugular venous access, which was followed by inferior venacavography. After the procedure anticoagulation and antibiotic medication were employed for 3-5 days. A follow-up for 4-10 months was made. Results: A total of 36 Gunther Tulip retrievable inferior vena cava filters were successfully implanted by one procedure, the average time cost for the filter delivery was 1.5 minutes (0.5-5 minutes). During the delivery procedure, the amplitude of elastic displacement of filter was less than 2 mm. One filter was implanted with a tilt of 25 degrees, and no newly-developed clinical manifestations of pulmonary embolism appeared after filter implant. In twelve patients Gunther Tulip filters were successfully retrieved by single manipulation in 45-75 days after filter delivery, and the retrieval procedure took the mean time of 4.4 minutes (2-15 minutes). Inferior venacavography confirmed that no vascular perforation or rupture occurred. In the remaining 24 patients the filters were kept in inferior vena cava and no clinical symptoms related to pulmonary embolism or inferior vena cava occlusion were observed during the follow-up period. Conclusion: Gunther Tulip retrievable inferior vena cava filter has many advantages in clinical use. The filter can be accurately placed to the scheduled position, it is very powerful in capturing the thrombus, it can be hold in the inferior vena cava for long time (long time window for thrombolysis therapy) before it is planed to be retrieved, and its retrieval success is very high. Moreover, with high technical successful rate the implantation of Gunther Tulip retrievable inferior vena cava filter is very safe and effective for the interventional treatment of acute deep venous thrombosis of lower extremity. (authors)

332

Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging / Anomalias congênitas da veia cava inferior: revisão dos achados na tomografia computadorizada multidetectores e ressonância magnética  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Anomalias da veia cava inferior são incomuns, ocorrendo em até 8,7% da população, quando consideradas as anomalias da veia renal esquerda. A veia cava inferior se desenvolve da sexta à oitava semanas de gestação, originada de três veias embrionárias pareadas: veias subcardinais, supracardinais e pós [...] -cardinais. A complexidade da ontogenia da veia cava inferior, com numerosas anastomoses entre essas três veias 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.

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

333

Hand-assisted laparoscopic radical nephrectomy in the treatment of a renal cell carcinoma with a level ii vena cava thrombus  

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Full Text Available SciELO Brazil | Language: English Abstract in english Excision of renal cell carcinoma (RCC) with corresponding vena cava thrombus is a technical challenge requiring open resection and vascular clamping. A 58 year old male with a right kidney tumor presented with a thrombus extending 1 cm into the vena cava. Using a hand-assisted transperitoneal 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.

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

334

Hand-assisted laparoscopic radical nephrectomy in the treatment of a renal cell carcinoma with a level ii vena cava thrombus  

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Full Text Available Excision of renal cell carcinoma (RCC with corresponding vena cava thrombus is a technical challenge requiring open resection and vascular clamping. A 58 year old male with a right kidney tumor presented with a thrombus extending 1 cm into the vena cava. Using a hand-assisted transperitoneal approach through a 7 cm gel-port, the right kidney was dissected and the multiple vascular collaterals supplying the tumor were identified and isolated. The inferior vena cava was mobilized 4 cm cephalad and 4 cm caudal to the right renal vein. Lateral manual traction was applied to the right kidney allowing the tumor thrombus to be retracted into the renal vein, clear of the vena cava. After laparoscopic ultrasonographic confirmation of the location of the tip of the tumor thrombus, an articulating laparoscopic vascular stapler was used to staple the vena cava at the ostium of the right renal vein. This allowed removal of the tumor thrombus without the need for a Satinsky clamp. The surgery was completed in 243 minutes with no intra-operative complications. The entire kidney and tumor thrombus was removed with negative surgical margins. Estimated blood loss was 300 cc. We present a laparoscopic resection of a renal mass with associated level II thrombus using a hand-assisted approach. In patients with minimal caval involvement, our surgical approach presents an option to the traditional open resection of a renal mass.

Jason R. Kovac

2010-06-01

335

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)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish 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.

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

336

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)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish 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.

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.

337

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

International Nuclear Information System (INIS)

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

338

The interventional therapy of symptomatic inferior vena cava thrombosis developed after filter implantation  

International Nuclear Information System (INIS)

Objective: To evaluate the effect and safety of transcatheter thrombolysis in treating symptomatic inferior vena cava (IVC) thrombosis occurred after filter implantation in IVC. Methods: During the period from October 2005 to September 2009, transcatheter thrombolysis was carried out in four patients with symptomatic IVC thrombosis which developed after filter implantation in IVC. A total of eight lower extremities were involved. IVC filter was implanted via right internal jugular vein, which was followed by recanalization of the occluded IVC with the help of guide wire and catheter, then, subsequent transcatheter intravenous thrombolysis was conducted. IVC filters were retrieved through femoral or right internal jugular vein after thrombus was sufficiently dissolved. Technical and clinical success rate, complications and the occurrence of postprocedural pulmonary embolism were observed and recorded. Results: A total of four retrievable filters were implanted into IVC, and all the four filters together with a previously implanted filter were successfully retrieved. Both technical and clinical success of recanalization and thrombolysis were achieved in all four patients and eight symptomatic lower limbs. The mean time for filter implantation and retrieval operation was 2.0 minutes (in the range of 1-3 minutes) and 7.6 minutes (in the range of 1-20 minutes), respectively. The average thrombolysis duration was 11.75 days (8-14 days). The average filter dwelling time was 40.4 days (range of 14-73 days). No complications such as massive bleeding occurred. During clinical follow-up period, no clinically detectable signs of pulmonary embolism were observed. Conclusion: For the treatment of symptomatic IVC thrombosis occurred after filter implantation in IVC, endovascular recanalization and transcatheter thrombolysis is effective, safe and feasible in clinical practice. (authors)

339

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

340

Inferior vena cava filters in the management of cancer-associated venous thromboembolism: a systematic review  

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Full Text Available This study systematically reviews outcomes after inferior vena cava (IVC filtration in cancer-associated venous thromboembolism (VTE. A comprehensive review of the English language literature was performed using MEDLINE, COCHRANE library, Embase and CINAHL on outcomes (i.e., pulmonary embolism, recurrent DVT, postphlebitic syndrome and survival following IVC filtration in cancer-associated VTE. Fourteen studies with 2,154 cancer patients receiving IVC filters post-VTE were included. All were observational studies. The mean duration of followup was 0.7–38 months and mean patient age was 56.8– 68 years. Among study participants, 47–87% had stage 3 or 4 cancers. Of the 47–93% of filters inserted for contraindications to anticoagulation (AC, 10–33% were placed for relative contraindications. Recurrent PE was seen in 0–6%, fatal PE in 0–4.5%, recurrent DVT in 0–18.2%, postphlebitic syndrome (PPS in 0–2.7%, and IVC thrombosis (ICVT in 3% of cancer patients. Median survival post-filter insertion was 2–10 months. Evidence supporting the utility of IVC filter insertion in cancer-associated VTE is limited to observational studies only. Preliminary data demonstrate similar safety and efficacy of filters in cancer and noncancer populations. The combination of filters and anticoagulation is no more effective than either modality alone. Retrievable filters are an attractive option for prevention of VTE in the presence of temporary risk factors or temporary contraindications to anticoagulation in patients who have a reasonable life expectancy, but there is no evidence to support their preferential use in patients with advanced malignancy.

Michael B. Streiff

2011-12-01

 
 
 
 
341

Superior vena caval syndrome caused by the tumor of the left hilum in a patient with unilateral persistent left superior vena cava diagnosed with multislice spiral computed tomography-a case report  

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Unilateral persistent left superior vena cava (PLSVC) is an infrequent finding with incidence of 18-20% among the individuals with PLSVC. The persistence of the left-sided superior vena cava is an effect of disturbances in development of the connection between the precardinal veins (anterior cardinal veins) and formation of the sinus venosus in early stages of embryogenesis. The paper presents a case of a 62-year-old patient with a mass lesion of the left hilum, which caused left-sided superior vena caval syndrome in the presence of unilateral SVC. Developmental mechanisms of superior vena caval syndrome are discussed. The evolution of changes related to infiltration and occlusion of PLSVC is shown on the basis of three selected MSCT examinations. (author)

342

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

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english 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.

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

2014-10-01

343

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

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Full Text Available 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 IVC who underwent extensive retroperitoneal and pelvic lymph node dissection is described for rarity of the condition and technical difficulties associated with such a condition.

Satheesan B

2009-01-01

344

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

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Full Text Available

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

Marc Gingell Littlejohn

2009-01-01

345

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

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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

346

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

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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.

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

347

Nickel hypersensitivity in patients with inferior vena cava filters: case report and literature and MAUDE database review.  

Science.gov (United States)

Placement of a prophylactic retrievable inferior vena cava (IVC) filter was requested in a 73-year-old woman with nickel hypersensitivity resulting in a clinical dilemma. Given that all retrievable filters contain nickel, the published literature and the Manufacturer and User Facility Device Experience (MAUDE) database were reviewed; no documented case of IVC filter placement in a patient with nickel hypersensitivity or reported hypersensitivity reaction in a patient after IVC filter placement could be identified. This article presents the uneventful course of the case described and a review of the literature and recommendations on use of nickel-containing devices in patients with nickel hypersensitivity. PMID:24954605

Morshedi, Maud M; Kinney, Thomas B

2014-08-01

348

Persistent left superior vena cava and partial anomalous pulmonary venous return in an old asymptomatic female patient.  

Science.gov (United States)

Persistent left superior vena cava is a rare congenital venous anomaly. It results from failure of closure of the left anterior cardinal vein during cardiac development. It is usually asymptomatic but can be associated with other congenital cardiac defects including atrial septal defects, ventricular septal defects, endocardial cushion defects, tetralogy of Fallot and rhythm disturbances. PLSVC should be considered in the presence of a dilated coronary sinus on transthoracic echocardiography. The diagnosis can be made when injection of contrast in left antecubital vein results in enhancement of the dilated coronary sinus before right atrium. MRI, CT-scan and catheterisation can be used to confirm the diagnosis. PMID:20049316

Sahin, Tayfun; Kilic, Teoman; Celikyurt, Umut; Bildirici, Ulas; Ural, Dilek

2009-01-01

349

Robotic repair of sinus venosus atrial septal defect with partial anomalous pulmonary venous return and persistent left superior vena cava.  

Science.gov (United States)

The presence of partial anomalous pulmonary venous return and/or persistent left superior vena cava (LSVC) is usually viewed as a contraindication for robotic repair of complex atrial septal defects, such as those of the sinus venosus type. Three patients, aged 29, 73, and 23 years, successfully underwent totally endoscopic, robotic-assisted repair of sinus venosus-type atrial septal defect with partial anomalous pulmonary venous return and persistent LSVC. Two different techniques--direct cannulation or placement of a sump sucker--were successfully used to manage venous return from the persistent LSVC. PMID:25238426

Lewis, Clifton T P; Bethencourt, Daniel M; Stephens, Richard L; Cline, Jennifer L; Tyndal, Charles M

2014-01-01

350

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

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english 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.

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

351

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

International Nuclear Information System (INIS)

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

352

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

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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

M. Vahedian

2011-10-01

353

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)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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. [...

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

354

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)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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. [...

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

2014-06-01

355

Implante intencional de filtros de veia cava em ambas as veias ilíacas comuns: relato de caso e revisão da literatura / Intentional placement of vena cava filters in both iliac veins: case report and literature review  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Os filtros de veia cava são utilizados para impedir a passagem de êmbolos dos membros inferiores para as artérias pulmonares e, normalmente, são colocadas imediatamente abaixo das veias renais. Em alguns casos, no entanto, existem dificuldades técnicas incomuns que devem ser superadas para tratar ad [...] equadamente alguns pacientes. Relatamos o caso de uma paciente em cujas veias ilíacas comuns foram implantados filtros de veia cava devido à baixa implantação das veias renais e da veia cava inferior curta. Abstract in english Vena cava filters are used to prevent the passage of emboli from the lower limbs to the pulmonary arteries and normally are placed immediately below the renal veins. In some cases however there are unusual technical difficulties that must be overcome to properly treat some patients. We report a case [...] of a patient in whose common iliac veins vena cava filters were deployed, due to the lower implantation of renal veins and a short inferior vena cava.

Daniel Queiroz, Neves; Renvik Demauir Cozine, Silva; Luis Claudio Rosa, Arantes; Márcio Cerbazzi Tavares, Cardoso; Mauro Henrique de, Lima; Gustavo Petorossi, Solano; Celso Luis Muhlethaler, Chouin; Paulo Eduardo Ocke, Reis.

356

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)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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.

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

357

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

International Nuclear Information System (INIS)

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

358

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

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

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

2000-09-01

359

Congenital anomaly of the inferior vena cava and factor V Leiden mutation predisposing to deep vein thrombosis  

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Full Text Available Brooke M Lamparello,1,* Cameron R Erickson,2,* Arun Kulthia,3 Vasudev Virparia,3 Zeyar Thet3 1St George’s University, Grenada, West Indies; 2Northeast Ohio Medical University, Rootstown, OH, USA; 3Department of Medicine, Coney Island Hospital, Brooklyn, NY, USA *These authors contributed equally to this work Abstract: A previously healthy 21-year-old man presented with back pain, bilateral extremity pain, and right lower extremity weakness, paresthesias, and swelling. Sonographic examination revealed diffuse deep vein thrombosis (DVT in the femoral and popliteal venous system. CT imaging revealed hypoplasia of the hepatic inferior vena cava (IVC segment with formation of multiple varices and collateral veins around the kidneys. Hematologic workup also discovered a factor V Leiden mutation, further predisposing the patient to DVT. The rare, often overlooked occurrence of attenuated IVC, especially in the setting of hypercoagulable state, can predispose patients to significant thrombosis. Keywords: inferior vena cava (IVC, deep vein thrombosis (DVT, lower extremities, thrombophilic, venography

Lamparello BM

2014-11-01

360

Long-Term Results of Vena Cava Filters: Experiences with the LGM and the Titanium Greenfield Devices  

International Nuclear Information System (INIS)

Purpose: Vena cava filter (VCF) application is the method of choice to prevent recurrent pulmonary embolism in patients with deep venous thrombosis. Because of the reported complications after VCF placement we summarize our long-term follow-up results with the LGM and Titanium Greenfield (TG) devices. Methods: Eighty-seven LGM VCF and 17 TG VCF were placed in 104 patients (average age 64 years). The follow-up examinations were performed by color-coded duplex sonography, plain radiographs, cavography, and computed tomo-graphy (CT). The maximum observation time was 81 months. Results: Filter migration occurred in 11% (8/76) of the LGM VCF and 15% (2/13) of the TG VCF. Vena cava thrombosis was seen in 17% (13/76) of the patients with an LGM VCF and in 31% (4/13) of those with a TG VCF. The patency rate was 95% (72/76) for the LGM VCF and 92% (12/13) for the TG VCF. Pulmonary embolism was noted in 3 patients after LGM VCF insertion and in no patient after TG VCF insertion. Conclusion: A VCF should only be inserted in a patient after pulmonary embolism and when there is strict proof of the indication

 
 
 
 
361

Three-year experience of prophylactic placement of inferior vena cava filters in women with gynecological cancer  

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Full Text Available Suresh B Babu,1 Asiya Maheen Khan,2 Philip JB Coates1 1Radiology Department, Derriford Hospital, Plymouth, UK; 2Radiology Department, City Hospital, Birmingham, UK Objective: To evaluate the outcomes of prophylactic placement of inferior vena cava (IVC filters to prevent pulmonary embolism (PE in women undergoing surgery and chemotherapy for gynecological cancer. Methods and materials: Thirty-eight IVC filters were placed in 38 women between January 2008 and January 2010; 25 of these were placed in gynecological cancer patients for prevention of PE during surgery and the postoperative period. The patients' electronic medical records, follow-up computed tomography scans, and outpatient follow-up notes were retrospectively reviewed for incidence of PE and adverse events. Results: After 6 months of follow-up, no PE was observed and there was no mortality. Nine filters were retrieved uneventfully, and there were no clinical complications associated with any indwelling filter. Conclusion: IVC filters are safe and beneficial towards preventing PE in women undergoing surgery and chemotherapy for gynecological cancer. Keywords: inferior vena cava filter, gynecological cancer, prophylaxis, pulmonary embolism

Babu SB

2013-08-01

362

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

International Nuclear Information System (INIS)

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

363

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

Science.gov (United States)

Scimitar syndrome is a rare and complex congenital anomaly characterized by partial or complete anomalous pulmonary venous return from the right or left lung into the inferior vena cava, through drainage into the hepatic vein, right atrium or left atrium. The syndrome is commonly associated with hypoplasia of the right lung and right pulmonary artery. We present an 11-year-old female with atypical and rare type of scimitar syndrome. The girl has had cough for 2 months before admission, without fever or abnormalities on medical examination. X-ray films revealed inflammatory and atelectatic changes with mediastinal shift to the right. CT and CT angiography - hypoplasia of the right lung with no visible interlobar fissures. No areas of consolidation in the pulmonary parenchyma. Mediastinum shifted to the right. Single wide venous vessels draining the upper part of the right lung entering the superior vena cava. In our patient, clinical symptoms are mild, but a thorough physical examination could have helped diagnose the syndrome earlier. PMID:24505225

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

2013-10-01

364

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

365

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

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

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

2013-12-15

366

Sistematização da veia cava cranial em búfalos (Bubalus bubalis bubalis Simpson, 1945) / Systematization of the cranial vena cava in buffalos (Bubalus bubalis bubalis Simpson, 1945)  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Para o presente trabalho utilizou-se 25 animais, fetos de búfalos, com idades variando entre 5 e 9 meses, sendo 15 fêmeas e 10 machos, com vistas à dissecação e sistematização dos vasos em estudo. Os animais foram coletados em abatedouro e fixados em solução aquosa de formol 10%. Obtiveram-se para a [...] Veia Cava Cranial os seguintes afluentes de origem: veias jugulares externas direita e esquerda, e os afluentes colaterais: as veias jugulares internas direita e esquerda, veias mediastínicas e pericárdicas, veias torácicas internas direita e esquerda, veias tímicas, veias subclávias direita e esquerda, o tronco costocervicovertebral direita esquerda, e ocasionalmente o ducto torácico. Abstract in english Twenty-five animals, Buffaloes fetus, with 5 to 9 months of age (15 females and 10 males) was analyzed by dissection after injected with latex substance. The fetuses were collected in a slaughterhouse and fixed in aqueous formol solution 10%. 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 mediastinals and pericardials veins; the internal right and left thoracic; thymic vein; the right and left subclavian vein, the right and left costocervicalvertebral venous trunk, and occasionally the thoracic duct.

Adelmar Afonso de, Amorim Júnior; Maria Angélica, Miglino; Marleyne José Afonso Accioly Lins, Amorim; Tatiana Carlesso dos, Santos.

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Ausência parcial de veia cava inferior associada à malformação intestinal / Partial absence of the inferior vena cava associated with bowel malformation  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Criança de 6 anos de idade, sexo feminino, procurou serviço médico devido a mal-formação gastrointestinal. Durante o acompanhamento médico, foi diagnosticada ausência parcial de veia cava inferior, alteração congênita rara que envolve a drenagem vascular do segmento inferior do corpo. Realizados exa [...] mes de imagem, os quais contribuíram para avaliação e descrição do caso. Mantido tratamento conservador com anticoagulante oral. Paciente apresenta boa evolução após longo tempo de acompanhamento cardiovascular. Abstract in english A 6-year-old female child sought medical service due to a gastrointestinal malformation. During a medical follow-up a partial absence of the inferior vena cava was diagnosed, which is a rare congenital alteration, involving the vascular drainage from the inferior segment of the body. Imaging exams w [...] ere performed, which contributed to evaluation and description of the case. Conservative treatment with an oral anticoagulant was maintained. The patient presents good evolution after a long-term cardiovascular follow-up.

Marcello Laneza, Felicio; Antonio Sergio, Martins; Rubens Ramos de, Andrade; Marcos Augusto de Moraes, Silva.

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Diagnostic imagings and embolotherapy for the superior mesenteric vein-inferior vena cava shunt  

International Nuclear Information System (INIS)

Diagnostic imaging and embolization therapy for the uncommon portal and mesenteric vein-inferior vena cave shunt (PV·SMV-IVC shunt) are reported. As the frequency of clinical symptoms such as hematemesis, melena and confusion caused by gastrointestinal varices, or hepatoencephalopathy was about 40%, it was important for this disease entity to be diagnosed with noninvasive diagnostic images. The careful examination of the area around the right renal vein was able to overcome the low diagnostic rate of 20-40% obtained with US and CT images. In cases of simple PV·SMV-IVC shut without gastrointestinal varices, embolization therapy using steel coils and done by the intravenous approach is easy and noninvasive. On the other hand, in cases of complex PV-SMV-IVC shunt with gastrointestinal varices, dual balloon occluded embolization therapy using a liquid sclerosing agent and done by the intravenous and portal approaches is preferable. (author)

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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  

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Full Text Available SciELO Chile | Language: Spanish Abstract in spanish 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

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.

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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  

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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

FRANCO INNOCENTI C

2008-04-01

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish El síndrome de vena cava superior (SVCS) es una complicación rara del cáncer de tiroides, que se produce como consecuencia de la invasión mediastínica por el tumor o por la invasión intravascular del mismo con trombosis. Creemos describir el primer caso de carcinoma insular de tiroides (variante tum [...] oral indiferenciada del ca. folicular) con SVCS resuelto mediante la colocación de un stent venoso, que deviene así una alternativa eficaz y menos agresiva que la quirúrgica. Se trata de un varón de 73 años que ingresa por un cuadro de disfonía y tumoración laterocervical derecha de dos meses de evolución; la PAAF de tiroides sugirió neoplasia folicular realizándose tiroidectomía total revelando el examen histológico un carcinoma insular de tiroides y administ