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Sample records for vena cava disease

  1. Inferior vena cava aneurysm. A case report

    Aneurysmal dilatation of the inferior vena cava can occur in patients with heart disease or, very likely, with congenital weakness of the vascular wall. Chest x-ray discloses a mass in right cardiophrenic angle. The diagnosis can be confirmed by ultrasound, more invasive measures being unnecessary. (Author) 6 refs

  2. Liver transplantation with preservation of the inferior vena cava in case of symptomatic adult polycystic disease.

    Lerut, Jan; Ciccarelli, Olga; Rutgers, Matthieu; Orlando, Giuseppe; Mathijs, Jules; Danse, Etienne; Goffin, Eric; Gigot, Jean-François; Goffette, Pierre

    2005-05-01

    Adult polycystic liver disease (APLD) is a rare disorder of the liver parenchyma, the treatment of which is still controversial. Conservative surgery may have a significant morbidity and is often ineffective in the long run. Liver replacement may be indicated in case of incapacitating hepatomegaly. Patients (one male, five females) undergoing liver transplantation for symptomatic APLD is presented in this study. The particular nature of this series is the fact that successful transplantation was performed in all cases with preservation of the recipient's inferior vena cava and without use of veno-venous bypass despite massive hepatomegaly and previous extensive liver surgery (in three cases). There was minimal morbidity and no mortality. All patients have excellent quality of life with a median follow-up of 41 months (range: 12-58) as testified by a median Karnofsky score of 90% (range: 80-100%). PMID:15819798

  3. Angiosarcoma of the superior vena cava

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

  4. Angiosarcoma of the superior vena cava

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

    1983-08-15

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

  5. Superior vena cava syndrome in children.

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

    1981-01-01

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

  6. A new Nitinol stent for use in superior vena cava syndrome

    Andersen, Poul Erik; Midtgaard, Annette; Brenøe, Anne-Sofie;

    2015-01-01

    time of stent deployment. RESULTS: All patients had superior vena cava obstruction and clinical superior vena cava syndrome caused by malignant expansive mediastinal disease (eight patients non-small cell lung cancer and four small cell lung cancer). The technical success with deployment of the stents......AIM: The aim of the study was to assess the early clinical experience with the Zilver Vena stent in treating patients with malignant superior vena cava syndrome. METHODS: Demographic, procedural, and follow-up data of 12 patients (seven women; mean age 69 years) treated for superior vena cava...

  7. Inferior vena cava leiomyosarcoma confirmed by catheter suction biopsy during digital subtraction angiography

    Wei, Ning; Xu, Xiang-Dong; Xu, Hao; ZU, MAO-HENG

    2014-01-01

    Leiomyosarcoma of vascular origin is a rare disease and most cases arise in the inferior vena cava. Inferior vena cava leiomyosarcoma (IVCLMS) usually presents in females in their sixth decade of life. The clinical symptoms are often non-specific and the diagnosis is often delayed. Current imaging techniques can accurately differentiate inferior vena cava neoplasms from other non-neoplastic lesions. However, definitive diagnosis of IVCLMS needs histologic evidence. We report a case of IVCLMS ...

  8. Superior vena cava syndrome in hemodialysis patient

    Azeb Molhem

    2011-01-01

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

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

    Do Thi Cam Giang

    2014-01-01

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

  10. Endovascular treatment of superior vena cava syndrome

    Duvnjak, Stevo; Andersen, Poul Erik

    2011-01-01

    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...

  11. Percutaneous insertion of the inferior vena cava filter

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

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

    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

  13. Clinical application and advancement of inferior vena cava filter

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

  14. Inferior vena cava leiomyosarcoma confirmed by catheter suction biopsy during digital subtraction angiography.

    Wei, Ning; Xu, Xiang-Dong; Xu, Hao; Zu, Mao-Heng

    2014-01-01

    Leiomyosarcoma of vascular origin is a rare disease and most cases arise in the inferior vena cava. Inferior vena cava leiomyosarcoma (IVCLMS) usually presents in females in their sixth decade of life. The clinical symptoms are often non-specific and the diagnosis is often delayed. Current imaging techniques can accurately differentiate inferior vena cava neoplasms from other non-neoplastic lesions. However, definitive diagnosis of IVCLMS needs histologic evidence. We report a case of IVCLMS in a 61-year old Chinese woman. This is the first IVCLMS case confirmed by catheter suction biopsy during digital subtraction angiography. PMID:25232438

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

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

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

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

    1984-10-01

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

  17. Right superior vena cava draining into the left atrium

    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.)

  18. Injuries of the inferior vena cava.

    Burch, J M; Feliciano, D V; Mattox, K L; Edelman, M

    1988-12-01

    Beginning in 1946, 577 patients with inferior vena cava injuries were managed at a single institution. After decreasing from 37 to 30 percent, the mortality rate showed a distinct increase in the last 7 years studied. This increase was related to an increasing percentage of patients who arrived in the emergency center in severe shock and required resuscitative thoracotomy. In-hospital care advances have not kept pace with improvements in prehospital care. Although venous complications have not been infrequent, morbidity has not been a significant long-term problem. Fatal pulmonary embolism occurred and was a special problem for patients over the age of 50. More basic research is needed to expedite diagnosis and vascular control in addition to understanding and treating the severe metabolic problems of patients dying from shock and hemorrhage. PMID:3202271

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

    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)

  20. Anatomy of the ostia venae hepaticae and the retrohepatic segment of the inferior vena cava.

    Camargo, A M; Teixeira, G G; Ortale, J R

    1996-01-01

    In 30 normal adult livers the retrohepatic segment of inferior vena cava had a length of 6.7 cm and was totally encircled by liver substance in 30% of cases. Altogether 442 ostia venae hepaticae were found, averaging 14.7 per liver and classified as large, medium, small and minimum. The localisation of the openings was studied according to the division of the wall of the retrohepatic segment of the inferior vena cava into 16 areas.

  1. Anatomy of the ostia venae hepaticae and the retrohepatic segment of the inferior vena cava.

    Camargo, A M; Teixeira, G G; Ortale, J R

    1996-02-01

    In 30 normal adult livers the retrohepatic segment of inferior vena cava had a length of 6.7 cm and was totally encircled by liver substance in 30% of cases. Altogether 442 ostia venae hepaticae were found, averaging 14.7 per liver and classified as large, medium, small and minimum. The localisation of the openings was studied according to the division of the wall of the retrohepatic segment of the inferior vena cava into 16 areas. PMID:8655416

  2. Neoplasms of the inferior vena cava - pictorial essay

    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)

  3. Troubleshooting OptEase inferior vena cava filter retrieval.

    Nakashima, Masaya; Kobayashi, Hideaki; Kobayashi, Masayoshi

    2016-01-01

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

  4. Superior vena cava syndrome: A radiation oncologist's perspective.

    Talapatra, Kaustav; Panda, Soumadip; Goyle, Sandeep; Bhadra, Kallol; Mistry, Rajesh

    2016-01-01

    Superior vena cava syndrome is referred to as a constellation of symptoms and signs caused by obstruction of superior vena cava. It can occur due to both benign and malignant causes with the latter being the predominant. There is a paradigm shift in the approach to manage this condition. It is no longer considered a medical emergency and histological diagnosis is necessary before treatment. This article reviews the causes, symptoms, pathophysiology, and overall management policy which have changed over decades. PMID:27461602

  5. Medical image of the week: persistent left superior vena cava

    Hammode E

    2014-10-01

    Full Text Available No abstract available. Article truncated after 150 words. A 19 year old man with acute lymphocytic leukemia was admitted to the ICU with septic shock. Due to areas of cellulitis on the right side of the chest and neck and femoral venous thrombi, a left subclavian central access was attempted. The chest x-ray obtained after line placement is shown below (Figure 1. Blood gas done from the line was consistent with venous blood and venous tranduction was seen. A CT of the chest (Figure 2 confirmed the diagnosis of persistent left superior vena cava (PLSVC. A persistent left superior vena cava is the most common congenital thoracic venous anomaly, seen in 0.3-0.5% of the population (1. Incidence is increased in patients with congenital heart disease to 5%. In most patients a right sided SVC is also present; hence the term SVC duplication has also been used. Embryologically a PLSVC is formed when the left anterior cardinal vein is ...

  6. Traumatismos de veia cava inferior Inferior vena cava injuries

    Cleinaldo de Almeida Costa

    2005-10-01

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

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

    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.)

  8. Large hemangioma in a persistent left superior vena cava.

    Hu, Wen; Wang, Xiang; Tan, Sichuang; Fan, Songqing; Liu, Jun; Yu, Fenglei; Tang, Jingqun

    2012-12-01

    Cardiac hemangiomas represent 1 to 2% of all detected benign heart tumors. Tumors in the coronary sinus have been reported; however, to our knowledge, there have been no reports of masses in a persistent left superior vena cava. We report here the first case of a 58-year-old man with a rare huge unicamerate cardiac hemangiomas in a persistent left superior vena cava. A communication vein between the coronary sinus and hemangiomas could be identified, and thrombus formation was found in the hemangiomas as well. PMID:23180384

  9. Primary lung lymphoma involving the superior vena cava

    Wei Sen

    2012-06-01

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

  10. Liver trauma and transection of the inferior vena cava

    CT of a child with severe liver trauma due to a seat belt injury demonstrated avulsion of a portion of the lateral segment of the left lobe of the liver. The location of nondependent extravasated contrast material aided in identification of the visceral fracture site (the sentinel contrast sign). Associated transection of the inferior vena cava was evidenced by hypoatenuating zones adjacent to all the major hepatic veins and vena cava (hepatic perivenous tracking). Recognition of these two signs is important so that the radiologist can help the surgeon select the optimal operative approach. (orig.)

  11. Hepatic and postrenal segment anomalies of inferior vena cava

    Choe, Yeon Hyeon; Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1986-06-15

    Postrenal segment anomalies of inferior vena cava such as bilateral inferior vena cava and left-sided inferior vena cava can simulate lymphadenopathy on CT scan and these anomalous veins need consideration in retroperitoneal operations such as procedures for prevention of venous embolism, splenorenal shunt operation and aortic prosthetic replacement. Retrocaval ureter is a rare cause of obstructive uropathy or medical deviation of ureter. We analyzed 16 cases of postrenal segment anomalies diagnosed by CT, vena cavography, retrograde pyelography and ultrasonography including six rare positional anomalies at hepatic segment of inferior vena cava diagnosed by cardiac angiography. The results were as follows. 1. Postrenal segment anomalies were 6 cases of bilateral IVC, 8 cases of left-sided IVC and 2 cases of retrocaval ureters. On CT scan, 3 cases of bilateral IVC and 4 cases of left-sided IVC were accompanied by malignant tumors, but caval veins could be discriminated from enlarged nodes because of continuous tubular nature of vein on consecutive sections with homogeneous strong enhancement. Two cases of retrocaval ureters showed hydroureteronephrosis due to ureteral compression by IVC. 2. Hepatic segment anomalies were 6 cases. Five cases of IVC on left side of vertebra crossed midline at live to enter right-sided right atrium and one case of IVC on right side crossed midline to enter left-sided right atrium. Four cases of complex cardiac anomalies, 4 cases of annapolis and 2 cases of situs ambiguous were associated with these anomalies.

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

    Gholamhossein Ajami; Khobiar Zare; Hamid Amoozgar; Mohammad Borzoee; Saeed Abtahi

    2010-01-01

    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...

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

    Leong, S

    2010-06-19

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

  14. Endovascular stenting for the management of port-a-cath associated superior vena cava syndrome.

    Kostopoulou, Vasiliki; Tsiatas, Marinos L; Kelekis, Dimitrios A; Dimopoulos, Meletios-Athanasios; Papadimitriou, Christos A

    2009-03-01

    Port-a-cath systems are often essential for the administration of long-term chemotherapy in the treatment of malignancies because they improve venous access, but they are associated with complications, mainly thrombosis of central veins. In the present report, we describe a case of right subclavian and superior vena cava port-a-cath-related thrombosis causing superior vena cava syndrome (SVCS) in a patient affected by Hodgkin's disease. The patient underwent percutaneous revascularization with stent positioning, experiencing immediate relief of symptoms. Endovascular procedures for the treatment of nonmalignant SVCS seem to represent a challenging therapeutic option. PMID:18322718

  15. Huge Trombus including Left Renal Vein, Ovarian Vein, and Inferior Vena Cava Mimicking Renal Colic

    Sakir Ongun

    2014-01-01

    Full Text Available A 31-year-old female presented with acute left flank pain; she had a C/S at the postpartum day 24. Ureteral stone was suspected but ultrasound examination was normal. Then Doppler ultrasound revealed a trombus in left renal vein and inferior vena cava. Contrast enhanced MDCT scan showed swelled and nonfunctional left kidney, a trombus including distal part of left ovarian vein, left renal vein, and inferior vena cava. We started anticoagulation treatment. Further examination revealed diagnosis of chronic myeloproliferative disease. The trombus was completely recanalized at 3-month followup.

  16. Duodenal Perforation Caused by an Inferior Vena Cava Filter

    Bae, Mi Ju; Chung, Sung Woon; Lee, Chung Won; Kim, Sangpil; Song, Seunghwan

    2012-01-01

    The inferior vena cava (IVC) filter is known as an effective and safe method for preventing fatal pulmonary thromboembolism in patients with deep vein thrombosis. Usually, the remaining IVC filters are asymptomatic and do not cause clinical problems. We report a case of duodenal perforation caused by a remaining IVC filter.

  17. Duodenal perforation caused by an inferior vena cava filter.

    Bae, Mi Ju; Chung, Sung Woon; Lee, Chung Won; Kim, Sangpil; Song, Seunghwan

    2012-02-01

    The inferior vena cava (IVC) filter is known as an effective and safe method for preventing fatal pulmonary thromboembolism in patients with deep vein thrombosis. Usually, the remaining IVC filters are asymptomatic and do not cause clinical problems. We report a case of duodenal perforation caused by a remaining IVC filter. PMID:22363914

  18. Advanced Techniques for Removal of Retrievable Inferior Vena Cava Filters

    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

    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.

  19. Combined Double Sleeve Lobectomy and Superior Vena Cava Resection for Non-small Cell Lung Cancer with Persistent Left Superior Vena Cava.

    Zhu, Daxing; Qiu, Xiaoming; Zhou, Qinghua

    2015-11-01

    A 65-year-old man with right central type of lung squamous carcinoma was admitted to our department. Bronchoscopy displayed complete obstruction of right upper lobe bronchus and infiltration of the bronchus intermedius with tumor. Chest contrast computed tomography revealed the tumor invaded right pulmonary artery, superior vena cava, and the persistant left superior vena cava flowed into the coronary sinus. The tumor was successfully removed by means of bronchial and pulmonary artery sleeve resection of the right upper and middle lobes combined with resection and reconstruction of superior vena cava (SVC) utilizing ringed polytetrafluoroethylene graft. To the best of our knowledge, this was the first report of complete resection of locally advanced lung cancer involving superior vena cava, right pulmonary artery trunk and main bronchus with persistant left superior vena cava. PMID:26582230

  20. Combined Double Sleeve Lobectomy and Superior Vena Cava Resection for Non-small Cell Lung Cancer with Persistent Left Superior Vena Cava

    Daxing ZHU

    2015-11-01

    Full Text Available A 65-year-old man with right central type of lung squamous carcinoma was admitted to our department. Bronchoscopy displayed complete obstruction of right upper lobe bronchus and infiltration of the bronchus intermedius with tumor. Chest contrast computed tomography revealed the tumor invaded right pulmonary artery, superior vena cava, and the persistant left superior vena cava flowed into the coronary sinus. The tumor was successfully removed by means of bronchial and pulmonary artery sleeve resection of the right upper and middle lobes combined with resection and reconstruction of superior vena cava (SVC utilizing ringed polytetrafluoroethylene graft. To the best of our knowledge, this was the first report of complete resection of locally advanced lung cancer involving superior vena cava, right pulmonary artery trunk and main bronchus with persistant left superior vena cava.

  1. Radiographic evaluation of caudal vena cava size in dogs

    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

  2. [Mediastinal Mature Teratoma Necessitating Resection of Superior Vena Cava].

    Aragaki, Masato; Iimura, Yasuaki; Hasegawa, Naoto; Kaga, Kichizo

    2015-09-01

    A 43-year-old woman was referred to our hospital for an abnormal shadow on chest X-ray. Computed tomography revealed a tumor with calcification of 9.8 cm in size at the anterior mediastinum. The infiltration into the left brachiocephalic vein and superior vena cava by tumor was suspected. Surgery was performed under a diagnosis of mature teratoma. The tumor was found to adhere firmly to superior vena cava (SVC), left brachiocephalic vein, right phrenic nerve, and the arch of the azygos vein. To ensure the blood flow, an artificial blood vessel was placed between left brachiocephalic vein and right atrium. Then SVC was clamped and the tumor was resected with the part of SVC. PMID:26329629

  3. Management of the Thrombosed Filter-Bearing Inferior Vena Cava

    Sildiroglu, Onur; Ozer, Harun; Turba, Ulku Cenk

    2012-01-01

    Inferior vena cava (IVC) filter thrombosis is a complex problem. Thrombus within an IVC filter may range from an asymptomatic small thrombus to critical IVC occlusion that affects both lower extremities. The published experience of IVC thrombosis management in relation to filters is either anecdotal or limited to a small group of patients; however, endovascular treatment methods appear to be safe and effective in patients with IVC thrombosis. This review focuses on filter-related IVC thrombos...

  4. Unusual variant of infrarenal duplication of inferior vena cava

    Ranjan Kumar Sahoo

    2016-01-01

    Full Text Available Infrarenal inferior vena cava (IVC duplication is a rare anomaly. Most of the cases are asymptomatic and are detected incidentally. Prior knowledge of the anomaly is essential for safe procedure by intervention radiologist, retroperitoneal operation, and multi-visceral recovery operation from deceased donor by surgeon. We report a case of infrarenal IVC duplication detected incidentally during contrast-enhanced computed tomography examination of abdomen of a patient presenting with viral hepatitis and mild obstructive jaundice.

  5. Decompression of superior vena cava during bidirectional Glenn shunt

    Kulkarni Venugopal; Mudunuri Ravikiran; Mulavisala Krishnaprasad; Byalal R

    2009-01-01

    Patients undergoing bi-directional Glenn shunt for various congenital anomalies of the heart will have their superior vena cava (SVC) clamped during the procedure. The duration of the procedure is variable, ranging from five to 30 minutes. This can affect the cerebral perfusion due to raised venous pressure [Cerebral blood flow = Mean arterial pressure − (Intracranial pressure + Central venous pressure)]. Shunting away the SVC blood is a well known technique to counter this probl...

  6. Asymptomatic Duodenal Perforation from an Inferior Vena Cava Filter

    Park, Jean R.; Oza, Veeral M; Krishna, Somashekar G

    2014-01-01

    Recent exponential increase in inferior vena cava (IVC) filter placements has led to a higher rate of filter complications. A 46-year-old man with a past history of IVC filter placement for bilateral deep vein thrombosis presented with lower abdominal pain. Imaging studies demonstrated IVC filter strut penetrations into multiple structures. Upper endoscopy confirmed an uncomplicated single IVC filter strut penetration into the duodenal wall. The abdominal pain was determined to be unrelated t...

  7. Modeling Flow Past a Tilted Vena Cava Filter

    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.

  8. Modeling Flow Past a Tilted Vena Cava Filter

    Singer, M A; Wang, S L

    2009-06-29

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

  9. Double vena cava inferior:A report of three cases

    Isin Ureyen; Zeynep Kestel; Elif Gulsah Sahin; Alper Karalok; Taner Turan; Nurettin Boran; Gokhan Tulunay

    2013-01-01

    Congenital anomalies of the vena cava inferior (VCI) develop as a result of the persistence of the embryonic venous system. The majority of cases is clinically silent and is diagnosed in routine dissection studies, in retroperitoneal surgeries, or through imaging for other reasons. We report three cases with a double VCI. We outline our operative policy, summarize the embryological development of the VCI and present these cases as a reminder of this rare anatomical variation.

  10. Acute lymphoid leukemia presenting with superior vena cava syndrome

    Mohammad Emami Ardestani; Firouzeh Moeinzadeh

    2013-01-01

    When superior vena cava (SVC) compress or obstructed by internal or external pressure, we encounter to SVC syndrome. The cause of this compression is malignant or benign. Although the widespread use of permanent central venous access catheters coupled with the improved success of chemotherapy has increased the incidence of SVC syndrome not caused by direct tumor infiltration (non-malignant SVC syndrome) but SVC syndrome may be a sign of advanced malignancy. In this report, we present a 30-yea...

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

    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 significant (p<0.01). It was also observed that post implantation anti coagulation did not significantly prevent later onset of filter thrombosis. (Author)

  12. Myofibroblastic tumor associated to superior vena cava syndrome

    Inflammatory myofibroblastic tumor (IMT) is an uncommon pathological entity of unknown cause, composed of differentiated myofibroblastic cells accompanied by plasma cells, lymphocytes and eosinophils, which involve extrapulmonary and pulmonary tissues. IMT has an unpredictable clinical course, rarely undergoes malignant transformation. Local invasion and involvement of the mediastinum and hiliar structures are unusual manifestations; however; we reports a case of superior vena cava syndrome and IMT

  13. Failure of Femoral Access to Electrophysiological Evaluation Due to Aplasia of the Inferior Vena Cava

    Parahuleva, Mariana S.; Burgazli, Mehmet; Soydan, Nedim; Franzen, Wolfgang; Güttler, Norbert; Erdogan, Ali

    2016-01-01

    We report an interesting case of a man with a persistent left superior vena cava (PLSVC) with left azygos vein who underwent electrophysiological evaluation. Further evaluation revealed congenital dilated azygos vein, while a segment connecting the inferior vena cava (IVC) to the hepatic vein and right atrium was missing. The azygos vein drained into the superior vena cava, and the hepatic veins drained directly into the right atrium. The patient did not have congenital anomalies of the remaining thoracoabdominal vasculature. PMID:27257399

  14. Ectopic Triggers of Superior Vena Cava in Atrial Fibrillation

    Jayasree Pillarisetti MD

    2009-04-01

    Full Text Available Superior vena cava (SVC triggers constitute 6- 8% of non-pulmonary vein (PV foci that initiate atrial fibrillation (AF.1 Since SVC cardiomyocytes originate from the right sinus horn they possess enhanced automacity and after-depolarization leading to arrhythmogenicity.2 In a recent study by Arruda et al. 12% of patients had SVC triggers and empiric adjunctive isolation of SVC-right atrium along with PVisolation resulted in higher long term success rate than the group that underwent PVI alone. They demonstrated that adjunctive isolation of SVC along with PV isolation (PVI is a safe and feasible strategy for ablation of AF.

  15. A Novel Technique for Inferior Vena Cava Filter Extraction

    Johnston, Edward William, E-mail: ed.johnston@doctors.org.uk; Rowe, Luke Michael Morgan; Brookes, Jocelyn; Raja, Jowad; Hague, Julian, E-mail: julian.hague@uclh.nhs.uk [University College Hospital, Multidisciplinary Endovascular Team (United Kingdom)

    2013-05-02

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

  16. Vena cava agenesi kan vise sig som inkarcereret lyskebrok

    Safir-Hansen, Kristina; Achiam, Michael Patrick

    The case describes a 45-year-old man with a rare finding of vena cava agenesia presented as incarcerated groin hernia. From childhood the patient had developed dilatation of subcutaneous veins with establishment of aneurismal dilatation in the lower right side of the abdomen and groin. The patient...... was submitted with severe abdominal pain in the lower right side. The case describes the difficulties of an initially incorrect radiological diagnosis of incarcerated groin hernia and the discrepancy of the clinical findings. The case stresses the importance of a thorough evaluation of each patient....

  17. Retrievable Inferior Vena Cava Filters for Venous Thromboembolism

    Inferior vena cava (IVC) filters are used as an alternative to anticoagulants for prevention of fatal pulmonary embolism (PE) in venous thromboembolic disorders. Retrievable IVC filters have become an increasingly attractive option due to the long-term risks of permanent filter placement. These devices are shown to be technically feasible in insertion and retrieval percutaneously while providing protection from PE. Nevertheless, there are complications and failed retrievals with these retrievable filters. The aim of the paper is to review the retrievable filters and their efficacy, safety, and retrievability

  18. Inferior Vena Cava Duplication: Incidental Case in a Young Woman.

    Coco, Danilo; Cecchini, Sara; Leanza, Silvana; Viola, Massimo; Ricci, Stefano; Campagnacci, Roberto

    2016-01-01

    A case of a double inferior vena cava (IVC) with retroaortic left renal vein, azygos continuation of the IVC, and presence of the hepatic portion of the IVC drained into the right renal vein is reported and the embryologic, clinical, and radiological significance is discussed. The diagnosis is suggested by multidetector computed tomography (MDCT), which reveals the aberrant vascular structures. Awareness of different congenital anomalies of IVC is necessary for radiologists to avoid diagnostic pitfalls and they should be remembered because they can influence several surgical interventions and endovascular procedures. PMID:27217964

  19. Leiomyosarcoma of the Inferior Vena Cava Confirmed by Aspiration Biopsy With a Catheter During Digital Subtraction Angiography.

    Yakupoglu, Abdullah; Ulus, Sila; Cantasdemir, Murat

    2016-04-01

    Leiomyosarcoma of the vascular origin is a rare malignant tumor. It originates from the smooth muscle cells of the media with intra- or extraluminal growth, and in most cases it arises in the inferior vena cava. The diagnosis is often delayed because the clinical symptoms of this disease are often nonspecific. Accurate diagnosis of inferior vena cava leiomyosarcoma (IVCLMS) needs histologic confirmation. We report a case of IVCLMS histologically confirmed by aspiration biopsy with a catheter during digital subtraction angiography presenting with pulmonary emboli in a 65-year-old man. PMID:27000390

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

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

    2013-08-01

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

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

    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

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

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

  3. Adrenocortical carcinoma with extension to the inferior vena cava and right atrium: 20-month-old girl with TP53 mutation

    Terry L. Levin, MD

    2015-01-01

    Full Text Available A 20-month-old female presented with respiratory distress and a right adrenal mass extending into the inferior vena cava and right atrium. The mass was initially thought to be neuroblastoma. Pathology later revealed adrenocortical carcinoma. Inferior vena cava extension is far more common in adrenocortical carcinoma than neuroblastoma, and its presence should prompt clinical and laboratory evaluation for an adrenocortical tumor. The genetic findings in TP53 associated with this disease are discussed.

  4. Simon nitinol vena cava filters: effectiveness and complications; Simon Nitinol-Vena-cava-Filter: Wirksamkeit und Komplikationen

    Wolf, F.; Thurnher, S.; Lammer, J. [Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria). Abt. fuer Angiographie und Interventionelle Radiologie

    2001-10-01

    Purpose: The aim of this retrospective analysis was to evaluate the clinical safety and effectiveness of the simon nitinol inferior vena cava filter (SNF) for prevention of pulmonary embolism. Patients and Methods: 117 patients (63 male, 54 female; aged 58.38 {+-} 14.59 years) underwent percutaneous implantation of an SNF from 1993 through 1999. Patient reports were retrospectively analysed for complications during and after implantation and deep venous thrombosis (DVT) and pulmonary embolism before and after implantation. Helical-CT with contrast media and plain abdominal radiography were performed on 35 patients, helical-CT alone on two patients. We checked the position and configuration of the SNF and looked for a perforation of the filter legs through the wall of the inferior vena cava (IVC). The IVC and deep pelvic veins were analysed for patency. Results: During implantation 10 of 117 (9%) patients had minor complications, major complications were reported in 0.9% (1/117). There was no significant increase in thrombosis of the deep pelvic veins and the IVC after implantation. Pulmonary re-embolism (PE) was documented in 9 out of 117 patients (7.7%). One out of the 35 examined patients (2.9%) showed a single strut fracture of the SNF. Tilting more than 15 was seen in 7 out of 37 patients (19%). Dislocation of the SNF more than 10 mm occurred in one out of 35 patients (2.9%), perforation through the wall of the IVC in all 37 patients. We found no occlusion of the IVC. (orig.) [German] Ziel: Das Ziel dieser Arbeit war, in einer retrospektiven Analyse die Sicherheit und Effektivitaet des simon nitinol vena cava filters (SNF) zu untersuchen. Patienten und Methoden: Zwischen 1993 und 1999 wurde bei 117 Patienten (63 Maenner, 54 Frauen; 58,38 Jahre {+-} 14,59 Jahre) ein SNF perkutan in die vena cava inferior (VCI) implantiert. Retrospektiv wurden die Krankengeschichten aller 117 Patienten studiert und auf Komplikationen in Bezug auf den SNF sowie auf neu

  5. 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

    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.

  6. Abnormal draining of great cardiac vein into superior vena cava

    Full text: A 47-year-old man presented with atypical chest pain in last three months. Physical examination findings were normal. ECG showed normal sinus rhythm. Transthoracic echocardiography revealed normal left and right ventricular systolic functions. ECG gated coronary CT angiography was performed. The patient's coronary CT angiography showed normal coronary arteries, however the great cardiac vein course was abnormal. The course of the vein was not in atrioventicular groove, bypassing the coronary sinus and draining to superior vena cava. The coronary sinus of patient is formed by posterior marginal vein, middle cardiac vein and lateral marginal vein and drained into the right atrium. We also observed subtle myocardial bridges on coronary arteries. Myocardial bridges appeared to explain patient's chest pain. With optimal medical therapy, the patient's symptoms resolved

  7. Simon nitinol vena cava filters: effectiveness and complications

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

  8. A rare case of left superior vena cava draining into left atrium demonstrated by MDCT.

    Ardilouze, Paul; Bricot, Vincent; Maurel, Christophe; Christiaens, Luc

    2009-01-01

    We describe a rare case of persistent left superior vena cava draining directly into the left atrium with no associated anomaly of the coronary sinus or the atrial septum, discovered by multidetector computed tomography. PMID:17692952

  9. Temporary vena cava filter for the thrombolytic treatment of venous thrombosis

    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

  10. A novel technique to remove inferior vena cava filters using a homemade snare device.

    Singh, Kuldeep; Zia, Saqib; Khan, Muhammad Asad; Marco, Sean; Hill, David

    2014-01-01

    The need to retrieve inferior vena cava filters is quite evident due to the long-term complications. We present a novel technique to remove inferior vena cava filters using a homemade snare created using a looped a 0.014-inch semistiff wire. Employing this technique, 18 consecutive retrievable filters were removed. All filters were easily snared on the very first attempt, and no complications occurred. Our novel technique to retrieve filters is efficient, safe, and cost-effective. PMID:26992977

  11. Living donor liver transplantation in the absence of inferior vena cava: a case report.

    Hatipoglu, S; Olmez, A; Ozgor, D; Kayaalp, C; Yilmaz, S

    2012-01-01

    Because of difficulties in the supply of cadaveric organs, of living donor liver transplantations are performed in increasing numbers. Congenital hepatic fibrosis associated with fibrosis and atrophy of the inferior vena cava were present in a potential recipient of living donor liver transplantation. This case report documented living donor liver transplantation as a treatment modality for a patient with absence of the inferior vena cava due to chronic liver failure. PMID:22841266

  12. Huge Trombus including Left Renal Vein, Ovarian Vein, and Inferior Vena Cava Mimicking Renal Colic

    Sakir Ongun; Sermin Coban; Abdullah Katgi; Funda Obuz; Aykut Kefi

    2014-01-01

    A 31-year-old female presented with acute left flank pain; she had a C/S at the postpartum day 24. Ureteral stone was suspected but ultrasound examination was normal. Then Doppler ultrasound revealed a trombus in left renal vein and inferior vena cava. Contrast enhanced MDCT scan showed swelled and nonfunctional left kidney, a trombus including distal part of left ovarian vein, left renal vein, and inferior vena cava. We started anticoagulation treatment. Further examination revealed diagnosi...

  13. Tratamento convencional e endovascular para rara associação de doenças: síndrome de veia cava superior e aneurisma aorto-ilíaco - controle após 12 meses Conventional and endovascular treatment for a rare combination of diseases: superior vena cava syndrome and aortoiliac aneurysm - control after 12 months

    Gustavo Petorossi Solano

    2011-09-01

    Full Text Available A associação entre a síndrome de veia cava superior e uma dilatação aneurismática das artérias aorta e ilíacas não é comum. A abordagem de cada uma destas patologias pode ser efetuada através do modo convencional, com cirurgia aberta ou pela técnica endovascular. Neste trabalho, relatamos as duas modalidades de intervenção cirúrgica executadas e discutimos suas indicações e os resultados deste caso em particular.The association between superior vena cava syndrome and an aorto-iliac aneurysm is not common. The approach to each of theses diseases can be either by the conventional way with open surgery or by endovascular techniques. We report the two methods of surgical intervention and discuss their indications and results in this particular case.

  14. Primary mediastinal melanoma presenting as superior vena cava syndrome: A case study

    Ann C Gaffey

    2016-03-01

    Full Text Available The rates of melanoma have increased over the past 30 years. Malignant melanoma most commonly occurs in the skin with secondary involvement of other organs. Here, we present an extremely rare case of malignant melanoma of the mediastinum with presentation of superior vena cava syndrome without clinical evidence of extrathoracic disease. The incidence of this clinical presentation is uncommon, resulting in only a handful of case reports in the literature. [Arch Clin Exp Surg 2016; 5(1.000: 56-58

  15. Superior vena cava obstruction in small-cell lung cancer

    Purpose: To identify prognostic or treatment factors influencing the response of superior vena cava obstruction (SVCO), time to SVCO recurrence, and overall survival of SCLC patients with SVCO at presentation; and to assess the role of retreatment in patients with SVCO at recurrent or persistent disease. Methods and Materials: Between January 1983 and November 1993, 76 consecutive patients who had small-cell lung cancer (SCLC) with SVCO were treated in our institution. Analysis was done according to the disease status at diagnosis of SVCO. The first analysis concerned a group of 50 patients who had SVCO at initial presentation. The second analysis concerned a group who had SVCO as a manifestation of persistent or recurrent disease. Results: In the first analysis, 93% had significant improvement in symptoms of SVCO after chemotherapy and 94% after mediastinal radiation. Response is almost universal despite a wide range of radiation fractionation and total dose used. Seventy percent remained SVCO-free before death. Thirty percent developed recurrence of SVCO symptoms 1-16 months (median 8) after the start of initial treatment. Those who received combined chemotherapy and radiation had a longer time to SVCO recurrence (p = 0.018) compared to those who received chemotherapy alone. This effect is mainly seen in limited-stage patients. The presence of SVCO recurrence tends to have an adverse effect on the overall survival (p = 0.077) irrespective of the time when the recurrences occurred (p = 0.296). The median survival of this whole group of 50 patients in the first analysis was 9.5 months, and the 2-year survival was 10%. Stage was strongly predictive of survival (p < 0.001). Sixteen percent (3 of 19) of the patients with limited-stage diseases were long-term survivors (two patients survived 35 months and one survived 70 months). The early mortality from SVCO was 2%. In the second analysis, 85% had previously been treated with chemotherapy alone. The response rate of

  16. A case of bilateral superior vena cava with variations in the azygos system and in the heart.

    Ortale, J R; Grill, E H

    1994-08-01

    A case of bilateral superior vena cava is described in an adult cadaver of undetermined sex and age. The persistent left superior vena cava had a larger diameter approximately equal to that of the right superior vena cava ending in a wide caliber coronary sinus. Variations in the azygos system were also found. The ventricles show thin walls with trabeculae carneae forming one to five strata in the left ventricle, and from one to three strata in the right ventricle. PMID:8085654

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

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

  18. Mesoaortic entrapment of a left inferior vena cava

    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

  19. Inferior vena cava filter placement in orthopedic surgery.

    Bass, Anne R; Mattern, Christopher J; Voos, James E; Peterson, Margaret G E; Trost, David W

    2010-09-01

    Inferior vena cava (IVC) filters were developed for the treatment of venous thromboembolism but in high-risk patients are often used for prophylaxis instead. In the study reported here, we reviewed all the orthopedic surgery cases in which IVC filters were used at our institution in 2005. Charts were analyzed and patients contacted by telephone for long-term follow-up. IVC filters were used in 90 (0.96%) of the 9,348 inpatient orthopedic surgeries. Sixty-one percent of filters were placed for prophylaxis, though only 42% of patients with prophylactic filters had a contraindication to anticoagulation. Eighty-one percent of patients with prophylactic filters who received anticoagulation received warfarin. Ratios of prophylactic-to-treatment filters were 3.25 for fracture surgeries, 2.1 for arthroplasties, and 0.89 for spine surgeries. Five percent of patients with prophylactic filters developed deep vein thrombosis. Fifty-two percent of filters were retrievable, but only 40% of those were removed a mean of 5.1 months (SD, 3.9 months) after placement. Filter removal was associated with complications in 11% of patients, and in another 10% the filter could not be removed. Forty-one patients were contacted a mean of 21 months (SD, 3 months) after filter placement. Only 32% of those who still had filters were on anticoagulation at follow-up. PMID:21290021

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

    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

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

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

  2. Study of 99Tcm-annexin V distribution in inferior vena cava thrombus models of rabbits

    To study 99Tcm-Annexin V distribution in inferior vena cava thrombus models of rabbits and uptake of 99Tcm-Annexin V in fresh and old venous thrombus. Rabbits (n=15) were randomly grouped into 3 groups (the fresh thrombus group, old thrombus group, and control group). The rabbits of two thrombus groups developed inferior vena cava thrombus models by operations. The control group received sham operation. The fresh thrombus group and control group rabbits were injected 99Tcm-Annexin V after operating 1 d; the old thrombus group 14 d. After 1 h all rabbits were killed by injecting overdose pentobarbital sodium. The thrombus (or the inferior vena cava about 3 cm below inferior pole of right kidney level in the control group rabbits), blood, thrombus area inferior vena cava, head lateral inferior vena cava (except the control group), thigh muscle, stomach, myocardium, pulmonary, liver, kidney, spleen, bone and small intestine were obtained from all group rabbits. The ex tissue and blood were weighed and measured by a Well-type detector. The percentage of the injected dose per gram of ex tissue (or blood) was calculated by the above data. The thrombus to blood, thrombus area inferior vena cava, head lateral inferior vena cava and thigh muscle ratios were calculated by percentage of the injected dose per gram of ex tissue (or blood). The test was used to compare the fresh thrombus group and old thrombus group by SPSS 17.0. The percentage of' the injected dose per gram of thrombi (0.01894± 0.002 16% ID/g) in the fresh thrombus group was higher than the old thrombus group (0.00473±0.001 28% ID/g), P<0.05. The thrombus to blood, thrombus area inferior vena cava, head lateral inferior vena cava and muscle ratios (3.42±1.06, 26.32±13.60, 31.23 ±16.00, 111.62±52.23) in the fresh thrombus group were higher than the old thrombus group (0.98±0.09, 5.12±2.01, 6.25±2.38, 21.82±5.93), P<0.05 for all. All the thrombi of the fresh thrombus group were confirmed fresh

  3. Congenital Aortocaval Fistula from Right Subclavian Artery to Superior Vena Cava in an Adult with Tetralogy of Fallot

    Soheila Chamanian

    2014-11-01

    Full Text Available Congenital   aortocaval   fistula in association with complex congenital heart disease has never been described before. We represent an adult with tetralogy of fallot and an undiagnosed subclavian artery to superior vena cava fistula in previous catheterisms. He underwent surgical correction, successfully. After 8 months post operation he was doing well with improved functional capacity and no cyanosis.

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

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

  5. Temporary Inferior Vena Cava Filters: How Do We Move Forward?

    Arous, Edward J; Messina, Louis M

    2016-05-01

    Despite their widespread use, the indications for the selective use of temporary inferior vena cava (IVC) filters remains uncertain with few trials supporting their use. Additionally, the risks of long-term temporary IVC filter insertion are being increasingly discussed amongst the mainstream media and through multiple class action lawsuits. Retrievable IVC filters were specifically designed to have a less secure implantation in order to facilitate retrieval. However, multiple reports have demonstrated significant filter-related complications, most commonly related to duration of implantation. Furthermore, the risk is not isolated to one manufacturer alone. The incidence of filter-related complications is linearly related to its duration of time on the market. Currently, the FDA recommends that IVC filters be removed within 25-54 days of their implantation. Unfortunately, little evidence exists to show that this recommendation is followed routinely. Recently, the PRESERVE Trial (NCT02381509) was initiated as a multicenter non-randomized open label study to determine the safety and effectiveness of commercially available IVC filters (both temporary and permanent) in individuals who require mechanical prophylaxis against pulmonary embolism. Until such evidence is developed, temporary IVC filters should be implanted based on best available evidence and routinely removed within the guidelines of the FDA of 25-54 days. A fair question at this point is whether the design features themselves that are required to manufacture a low profile removable IVC filter can achieve effective prophylaxis against pulmonary embolism at a low rate of short and long-term complications. PMID:27012891

  6. Determinants of survival after inferior vena cava trauma.

    Kuehne, J; Frankhouse, J; Modrall, G; Golshani, S; Aziz, I; Demetriades, D; Yellin, A E

    1999-10-01

    Inferior vena cava (IVC) injuries continue to be associated with mortality rates of 21 to 66 per cent despite advances in prehospital, surgical, and critical care. The purpose of this study was to evaluate outcome of patients with IVC injury after treatment at a major urban trauma center and to identify factors predictive of survival. Between 1989 and 1995, 158 patients presented to the Los Angeles County + University of Southern California Medical Center with IVC injuries. One hundred thirty-six patient records were available for review, and 69 data points were collected and analyzed. Mean age was 26 years (range, 6-54), and 122 (90%) patients were male. Mechanism of injury included gunshot in 88 (65%) patients, stab in 23 (17%) patients, shotgun in 7 (5%) patients, and blunt trauma in 18 (13%) patients. The mean Injury Severity Score was 25. Seventy (52%) patients were hypotensive. Eleven (8%) patients died before surgical intervention, and 25 (18%) patients died before operative repair. Repair (79), ligation (20), or observation (1) was accomplished in 100 (74%) patients. Overall survival was 48 per cent and 65 per cent in the 100 patients surviving to operative repair, including 5 of 20 patients requiring IVC ligation. Significant differences (Pthoracotomy, blood loss, level of injury, tamponade, and associated aortic injury. Logistic regression analysis identified hypotension, anatomic level of injury, and associated aortic injury as significant predictors of outcome (P = 0.001). Survival is predominantly determined by severity and anatomic accessibility of the IVC injury and by the absence of associated major vascular injuries. Ligation may control otherwise exsanguinating injuries and should be considered early in the management of complex injuries. PMID:10515547

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

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

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

    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

  9. Advanced Hepatocellular Carcinoma with Subtotal Occlusion of the Inferior Vena Cava and a Right Atrial Mass

    Christian Steinberg

    2013-01-01

    Full Text Available Hepatocellular carcinoma usually metastasizes to regional lymph nodes, lung, and bones but can rarely invade the inferior vena cava with intravascular extension to the right atrium. We present the case of a 75-year-old man who was admitted for generalized oedema and was found to have advanced HCC with invasion of the inferior vena cava and endovascular extension to the right atrium. In contrast to the great majority of hepatocellular carcinoma, which usually develops on the basis of liver cirrhosis due to identifiable risk factors, none of those factors were present in our patient.

  10. Surgical Management of Undiagnosed Laceration of Superior Vena Cava Caused by Blunt Trauma.

    Bouabdallaoui, Nadia; Debbagh, Hassan; Schoell, Thibaut; Lebreton, Guillaume

    2016-05-01

    Intrapericardial rupture of the superior vena cava resulting from blunt thoracic trauma is a rare and life-threatening condition that has to be ruled out in the presence of signs of cardiac tamponade and a history of blunt thoracic trauma. We report the case of undiagnosed superior vena cava laceration caused by a high-speed road traffic accident in a 25 year-old patient revealed by cardiac tamponade. We highlight the need of urgent surgical exploration in all patients whose condition is unstable in the setting of blunt thoracic trauma regardless of imaging conclusions. PMID:27106431

  11. Surgical Management of Undiagnosed Laceration of Superior Vena Cava Caused by Blunt Trauma

    Bouabdallaoui, Nadia; Debbagh, Hassan; Schoell, Thibaut; Lebreton, Guillaume

    2016-01-01

    International audience Intrapericardial rupture of the superior vena cava resulting from blunt thoracic trauma is a rare and life-threatening condition that has to be ruled out in the presence of signs of cardiac tamponade and a history of blunt thoracic trauma. We report the case of undiagnosed superior vena cava laceration caused by a high-speed road traffic accident in a 25 year-old patient revealed by cardiac tamponade. We highlight the need of urgent surgical exploration in all patien...

  12. Trimodality Therapy for an Advanced Thymic Carcinoma With Both Aorta and Vena Cava Invasion.

    Momozane, Tohru; Inoue, Masayoshi; Shintani, Yasushi; Funaki, Soichiro; Kawamura, Tomohiro; Minami, Masato; Shirakawa, Yukitoshi; Kuratani, Toru; Sawa, Yoshiki; Okumura, Meinoshin

    2016-08-01

    A case of locally advanced thymic carcinoma that was successfully resected with the great vessels after chemoradiation therapy is reported. A 57-year-old man with Masaoka stage III thymic carcinoma received two cycles of cisplatin/docetaxel and 60 Gy irradiation. The response was stable disease with 19% size reduction, and a radical resection with the ascending aorta and superior vena cava with the patient under circulatory arrest with the use of cardiopulmonary bypass was performed. The postoperative course was uneventful, and the patient has been free of disease for 28 months. Trimodality therapy with use of a cardiovascular surgical procedure might be a valuable option in locally advanced thymic carcinoma. PMID:27449450

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

    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). 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. 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

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

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

    2009-12-03

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

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

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

  16. Cardiac Metastasis from Invasive Thymoma Via the Superior Vena Cava: Cardiac MRI Findings

    Cardiac tumors are rare, and metastatic deposits are more common than primary cardiac tumors. We present cardiac magnetic resonance imaging (MRI) findings of a 50-year-old woman with invasive thymoma. Cardiac MRI revealed a heterogeneous, lobulated anterior mediastinal mass invading the superior vena cava and extending to the right atrium. In cine images there was no invasion to the right atrial wall.

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

    Wanscher, Maria Rørbæk; Frifelt, J J; Smith-Sivertsen, C;

    1988-01-01

    During an 18-month period, 82 consecutive patients (37 women and 45 men), with a mean age of 50 yr (range 15 to 74), underwent hemodialysis with 91 polyurethane double-lumen subclavian superior vena cava catheters inserted via the right subclavian vein. Upon catheter removal, venograms were...

  18. Superior Vena Cava Syndrome: A Presenting Feature of Mediastinal Germ Cell Tumor

    Mahua Roy

    2010-04-01

    Full Text Available Superior vena cava syndrome (SVCS is rare in children. Non-Hodgkin’s Lymphoma (NHL is the most common cause of SVCS in children. This report an adolescent male who presented with SVCS due to mixed germ cell tumor (GCT of the anterior mediastinum with predominant yolk cell component. Such etiology of SVCS is rarely reported.

  19. Origin of the infrarenal part of the caudal vena cava in the pig.

    Cornillie, P; Van Den Broeck, W; Simoens, P

    2008-10-01

    The vascular topography in the lumbar region of pig embryos and young fetuses was three-dimensionally reconstructed to study some controversial aspects of the origin and development of the infrarenal part of the caudal vena cava. Contrary to general belief, it was found that the supracardinal veins, which form the azygos veins in the thorax, do not take part in the construction of the caudal vena cava in the lumbar region. These veins do appear in the abdomen, but they are only involved in the formation of the lumbar and ascending lumbar veins. The infrarenal part of the caudal vena cava arises from the lumbar part of the right caudal cardinal vein. Whilst this venous pattern is established, the lumbar part of the left caudal cardinal vein disappears and its former location is occupied by large lymphatic connections between the cysterna chyli and the retroperitoneal mesenteric lymphatic sac. On the basis of these findings, a number of hypotheses on the development of anatomical variations of the caudal vena cava should be reconsidered. PMID:18537942

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

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

    1993-03-01

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

  1. Kirurgisk radikal resektion af leiomyosarkom i retrohepatiske vena cava med intrakardial tumortrombosering

    Arendrup, Henrik C; Larsen, Peter Nørgaard; Rasmussen, Allan; Pedersen, Christian Ross

    2005-01-01

    1 x 1 cm in the wall of the vena cava while the intracaval tumour was 12 cm long with a diameter of 5 cm and 1.5 cm in the right atrium. Using venovenous bypass with circulatory support, the tumour was excised in toto and the caval vein closed with a pericardial patch. The patient was discharged in...

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

    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)

  3. Superior Vena Cava Syndrome: A Presenting Feature of Mediastinal Germ Cell Tumor

    Mahua Roy; Rajat Bandyopadhyay; Narayan Pandit; Soumita Sengupta

    2010-01-01

    Superior vena cava syndrome (SVCS) is rare in children. Non-Hodgkin’s Lymphoma (NHL) is the most common cause of SVCS in children. This report an adolescent male who presented with SVCS due to mixed germ cell tumor (GCT) of the anterior mediastinum with predominant yolk cell component. Such etiology of SVCS is rarely reported.

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

    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

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

    Gustavo J. Ventura Couto

    2008-03-01

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

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

    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)

  7. [Duplication of the superior vena cava and other malformations discovered at insertion of a port-a-cath].

    Hammerer, V; Jeung, M; Mennecier, B; Demian, M; Pauli, G; Quoix, E

    2005-09-01

    We report a clinical case of a persistent left superior vena cava discovered in a 50-year-old female patient when a port-a-cath was inserted. This already seldom malformation was associated with an arteria lusoria and polysplenia with left inferior vena cava with hemiazygos continuation, right-sided stomach, short pancreas, preduodenal portal vein and intestinal malrotation, but without any cardiac abnormalities. PMID:16208194

  8. Ultrasonographic assessment of inferior vena cava/abdominal aorta diameter index: a new approach of assessing hypovolemic shock class 1

    Rahman, Nik Hisamuddin NA; Ahmad, Rashidi; Kareem, Meera Mohaideen; Mohammed, Mohammad Iqhbal

    2016-01-01

    Background We designed this study to expand the usage of ultrasound to detect early occurrence of hypovolemia. We explore the potential use of inferior vena cava (IVC) and abdominal aorta (AA) diameter index (IVC:AA) measured ultrasonographically to detect class 1 hypovolemic shock with blood loss less than 15%.ᅟ Methods The aim of this study was to determine the changes in the diameter of inferior vena cava and abdominal aorta in blood donors by using ultrasound, pre and post blood donation....

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

    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.

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

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

    2014-06-15

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

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

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

    2013-06-15

    Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications. (author)

  12. Creating a Fontan fenestration in a child with dextrocardia and interrupted inferior vena cava

    Pradeepkumar Charlagorla

    2016-01-01

    Full Text Available Plastic bronchitis is a rare life-threatening complication of the Fontan operation. Transcatheter Fontan fenestration can ameliorate symptoms by decompressing elevated venous pressures. Transcatheter creation of a fenestration can be technically challenging in cases with complex venous anatomy. We report a case of a 5-year-old boy with heterotaxy, dextrocardia with unbalanced atrioventricular canal (AVC, atrial and visceral situs inversus, left-sided superior vena cava (SVC, and left-sided interrupted inferior vena cava (IVC with azygos continuation. With few modifications to the equipment, a successful Fontan fenestration with stent implantation was performed via transjugular approach. At 2-year follow-up, his symptoms of plastic bronchitis improved significantly.

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

    Pelta, A.M.; Jørgensen, Maja; Just, Sven Richardt Lundgren; Jensen, Leif Pandora

    2008-01-01

    In this case report the treatment of a young man with bilateral iliaco-femoral DVT and vena cava aplasia is presented. The patient was treated with catheter-directed thrombolysis; the catheters were introduced in the thrombus of both legs via v. popliteae. The treatment led to almost complete thr...... 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......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...

  14. Persistent Left Superior Vena Cava: A Rare Case with Clinical Significance

    Kumar, Raj; Yadav, Sankalp; Verma, Deepak

    2016-01-01

    Persistent Left Superior Vena Cava (PLSVC) is a rare congenital vascular anomaly (incidence of 0.3-0.5% of the general population) which being mostly asymptomatic in its presentation, is usually detected incidentally. There are many practical clinical implications associated with it including arrhythmias. We report a rare case of PLSVC with absent Right Superior Vena Cava (RSVC) (isolated PLSVC), in a 55-year-old lady who had complete heart block followed by sepsis and was diagnosed to have this condition during the permanent cardiac pacemaker implantation and central venous catheter insertion showing an abnormal path of the catheter/pacing leads. The authors also give an insight into its clinical relevance. PMID:27437282

  15. Superior vena cava syndrome from an invasive thymoma with transcaval invasion to the right atrium.

    Afzal, Ashwad; Wong, Ivan; Korniyenko, Aleksandr; Ivanov, Alex; Worku, Berhane; Gulkarov, Iosif

    2016-01-01

    Invasive thymoma with transcaval extension to the right atrium is a rare cause of superior vena cava syndrome. We present a case on a 74-year-old female presenting with dyspnea on exertion, and facial and upper extremity swelling. Physical examination revealed mild facial swelling, non-pitting edema involving the upper extremities and distention of superficial veins of the anterior chest wall and jugular veins. An echocardiogram showed moderate right atrial dilation with a mobile mass in the atrial cavity prolapsing through the tricuspid valve. Cardiac magnetic resonance imaging revealed a 9.9 × 4.3 cm heterogeneous mass in the anterior mediastinum compressing the superior vena cava and endovenously extending into the right atrium. Tissue biopsy of the mediastinal mass revealed a type B1 thymoma, further staged as a Masaoka IVa invasive thymoma that underwent successfulen blocresection followed by removal of intracaval and right atrial mass. PMID:27099229

  16. Fat collections related to the intrahepatic inferior vena cava: CT features

    Purpose: To evaluate fat collections related to inferior vena cava, their causes, and to make a review of the literature about these benign incidental findings. Materials and Methods: Two thousands and one hundred thoracoabdominal CT scans were performed between May 2000 and March 2001. We used a PQ 5000 spiral CT scanner. The studies were performed with and without contrast media. Results: We found three cases of fat collections related to inferior vena cava (IVC). They were located posteromedial and anteromedial to IVC. Conclusion: Fat collections related to the IVC are benign incidental findings. The knowledge with regards to these findings should preclude erroneous diagnosis of intracaval thrombus, intracaval lipomas or secondary extensions of tumors. (author)

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

    Omer Dai

    2014-04-01

    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.

  18. Totally endoscopic robotic resection of left atrial myxoma with persistent left superior vena cava.

    Tarui, Tatsuya; Ishikawa, Norihiko; Ohtake, Hiroshi; Watanabe, Go

    2016-07-01

    A 68-year old man with a cardiac tumour was admitted for robotic tumour resection using the da Vinci S Surgical System. While undergoing preoperative examination, he was found to have a persistent left superior vena cava. After general anaesthesia and single-lung ventilation, cardiopulmonary bypass was established, with venous drainage through bilateral internal jugular and right femoral veins and arterial return through the right femoral artery. Robotic tumour resection was performed by four ports in the right chest. There were no difficulties during the operation, and successful tumour resection was achieved with satisfactory margins. He was discharged without complications. Persistent left superior vena cava is very rare, but if diagnosed preoperatively and an appropriate operative plan is made, robotic cardiac surgery can be performed safely. With robotic surgery, cardiac tumour resection can be feasibly performed, with cosmetic benefits. PMID:26989070

  19. [Compensative dilatation of the vena azygos by abnormalities of the vena cava inferior - a contribution to the differential diagnosis of the tumorsuspected right tracheobronchial angle (author's transl)].

    Strauss, H J; Strauss, G

    1976-08-01

    Report on 2 patients, with a mediastinal enlargement at the right tracheobronchial angle revealing an ectasis of the orifice of vena-azygos. It could be shown that the enlargement of the vena azygos ist due to an increase of the flow-volume, caused by an abnormal embryonic drainage of the vena cava inferior into the vena azygos. The diagnostic possibilities for differentiation from vascular and nonvascular space-occupying processes in that region are discussed. An exact diagnosis is possible by angiography. PMID:1020364

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

    Klop, B

    2011-01-01

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

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

    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.)

  2. Cement Embolus Trapped in the Inferior Vena Cava Filter during Percutaneous Vertebroplasty

    Li, Zhi; Ni, Rui-fang; Zhao, Xin; Yang, Chao; Li, Ming-Ming

    2013-01-01

    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 p...

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

    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

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

    Wang Quan

    2012-06-01

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

  5. Síndrome de veia cava superior Superior vena cava syndrome

    SAMUEL ZUÍNGLIO DE BIASI CORDEIRO

    2002-09-01

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

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

    Gholamhossein Ajami

    2010-06-01

    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.

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

    Hamid Amoozgar

    2010-06-01

    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.

  8. Superior Vena Cava Syndrome due to Thrombosis: A Rare Paraneoplastic Presentation of Bronchogenic Carcinoma

    Avradip Santra

    2016-07-01

    Full Text Available Superior vena cava (SVC syndrome is not an uncommon occurrence in patients with malignancy and it is often described as a medical emergency. In majority of the cases, SVC syndrome occurs due to mechanical obstruction of the SVC by extraluminal compression with primary intrathoracic malignancies. However, intraluminal obstruction due to thrombosis can also produce symptoms and signs of SVC syndrome. Clot-related SVC obstruction is mostly associated with indwelling central venous catheter and pacemaker leads, although such thrombosis can occur spontaneously in a background of a hypercoagulable state, e.g., malignancy. Here, an unusual case of sudden onset SVC syndrome has been reported, which on initial radiologic evaluation was found to have a lung nodule without any significant mediastinal mass or adenopathy compressing SVC. Subsequent investigation with Doppler ultrasonography of the neck showed thrombosis in the right internal jugular, right subclavian and right brachiocephalic vein, which was responsible for SVC syndrome. Histopathological evaluation of lung nodule confirmed presence of an adenocarcinoma. Therefore, venous thromboembolism as a paraneoplastic syndrome should be kept in mind while evaluating a case of SVC obstruction in a cancer patient. Management of the underlying disease is of prime importance in such cases and anticoagulation is the mainstay of therapy. Ability to identify paraneoplastic syndrome may have a significant effect on clinical outcome, ranging from early diagnosis to improved quality of life of the patient.

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

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

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

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

    2005-01-01

    A veia cava superior é formada pela união das duas veias inominadas, direita e esquerda, e localiza-se no mediastino médio, à direita da artéria aorta e anteriormente à traquéia. A síndrome da veia cava superior representa um conjunto de sinais (dilatação das veias do pescoço, pletora facial, edema de membros superiores, cianose) e sintomas (cefaléia, dispnéia, tosse, edema de membro superior, ortopnéia e disfagia) decorrentes da obstrução do fluxo sanguíneo através da veia cava superior em d...

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

    Elton Correia Alves

    2010-12-01

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

  12. Advanced Stage T-Cell Non-Hodgkin lymphoma in an 11-Month-Old Infant and Related Superior Vena Cava Syndrome: Importance of Transthoracic Echocardiography.

    Yilmaz, Osman; Karabag, Kezban; Keskin Yildirim, Zuhal; Calik, Muhammet; Kilic, Omer

    2014-01-01

    Superior vena cava syndrome (SVCS) is rare in infants. Non-Hodgkin lymphoma is the most common cause of SVCS in children. Swelling in the face and neck are the most common clinical symptoms associated with this syndrome. However, these clinical findings are also observed in allergic diseases, which therefore often leads to misdiagnosis. Here, we reported the importance of echocardiography in diagnosing SVCS in an infant with advanced stage non-Hodgkin lymphoma. PMID:24639614

  13. Advanced Stage T-Cell Non-Hodgkin lymphoma in an 11-Month-Old Infant and Related Superior Vena Cava Syndrome: Importance of Transthoracic Echocardiography

    YILMAZ, Osman; KARABAG, Kezban; KESKIN YILDIRIM, Zuhal; CALIK, Muhammet; KILIC, Omer

    2014-01-01

    Superior vena cava syndrome (SVCS) is rare in infants. Non-Hodgkin lymphoma is the most common cause of SVCS in children. Swelling in the face and neck are the most common clinical symptoms associated with this syndrome. However, these clinical findings are also observed in allergic diseases, which therefore often leads to misdiagnosis. Here, we reported the importance of echocardiography in diagnosing SVCS in an infant with advanced stage non-Hodgkin lymphoma.

  14. Acute iliofemoral venous thrombosis in patients with atresia of the inferior vena cava can be treated successfully with catheter-directed thrombolysis

    Broholm, Rikke; Jørgensen, Maja; Just, Sven; Jensen, Leif P; Bækgaard, Niels

    2011-01-01

    To assess the effectiveness and clinical outcomes of catheter-directed thrombolysis in patients with atresia of the inferior vena cava (IVC) and acute iliofemoral deep vein thrombosis (DVT).......To assess the effectiveness and clinical outcomes of catheter-directed thrombolysis in patients with atresia of the inferior vena cava (IVC) and acute iliofemoral deep vein thrombosis (DVT)....

  15. Repair of the inferior vena cava with autogenous peritoneo-fascial patch graft following abdominal trauma: a case report.

    Emmiler, Mustafa; Kocogullari, Cevdet Ugur; Yilmaz, Sezgin; Cekirdekci, Ahmet

    2008-01-01

    Abdominal vascular injuries are among the most challenging and lethal injuries in traumatized patients. Inferior vena cava is the most frequently injured vein during the blunt or penetrating trauma. The primary repair, end to end anastomosis, endovascular stenting, or graft interposition with autogenous or synthetic materials should be considered in selected cases. However, in cases the synthetic graft was preferred, intestinal contaminations due to small or large bowel perforation accompanying the trauma have been cited as a limiting factor for the use of such grafts as in the current case. However, a previous history of lower leg variceal surgery prevents the use of great saphenous vein as a graft. So in the present case, the authors report a patient with inferior vena cava injury repaired with autogenous peritoneo-fascial graft. The authors have used APF graft in traumatic inferior vena cava injury for the first time. PMID:18667465

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

    Atduev V.A.

    2012-06-01

    Full Text Available The aim of the investigation is to analyze the results of thrombectomy from inferior vena cava in renal cell carcinoma to reveal the main prognostic factors of postoperative complications. Materials and Methods. Nephrectomy with thrombectomy from inferior vena cava was performed in 34 patients. Thrombus level Т3b was revealed in 27 patients (79.4% (thrombus length — 5.10±1.75 cm, Т3с — in 7 patients (20.6% (thrombus length — 14.80±0.98 см. 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 IIIв 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.

  17. Filtros de vena cava en pacientes con cáncer

    Fernando A. Díaz Couselo

    2012-08-01

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

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

    Pelta, A.M.; Jorgensen, M.; Jensen, L.P.; Just, Sven Richardt Lundgren

    2008-01-01

    In this case report the treatment of a young man with bilateral iliaco-femoral DVT and vena cava aplasia is presented. The patient was treated with catheter-directed thrombolysis; the catheters were introduced in the thrombus of both legs via v. popliteae. The treatment led to almost complete thr...... 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...

  19. Absent right superior caval vein (vena cava) with normal atrial arrangement.

    Choi, J. Y.; Anderson, R H; Macartney, F J

    1987-01-01

    Eight cases of absent right superior caval vein (vena cava) with normal atrial arrangement from the Great Ormond Street database were reviewed. In each case the right subclavian vein and jugular vein drained into a persistent left superior caval vein through a bridging vein. In six cases the left superior caval vein drained into the right atrium by way of the coronary sinus, and in two cases it drained into the left atrium directly because of the complete unroofing of the coronary sinus. The ...

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

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

    2015-10-15

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

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

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

    2013-06-15

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

  2. Azygos Tip Placement for Hemodialysis Catheters in Patients with Superior Vena Cava Occlusion

    Chronic central venous access is necessary for numerous life-saving therapies. Repeated access is complicated by thrombosis and occlusion of the major veins, such as the superior vena cava (SVC), which then require novel vascular approaches if therapy is to be continued. We present two cases of catheterization of the azygos system in the presence of an SVC obstruction. We conclude that the azygos vein may be used for long-term vascular access when other conduits are unavailable and that imaging studies such as magnetic resonance venography, contrast-enhanced computed tomography or conventional venography can be employed prior to the procedure to aid with planning and prevent unforeseen complications

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

    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.

  4. Circulating microRNA profile in patients with membranous obstruction of the inferior vena cava

    SUN, GUI-XIANG; SU, YONG; LI, YING; ZHANG, YA-FENG; XU, LI-CHUN; ZU, MAO-HENG; HUANG, SHUI-PING; ZHANG, JIN-PENG; LU, ZHAO-JUN

    2016-01-01

    Membranous obstruction of the inferior vena cava (MOVC) is a common type of Budd-Chiari syndrome. However, the pathogenesis of MOVC has not been fully elucidated. Recent studies demonstrated that microRNAs (miRNAs or miRs) are involved in multiple diseases. To the best of our knowledge, specific changes in the expression of miRNAs in MOVC patients have not been previously assessed. The present study used a microarray analysis, followed by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) validation, with the aim to access the miRNA expression levels in the plasma of 34 MOVC patients, compared with those in healthy controls. The results revealed a total of 16 differentially expressed miRNAs in MOVC patients. Subsequently, RT-qPCR analysis verified the statistically consistent expression of 5 selected miRNAs (miR-125a-5p, miR-133b, miR-423-5p, miR-1228-5p and miR-1266), in line with the results of the microarray analysis. These 5 miRNAs, which were described as crucial regulators in numerous biological processes and vascular diseases, may play an important role in the pathogenesis of MOVC. Bioinformatics analysis of target genes of the differentially expressed miRNAs revealed that these predicted targets were significantly enriched and involved in several key signaling pathways important for MOVC, including the ErbB, Wnt, MAPK and VEGF signaling pathway. In conclusion, miRNAs may involve in multiple signaling pathways contributing to the pathological processes of MOVC. The present study offers an intriguing new perspective on the involvement of miRNAs in MOVC; however, the precise underlying mechanisms require further validation. PMID:26997997

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

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

    2008-01-15

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

  6. Relationship between encephalopathy and portal vein-vena cava shunt:Value of computed tomography during arterial portography

    Qian Chu; Zhen Li; Su-Ming Zhang; Dao-Yu Hu; Ming Xiao

    2004-01-01

    AIM: To assess the value of computed tomography during arterial portography (CTAP) in portal vein-vena cava shunt,and analysis of the episode risk in encephalopathy.METHODS: Twenty-nine patients with portal-systemic encephalopathy due to portal hypertension were classified by West Haven method into grade Ⅰ(29 cases), gradeⅡ(16 cases), grade Ⅲ(10 cases), grade Ⅳ( 4 cases). All the patients were scanned by spiral-CT. Plane scans, artery phase and portal vein phase enhancement scans were performed, and the source images were thinly reconstructed to 1.25 mm. We reconstructed the celiac trunk, portal vein,inferior vena cava and their branches and subjected them to three-dimensional vessel analysis by volume rendering(VR) technique and multiplanar volume reconstruction(MPVR) technique. The blood vessel reconstruction technique was used to evaluate the scope and extent of portal vein-vena cava shunt, portal vein emboli and the fistula of hepatic artery- portal vein. The relationship between the episode risk of portal-systemic encephalopathy and the scope and extent of portal vein-vena cava shunt,portal vein emboli and fistula of hepatic artery- portal vein was studied.RESULTS: The three-dimensional vessel reconstruction technique of spiral-CT could display celiac trunk, portal vein,inferior vena cava and their branches at any planes and angles and the scope and extent of portal vein-vena cava shunt, portal vein emboli and the fistula of hepatic artery- portal vein. In twenty-nine patients with portal-systemic encephalopathy, grade Ⅰ accounted for 89.7% esophageal varices, 86.2% paragastric varices; grade Ⅱ accounted for68.75% cirsomphalos, 56.25% paraesophageal varices,62.5% retroperitoneal varices and 81.25% dilated azygos vein; grade Ⅲ accounted for 80% cirsomphalos, 60%paraesophageal varices, 70% retroperitoneal varices, 90%dilated azygos vein, and part of the patients in grades Ⅱand Ⅲ had portal vein emboli and fistula of hepatic arteryportal vein

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

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

    2007-03-15

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

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

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

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

    Vučićević-Trobok Jadranka

    2002-01-01

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

  10. Radiation dose is associated with prognosis of small cell lung cancer with superior vena cava syndrome

    Wang, Zhen-Bo; Ning, Fang-Ling; Wang, Xiao-Le; Cheng, Yu-Feng; Dong, Xin-Jun; Liu, Chang-Min; Chen, Shao-Shui

    2015-01-01

    Approximately 10% of small cell lung cancer (SCLC) cases develop superior vena cava syndrome (SVCS). Many SCLC patients with SVCS have relatively limited disease, requiring curative rather than palliative treatment. Besides chemotherapy, radiotherapy is important for treating SCLC with SVCS. We retrospectively evaluated the influence of radiotherapy dose on the prognosis of 57 patients with SCLC with SVCS treated with concurrent chemoradiotherapy. The mean biological equivalent radiation dose was 71.5 Gy. We administered etoposide/cisplatin as sequential and concurrent chemotherapy. All patients received at least one cycle of concurrent chemotherapy. All patients had partial or complete response; SVCS-associated symptoms were reduced in 87.7% (50/57) of patients within 3-10 days after treatment. Radiation dose did not affect 2-year local control (74.2% vs. 80.8%). Patients who received high-dose radiation had a lower 2-year overall survival rate than those who received low-dose radiation (11.6 vs. 33%; P = 0.024). The high dose group median survival was 15.0 months (95% confidence interval [CI]: 11.2-19.0) compared with 18.7 months (95% CI: 13.9-23.6) in the low dose group. Grade 3/4 neutropenia occurred in 22/26 high dose patients (84.6%) and 21/31 low dose patients (67.7%). In the high dose group, 30.8% of patients had grade 3/4 esophagitis compared with 19.4% of low dose patients. Only 29.0% of low dose patients received < 4 cycles of chemotherapy in the first 12 weeks after treatment began compared with 46.2% of high dose patients. Concurrent chemoradiotherapy is a tolerable modality for treating stage IIIA/IIIB SCLC with SVCS. Moderate-dose radiotherapy is preferable. PMID:26064339

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

    Hikmat Abdel-Razeq

    2011-03-01

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

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

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

    2013-02-15

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

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

    S. V. Mukhtarulina

    2014-12-01

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

  14. CT of inferior vena cava filters: normal presentations and potential complications.

    Georgiou, Nicholas A; Katz, Douglas S; Ganson, George; Eng, Kaitlin; Hon, Man

    2015-12-01

    With massive pulmonary embolism (PE) being the first or second leading cause of unexpected death in adults, protection against PE is critical in appropriately selected patients. The use of inferior vena cava (IVC) filters has increased over the years, paralleling the increased detection of deep venous thrombosis (DVT) and PE by improved and more available imaging techniques. The use of IVC filters has become very common as an alternative and/or as a supplement to anticoagulation, and these filters are often seen on routine abdominal CT, including in the emergency setting; therefore, knowledge of the normal spectrum of findings of IVC filters by the radiologist on CT is critical. Additionally, CT can be used specifically to identify complications related to IVC filters, and CT may alternatively demonstrate IVC filter-related problems which are not specifically anticipated clinically. With multiple available IVC filters on the US market, and even more available outside of the USA, it is important for the emergency and the general radiologist to recognize the different models and various appearances and positioning on CT, as well as their potential complications. These complications may be related to venous access, but also include thrombosis related to the filter, filter migration and penetration, and problems associated with filter deployment. With the increasing number of inferior vena cava filters placed and their duration within patients increasing over time, it is critical for emergency and other radiologists to be aware of these findings on CT. PMID:26183040

  15. A new type of inferior vena cava filter and its animal experiment

    YU; Xue-bao; LIU; Mei-rong; GUO; Jin-fang; HU; Yu-ling

    2005-01-01

    This article explains the definition of pulmonary embolism as well as its causes and elaborates on a new type of inferior vena cava filter(VCF)we have developed. Shaped like a waistdrum,the VCF is mainly made of TiNi shape memory alloy-wire. It has a subulate wire frame which can intercept the thrombus on each side. Its medial body is made up of straight shape memory alloywire . Every pillar is bound by several shape memory alloy springs. This type of inferior vena cava filter has a good resistance to fatigue and is hard to be broken. Through animal experiments its framework has been proved to be lasting. Neither deformation nor fragmentation happened when the VCF had been kept in the body for a long time. The thrombus interception efficiency of our VCF is higher than imported VCFs. The filter is unfavorable for thrombosis. After implantation,the IVC was completely unimpeded and no displacement occurred. Moreover the VCF did little damage to the Wall of vein. Neither IVC perforation nor haematoma occurred after the operation.

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

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

    2000-08-01

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

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

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

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

    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.

  19. Dramatic response of follicular thyroid carcinoma with superior vena cava syndrome and tracheal obstruction to external-beam radiotherapy

    Wilford, M.R.; Chertow, B.S.; Lepanto, P.B.; Leidy, J.W. Jr. (Section of Endocrinology, Marshall University School of Medicine, Huntington, West Virginia (USA))

    1991-06-01

    We report a patient with follicular thyroid carcinoma progressing to superior vena cava (SVC) syndrome and tracheal obstruction despite multiple doses of radioactive iodine therapy but subsequently responding dramatically to external-beam radiotherapy (RT). Although RT is not considered to be the treatment of choice for follicular carcinoma, RT in our patient produced unequivocal improvement of SVC syndrome and tracheal obstruction.

  20. 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

    David Ibáñez Muñoz

    2011-09-01

    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.

  1. Optease Vena Cava Filter Optimal Indwelling Time and Retrievability

    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.

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

    Veroux, Pierfrancesco; Veroux, Massimiliano; Bonanno, Maria Giovanna; Tumminelli, Maria Giuseppina [Department of Surgery and Transplantation, University Hospital, Via S. Sofia, 78, 95123 Catania (Italy); Baggio, Elda [Department of Surgery and Gastroenterological Sciences, University Hospital of Verona (Italy); Petrillo, Giuseppe [Department of Radiology, University Hospital, Via S. Sofia, 78, 95123 Catania (Italy)

    2002-07-01

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

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

    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

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

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

    2015-08-01

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

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

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

    2002-06-01

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

  6. CT of anomalies of the inferior vena cava and left renal vein

    Incidence of anomalies of the inferior vena cava (IVC) and left renal vein (LRV) was examined with post-contrast abdominal CT studies in the last five years and seven months retrospectively. Of the total 1100 cases, right retrocaval ureter was noted in two cases (0.2 %), left IVC was two (0.2 %) and bilateral IVC was twelve (1.1 %) about anomalies of the IVC. As to anomalies of the LRV, retroaortic LRV was four (0.4 %) and circumaortic LRV was six (0.5 %). These results did not always agree with those of previous reports on dissection cases. Particularly, incidence of anomalies of the LRV on CT was much lower than that on dissection. We speculated that racial difference was one of its causes. Clinical usefulness of CT for evaluation of anomalies of the IVC and LRV was stressed. (author)

  7. Successful Venous Angioplasty of Superior Vena Cava Syndrome after Heart Transplantation

    Thomas Strecker

    2014-01-01

    Full Text Available 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.

  8. Surgical repair for giant ascending aortic aneurysm to superior vena cava fistula with positive syphilitic test.

    Sekine, Yuji; Yamamoto, Shin; Fujikawa, Takuya; Oshima, Susumu; Ono, Makoto; Sasaguri, Shiro

    2015-10-01

    Syphilitic aortitis is usually associated with thoracic aortic saccular aneurysm, aortic regurgitation and coronary ostial stenosis. However, syphilitic aneurysms have rarely been reported today. Here, we report a patient with ascending aortic aneurysm with aorta-superior vena cava (SVC) fistula with positive syphilitic test. A 52-year-old man was admitted to our institution with a giant ascending aortic aneurysm complicated with SVC syndrome. Computed tomography revealed a giant ascending aneurysm 79 mm in diameter. The result of serodiagnostic tests for syphilis had not been judged yet preoperatively. Total arch replacement concomitant with elephant trunk was performed. Intraoperatively, we detected the ascending aorta to SVC fistula. Postoperatively, we suspected the syphilitic aneurysm strongly, because preoperative serodiagnostic test was concluded to be positive. However, histological examination did not show typical syphilitic features. The patient remains asymptomatic 1 year later. Although extremely rarely today, syphilitic aneurysm should be still considered in the differential diagnosis of ascending aortic aneurysm. PMID:24000069

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

    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)

  10. Accidental implantation of hemodialysis catheter in persistent left superior vena cava

    The implantation of central catheters for hemodialysis in patients with renal failure is a common practice. The venous access to the internal jugular vein through percutaneous puncture is the most recommended procedure because it produces the lowest percentage of stenosis. The right internal jugular vein puncture is the most appropriate one because it goes directly in vertical direction into the right atrium, but in some cases its canalization is impossible making it necessary to puncture the left internal jugular vein, the one next to the innominated vein that ends in the superior cava, with the result that its path is much curved. 3 cases in which the left intern jugular catheter that was inserted to perform hemodialysis accidentally canalized the anomaly in the persistent left superior vena cava were presented. In all the cases and before proceeding with the hemodialysis it was demonstrated by the gases of the punctuated vessel, echocardiogram or contrast medium that the catheter was positioned in the venous system that drains in the right atrium.

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

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

    2000-11-01

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

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

    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

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

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

    2008-02-04

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

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

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

  15. Clinically asymptomatic thrombosis of the inferior vena cava as an incidental finding by sonography after surgical treatment of a tumor in the mediastinum

    In the case of suspected thrombosis of the venia cava caudalis, ultrasonography, CT and NMR imaging are excellent diagnostic tools. For a diagnostic scanning of the collateral vene, phlebography of the inferior vena cava is the method yielding the most significant results. (orig.)

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

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

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

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

    2007-05-15

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

  18. Renal Artery Stump to Inferior Vena Cava Fistula: Unusual Clinical Presentation and Transcatheter Embolization with the Amplatzer Vascular Plug

    Fistulous communication between the renal artery stump and inferior vena cava following nephrectomy is rare. We describe the case of a 52-year-old man with a fistula detected on investigation for hemolytic anemia in the postoperative period. The patient had had a nephrectomy performed 2 weeks prior to presentation for blunt abdominal trauma. The fistula was successfully occluded percutaneously using an Amplatzer vascular plug. The patient recovered completely and was discharged 2 weeks later.

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

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

    2012-01-01

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

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

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

  1. Innominate vein-right atrial bypass for relief of superior vena cava syndrome due to pacemaker lead thrombosis.

    Deo, Salil V; Burkhart, Harold M; Araoz, Philip A; Brady, Peter A

    2010-11-01

    We present a patient with superior vena cava (SVC) obstruction due to multiple intraluminal pacemaker leads. Previous attempts at balloon dilatation of the SVC and surgical angioplasty did not provide a long-term solution. A Gore-Tex (W. L. Gore & Associates, Flagstaff, AZ, USA) conduit interposed between the innominate vein and right atrial appendage has resulted in symptomatic relief at a follow-up of 6 months. PMID:21039859

  2. GCS as a predictor of mortality in patients with traumatic inferior vena cava injuries: a retrospective review of 16 cases

    Cudworth, Michael; Fulle, Angelo; Ramos, Juan P; Arriagada, Ivette

    2013-01-01

    Introduction Recent research has determined Glasgow Coma Scale (GCS) to be an independent predictor of mortality in patients with traumatic inferior vena cava (IVC) injuries. The aim of this study was to evaluate the use of GCS, as well as other factors previously described as determinants of mortality, in a cohort of patients presenting with traumatic IVC lesions. Methods A 7-year retrospective review was undertaken of all trauma patients presenting to a tertiary care trauma center with trau...

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

    Shi, Xiang-min; YUAN, HONG-TAO; Guo, Hong-Yang; Guo, Jian-Ping; Shan, Zhao-Liang; Wang, Yu-tang

    2015-01-01

    To analyze characteristics of electrocardiogram (ECG), electrophysiological intracardiac mapping and radiofrequency ablation (RF) of paroxysmal atrial fibrillation (PAF) originating from superior vena cava (SVC), aiming to investigate electrophysiological characteristics of PAF with SVC origin. Clinical data of 30 subjects (18 men and 12 women, aged, 58.6 ± 15.5 years) with PAF of SVC origin were retrospectively analyzed; All patients underwent RF during 2006.9-2012.7. ECG of AF and atrial pr...

  4. OptEase and TrapEase Vena Cava Filters: A Single-Center Experience in 258 Patients

    We aimed to evaluate the efficacy and safety of the OptEase and TrapEase (both from Cordis, Roden, Netherlands) vena cava filters in the prevention of pulmonary embolism (PE). Between May 2004 and December 2008, OptEase (permanent/retrievable; n = 228) or TrapEase (permanent; n = 30) vena cava filters were placed in 258 patients (160 female and 98 male; mean age 62 years [range 22 to 97]). Indications were as follows: prophylaxis for PE (n = 239), contraindication for anticoagulation in the presence of PE or DVT (n = 10), and development of PE or DVT despite anticoagulation (n = 9). Medical records were retrospectively reviewed for indications, clinical results, and procedure-related complications during placement and retrieval. Clinical PE did not develop in any of the patients. However, radiologic signs of segmental PE were seen in 6 of 66 patients with follow-up imaging data. Migration or fracture of the filter or cava perforation was not seen in any of the patients. Except for a single case of asymptomatic total cava thrombosis, no thrombotic occlusion was observed. One hundred forty-one patients were scheduled to undergo filter removal; however, 17 of them were not suitable for such based on venography evaluation. Removal was attempted in 124 patients and was successful in 115 of these (mean duration of retention 11 days [range 4 to 23]). Nine filters could not be removed. Permanent/retrievable vena cava filters are safe and effective devices for PE prophylaxis and for the management of venous thromboembolism by providing the option to be left in place.

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

    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)

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

    Antonio Eduardo Zerati

    2005-10-01

    Full Text Available OBJECTIVE: To study the immediate and late results obtained from the implantation of vena cava filters in cancer patients with deep vein thrombosis concomitant with neoplasia. METHODS: This was a retrospective evaluation of 50 patients with an association of cancer and deep venous thrombosis who underwent interruption of the inferior vena cava and the insertion of permanent vena cava filters. The indications for the procedure, filter implantation technique, early and late complications related to the operation, and the clinical evolution were evaluated. RESULTS: The most frequent indication for filter implantation was the contraindication for full anticoagulant treatment (80%. The femoral vein was the preferred access route (86% of the patients. There were no complications related to the surgical procedure. During the follow-up, the following complications were observed: 1 episode of nonfatal pulmonary thromboembolism, 2 cases of occlusion of the inferior vena cava, and 1 case of thrombus retained in the device. Twenty patients (40% died due to progression of the neoplasm. CONCLUSIONS: Interruption of the inferior cava vein using an endoluminal filter is a procedure with a low rate of complications. It is a safe and efficient measure for preventing pulmonary embolism in cancer patients who have deep vein thrombosis of the lower limbs.OBJETIVO: Estudar os resultados imediatos e tardios obtidos com a implantação de filtros de veia cava inferior em pacientes com trombose venosa profunda concomitante a neoplasia. MÉTODOS: Avaliamos retrospectivamente 50 pacientes com câncer e trombose venosa profunda associada submetidos a interrupção de veia cava inferior com filtros intraluminais definitivos. Foram estudados aspectos referentes à indicação do procedimento, à técnica de implante dos dispositivos, complicações precoces e tardias relacionadas à operação e à evolução dos pacientes. RESULTADOS: A indicação mais freqüente para o

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

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

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

    Winston B. Yoshida

    2008-09-01

    Full Text Available Este estudo apresenta resultados preliminares obtidos com um novo filtro permanente de veia cava, baseado no desenho de Greenfield, com três hastes prolongadas de um total de seis, para dar estabilidade central ao filtro na luz da veia cava. Neste artigo, relatamos sua avaliação clínica preliminar quanto à aplicabilidade, eficácia e segurança. De agosto de 2004 a dezembro de 2006, 15 filtros foram implantados em nove homens e seis mulheres, com idades variando de 38 a 79 anos (média de 57,8 anos. O acesso foi feito sempre por via transjugular. As indicações foram: trombose venosa proximal, com contra-indicação de anticoagulação em 12 pacientes; complicações hemorrágicas com anticoagulação em dois pacientes; e embolia pulmonar, apesar de anticoagulação adequada, em um paciente. Os filtros foram avaliados quanto à liberação, inclinação, mau posicionamento e perfuração de cava. No seguimento, avaliou-se trombose no local de acesso, tromboembolismo venoso recorrente, migração do filtro e trombose de cava pelo ultra-som. Nenhum paciente recebeu anticoagulantes no seguimento. O filtro foi liberado com sucesso em todos os casos sem mau posicionamento, inclinação, perfuração ou trombose de acesso. Os pacientes foram seguidos entre 3 e 23 meses (média de 11 meses. Nenhum paciente teve recorrência de tromboembolismo venoso. Não houve casos de trombose de veia cava ou migração do filtro. Óbito ocorreu em sete casos, todos relacionados com a moléstia de base. Os resultados preliminares indicam potencial eficácia e segurança do uso do novo filtro no período estudado.This study presents preliminary results obtained from a new permanent filter, based on Greenfield's filter design, with prolongations on three of six struts to stabilize it centrally in the vena caval lumen. The preliminary clinical evaluation of the filter with regard to feasibility, efficacy and safety is reported. From August 2004 to December 2006

  9. Downhill oesophageal varices resulting from superior vena cava graft occlusion after resection of a thymoma†

    Inoue, Yoshimasa; Sakai, Shoji; Aoki, Teruhiro

    2013-01-01

    Downhill oesophageal varices (DEV) may occur as a rare complication of superior vena cava (SVC) obstruction. DEV are usually associated with SVC obstruction caused by systemic vasculitis or mediastinal tumours. In this report, we describe a very rare case of DEV resulting from SVC graft occlusion after resection of a thymoma. A 66-year old man with an invasive thymoma was treated by radical resection and bypass grafting from the right brachiocephalic vein to the right atrium. Occlusion of the SVC graft was diagnosed postoperatively; however, the patient could be managed conservatively. Although there had been no significant findings in the oesophagus in previous endoscopic examinations, grade F2 varices were found in the proximal oesophagus in the 19th postoperative month, and DEV caused by SVC graft occlusion was diagnosed. Until now, 2 years since the diagnosis, no apparent symptoms or deterioration of the DEV have been observed. The possible development of DEV should be borne in mind during the follow-up of patients with postoperative SVC graft occlusion. PMID:23686892

  10. Mesothelioma with superior vena cava obstruction in young female following short latency of asbestos exposure

    Anupam Patra

    2015-01-01

    Full Text Available An 18 years female was admitted with right-sided chest pain, dry cough, and low-grade fever and weight loss for last 1 month. On examination, patient had features of superior vena cava (SVC syndrome with right-sided pleural effusion. Chest X-ray showed mediastinal widening with nonhomogenous opacity mainly in the periphery of right upper and mid zone with right-sided pleural effusion. Ultrasonography thorax confirmed mild pleural effusion. Pleural fluid analysis showed lymphocytic, exudative, low adenosine deaminase with negative for Pap smear. Contrast-enhanced computed tomography (CT thorax revealed large extensive nodular soft tissue lesion along right mediastinum as well as costal pleura, with enlarged pretracheal lymphadenopathy and SVC obstruction. CT guided Tru-cut biopsy report came as malignant epithelial tumor with polygonal shape, abundant eosinophilic cytoplasm and nuclei with prominent nucleoli suggestive of mesothelioma of epithelioid type. The tumor cell expressed calretinin, WT-1, and immunonegative for thyroid transcription factor-1.

  11. Dynamic Limb Bioimpedance and Inferior Vena Cava Ultrasound in Patients Undergoing Hemodialysis.

    Tiba, Mohamad H; Belmont, Barry; Heung, Michael; Theyyunni, Nik; Huang, Robert D; Fung, Christopher M; Pennington, Amanda J; Cummings, Brandon C; Draucker, Gerard T; Shih, Albert J; Ward, Kevin R

    2016-01-01

    Assessment of volume status in critically ill patients poses a challenge to clinicians. Measuring changes in the inferior vena cava (IVC) diameter using ultrasound is becoming a standard tool to assess volume status. Ultrasound requires physicians with significant training and specialized expensive equipment. It would be of significant value to be able to obtain this measurement continuously without physician presence. We hypothesize that dynamic changes in limb's bioimpedance in response to respiration could be used to predict changes in IVC. Forty-six subjects were tested a hemodialysis session. Impedance was measured via electrodes placed on the arm. Simultaneously, the IVC diameter was assessed by ultrasound. Subjects were asked to breathe spontaneously and perform respiratory maneuvers using a respiratory training device. Impedance (dz) was determined and compared with change in IVC diameter (dIVC; r = 0.76, p < 0.0001). There was significant relationship between dz and dIVC (p< 0.0001). Receiver-operator curves for dz at thresholds of dIVC (20% to70%) demonstrated high predictive power with areas under the curves (0.87-0.99, p < 0.0001). This evaluation suggests that real-time dynamic changes in limb impedance are capable of tracking a wide range of dynamic dIVC. This technique might be a suitable surrogate for monitoring real-time changes in dIVC to assess intravascular volume status. PMID:26919184

  12. Radiological diagnosis of total anomalous pulmonary venous connection with right superior vena cava

    Objective: To evaluate radiographic diagnosis in total anomalous pulmonary venous connection with right superior vena cava (RSVC-TAPVC) and analyze the variant of its pulmonary venous connection and the influence on surgical operation. Methods: In 11 patients who were diagnosed by angiocardiography and confirmed by surgical operation, all chest radiographs were studied retrospectively and compared with their angiocardiography and surgical results. The variant of pulmonary venous connection was analyzed and the influence on surgical operation was also discussed. Results: 6 patients showed 'right hemi-snowman sign' in posteroanterior view and 3 showed a pre-tracheal density on the lateral view or other sign caused by drainage vein. 6 of 9 angio-cardiographs showed pulmonary or drainage venous stenosis. There were 2, 4 and 3 cases respectively whose right pulmonary veins connected with common pulmonary or drainage veins in one, two, and three branches. 2 of 3 died cases were caused by mistaken ligation of right superior pulmonary vein during the operation. Conclusion: About 82% cases of the RSVC-TAPVC can be diagnosed by chest radiograph because of the 'right hemi-snowmen sign' and other supplementary signs. In about 78% cases, the right pulmonary veins join right drainage (or connecting) vein in two or more branches at separate levels and this variant has surgical implications

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

    Adrien Riviere

    2014-01-01

    Full Text Available Introduction. Angiomyolipoma is a common benign renal tumor. It is associated with Tuberous Sclerosis Complex (TSC in 20% of patients. Angiomyolipomas are classically multiple, bilateral, and growing; they may lead to complications such as Wunderlich syndrome or, in rare cases, to venous extension. Observation. a 74-year-old woman with TSC presented with an angiomyolipoma of the right kidney with inferior vena cava (IVC fatty thrombus. She underwent partial nephrectomy and thrombectomy. After a 7-year follow-up there was no evidence of recurrence or metastasis and her renal function was preserved. Review of Literature. It is the 44th reported angiomyolipoma associated with IVC thrombus. The mean size of angiomyolipomas was 86.1 mm and 67.4% of patients were symptomatic. Pulmonary embolism was found in 6 patients. There were 2 cases of recurrence/metastatic outcome after radical nephrectomy and thrombectomy. They were associated with epithelioid form. The mean size of epithelioid tumors was significantly bigger than in classical angiomyolipomas (127.1 mm versus 82.6 mm, P=0.037. With a median follow-up of 12 months, 91.3% of patients were recurrence and metastasis free, with 3 cases of nephron sparing surgery. Conclusion. Nephron sparing surgery for angiomyolipoma with IVC fatty thrombus can be safely performed in TSC, even in sporadic angiomyolipoma.

  14. Persistent left superior vena cava mistaken for nodal metastasis: a case report

    Papandrinopoulou Dimitra

    2010-06-01

    Full Text Available Abstract Introduction Evaluation of the mediastinum is crucial for patients with lung cancer. Mediastinal lymph node metastases play a dramatic role in the process of staging. Physicians should be aware of the potential pitfalls regarding mediastinal evaluation. This case report provides an example. Case presentation We report the case of a 57-year-old Caucasian man who presented with a four-month history of non-productive cough. He was diagnosed with non-small cell lung cancer. Initially, it was thought to be inoperable due to the presence of a para-aortic lymph node. A more careful examination of the mediastinum revealed that the "lymph node" was in fact a persistent left superior vena cava. Conclusions This study highlights the difficulties in mediastinal staging, especially when intravenous contrast is not used. The recognition of this vascular malformation dramatically changed the therapeutic decisions, giving our patient the opportunity of surgical resection. To the best of our knowledge, such correlation has not been described in English literature.

  15. Catheterobronchial fistula due to vena cava superior thrombosis as a late complication of ventriculoatrial shunt.

    Parízek, J; Nytra, T; Zemánková, M; Eliás, P; Sercl, M; Nĕmecková, J; Jakubec, J

    1994-09-01

    A case of a catheterobronchial fistula as a rare late complication of a ventriculoatrial shunt is reported. The ventriculoatrial shunt was implanted in a 4-month-old boy suffering from extreme postinfectious hydrocephalus. During the following years, twelfth nerve palsy on the right, vertebralgias, and salty taste sensations in the mouth associated with intermittent coughing and swelling of the neck and supraclavicular region on the right side developed. Valvography established a diagnosis of fistula 12 years after the implantation of a shunt. Ultrasonography of the neck and mediastinum and contrast-enhanced dynamic computed tomographic scanning demonstrated a catheterobronchial fistula to the subsegmental bronchus of the anterior segment of the right upper lung lobe, a thrombosis of the right internal jugular and both right and left brachiocephalic veins and the superior vena cava, and an extensive collateral venous system mainly draining into the azygos vein. Normalization of cerebrospinal fluid and blood flow and pressure allowed extraction of the "atrial" catheter without complications. One year after surgery the boys is in good health and without signs of shunt dependence. PMID:7842439

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

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

  17. On determining the characteristics of a Greenfield Inferior Vena Cava Filter using CFD

    Swaminathan, Tirumani; Hu, Howard; Patel, Aalpen

    2004-11-01

    In those patients with deep venous thrombosis (DVT) or those at a high risk for DVT, and who have contraindications to or are unresponsive to anticoagulation therapy, vena cava filters are often used to prevent recurrent pulmonary emboli. Ideally, the filter should be efficacious while being non-thrombogenic and non-impeding to the blood flow. In reality, the filter has to establish a balance between clot capture efficiency and flow impedance before and after clot capture. The development and use of numerical tools to study the characteristics of filters and its application to the case of a Greenfield filter has been presented here. A detailed model resolving the flow field around the filter to a fine detail is described. The thrombogenecity of the filter in un-occluded flows is determined by analyzing plots of shear stresses and velocity fields. To evaluate a filter's clot capturing efficacy, a Thin Wire Model (TWM) has been developed and used in conjunction with a moving finite element scheme to study the probability of clot capturing for the Greenfield filter.

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

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

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

    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

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

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

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

    Rachna Raman

    2011-12-01

    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.

  2. Collateral circulation in ferrets (Mustela putorius) during temporary occlusion of the caudal vena cava.

    Calicchio, Kristina W; Bennett, R Avery; Laraio, Leonard C; Weisse, Chick; Zwingenberger, Allison L; Rosenthal, Karen L; Johnston, Matthew S; Campbell, Vicki L; Solomon, Jeffrey A

    2016-05-01

    OBJECTIVE To determine whether extent of collateral circulation would change during temporary occlusion of the caudal vena cava (CVC) in ferrets (Mustela putorius), a pressure change would occur caudal to the occlusion, and differences would exist between the sexes with respect to those changes. ANIMALS 8 adult ferrets (4 castrated males and 4 spayed females). PROCEDURES Ferrets were anesthetized. A balloon occlusion catheter was introduced through a jugular vein, passed into the CVC by use of fluoroscopy, positioned cranial to the right renal vein, and inflated for 20 minutes. Venography was performed 5 and 15 minutes after occlusion. Pressure in the CVC caudal to the occlusion was measured continuously. A CBC, plasma biochemical analysis, and urinalysis were performed immediately after the procedure and 2 or 3 days later. RESULTS All 8 ferrets survived the procedure; no differences were apparent between the sexes. Vessels providing collateral circulation were identified in all ferrets, indicating blood flow to the paravertebral venous plexus. Complications observed prior to occlusion included atrial and ventricular premature contractions. Complications after occlusion included bradycardia, seizures, and extravasation of contrast medium. Mean baseline CVC pressure was 5.4 cm H2O. During occlusion, 6 ferrets had a moderate increase in CVC pressure (mean, 24.3 cm H2O) and 2 ferrets had a marked increase in CVC pressure to > 55.0 cm H2O. CONCLUSIONS AND CLINICAL RELEVANCE Caval occlusion for 20 minutes was performed in healthy ferrets with minimal adverse effects noted within the follow-up period and no apparent differences between sexes. The CVC pressure during occlusion may be prognostic in ferrets undergoing surgical ligation of the CVC, which commonly occurs during adrenal tumor resection. PMID:27111022

  3. 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

    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)

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

    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

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

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

    2013-12-15

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

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

    Marc Gingell Littlejohn

    2009-01-01

    Full Text Available

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

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

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

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

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

    2014-10-15

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

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

    Robinson RA

    2013-05-01

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

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

    M. Vahedian

    2011-10-01

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

  11. Focal Hepatic Hot Spot From Superior Vena Cava Occlusion Visualized on Ventilation/Perfusion Scintigraphy With Contrast-Enhanced CT Correlate.

    Lawrence, Michael; Schuster, David M

    2016-05-01

    A 57-year-old woman with superior vena cava stenosis from repeated central line placements underwent ventilation/perfusion scanning after presenting with pleuritic chest pain. The ventilation/perfusion scan was not characteristic for pulmonary embolus, but perfusion images demonstrated abnormal radiotracer activity within hepatic segment 4, along with extensive collateral vessels as seen on SPECT/CT. Two months later, the patient presented with similar complaints and had a chest CT with contrast to evaluate for pulmonary embolus. This showed occlusion of the superior vena cava and arterial enhancement within segment 4 in a similar distribution to the radiotracer in the perfusion scan. PMID:26825208

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

    Moran, M

    2012-02-01

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

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

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

    2014-01-01

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

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

    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

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

    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

  16. Gunther Tulip Inferior Vena Cava Filter Placement During Treatment for Deep Venous Thrombosis of the Lower Extremity

    Purpose. To evaluate the efficacy and safety of Gunther tulip retrievable vena cava filter (GTF) implantation to prevent pulmonary embolism during intravenously administered thrombolytic and anticoagulation therapy and interventional radiological therapy for occlusive or nonocclusive deep venous thrombosis (DVT) of the lower extremity. Methods. We evaluated placement of 55 GTFs in 42 patients with lower extremity DVT who had undergone various treatments including those utilizing techniques of interventional radiology. Results. Worsening of pulmonary embolism in patients with existing pulmonary embolism or in those without pulmonary embolism at the time of GTF insertion was avoided in all patients. All attempts at implantation of the GTF were safely accomplished. Perforation and migration experienced by one patient was the only complication. Mean period of treatment for DVT under protection from pulmonary embolism by the GTF was 12.7 ± 8.3 days (mean ± SD, range 4-37 days). We attempted retrieval of GTFs in 18 patients in whom the venous thrombus had disappeared after therapy, and retrieval in one of these 18 cases failed. GTFs were left in the vena cava in 24 patients for permanent use when the DVT was refractory to treatment. Conclusion. The ability of the GTF to protect against pulmonary embolism during treatment of DVT was demonstrated. Safety in both placement and retrieval was clarified. Because replacement with a permanent filter was not required, use of the GTF was convenient when further protection from complicated pulmonary embolism was necessary

  17. Endovascular treatment of thrombosed inferior vena cava filters: Techniques and short-term outcomes

    Mohammad Arabi

    2015-01-01

    Full Text Available Purpose: To present the techniques for endovascular treatment of thrombosed filter-bearing inferior vena cavae (IVCs, along with short-term clinical and imaging follow-up. Materials and Methods: A total of 45 consecutive patients (17 females and 28 males, aged 19-79 years (mean age of 49 years, who had IVC filter placement complicated by symptomatic acute or chronic iliocaval thrombosis and underwent endovascular therapy were studied. All patients presented with lower extremity swelling and/or pain. One patient also had bilateral lower extremity swelling and chronic gastrointestinal (GI bleeding which was secondary to chronic systemic to portal venous collaterals. Patients underwent one or more of the following endovascular treatments depending on the chronicity and extent of thrombosis: (a catheter-directed thrombolysis (CDT (n = 25, (b pharmacomechanical thrombolysis (PMT (n = 15, (c balloon angioplasty (n = 45, and/or (d stent placement across the filter (n = 42. In addition, 16 patients underwent groin arteriovenous fistula (AVF creation (36% and 3 (7% had femoral venous thrombectomy to improve flow in the recanalized iliac veins and IVCs. Results: Anatomical success was achieved in all patients. Follow-up was not available in 10 patients (lost to follow-up, n = 4; expired due to comorbidities, n = 2; lost to follow-up after re-intervention, n = 4. At a mean follow-up time of 13.3 months (range 1-48 months, clinical success was achieved in 27 patients (60%, i.e. in 21 patients without re-intervention and in 6 patients with re-intervention. Clinical success was not achieved despite re-intervention in eight patients. Higher clinical success was noted in patients who did not require repeat interventions (P = 0.03 and the time to re-intervention was significantly shorter in patients who had clinical failure (P = 0.01. AVF creation did not improve the clinical success rate (P = 1. There was no significant difference in clinical success between

  18. Safety and efficacy of interventional treatment for occlusion of the entire inferior vena cava

    Objective: To evaluate the safety and efficacy of interventional treatment of occlusion of the entire inferior vena cava (IVC). Methods: The clinical data of 6 patients with entire IVC occlusion were analyzed retrospectively. All patients were diagnosed by color Doppler ultrasound and DSA. Venography was performed under local anesthesia via internal jugular vein and femoral vein approach. The occlusion of IVC and hepatic vein were treated with balloon dilatation and/or stent placement. Follow-up examination with color Doppler ultrasound was taken 1, 3, 6, 12 months after treatment and annually thereafter to assess the patency of IVC and hepatic vein. The pressure gradient of hepatic vein-right atrium and IVC-right atrium before and after interventional treatment were compared with paired t test. Results: In 5 cases, both IVC and 1 hepatic vein were recanalized successfully. In 1 case,recanalization of IVC failed,but the right hepatic vein was recanalized successfully. The mean pressure gradient of hepatic vein-right atrium decreased from (23.2 ± 2.0) cmH2O (1 cmH2O =0.098 kPa) before treatment to (8.7 ± 3.2) cmH2O after treatment in 6 cases (t=21.6, P<0.05). The mean pressure gradient of IVC-right atrium decreased from (26.6 ± 2.7) cmH2O before treatment to (9.4 ± 1.1) cmH2O after treatment (t=16.1, P<0.05). Abdominal pains occurred in 3 patients after stent implantation which disappeared in 24 hours. No other complications such as bleeding and death occurred. During a mean follow-up of (42 ± 27) months (16 to 90 months), hepatic vein patency was maintained in 6 cases and IVC patency was maintained in 5 cases. Conclusion: Interventional treatment of occlusion of the entire IVC is a safe and effective method. (authors)

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

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

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

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

    2014-01-01

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

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

    Katsuro Harada Júnior

    2012-09-01

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

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

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

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

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

    2009-04-15

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

  4. Inferior vena cava obstruction and collateral circulation as unusual manifestations of hepatobiliary cystadenocarcinoma

    Nikolaos Arkadopoulos; Anneza I Yiallourou; Constantinos Palialexis; Emmanouil Stamatakis

    2013-01-01

    BACKGROUND: Hepatobiliary cystadenocarcinoma represents a rare epithelial malignant tumor derived from the intrahepatic bile duct. METHODS: A 71-year-old woman, who had undergone laparos-copic drainage of a cystic lesion of the right hepatic lobe, was misdiagnosed  as  having  hepatic  echinococcal  disease,  and received intracystic infusion of 95% ethanol four years ago. She was admitted to our hospital for further treatment. RESULTS: Physical  examination  revealed  dilated  superficial veins  across  the  right  abdominal  wall.  After  mapping  the direction of blood flow in these vessels, we assumed that this was a sign of inferior vena cava obstruction. Abdominal ultrasound, computed tomography, magnetic resonance imaging combined with  magnetic  resonance  angiography  showed  a  large  cystic mass in the right upper quadrant and epigastrium, displacing the  adjacent  structures,  adherent  to  the  inferior  vena  cava, which  was  not  patent,  resulting  in  dilation  of  superficial epigastric  veins.  The  patient  underwent  an  exploratory laparotomy.  Total  excision  of  the  huge  mass  measuring  16× 15  cm  was  possible  under  selective  vascular  exclusion  of  the liver. Removal of the tumor resulted in immediate restoration of flow in the inferior vena cava. On the basis of the pathology and findings of immunohistochemical analysis, a hepatobiliary cystadenocarcinoma was diagnosed. CONCLUSIONS: In the present case, hepatobiliary cystadenocar-cinoma was accompanied by dilated superficial venous collaterals due to inferior vena

  5. Massive catheter-related thrombosis of vena cava superior protruding into the right atrium in a hemodialysis patient.

    Mach, Lukas; Ondruskova, Olga; Nemec, Petr; Orban, Marek

    2015-10-01

    A 36-year-old man with chronic renal insufficiency secondary to type 1 diabetes mellitus was on hemodialysis via central venous catheter (CVC), newly placed into the right subclavian vein after his arteriovenous fistula became dysfunctional. Seven days after CVC insertion, the patient developed fever and on day 11 echocardiography showed a large nearly occluding thrombus in the superior vena cava (SVC) extending into the right atrium (RA). Emergency surgical thrombectomy was successfully performed and an 11 cm long thrombus extending from the RA cranially into the SVC occupying majority of the vein's lumen was removed. Cultures from the thrombus and CVC were negative, but polymerase chain reaction was positive for Staphylococcus aureus. This particular case was interesting for a marked discrepancy between large SVC occluding thrombosis and a relatively mild clinical presentation with fever, and it highlights the importance of correct timing of echocardiography exam which might prevent potentially fatal consequences such as pulmonary embolism. PMID:25645521

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

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

  7. The Incidental Finding of a Persistent Left Superior Vena Cava: Implications for Primary Care Providers—Case and Review

    Loren Garrison Morgan

    2015-01-01

    Full Text Available Persistent left superior vena cava (PLSVC is the most common thoracic venous anomaly and is a persistent congenital remnant of the vena caval system from early cardiac development. Patients with congenital anomalous venous return are at increased risk of developing various cardiac arrhythmias, due to derangement of embryologic conductive tissue during the early development of the heart. Previously this discovery was commonly made during the placement of pacemakers or defibrillators for the treatment of the arrhythmias, when the operator encountered difficulty with proper lead deployment. However, in today’s world of various easily obtainable imaging modalities, PLSVC is being discovered more and more by primary care providers during routine testing or screening for other ailments. Given the known association between anomalous venous return and the propensity for cardiac arrhythmias, we review the embryology of PLSVC and the mechanisms by which it leads to conduction abnormalities. We also provide the practitioner with recommendations for certain baseline cardiac observations and suggestions for proper surveillance in hopes that better understanding will reduce unnecessary and potentially harmful testing, premature subspecialty referral, and unneeded patient anxiety.

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

    Kotasthane Vaishali D

    2010-07-01

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

  9. Reproduction of a new inferior vena cava thrombosis model and study of the evolutionary process of thrombolysis in rats

    Jian FU

    2015-10-01

    Full Text Available Objective To investigate the reproduction of a new model of thrombosis of inferior vena cava (IVC, and explore the natural process of thrombolysis and its mechanism in rats. Methods Forty-eight SD rats were randomly classified into experimental group and control group. In the experimental group, the lumen of the vena cava was blocked by about 80%-90% with a ligature of IVC below the left renal vein, and then the animals were redivided into three subgroups (n=12, each. In group A, the IVC endothelium was damaged and its tributaries were ligated. In group B, the IVC endothelium was damaged and its tributaries were not ligated. In group C, no damage was done to the endothelium of the IVC but all its tributaries were ligated. A sham-operated group served as control. The length and weight of the vinous thrombus and the percentage of the IVC luminal area were compared after operation to determine the optimum animal model of venous thrombosis. According to the best mode to establish the model, the thrombus specimens were collected and detected by HE and Masson staining, and the ED-1 expressions were examined by immunohistochemical staining after thrombus formation in 30 rats. The natural evolution of intravenous thrombolysis was analyzed dynamically and the cell types involved in this process were observed. Results Gross observation showed that the experimental group was successfully induced thrombus formation. The thrombus length and weight in group A was significantly higher than that in group B and group C, and no difference between group B and C. The thrombus area in group A was significantly higher than that in groups B and group C, which identified the group A was the optimal model group of venous thrombosis. In the group reproduced by the best mode of the model, HE and Masson staining results showed that new capillaries and the components of collagen and extracellular matrix increased gradually with the passage of time in the process of

  10. Simultaneous removal of a tumour of the right atrium and inferior vena cava and coronary bypass-grafting in a patient with recurrent clear renal cell carcinoma

    Pietrzyk, Edward; Głuszek, Stanisław; Michta, Kamil; Kot, Marta; Wożakowska-Kapłon, Beata

    2015-01-01

    Metastatic cardiac tumours are the most common malignant cardiac tumours. In the early stages they are usually asymptomatic, but their consequences can be very serious, and the prognosis is poor. We present a patient with recurrent renal cell carcinoma as a tumour of the right atrium and the vena cava inferior in whom cancerous masses were removed with simultaneously coronary artery bypass-grafting. PMID:26855653

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

    R Nafisi-Moghadam; Mansourian, H.R

    2007-01-01

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

  12. Absence of inferior vena cava in 14-year old boy associated with deep venous thrombosis and positive Mycoplasma pneumoniae serum antibodies- a case report

    Kalicki, Boleslaw; Sadecka, Monika; Wawrzyniak, Agata; Kozinski, Piotr; Dziekiewicz, Miroslaw; Jung, Anna

    2015-01-01

    Background Absence of the inferior vena cava is a rare vascular anomaly, which usually remains asymptomatic in childhood. It is recognized as the risk factor for deep venous thrombosis, since the collateral circulation does not provide adequate drainage of the lower limbs. Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in school-aged children and adolescents. Mycoplasma pneumoniae infection might be associated with deep venous thrombosis but its pathophysiology remain...

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

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

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

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

    2013-10-15

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

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

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

  16. Digital subtraction phlebography of the arm veins and vena cava superior

    We report on the results of 40 digital subtraction phlebograms of the great veins of the upper extremities and the mediastinum in 32 patients. In all cases diagnostic satisfactory examinations were achieved that demonstrated the anatomy of the veins in question. The method can be either used for the primary diagnosis or for controls during lysis of thrombotic lesions. The v. cava superior could be opacified even after ipsilateral injection of diluted contrast media in one-sided thrombotic occlusions of these veins. (orig.)

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

    Rhee, Sun Jung; Park, Seong Jin; Lee, Hae Kyung; Yi, Boem Ha; Park, Sung Il; Hong, Soo Jin; Kim, Hee Kyung; Park, Jeong Mi [Soonchunhyang University Hospital, Bucheon (Korea, Republic of)

    2008-10-15

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

  18. Chylous ascites after radical nephrectomy and inferior vena cava thrombectomy. Successful conservative management with somatostatin analogue.

    Leibovitch, Ilan; Mor, Yoram; Golomb, Jacob; Ramon, Jacob

    2002-02-01

    Postoperative chylous ascites is a rare complication of retroperitoneal surgery. The treatment of postoperative chylous ascites is primarily conservative, consisting of repeated paraceteses, medium chain triglyceride (MCT) diet, salt restriction, diuretics and bowel rest with total parenteral nutrition. Occasionally, chylous ascites may take a protracted course which may necessitate insertion of peritoneo-venous shunts or direct surgical lymphostasis. Recently, Somatostatin was shown to be highly effective in closure of refractory lymphatic fistulas. We present a case of refractory chylous ascites following radical nephrectomy with inferior vena caval thrombectomy that failed to respond to conventional conservative measures and resolved rapidly following the administration of Somatostatin. PMID:12074412

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

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

    2014-02-15

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

  20. The characteristics of action potential and nonselec-tive cation current of cardiomyocytes in rabbit superior vena cava

    2008-01-01

    As a special focus in initiating and maintaining atrial fibrillation (AF), cardiomyocytes in superior vena cava (SVC) have distinctive electrophysiological characters. In this study, we found that comparing with the right atrial (RA) cardiomyoctyes, the SVC cardiomyoctyes had longer APD90 at the different basic cycle lengths; the conduction block could be observed on both RA and SVC cardiomyoctyes. A few of SVC cardiomyoctyes showed slow response action potentials with automatic activity and some others showed early afterdepolarization (EAD) spontaneously. Further more, we found that there are nonselective cation current (INs) in both SVC and RA cardiomyocytes. The peak density of INs in SVC cardiomyocytes was smaller than that in RA cardiomyocytes. Removal of extracellular divalent cation and glucose could increase INs in SVC cardiomyocytes. The agonist or the antagonist of INs may in-crease or decrease APD. To sum up, some SVC cardiomyocytes possess the ability of spontaneous activity; the difference of transmembrane action potentials between SVC and RA cardiomyocytes is partly because of the different density of INs between them; the agonist or the antagonist of INs can in-crease or decrease APD leading to the enhancement or reduction of EAD genesis in SVC cardiomyo-cytes. INs in rabbit myocytes is fairly similar to TRPC3 current in electrophysiological property, which might play an important role in the mechanisms of AF.

  1. Are inferior vena cava filters effective for prophylaxis of critical pulmonary embolism in patients with cancer and coexisting venous thromboembolism?

    Cancer sometimes causes venous thromboembolisms (VTE) including pulmonary embolisms (PE), which impedes aggressive treatment such as chemotherapy. From January 2003 to March 2007, there were 120 hospitalized patients with existing VTE in The University of Tokyo Hospital. Among them we reviewed 39 patients with cancer who required aggressive chemoradiotherapy and examined whether inferior vena cava (IVC) filtration was necessary in addition to ordinary anticoagulant therapy. The clinical stage of cancer was stage I in 7, stage II in 4, stage III in 11, and stage IV in 17. Most were advanced cancer. Of the 39, 9 underwent an IVC filter placement (filter group) and 30 did not (no-filter group). All of them received regular anticoagulant therapy. In the long-term follow up averaging 16.9 months, one patient of the filter group required discontinuation of chemotherapy due to symptomatic PE, but there was no such a case in the no-filter group. Filter-related complications such as IVC occlusion or migration did not occur. Computed tomography showed VTE in the long-term course in 27 out of 39 patients, and suggested increased thrombi in cases of recurrent cancer and those with poor outcome. Seventeen died of cancer but no one died of PE during the study. This study showed that IVC filters offered no beneficial effect for the patients with existing VTE who receive aggressive chemotherapy. (author)

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

    Kaori Sugawara

    2014-05-01

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

  3. Percutaneous embolization of a giant collateral vessel originating from the azygos vein via the inferior vena cava.

    Witzke, Christian; Bhatt, Ami; Inglessis, Ignacio

    2013-11-15

    We present the case of a 45-year-old man with univentricular heart, small outlet chamber, and L-transposition of the great vessels. As an infant, the patient underwent multiple palliative surgical interventions. He presented with worsening dyspnea and fatigue and was found to have systemic oxygen saturation of 85% on 2 L of oxygen by nasal cannula, whereas he had chronically remained between 90 and 95% throughout most of adulthood. There was no evidence of significant valvular regurgitation or stenosis, nor was there an overt intracardiac shunt by echocardiography. Cardiac CT and cardiac MRI revealed a large serpiginous systemic to pulmonary venovenous collateral located behind the left atrium. The collateral drained into the lower right pulmonary vein as it entered the left atrium. The tributary veins to the "giant" collateral were determined by these images modalities. The patient underwent a percutaneous embolization of this giant venovenous collateral via a remnant supracardinal vein originating from the infrarenal inferior vena cava using two Amplatzer Vascular Plug II. Immediately after the procedure the patient's oxygen saturation increased to 90% on room air at rest. At 2 months follow-up the patient had a marked clinical improvement with oxygen saturation as high as 95% on room air while walking. Our case illustrates a successful embolization of a giant collateral via an embryological venous remnant connecting the IVC to the azygos system. PMID:22936600

  4. Analysis of Doppler flow spectra of the superior vena cava in a canine model of acute thromboembolic pulmonary hypertension.

    Sun, Dan Dan; Chen, Hong Mao; Duan, Yun You; Yuan, Li Jun; Shang, Fu Jun; Liang, Ning Nan; Cao, Wei

    2011-10-01

    We aimed to establish a canine model of acute thromboembolic pulmonary hypertension (ATEPH) and to explore the feasibility of diagnosing pulmonary hypertension (PH) through the Doppler flow spectra of the superior vena cava (SVC). A canine model of ATEPH was developed by infusing thrombus into the right femoral vein. The pulmonary arterial pressure was simultaneously measured via a right heart catheter with the guidance of ultrasound. The maximum systolic peak flow velocity (SPV), ventricular reverse peak flow velocity (VRPV), diastolic peak flow velocity (DPV), and atrial reverse peak flow velocity (ARPV) of the SVC were measured by transthoracic echocardiography. ATEPH was successfully established in 24 dogs (88.9%) with the pulmonary arterial systolic pressure (PASP) greater than 30 mmHg. ARPV increased significantly with the increase of PASP, and was positively correlated with PASP (PSPV larger than 0.8 could be better adopted to identify all the subjects with PH in this study. The Doppler flow spectra of the SVC could be employed to assess the severity of ATEPH.  PMID:21916968

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

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

  6. Supra hepatic inferior vena cava and right atrial thrombosis following a traffic car crash

    Sabzi, Feridoun; Karim, Hosein; Haghi, Marjan

    2016-01-01

    Abstract: We present a case of nephrotic syndrome associated with right atrial and supra hepatic vein part of inferior vena caval thrombosis. This patient presented with dyspena, lower extremity edema and back pain after a vehicle accident and blunt trauma to the abdomen. Trauma should be considered not only as a thrombophilic pre-disposition, but also as a predisposing factor to IVC endothelium injury and thrombosis formation. Echocardiography revealed supra hepatic vein IVC thrombosis floating to the right atrium. A C-T scan with contrast also showed pulmonary artery emboli to the left upper lobe. With open heart surgery, the right atrial and IVC clot were extracted and the main left and right pulmonary arteries were evaluated for possible clot lodging. The patient had an uneventful postoperative recovery and thrombosis has not reoccurred with periodical follow-up examinations. PMID:26836612

  7. The characteristics of action potential and nonselective cation current of cardiomyocytes in rabbit superior vena cava

    WANG Pan; YANG XinChun; LIU XiuLan; BAO RongFeng; LIU TaiFeng

    2008-01-01

    As s special focus in initiating and maintaining atrial fibrillation (AF), cardiomyocytes in superior vena cavs (SVC) have distinctive electrophysiological characters. In this study, we found that comparing with the right atrial (RA) cardiomyoctyes, the SVC cardiomyoctyes had longer APD90 at the different basic cycle lengths; the conduction block could be observed on both RA and SVC cardiomyoctyes. A few of SVC cardiomyoctyes showed slow response action potentials with automatic activity and some others showed early afterdepolarization (EAD) spontaneously. Further more, we found that there are nonselective cation current (INs) in both SVC and RA cardiomyocytes. The peak density of INs in SVC cardiomyocytes was smaller than that in RA cardiomyocytes. Removal of extracellular divalent cation and glucose could increase INs in SVC cardiomyocytes. The agonist or the antagonist of INs may increase or decrease APD. To sum up, some SVC cardiomyocytes possess the ability of spontaneous activity; the difference of transmembrane action potentials between SVC and RA cardiomyocytes is partly because of the different density of INs between them; the agonist or the antagonist of INs can increase or decrease APD leading to the enhancement or reduction of EAD genesis in SVC cardiomyocytes. INs in rabbit myocytes is fairly similar to TRPC3 current in electrophysiological property, which might play an important role in the mechanisms of AF.

  8. 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

    Alexander Alves da Silva

    2009-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A persistência da veia cava superior esquerda ocorre isoladamente em 0,5% da população normal, porém nos pacientes com cardiopatia congênita chega a estar presente em 3% a 10% dos casos. O objetivo deste relato foi apresentar um caso de diagnóstico intraoperatório com o auxílio da ecocardiografia transesofágica e ressaltar a importância da sua utilização rotineira em intervenções cirúrgicas para correção de cardiopatia congênita. RELATO DO CASO: Paciente do sexo masculino, 16 anos, ASA II, com diagnóstico prévio de comunicação interatrial (CIA tipo seio venoso superior com drenagem anômala parcial de veias pulmonares em programação para correção cirúrgica da cardiopatia. Após indução da anestesia geral foi realizado ecocardiograma transesofágico (ETE. O exame inicial mostrou dilatação das câmaras cardíacas direitas, CIA tipo seio venoso superior de 17 milímetros, drenagem anômala da veia pulmonar superior direita desembocando na veia cava superior (VCS direita e dilatação do seio coronário, o que aventou a possibilidade da persistência da veia cava superior esquerda. Para a confirmação da suspeita foram injetados no acesso venoso do braço esquerdo 10 mL de solução fisiológica a 0,9% (faz o papel de "contraste" no exame ecocardiográfico e imediatamente após foram visualizadas as microbolhas passando pelo seio coronário, teste positivo para o diagnóstico de VCS superior esquerda persistente. CONCLUSÕES: A ecocardiografia transesofágica rotineira no intraoperatório de pacientes com cardiopatia congênita tem fundamental importância como método auxiliar não só ao cirurgião, muitas vezes influenciando diretamente na técnica cirúrgica empregada, como também para o anestesiologista, que pode extrair do exame uma série de informações úteis no manuseio hemodinâmico do paciente.JUSTIFICATIVA Y OBJETIVOS: La persistencia de la vena cava superior izquierda ocurre

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

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

    2012-10-15

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

  10. Efficacy and Safety of Endovascular Intervention for the Management of Primary Entire-Inferior Vena Cava Occlusion

    Zhang, Qingqiao, E-mail: 1427286069@qq.com; Huang, Qianxin, E-mail: 18705206105@163.com; Shen, Bin, E-mail: 753021357@qq.com; Sun, Jingmin, E-mail: 383937658@qq.com; Wang, Xiaolong, E-mail: 781198238@qq.com; Liu, Hongtao, E-mail: hongtao6@vip.sina.com [The Affiliated Hospital of Xuzhou Medical College, Department of Interventional Radiology and Vascular Surgery (China)

    2015-06-15

    PurposeThis study was designed to investigate the safety and efficacy of endovascular intervention for the treatment of primary entire-inferior vena cava (IVC) occlusion.MethodsEndovascular interventions were performed in six patients for the treatment of primary entire-IVC occlusion. IVC and hepatic venography were performed via the jugular and femoral veins. Balloon angioplasty was used to revascularize the hepatic vein and IVC and a stent was placed in the IVC to maintain patency. Postoperative color Doppler ultrasonography was performed at 1, 3, 6, and 12 months, and then annually, to monitor the patency of the hepatic vein and IVC.ResultsThe IVC and one or two hepatic veins were successfully revascularized in five patients. Revascularization was successful in the right and left hepatic veins in one patient; however, IVC patency could not be established in this patient. Eleven Z-type, self-expanding stents were placed into the IVCs of five patients (three stents in two patients, two stents in two patients, and one stent in one patient). There were no instances of postoperative bleeding or mortality. Follow-up was conducted for 18–90 months (42.8 ± 26.5 months). None of the five patients suffered restenosis of the IVC or hepatic veins. However, there was one of the six cases of right hepatic vein restenosis at 18 months postprocedure that was revascularized after a second balloon dilatation.ConclusionsEndovascular intervention is safe and efficacious for the treatment of primary entire-IVC occlusion.

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

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

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

    Miletin, J

    2012-02-01

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

  13. Mechanism for the tilting of Geunther Tulip inferior vena cava filter inserted via femoral vein: an experimental study in vitro

    Objective: To clarify the mechanism causing the tilting of Geunther Tulip inferior Vena Cava filter (GTF) which is inserted via femoral vein access by means of the experiment in vitro. Methods: The caval model was established by placing one 25 mm × 10 cm Dacron graft and two 10 mm × 20 cm Dacron grafts into a transparent bifurcate glass tube. The study consisted of two groups: right straight group (GRS) (n=100) and left straight group (GLS) (n=100). The distance (DCH) between the caval right wall and the hook was measured. The degree of tilting (DT) was classified into 5 grades and the data were recorded. Before and after the GTF was released, the angle (ACM1,2) between the axis of IVC and the metal mount, the distance (DCM1,2) between the caval right wall and the metal mount, the angle (ACF) between the axis of IVC and the axis of the filter and the diameter of IVC (DIVC) were measured separately. Results: The degree of GTF tilting in each group revealed a divergent tendency. In Group RS, the apex of the filter tended to be grade Ⅲ compared that in Group LS (59% vs 36%, P=0.003). The differences in most variables between GRS and GLS were considered as statistical significance. Significant positive correlation existed between ACM1 and ACF, ACM1-ACM2 and DCH1-DCH2 in each group, respectively, while significant negative association was also existed between DCH1 and ACF in each group. Conclusion: The tilting angle of GTF filter axis before it is released is a major cause of the occurrence of femoral GTF filter tilting. (authors)

  14. Correlation of the ratio of caudal vena cava diameter and aorta diameter with systolic pressure variation in anesthetized dogs.

    Meneghini, Caterina; Rabozzi, Roberto; Franci, Paolo

    2016-02-01

    OBJECTIVE To evaluate the correlation coefficient of the ratio between diameter of the caudal vena cava (CVC) and diameter of the aorta (Ao) in dogs as determined ultrasonographically with systolic pressure variation (SPV). ANIMALS 14 client-owned dogs (9 females and 5 males; mean ± SD age, 73 ± 40 months; mean body weight, 22 ± 7 kg) that underwent anesthesia for repair of skin wounds. PROCEDURES Anesthesia was induced. Controlled mechanical ventilation with a peak inspiratory pressure of 8 cm H2O was immediately started, and SPV was measured. During a brief period of suspension of ventilation, CVC-to-Ao ratio was measured on a transverse right-lateral intercostal ultrasonographic image obtained at the level of the porta hepatis. When the SPV was ≥ 4 mm Hg, at least 1 bolus (3 to 4 mL/kg) of Hartmann solution was administered IV during a 1-minute period. Bolus administration was stopped and the CVC-to-Ao ratio measured when SPV was SPV and CVC-to-Ao ratio before bolus administration were 7 ± 2 mm Hg and 0.52 ± 0.16, respectively. Mean ± SD SPV and CVC-to-Ao ratio after bolus administration were 2 ± 0.6 mm Hg and 0.91 ± 0.13, respectively. CONCLUSIONS AND CLINICAL RELEVANCE In this study, the CVC-to-Ao ratio was a feasible, noninvasive ultrasonographically determined value that correlated well with SPV. (Am J Vet Res 2016;77:137-143). PMID:27027706

  15. Social and Demographic Factors Influencing Inferior Vena Cava Filter Retrieval at a Single Institution in the United States

    Smith, S. Christian, E-mail: csmith@aemrc.arizona.edu; Shanks, Candace, E-mail: Candace.Shanks@osumc.edu; Guy, Gregory, E-mail: Gregory.Guy@osumc.edu; Yang, Xiangyu, E-mail: Xiangyu.Yang@osumc.edu; Dowell, Joshua D., E-mail: Joshua.Dowell@osumc.edu [The Ohio State University Wexner Medical Center, Division of Interventional Radiology, Department of Radiology (United States)

    2015-10-15

    PurposeRetrievable inferior vena cava filters (IVCFs) are associated with long-term adverse events that have increased interest in improving filter retrieval rates. Determining the influential patient social and demographic factors affecting IVCF retrieval is important to personalize patient management strategies and attain optimal patient care.Materials and MethodsSeven-hundred and sixty-two patients were retrospectively studied who had a filter placed at our institution between January 2011 and November 2013. Age, gender, race, cancer history, distance to residence from retrieval institution, and insurance status were identified for each patient, and those receiving retrievable IVCFs were further evaluated for retrieval rate and time to retrieval.ResultsOf the 762 filters placed, 133 were permanent filters. Of the 629 retrievable filters placed, 406 met the inclusion criteria and were eligible for retrieval. Results revealed patients with Medicare were less likely to have their filters retrieved (p = 0.031). Older age was also associated with a lower likelihood of retrieval (p < 0.001) as was living further from the medical center (p = 0.027). Patients who were white and had Medicare were more likely than similarly insured black patients to have their filters retrieved (p = 0.024).ConclusionsThe retrieval rate of IVCFs was most influenced by insurance status, distance from the medical center, and age. Race was statistically significant only when combined with insurance status. The results of this study suggest that these patient groups may need closer follow-up in order to obtain optimal IVCF retrieval rates.

  16. Social and Demographic Factors Influencing Inferior Vena Cava Filter Retrieval at a Single Institution in the United States

    PurposeRetrievable inferior vena cava filters (IVCFs) are associated with long-term adverse events that have increased interest in improving filter retrieval rates. Determining the influential patient social and demographic factors affecting IVCF retrieval is important to personalize patient management strategies and attain optimal patient care.Materials and MethodsSeven-hundred and sixty-two patients were retrospectively studied who had a filter placed at our institution between January 2011 and November 2013. Age, gender, race, cancer history, distance to residence from retrieval institution, and insurance status were identified for each patient, and those receiving retrievable IVCFs were further evaluated for retrieval rate and time to retrieval.ResultsOf the 762 filters placed, 133 were permanent filters. Of the 629 retrievable filters placed, 406 met the inclusion criteria and were eligible for retrieval. Results revealed patients with Medicare were less likely to have their filters retrieved (p = 0.031). Older age was also associated with a lower likelihood of retrieval (p < 0.001) as was living further from the medical center (p = 0.027). Patients who were white and had Medicare were more likely than similarly insured black patients to have their filters retrieved (p = 0.024).ConclusionsThe retrieval rate of IVCFs was most influenced by insurance status, distance from the medical center, and age. Race was statistically significant only when combined with insurance status. The results of this study suggest that these patient groups may need closer follow-up in order to obtain optimal IVCF retrieval rates

  17. Impact of intra-abdominal pressure on retrohepatic vena cava shape and flow in mechanically ventilated pigs

    Conflicting results have been found regarding correlations between right atrial pressure (RAP) and inferior vena cava (IVC) diameter in mechanically ventilated patients. This finding could be related to an increase in intra-abdominal pressure (IAP). This study was designed to clarify whether variations in IVC flow rate caused by positive pressure ventilation are associated with changes in the retrohepatic IVC cross-section (ΔIVC) during major changes in volume status and IAP. Nine pigs were anesthetized, mechanically ventilated and equipped. IAP was set at 0, 15 and 30 mmHg during two conditions, i.e. normovolemia and hypovolemia, generated by blood removal to obtain a mean arterial pressure value lower than 60 mmHg. At each IAP increment, cardiac output, IVC flow and surface area were respectively assessed by flowmeters and transesophageal echocardiography. At normal IAP, even in presence of respiratory changes in IVC flows, no ΔIVC were observed during the two conditions. At high IAP, neither ΔIVC nor modulations of IVC flow were observed whatever the volemic status. The majority of animals with an IVC area of less than 0.65 cm2 showed evidence of IAP greater than RAP values. Negative RAP–IAP pressure gradients were found to occur with an IVC area of less than 0.65 cm2, suggesting that IVC dimensions determined using standard ultrasound techniques may indicate the direction of the RAP–IAP gradient. The clinical relevance of the present findings is that volume status should not be estimated from retrohepatic IVC dimensions in cases of high IAP. (paper)

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

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

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

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

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

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

    2015-01-01

    To analyze characteristics of electrocardiogram (ECG), electrophysiological intracardiac mapping and radiofrequency ablation (RF) of paroxysmal atrial fibrillation (PAF) originating from superior vena cava (SVC), aiming to investigate electrophysiological characteristics of PAF with SVC origin. Clinical data of 30 subjects (18 men and 12 women, aged, 58.6 ± 15.5 years) with PAF of SVC origin were retrospectively analyzed; All patients underwent RF during 2006.9-2012.7. ECG of AF and atrial premature contractions (APCs), procedure and fluoroscopic time, numbers of ablation sites within SVC, complications and success rate were studied. Compared with P wave of sinus rhythm (SR), APCs of SVC origin exhibited higher amplitude in lead II (0.23 ± 0.11 vs. 0.15 ± 0.06 mv), III (0.19 ± 0.09 vs. 0.13 ± 0.08 mv), AVF (0.21 ± 0.13 vs. 0.14 ± 0.10 mv), V2 (0.24 ± 0.07 vs. 0.15 ± 0.09 mv) and V3 (0.21 ± 0.09 vs. 0.12 ± 0.05 mv) (P atrial flutter within 1 month after completion of ablation and were controlled by antiarrhythmic drugs. The APCs and AF of SVC origin manifested distinctive ECG features, which could be helpful to distinguish SVC from other foci before ablation, the completion of SVCI required shorter procedure and fluoroscopic time, as well as less ablation points, and meanwhile, the success rate was high with less complication. PMID:25784993

  1. Liver Trapping of (99m)Tc Macroaggregated Albumin During Ventilation/Perfusion Scintigraphy in a Patient With Superior Vena Cava Stenosis as Demonstrated by SPECT/CT.

    Rousseau, Etienne; Leclerc, Yves; Prévost, Sylvain; Keu, Khun Visith

    2015-07-01

    A 50-year-old woman presented to our institution with a 1-day history of right posterior thoracic pain and dyspnea. She had a previous history of conservative resection of a high-grade basal-like infiltrating ductal carcinoma of the right breast 2 years before, subsequently treated by chemotherapy and radiotherapy. A ventilation and perfusion (VQ) scintigraphy performed for suspected pulmonary embolism showed an abnormal deposition of (99m)Tc macroaggregated albumin ((99m)Tc-MAA) in the left lobe of the liver. This unusual finding prompted additional imaging that demonstrated a superior vena cava stenosis. PMID:26018706

  2. Hubungan Diameter Vena Cava Inferior Dengan Nilai N-Terminal Pro-Brain Natriuretic Peptide (Nt-Probnp) Pada Pasien Gagal Jantung Kronik Tidak Terkompensasi Akibat Penyakit Jantung Koroner Dan Penyakit Jantung Hipertensi di RSUP H. Adam Malik Medan

    T. Realsyah

    2016-01-01

    The inferior vena cava (IVC) diameter and degree of inspiratory collapse areused as echocardiographic indices in the estimation of right atrial pressure. N-terminal pro-B natriuretic peptide (NT-ProBNP) are established biomarkers of myocardial wall stress. There is no informationavailable regarding the association between the IVC diameterand NT-ProBNPs in patients with Decompensated Chronic heart failure. The purpose of this investigationis to analyse the correlation of inferior vena c...

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

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

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

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

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

    Weissman Alan

    2011-06-01

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

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

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

    2010-01-01

    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...

  7. 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

    Daniel Queiroz Neves

    2010-12-01

    Full Text Available 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 adequadamente 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.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.

  8. Nursing for the catheter thrombolysis to the deep vein and inferior vena cava thrombosis%下肢深静脉合并下腔静脉血栓导管溶栓治疗的护理

    杨云英; 叶思欣; 杨梅

    2015-01-01

    Objective To investigate the use of catheter thrombolysis therapy to the deep vein and inferior vena cava thrombosis and summarize the nursing points. Method Eight patients (13 limbs) deep vein thrombosis with inferior vena cava thrombosis adopted the catheter thrombolysis, under this procedure we did the care including the limbs and thrombolysis, and observed the complications. Result Five patients (9 limbs) had the thrombus completely dissolved, 3 cases (4 limbs) had the partial dissolution of thrombus. Conclusion Holding limb effective position, close observation of the disease and prevention of complications are very important to improve the efficacy for the catheter thrombolysis.%目的:探讨下肢深静脉合并下腔静脉血栓导管溶栓治疗的护理要点。方法对8例(13条患肢)下肢深静脉血栓合并下腔静脉血栓患者采用导管溶栓治疗,此过程做好患肢护理、溶栓护理、病情及并发症观察。结果5例(9条患肢)血栓完全溶解,3例(4条患肢)血栓部分溶解。结论保持患肢有效体位,严密病情观察及并发症的预防,对提高下肢深静脉合并下腔静脉血栓溶栓治疗效果具有重要意义。

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

    Kocot Arkadius

    2012-06-01

    Full Text Available Abstract Background To evaluate oncological and clinical outcome in patients with renal cell carcinoma (RCC and tumor thrombus involving inferior vena cava (IVC treated with nephrectomy and thrombectomy. Methods We identified 50 patients with a median age of 65 years, who underwent radical surgical treatment for RCC and tumor thrombus of the IVC between 1997 and 2010. The charts were reviewed for pathological and surgical parameters, as well as complications and oncological outcome. Results The median follow-up was 26 months. In 21 patients (42% distant metastases were already present at the time of surgery. All patients underwent radical nephrectomy, thrombectomy and lymph node dissection through a flank (15 patients/30%, thoracoabdominal (14 patients/28% or midline abdominal approach (21 patients/42%, depending upon surgeon preference and upon the characteristics of tumor and associated thrombus. Extracorporal circulation with cardiopulmonary bypass (CPB was performed in 10 patients (20% with supradiaphragmal thrombus of IVC. Cancer-specific survival for the whole cohort at 5 years was 33.1%. Survival for the patients without distant metastasis at 5 years was 50.7%, whereas survival rate in the metastatic group at 5 years was 7.4%. Median survival of patients with metastatic disease was 16.4 months. On multivariate analysis lymph node invasion, distant metastasis and grading were independent prognostic factors. There was no statistically significant influence of level of the tumor thrombus on survival rate. Indeed, patients with supradiaphragmal tumor thrombus (n = 10 even had a better outcome (overall survival at 5 years of 58.33% than the entire cohort. Conclusions An aggressive surgical approach is the most effective therapeutic option in patients with RCC and any level of tumor thrombus and offers a reasonable longterm survival. Due to good clinical and oncological outcome we prefer the use of CPB with extracorporal

  10. Phlegmasia Caerulea Dolens in a Patient With an Inferior Vena Cava Filter: Treatment of Massive Iliocaval Thrombosis Using Local Intravenous Catheter-Directed Thrombolysis

    Cookson, Daniel, E-mail: danielthomascookson@yahoo.co.uk [Middlemore Hospital, Department of Radiology (New Zealand); Caldwell, Stuart, E-mail: stuart.caldwell@middlemore.co.nz [Middlemore Hospital, Department of Vascular Surgery (New Zealand)

    2012-10-15

    Phlegmasia caerulea dolens (PCD) is a potentially disastrous complication of inferior vena cava filter insertion, and its optimum management has not been clearly established. We present a case report of a patient with pulmonary embolism and acute adrenal haemorrhage who developed PCD secondary to massive iliocaval thrombosis after insertion of a Cook Celect removable filter. Local intravenous catheter-directed thrombolysis (CDT), followed by systemic anticoagulation, achieved limb salvage and virtual resolution of symptoms at 3 months without complications. CDT can be a successful primary treatment of filter-associated PCD and can be safe in selected patients with acute nontraumatic haemorrhage. Systemic anticoagulation may subsequently restore complete venous patency and may therefore be a useful approach to postthrombolysis management of residual iliocaval thrombus when filter removal is indicated.

  11. Catheter-Directed Thrombolysis of Acute Deep Vein Thrombosis in the Lower Extremity of a Child with Interrupted Inferior Vena Cava

    We present the case of a 14-year-old girl who developed acute deep vein thrombosis (DVT) in her right lower extremity. Laboratory testing revealed protein S deficiency, and the patient's father also had this abnormality with a history of lower extremity DVT. Manual thromboaspiration followed by catheter-directed thrombolysis resulted in total clearance of all thrombi. Computed tomography and later venography revealed an interrupted inferior vena cava. Catheter-directed thrombolysis is an established treatment for adults with acute DVT. To the best of our knowledge, this report is the first to describe catheter-directed thrombolysis in a pediatric patient with lower extremity DVT. Our results suggest that catheter-directed thrombolysis is safe and effective for use in selected older children and adolescents with acute DVT in the lower extremity

  12. Phlegmasia Caerulea Dolens in a Patient With an Inferior Vena Cava Filter: Treatment of Massive Iliocaval Thrombosis Using Local Intravenous Catheter-Directed Thrombolysis

    Phlegmasia caerulea dolens (PCD) is a potentially disastrous complication of inferior vena cava filter insertion, and its optimum management has not been clearly established. We present a case report of a patient with pulmonary embolism and acute adrenal haemorrhage who developed PCD secondary to massive iliocaval thrombosis after insertion of a Cook Celect removable filter. Local intravenous catheter-directed thrombolysis (CDT), followed by systemic anticoagulation, achieved limb salvage and virtual resolution of symptoms at 3 months without complications. CDT can be a successful primary treatment of filter-associated PCD and can be safe in selected patients with acute nontraumatic haemorrhage. Systemic anticoagulation may subsequently restore complete venous patency and may therefore be a useful approach to postthrombolysis management of residual iliocaval thrombus when filter removal is indicated.

  13. Case report: Completely unroofed coronary sinus with a left superior vena cava draining into the left atrium studied by cardiovascular magnetic resonance

    A persistent left superior vena cava (LSVC) draining through a dilated coronary sinus into the right atrium is a relatively common congenital cardiovascular anomaly. It is readily identified by cardiovascular magnetic resonance (CMR). However, a LSVC draining into the left atrium (LA) and associated with unroofing of the coronary sinus, with resulting interatrial communication, is rare and may have important clinical consequences. As with any large atrial septal defect, it can be associated with a higher than expected incidence of pulmonary arterial hypertension, systemic embolization, and brain abscesses. In this report, we present a case of a completely unroofed coronary sinus with a persistent LSVC draining directly into the LA and illustrate the role of CMR in the diagnosis and evaluation of such anomalies

  14. [On the venous system in the retroperitoneal region (a contribution to the persistence of the primitive vena cava system) (author's transl)].

    Besier, H; Stofft, E

    1977-01-01

    A vasal anomaly in the region of the Vena cava inferior is being described in the corpse of a 25-year-old man. 1. In the course of development the V. subcardinalis has not been joined to the Pars hepatica of the V. cava inferior, which originates from the V. hepatis revehens communis. In our case the Anastomosis intersubcardinalis remains and is subjected to a slight retroaortal displacement to the left. 2. Among the Vv. sacrocardinales the V. sacrocardinalis sinistra, which ought to involute after the sixth embryonal week, has been retained together with the Anastomosis intersacrocardinalis. 3. The Vv. supracardinales are connected with the intersubcardinal anastomosis and the intersupracardinal transversal anastomosis has been retained. 4. The Vv. caudales end in the Anastomosis sacrocardinalis at a point before the Sacrum and the Anastomosis intercaudalis has been retained, too. 5. The caudal section of the right lower cardinal vein in its prerenal part is retained with an anastomosis to the right subcardinal vein. 6. The portal blood of the liver is directly distributed to the atrium dextrum after it has passed through three Vv. hepaticae. The Lig. venosum is intrahepatic and is joined to the Vv. hepaticae. 7. The primitive bilateral-symmetric veinous system of the caudal half of the body continues to exist almost completely. PMID:603065

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

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

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

    Le Blanche, Alain F., E-mail: le_blanche.alain@chu-amiens.fr [University of Picardie-Jules Verne (France); Ricco, Jean-Baptiste [University of Poitiers (France); Bonneau, Michel [Institut National de la Recherche Agronomique (I.N.R.A.) and Assistance Publique-Hopitaux de Paris (APHP), Centre of Research in Interventional Imaging - CRII (France); Reynaud, Philippe [Hopital Europeen Georges Pompidou (HEGP) APHP, Department of Respiratory Diseases (France)

    2012-10-15

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

  17. Nursing Care of 4 Patients with Inferior Vena Cava Thrombosis Treated by Temporary Inferior Vena Cava Filter plus Catheter-directed Thrombolysis%4例肾静脉以上临时性腔静脉滤器植入联合导管溶栓治疗下腔静脉血栓患者的护理

    周菊珍; 金伟飞; 蒋美; 姚碧连

    2012-01-01

    This paper summarized the nursing experience of four cases of patients with inferior vena cava thrombosis, which were treated with temporary inferior vena cava filter (IVCF) combined with catheter-directed thrombolysis. The importance of nursing went to the placement of IVCF to prevent its displacement, limb nursing and catheter-directed thrombolysis. All the laboratory indexes were under the monitoring and measures were taken for the prevention of complication of pulmonary embolism and education for discharge was conducted as well. During the treatment, bleeding in puncture point occurred in one case, displacement of catheter one case and gastrointestinal bleeding one case and after treatment, all the swelling of extremities and inferior vena cava thrombosis disappeared. IVCF was removed 3 to 4 weeks after discharge and after 3 to 38 months follow-ups, no thrombosis reoccurred.%总结4例下腔静脉血栓患者行肾静脉以上临时腔静脉滤器植入联合腔内导管溶栓治疗的护理经验.做好临时性腔静脉滤器置入的护理,严防滤器移位;做好肢体护理及导管溶栓护理;密切观察患者出血情况,监测实验室指标;预防和观察肺栓塞并发症;做好出院指导.4例患者患肢肿胀消退,下腔静脉血栓均消失,出现穿刺点出血1例,导管移位1例,消化道出血1例,经及时发现积极治疗护理,痊愈出院,术后3~4 周拔除临时滤器,随防3~38 个月无血栓复发.

  18. Real-time flow - determination of vena cava inferior on two different levels via 'RACE' pulse sequence in MR

    A new and simple parameter for quantiative evaluation of liver perfusion is outlined: Post-sinusoidal quantitative measurement of the entire liver venous flow: This is a result of the differences in evaluated flow volumes at two different levels in the inferior V.cava. The first level is the height of diaphragm, and the second is situated just cranial of the renal vessels. Normal values obtained from a group of healthy volunteers are presented. A gradient-echo pulse sequence called RACE, enabling flow measurements in real-time, is outlined. (orig.)

  19. Effect of utilization of veno-venous bypass vs. cardiopulmonary bypass on complications for high level inferior vena cava tumor thrombectomy and concomitant radical nephrectomy

    Ross M. Simon

    2015-10-01

    Full Text Available ABSTRACT Purpose: To determine if patients with renal cell carcinoma (RCC with levels III and IV tumor thrombi are receive any reduction in complication rate utilizing veno-venous bypass (VVB over cardiopulmonary bypass (CPB for high level (III/IV inferior vena cava (IVC tumor thrombectomy and concomitant radical nephrectomy. Materials and Methods: From May 1990 to August 2011, we reviewed 21 patients that had been treated for RCC with radical nephrectomy and concomitant IVC thrombectomy employing either CPB (n =16 or VVB (n=5. We retrospectively reviewed our study population for complication rates and perioperative characteristics. Results: Our results are reported using the validated Dindo-Clavien Classification system comparing the VVB and CPB cohorts. No significant difference was noted in minor complication rate (60.0% versus 68.7%, P=1.0, major complication rate (40.0% versus 31.3%, P=1.0, or overall complication rate (60.0% versus 62.5%, P=1.0 comparing VVB versus CPB. We also demonstrated a trend towards decreased time on bypass (P=0.09 in the VVB cohort. Conclusion: The use of VVB over CPB provides no decrease in minor, major, or overall complication rate. The use of VVB however, can be employed on an individualized basis with final decision on vascular bypass selection left to the discretion of the surgeon based on specifics of the individual case.

  20. 下腔静脉癌栓的诊治进展%Advancements in Diagnosis and Treatment of Inferior Vena Cava Tumor Thrombus

    郝嘉; 游凯

    2011-01-01

    下腔静脉癌栓常在恶性肿瘤中伴发,治疗上仍较棘手.目前如何选择适宜的诊治方法和它对肿瘤预后的影响尚未达成共识.现系统回顾下腔静脉癌栓的分型、诊断、围术期的综合治疗方法和预后方面的进展,重点综述外科治疗下腔静脉癌栓的各种辅助方法、手术切口和术后联合治疗方式.%Inferior vena cava tumor thrombus ( IVCTT) is one of the factors resulting in a poor prognosis for patients with carcmoma.The classification, improvement of diagnosis, comprehensive treatments, and overall suwival of IVCTT were analyzed. The review focuses on multiple surpcal methods, incision access, and combined postoperative therapies.

  1. Diagnosis of an infected central venous catheter with ultrasound and computed tomography; Diagnose eines infizierten Thrombus der Vena cava inferior mit Sonographie und Computertomographie

    Tacke, J. [RWTH Aachen (Germany). Klinik fuer Radiologische Diagnostik; Adam, G. [RWTH Aachen (Germany). Klinik fuer Radiologische Diagnostik; Sliwka, U. [RWTH Aachen (Germany). Neurologische Klinik; Klosterhalfen, B. [RWTH Aachen (Germany). Inst. fuer Pathologie; Schoendube, F. [RWTH Aachen (Germany). Klinik fuer Thorax- Herz- und Gefaesschirurgie

    1995-08-01

    The authors report the case of a 16-year-old male patient, who suffered from meningitis and Waterhouse-Friderichsen syndrome. After initial improvement in the intensive care unit, he developed septic temperatures, caused by an infected thrombus of a central venous catheter in the inferior vena cava, Color-coded ultrasound showed hyperechogenic signals and missing flow detection at the catheter tip. Computed tomography showed air bubbles in the thrombosed catheter tip and confirmed the diagnosis. Vasuclar surgery was done and an infected, 17-cm-long infected thrombus was removed. (orig./VHE) [Deutsch] Die Autoren berichten ueber den Fall eines 16jaehrigen Patienten, dem wegen einer Meningitis und der Zeichen eines Waterhouse-Friderichsen-Syndroms ein femoralvenoeser Zentralkatheter gelegt wurde. Nach initialer Entfieberung entwickelte sich eine Sepsis, deren Ursache in einem infizierten Thrombus des Zentralvenenkatheters lag. Die Diagnose wurde sonographisch gestellt und nachfolgend computertomographisch bestaetigt. In beiden Verfahren wiesen Lufteinschluesse im Katheterthrombus auf die Injektion hin. Der Befund wurde durch eine gefaesschirurgische Thrombektomie bestaetigt und therapiert. (orig./VHE)

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

    R. Nafisi-Moghadam

    2007-05-01

    Full Text Available Background and Objective: The assessment of blood volume is now one of the most commonly needed interventions in the first line of care and severe ill patients. Measuring central venous pressure (CVP is an invasive method, most frequently used in clinical practice for the assessment of volume status. The di-ameter of the inferior vena cava (IVC is a parameter to estimate central venous pressure. The purpose of this study was to determine whether measurement of the anterior-posterior diameter of the IVC by ultra-sonography, correlates with CVP. Materials and Methods: It was a descriptive and pro-spective study on 50 patients; CVP was measured in supine position by CVP manometer. Anterior – pos-terior IVC diameter was assessed by ultrasonography during inspiration and expiration. Results: The mean of CVP during inspiration and ex-piration was 11.31+5.59, 12.20 + 5.65cmH2o, respec-tively. The mean of inspiratory and expiratory IVC diameter was 7.71+3.56, 11.97+3.28 mm, respectively. There was significant relation between CVP and IVC diameter in the inspiration (r=0.664, p<0.0001 and expiration (r=0.495, p=0.001. The relation between these two variables was linear. Conclusion: Result of this study showed that IVC di-ameter measurement by ultrasonography can be used to estimate the mean of CVP.

  3. Contrast-fluid level in the inferior vena cava (IVC niveau sign) in patients with acute type A aortic dissection. Computed tomography findings during acute cardiac tamponade

    The purpose of this study was to report a new computed tomography (CT) finding in acute cardiac tamponade: a contrast-fluid level in the hepatic inferior vena cava (IVC) during an arterial dominant phase CT study (IVC niveau sign) in patients with acute type A aortic dissection. We retrospectively reviewed CT studies with the diagnosis of proximal aortic dissection (Stanford type A) with acute cardiac tamponade. There were 12 patients enrolled in the study (6 women, 6 men; mean age 66 years). A total of 62 patients were selected as a control chronic pericardial effusion group to compare with the acute cardiac tamponade group. Among the 12 patients with acute cardiac tamponade, the IVC niveau sign was seen in 7 (58%). In the control chronic pericardial effusion group (n=62), we identified the IVC niveau sign in only one patient (1.6%). There was a significant difference in the presence of the IVC niveau sign between the acute cardiac tamponade and chronic pericardial effusion groups (P<0.0001). The presence of the IVC niveau sign suggests acute cardiac tamponade in patients with acute type A aortic dissection. (author)

  4. Thrombolysis for treating deep venous thrombosis by high-dose urokinase: the usefulness of preventive placement of inferior vena cava filter

    Objective: To investigate the feasibility and efficacy of high-dose urokinase thrombolysis for treating lower limb deep venous thrombosis (DVT) after inferior vena cava (IVC) filter placement. Methods: Thirteen patients of venographically proved DVT underwent preventive IVC filter placement for thrombolysis by high-dose urokinase. Antegrade infusion of high-dose urokinase was performed via the dorsalis pedis vein of the involved lower limb. The total dose of urokinase was 9 000 000 ∼ 16 000 000 units, and the procedure of thrombolysis was performed in ICU ward where the patients were closely monitored clinically and laboratorially. Results: A total of 13 IVC filters were successfully deployed without disposition and migration. The therapeutic effects were divided into four scales as follows: complete disappearance of the venous thrombosis and clinically asymptomatic (n = 2); remarkable recovery characterized by markedly improved clinical symptoms and venographically proved patent lumen in which the diameter was larger than 70% (n = 9); effective treatment indicating improved symptoms to some degrees and venographically proved patent lumen in which the diameter was smaller than 70% ( n = 2); and ineffective treatment (n = 0). No pulmonary embolism and hemorrhage occurred during the procedure of thrombolysis. Conclusion: High-dose urokinase for treating DVT is safe and effective after preventive placement of IVC filter

  5. Retrievable stent filter placement for the treatment of budd-chiari syndrome complicated with inferior vena cava thrombosis: its mid-term results

    Objective: To investigate the mid-term efficacy of retrievable stent filter placement for the treatment of Budd-Chiari syndrome (BCS) complicated with inferior vena cava (IVC) thrombosis. Methods: Eight patients of BCS complicated with IVC thrombosis were enrolled in this study. IVC thrombosis included segmental occlusion (n = 2) and membranous occlusion (n = 6). In all patients, the IVC was re-canalized by using blunt wire after anticoagulation and thrombolytic therapy, then, the re-canalized site was expanded with small balloon, which was followed by the placement of retrievable stent filter, and, finally, IVC size was dilated with larger balloon. Anticoagulation and thrombolytic therapy was given after the procedure. And all the retrievable stent filters were withdrawn from the IVC through internal jugular vein when the thrombus in IVC was dissolved. In patients with segmental occlusion of IVC, in addition to the placement of retrievable stent filter a 'Z' type vessel stent was also placed during the same interventional session. Follow-up examination with color Doppler sonography was conducted in all patients. Results: Technical success was achieved in all 8 patients without pulmonary infarction or other complications both during and after the operation. Immediately after the thrombus completely disappeared, the retrievable stent filter was successfully taken out in all patients. During a following-up period of 3-12 months, color Doppler sonographs showed that the IVC remained patent in 6 patients and had a recurrence of stenosis in 2 patients. Conclusion: Placement of retrievable stent filter is a safe and effective treatment for BCS complicated with IVC thrombosis. (authors)

  6. Creation of an iOS and Android Mobile Application for Inferior Vena Cava (IVC) Filters: A Powerful Tool to Optimize Care of Patients with IVC Filters.

    Deso, Steven E; Idakoji, Ibrahim A; Muelly, Michael C; Kuo, William T

    2016-06-01

    Owing to a myriad of inferior vena cava (IVC) filter types and their potential complications, rapid and correct identification may be challenging when encountered on routine imaging. The authors aimed to develop an interactive mobile application that allows recognition of all IVC filters and related complications, to optimize the care of patients with indwelling IVC filters. The FDA Premarket Notification Database was queried from 1980 to 2014 to identify all IVC filter types in the United States. An electronic search was then performed on MEDLINE and the FDA MAUDE database to identify all reported complications associated with each device. High-resolution photos were taken of each filter type and corresponding computed tomographic and fluoroscopic images were obtained from an institutional review board-approved IVC filter registry. A wireframe and storyboard were created, and software was developed using HTML5/CSS compliant code. The software was deployed using PhoneGap (Adobe, San Jose, CA), and the prototype was tested and refined. Twenty-three IVC filter types were identified for inclusion. Safety data from FDA MAUDE and 72 relevant peer-reviewed studies were acquired, and complication rates for each filter type were highlighted in the application. Digital photos, fluoroscopic images, and CT DICOM files were seamlessly incorporated. All data were succinctly organized electronically, and the software was successfully deployed into Android (Google, Mountain View, CA) and iOS (Apple, Cupertino, CA) platforms. A powerful electronic mobile application was successfully created to allow rapid identification of all IVC filter types and related complications. This application may be used to optimize the care of patients with IVC filters. PMID:27247483

  7. Placement and retrieval of a Guenther tulip filter in patients with a free floating thrombus in inferior vena cava

    Seong, Min Hyun; Kim, Young Hwan; Lee, Sang Kwon; Choi, Jin Soo; Kim, Mi Jeong; Koo, Ja Hyun; Kim, Hyoung Tae; Cho, Won Hyun [Keimyung University College of Medicine, Daegu (Korea, Republic of); Seong, Nak Kwan [Daegu Catholic School of Medicine, Daegu (Korea, Republic of)

    2005-07-15

    We wanted to assess the technical feasibility and clinical efficacy of the placement and retrieval of a Guenther Tulip filter for the prevention of fatal pulmonary embolism during the management of patients with a free floating thrombus in their inferior vena ca va (IVC). Six patients having a free floating thrombus in their IVC (three patients with an isolated free floating thrombus in the IVC that resulted from immobilization due to traumatic liver injury or cerebral infarction, two patients with coexisting deep vein thrombosis in the left lower extremity that was caused by May-Thurner syndrome, and one patient with coexisting deep vein thrombosis in the right lower extremity that was due to nephrotic syndrome and immobilization after hip joint replacement) underwent placement and retrieval of a Guenther Tulip filter. The placement of the filter was performed through the right internal jugular vein to prevent the risk of detachment of the thrombus during the procedure. Retrieval of filter was performed after the free floating thrombus of the IVC had disappeared on follow-up CT because of anticoagulation therapy, aspiration thrombectomy or catheter directed Urokinase thrombolysis. The Guenther Tulip filter was successfully placed in the IVC in all six patients and it was retrieved after the management of the free floating thrombus. The mean duration of the placement of the filter was 11 days (range:7-25 days). Two patients underwent placement of an iliac vein stent for the management of May-Thurner syndrome. Detachment of the free floating thrombus in the IVC and the subsequent thrombus entrapment in the filter were documented during aspiration thrombectomy or Urokinase thrombolysis in four patients. Recurrent thrombus didn't occur during the follow-up period (range:3-20 months) in five of the six patients. In one patient, a recurrent thrombus due to the discontinuance of anticoagulation therapy was identified at the filter detachment site of the IVC on the

  8. Malignant thrombosis of the superior vena cava caused by non-small-cell lung cancer treated with radiation and erlotinib: a case with complete and prolonged response over 3 years

    Wang JY

    2013-07-01

    Full Text Available Jianyang Wang,1 Jun Liang,1 Wenqing Wang,1 Han Ouyang,2 Luhua Wang11Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 2Department of Diagnostic Radiology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of ChinaAbstract: Most cases of superior vena cava (SVC syndrome resulting from neoplasm, especially from lung cancer, remain a serious challenge to treat. Here, for the first time as far as we are aware, we report the case of a non-small-cell lung cancer patient with a massive SVC malignant thrombosis who was treated with thoracic irradiation and erlotinib. The treatment regimen consisted of erlotinib 150 mg/day and a total dose of 66 Gy/33 fractions delivered to the tumor, malignant thrombosis, and metastasis mediastinal lymph nodes. The malignant thrombosis responded dramatically and the combined regimen was well tolerated. After discharge, the erlotinib was prescribed as maintenance therapy. The patient was followed closely for the next 3 years. During this time, positron emission tomography/computed tomography scans and serum tumor marker screens were undertaken. By 6 months, the primary tumor showed complete response and by 9 months, the SVC thrombosis had disappeared. No sign of relapse has been found to date.Keywords: superior vena cava syndrome, radiotherapy, thoracic irradiation, neoplasm

  9. Rare case of primary inferior vena cava leiomyosarcoma on F-18 fluorodeoxyglucose positron emission tomography-computed tomography scan: Differentiation from nontumor thrombus in a background of procoagulant state

    We report a rare case of leiomyosarcoma of the inferior vena cava (IVC) in which F-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography-computed tomography (PET-CT) scan provided vital evidence, which led to its diagnosis, in a background of procoagulant state of the patient, where previous ultrasound-Doppler and echocardiography studies were nonspecific and revealed bilateral lower limb deep vein thrombosis with thrombus in IVC. The whole body F-18 FDG PET-CT scan was done in view of no significant improvement in clinical status of the patient over few months in spite of appropriate medical management. FDG PET-CT scan revealed high grade uptake in a large mass lesion occupying the right atrium, extending superiorly into terminal superior vena cava, inferiorly into dilated IVC and probably into hepatic veins. CT guided biopsy of this F-18 FDG avid mass was consistent with the diagnosis of leiomyosarcoma, which however was not amenable to surgery at this stage. F-18 FDG PET-CT accurately differentiated tumor mass from bland thrombus and further had a significant impact on the management, since aggressive surgery combined with adjuvant therapy offers the best outcome for patients with leiomyosarcoma of the IVC

  10. Percutaneous biopsy for small lymphadenopathy around the abdominal aorta and inferior vena cava using the modified coaxial technique under CT guidance

    Song, Chi Sung [Boramae Hospital, Seoul (Korea, Republic of)

    2006-03-15

    The author wanted to report the accuracy and safety of performing percutaneous biopsy of a small lymphadenopathy around the abdominal aorta and inferior vena cava (IVC) with using the modified coaxial technique (MCT) under CT guidance. Thirty-six cases of CT-guided biopsy using MCT were performed in 35 patients (15 men and 20 women, aged 21-80 years, mean age:56.5 years), who had small lymphadenopathy around the abdominal aorta and IVC. The maximum diameters of the target nodes were 11-20 mm in 21 cases, 21-30 mm in 14 cases and 31-40 mm in 1 case (mean diameter: 19.8 mm). The locations of the target lesions were the left or posterior side of the aorta (n=22), between the aorta and IVC (n=7), and the right or posterior side of the IVC (n=7). Using the modified coaxial technique, a guiding cannula was introduced precisely to the border of the target lesion. Fine needle aspiration biopsy was performed through the cannula and this was followed by multiple core biopsies (6-8 cores) using an automated biopsy gun. The pathologic results and complications were reviewed. The clinical course after biopsy and the histopathologic diagnosis were reviewed by following up the medical records. From examining the 36 biopsies, a definitive pathologic diagnosis was made in 33 cases (92%). The etiologies were as follows; 16 (44%) metastatic tumors, 11 (31%) lymphomas and 6 cases (17%) of tuberculosis with positive acid-fast bacilli (AFB). Two cases were reported as chronic granulomatous inflammation due to suspected tuberculosis, and they were treated with tuberculosis medication. One case was reported as chronic inflammation and so re-biopsy was performed; this resulted in the diagnosis of tuberculosis with positive AFB. Serious complications such as rupture of major vessels or bowel perforation did not occur. It is considered that performing percutaneous biopsy for small lymphadenopathy around the abdominal aorta and IVC with using the modified coaxial technique under CT guidance

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

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

  12. Axitinib for preoperative downstaging of renal cell carcinoma with sarcomatoid differentiation and direct invasion of the duodenum and inferior vena cava: a case report

    Yuki H

    2014-02-01

    Full Text Available Hideo Yuki,1,* Takao Kamai,1,* Keiichi Kubota,2 Hideyuki Abe,1 Daisaku Nishihara,1 Tomoya Mizuno,1 Akinori Masuda,1 Hironori Betsunoh,1 Masahiro Yashi,1 Yoshitatsu Fukabori,1 Ken-Ichiro Yoshida1 1Department of Urology, 2Department of Gastroenterological Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan *These authors contributed equally to this manuscript Background: Renal cell carcinoma (RCC with sarcomatoid differentiation is invasive, refractory to treatment, and has a higher mortality. Therefore, systemic therapy is still challenging, and the curative resection of localized or locally advanced RCC with sarcomatoid differentiation is very important. Axitinib is a potent and selective second-generation vascular endothelial growth factor receptor tyrosine kinase inhibitor with improved safety and tolerability. Axitinib is generally recommended as second-line therapy for advanced RCC because the phase III axitinib versus sorafenib in advanced RCC (AXIS trial demonstrated that it achieved longer progression-free survival than sorafenib in patients with metastatic RCC after failure of an approved first-line regimen. Methods: We present a 73-year-old man who had a large (13 cm in diameter right RCC with sarcomatoid differentiation that directly invaded the duodenum and inferior vena cava. The patient presented with gastrointestinal bleeding, was unable to eat solid food, and had become emaciated. Thus, his classification was poor risk with anemia, hypercalcemia, and poor performance status, according to the Memorial Sloan-Kettering Cancer Center criteria. He seemed unlikely to survive if radical nephrectomy, cavotomy with thrombectomy, and pancreatoduodenectomy were performed. To reduce the tumor burden and potential operative complications, we administered axitinib as first-line neoadjuvant therapy. Results: Six weeks of treatment reduced the tumor burden without causing severe toxicities. Subsequently, radical right nephrectomy, cavotomy

  13. Factors Associated with Advanced Inferior Vena Cava Filter Removals: A Single-Center Retrospective Study of 203 Patients Over 7 Years

    PurposeTo identify factors associated with advanced inferior vena cava filter (IVCF) retrieval to raise awareness on technical considerations, retrieval efficiency, and patient safety.Materials and MethodsA single-center retrospective review was performed of 203 consecutive retrievable IVC filters placed between 2007 and 2014. Attempted retrievals were classified as advanced if the routine “snare and sheath” technique was initially unsuccessful after multiple attempts, or an alternate endovascular maneuver or access site was utilized. Patient and filter characteristics were recorded.Results203 attempted retrievals were reviewed (48.7 % male, 51.2 % female, mean age 52.7 years, mean dwell time 109 days). Advanced retrievals were observed in 20 patients (9.8 %) (15 females, 5 males). Fluoroscopy time (p ≤ 0.01, 34.3 ± 21.1 and 5.3 ± 4.5 min for advanced retrievals and routine retrievals respectively, same below), gender (p = 0.031), and retrieval tilt angle (p ≤ 0.01, 5.7 ± 5.10° vs. 11.9 ± 11.03°) were associated with advanced retrievals. Females were 3.16 times more likely to have an advanced retrieval performed than males with a significantly higher tilt angle in those with advanced retrieval. History of cancer (p = 0.502), dwell time (p = 0.916), retrieval caval diameter (p = 0.053), placement caval diameter (p = 0.365), filter type (p = 0.710), strut perforation (p = 0.506), placement tilt angle (p = 0.311), and age (p = 0.558) were not found significantly associated with advanced retrievals.ConclusionsWomen are at increased risk for advanced filter retrieval secondary to a significant change in filter tilt over time compared to men, independent of filter type or competing demographic or filter risks, likely placing them at increased risk for higher procedural fluoroscopy times

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

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

    2013-05-11

    PurposeEvaluation of long-term outcomes of venoplasty and Gianturco stents to treat inferior vena cava (IVC) obstruction after liver transplantation.MethodsWe retrospectively analyzed records from 33 consecutive adult patients referred with the intent to treat suspected IVC obstruction after liver transplantation. Treatment was performed for occlusion or stenosis with a gradient exceeding 3 mmHg. The primary treatment was venoplasty and, if refractory, Gianturco stent placement. Recurrence prompted repeat venoplasty or stent placement.ResultsOf the 33 patients, 25 (aged 46.9 ± 12.2 years) required treatment at a mean of 2.3 years (14 days to 20.3 years) after transplantation. For technically successful cases, primary treatment was venoplasty alone (14) or with stent placement (10). Technical success was 96 % (24 of 25) reflecting failure to cross one occlusion. Clinical success was 88 % (22 of 25) reflecting the technical failure and two that died of unrelated complications within 5 weeks. Cumulative primary patencies were 57.1 % at 6 months (n = 21) and 51.4 % at 1 (n = 10), 3 (n = 7), 5 (n = 6), and 7 (n = 5) years. Cumulative primary assisted patency was 95.2 % at 6 months (n = 21) and at 1 (n = 15), 3 (n = 9), 5 (n = 8), and 7 (n = 8) years. The 17 patients stented for refractory (n = 10) or recurrent (n = 7) stenosis had cumulative primary and primary assisted patencies of 86.0 and 100 %, respectively, from 6 months (n = 14) to 7 years (n = 3). No major complications occurred; one fractured stent was observed after 11.6 years.ConclusionFor IVC obstruction following liver transplantation, excellent long-term outcomes can be achieved by venoplasty and Gianturco stent placement.

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

    PurposeEvaluation of long-term outcomes of venoplasty and Gianturco stents to treat inferior vena cava (IVC) obstruction after liver transplantation.MethodsWe retrospectively analyzed records from 33 consecutive adult patients referred with the intent to treat suspected IVC obstruction after liver transplantation. Treatment was performed for occlusion or stenosis with a gradient exceeding 3 mmHg. The primary treatment was venoplasty and, if refractory, Gianturco stent placement. Recurrence prompted repeat venoplasty or stent placement.ResultsOf the 33 patients, 25 (aged 46.9 ± 12.2 years) required treatment at a mean of 2.3 years (14 days to 20.3 years) after transplantation. For technically successful cases, primary treatment was venoplasty alone (14) or with stent placement (10). Technical success was 96 % (24 of 25) reflecting failure to cross one occlusion. Clinical success was 88 % (22 of 25) reflecting the technical failure and two that died of unrelated complications within 5 weeks. Cumulative primary patencies were 57.1 % at 6 months (n = 21) and 51.4 % at 1 (n = 10), 3 (n = 7), 5 (n = 6), and 7 (n = 5) years. Cumulative primary assisted patency was 95.2 % at 6 months (n = 21) and at 1 (n = 15), 3 (n = 9), 5 (n = 8), and 7 (n = 8) years. The 17 patients stented for refractory (n = 10) or recurrent (n = 7) stenosis had cumulative primary and primary assisted patencies of 86.0 and 100 %, respectively, from 6 months (n = 14) to 7 years (n = 3). No major complications occurred; one fractured stent was observed after 11.6 years.ConclusionFor IVC obstruction following liver transplantation, excellent long-term outcomes can be achieved by venoplasty and Gianturco stent placement

  16. Factors Associated with Advanced Inferior Vena Cava Filter Removals: A Single-Center Retrospective Study of 203 Patients Over 7 Years

    Dowell, Joshua D., E-mail: Joshua.Dowell@osumc.edu; Wagner, Daniel, E-mail: Daniel.Wagner@osumc.edu; Elliott, Eric, E-mail: Eric.Elliott@osumc.edu [The Ohio State University Wexner Medical Center, Department of Radiology, Division of Interventional Radiology (United States); Yildiz, Vedat O., E-mail: Vedat.Yildiz@osumc.edu; Pan, Xueliang, E-mail: Jeff.Pan@osumc.edu [The Ohio State University Wexner Medical Center, Center for Biostatistics (United States)

    2016-02-15

    PurposeTo identify factors associated with advanced inferior vena cava filter (IVCF) retrieval to raise awareness on technical considerations, retrieval efficiency, and patient safety.Materials and MethodsA single-center retrospective review was performed of 203 consecutive retrievable IVC filters placed between 2007 and 2014. Attempted retrievals were classified as advanced if the routine “snare and sheath” technique was initially unsuccessful after multiple attempts, or an alternate endovascular maneuver or access site was utilized. Patient and filter characteristics were recorded.Results203 attempted retrievals were reviewed (48.7 % male, 51.2 % female, mean age 52.7 years, mean dwell time 109 days). Advanced retrievals were observed in 20 patients (9.8 %) (15 females, 5 males). Fluoroscopy time (p ≤ 0.01, 34.3 ± 21.1 and 5.3 ± 4.5 min for advanced retrievals and routine retrievals respectively, same below), gender (p = 0.031), and retrieval tilt angle (p ≤ 0.01, 5.7 ± 5.10° vs. 11.9 ± 11.03°) were associated with advanced retrievals. Females were 3.16 times more likely to have an advanced retrieval performed than males with a significantly higher tilt angle in those with advanced retrieval. History of cancer (p = 0.502), dwell time (p = 0.916), retrieval caval diameter (p = 0.053), placement caval diameter (p = 0.365), filter type (p = 0.710), strut perforation (p = 0.506), placement tilt angle (p = 0.311), and age (p = 0.558) were not found significantly associated with advanced retrievals.ConclusionsWomen are at increased risk for advanced filter retrieval secondary to a significant change in filter tilt over time compared to men, independent of filter type or competing demographic or filter risks, likely placing them at increased risk for higher procedural fluoroscopy times.

  17. Surgical resection of a renal cell carcinoma involving the inferior vena cava: the role of the cardiothoracic surgeon

    Parissis, Haralabos

    2010-11-05

    Abstract Background The techniques for the resection of renal tumors with IVC extension are based on the experience of individual units. We attempt to provide a logical approach of the surgical strategies in a stepwise fashion. Methods Over 6-years 9 patients with renal cell carcinoma invading the IVC, underwent surgery. There were 6 males. The extension was at level IV in 4 and III in 5 cases. CPB used in 8 and hypothermia and circulatory arrest in all patients with level IV disease. The results and an algorithm of the plan of action, as per level of extension are presented. Results Plan of action: For level I-II disease: No Cardiothoracic involvement, For level III: Cardiopulmonary Bypass (CPB) & control of the cavo-atrial junction. For level IV: use of brief periods of Circulatory Arrest & repair of the Cavotomy with a pericardial patch. Postoperative morbidity: prolonged ICU stay, 3 patients (33.3%); tracheostomy, 1 (11.1%); Sepsis, 2 (22.2%); CVA 1, (11.1%). Mortality: 2 patients (22.2%) Conclusions Total clearance of the IVC from an adherent tumor is important, therefore extensive level IV disease presents a surgical challenge. We recommend CPB for level III and brief periods of Total Circulatory Arrest (TCA) for level IV disease.

  18. Accuracy of Inferior Vena Cava Ultrasound for Predicting Dehydration in Children with Acute Diarrhea in Resource-Limited Settings.

    Payal Modi

    Full Text Available Although dehydration from diarrhea is a leading cause of morbidity and mortality in children under five, existing methods of assessing dehydration status in children have limited accuracy.To assess the accuracy of point-of-care ultrasound measurement of the aorta-to-IVC ratio as a predictor of dehydration in children.A prospective cohort study of children under five years with acute diarrhea was conducted in the rehydration unit of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b. Ultrasound measurements of aorta-to-IVC ratio and dehydrated weight were obtained on patient arrival. Percent weight change was monitored during rehydration to classify children as having "some dehydration" with weight change 3-9% or "severe dehydration" with weight change > 9%. Logistic regression analysis and Receiver-Operator Characteristic (ROC curves were used to evaluate the accuracy of aorta-to-IVC ratio as a predictor of dehydration severity.850 children were enrolled, of which 771 were included in the final analysis. Aorta to IVC ratio was a significant predictor of the percent dehydration in children with acute diarrhea, with each 1-point increase in the aorta to IVC ratio predicting a 1.1% increase in the percent dehydration of the child. However, the area under the ROC curve (0.60, sensitivity (67%, and specificity (49%, for predicting severe dehydration were all poor.Point-of-care ultrasound of the aorta-to-IVC ratio was statistically associated with volume status, but was not accurate enough to be used as an independent screening tool for dehydration in children under five years presenting with acute diarrhea in a resource-limited setting.

  19. 上腔静脉X线投影测量与患者相关因素的探讨%Studying and analyzing the relationship between X-ray cephalometry of superior vena cava and patient-related factors

    耿才正; 陈姬雅; 王建铭

    2012-01-01

    Objective The aim of this study was to explore the relationship between the variables (age, sex, height, weight) and the lower segment of superior vena cava on the posteroanterior thorax radiograph, and to improve the in-vitro measurements accuracy of beside PICC. Methods The data of 100 cases adults physical examination were collected in Tai-Zhou hospital. We measnred the distance between the middle of the lower segment of superior vena cava to the inner side of the right clavicle, observed the front rib units which was projected the middle of the lower segment of superior vena cava, and then analyzed the correlation between the data (distance between vertical segment, the front rib units) and the variable (age, sex, height, weight) with IBM SPSS Statistics vl9 software. Results The front rib units planes was no significant correlation with sex. age, height and weight ( r =0. 196~0. 130, P =0. 051~0. 936). The distance between vertical segment was obvious correlation with body height and sex ( r =0. 197, -0. 339, P =0. 049,0. 001) and no significant correlation with age and body weight( r =0. 052, -0. 066, F =0. 604, 0. 512). Conclusion The projection of the lower segment of superior vena cava has the individual differences, which is affected by many factors besides age, sex, height and weight. Thus, it is difficult to improve the in-vitro measurements accuracy of beside PICC by analyzing the age. sex, height and weight of the patient.%目的 探讨成人上腔静脉下段后前位胸片投影是否与性别、年龄、身高、体重相关,以期提高床旁PICC体外测量的准确性.方法 成人体检资料100份,在后前位胸片上测量上腔静脉下段中点至右锁骨内端下缘距离(即横L体外测量法垂直段距离,以下简称“垂直段距离”),上腔静脉下段中点所在前肋肋单元平面,各数据会同性别、年龄、身高、体重,利用IBM SPSS Statistics v19统计软件作Pearson相关分析.结果 上腔静脉下段中点

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

    Carlos R Moraes

    1988-08-01

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

  1. 下腔静脉病变的 CT 与 MRI 诊断价值%Study on the significance of CT scanning and MRI in diagnosis of lesions in inferior vena cava

    王文生; 丁长青; 孙迎迎; 罗慧; 代兰兰; 丁爱兰

    2014-01-01

    Objective To explore the significance of multi - slice spiral CT scanning and MRI in diagnosis of lesions in inferior vena cava (IVC). Methods The data of 16 - slice spiral CT scanning and 0. 35T MRI imaging of 80 patients with clinically confirmed IVC lesions were retrospectively analyzed. The CT scanning was given with multi - phase contrast - enhanced examination,MRI was mainly by plain scanning. These examinations were focused on analyzing the scope and nature of inferior vena cava. Results Among these 80 cases,9 cases were congenital malformation of IVC(5 cases were diagnosed by CT scanning,and 4 cases by MRI),formation of emboli in 36 cases(including 5 with thrombo-sis,31 with cancer embolus;32 cases were diagnosed by CT,and 4 cases by MRI ),16 cases of Budd Chiari syndrome(diagnosed by CT scan-ning in 15 cases,MRI in 1 case),stenosis caused by external pressure in 12 cases(diagnosed by CT scanning in 8 cases,and by MRI in 4 ca-ses),placement of stent in 3 cases(diagnosed by CT scanning). Conclusion Multi - slice spiral CT scanning and MRI can rapidly,accurately and non - invasively demonstrate IVC and its lesions,hence they are worthy to be applied for clinical diagnosis.%目的:探讨多层螺旋 CT 及 MRI 在下腔静脉病变中的诊断价值。方法回顾性分析临床证实的80例下腔静脉病变的16层螺旋 CT 及0.35T MRI 资料,CT 以多期增强检查为主,MRI 以平扫为主。重点分析下腔静脉病变部位、范围及性质。结果检出下腔静脉先天畸形9例(其中 CT 诊断5例,MRI 诊断4例),下腔静脉栓子形成36例(其中血栓5例,癌栓31例;CT 诊断32例,MRI 诊断4例),布加综合征16例(其中 CT 诊断15例,MRI 诊断1例),外压性狭窄12例(其中 CT 诊断8例,MRI 诊断4例),支架置入3例(均为 CT 诊断)。结论多层螺旋 CT 及 MRI 能够快速、无创较为准确显示下腔静脉及其病变,值得临床应用。

  2. 支架植入术治疗上腔静脉综合征:金属支架的选择%Stent implantation for the treatment of superior vena cava syndrome:Selection of metallic stents

    杨维竹; 潘恒; 黄兢姚; 江娜; 郑曲彬; 林俊清

    2013-01-01

    目的 探讨支架植入术治疗上腔静脉综合征(SVCS)中选择金属支架的要点.方法 收集51例SVCS,CT均显示上腔静脉(SVC)明显狭窄或闭塞;经股静脉穿刺插管,以球囊扩张狭窄或闭塞段后植入1枚或多枚金属内支架(Smart支架、Z-Stent支架、Fluency支架),直至复查造影显示SVC血流通畅.术后评价疗效.结果 51例SVCS中,50例双侧头臂静脉汇合处受累.支架植入术均获成功,28例植入Smart支架,17例植入Z-Stent,4例植入Fluency支架,2例为Smart支架内套Fluency支架;31例植入1枚支架,12例植入2枚支架,8例植入3枚支架.支架植入后48例临床症状明显改善,上腔静脉压显著下降.术中无SVC破裂等严重并发症发生.46例接受随访,其中18例于随访期内重现SVC阻塞症状,包括11例植入Smart支架、7例植入Z-Stent支架者,植入Fluency支架者未见复发.结论 根据SVC病变程度、位置,选择植入结构和特性适当的金属支架可使介入治疗SVCS安全、有效.%Objective To investigate the elective points of different types of metallic stents for implantation in patients with superior vena cava syndrome (SVCS).Methods Fifty-one patients with SVCS were enrolled.Enhanced CT showed obvious stenosis or occlusion of the superior vena cava (SVC) in all patients.Stent implantation was performed after balloon dilatation through femoral vein.One or more stents (Smart stent,Z-Stent and Fluency stent) were positioned till the obstruction of SVC flow was relieved.The therapeutic effects of stent implantation were evaluated.Results Among all 51 patients,invasion of bilateral brachiocephalic veins were observed in 50 patients.Technical success of stent implantation was achieved in all patients including 28 patients with Smart stent,17 with Z-Stent,4 with Fluency stent and 2 patients with Fluency+Smart stent.Significant improvements of SVCS symptoms was noticed in 48 patients after stent implantation,and the pressure of SVC

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

    Vučićević-Trobok Jadranka; Bogdanov Biljana; Trifković Miroslava; Srdić Svetozar

    2002-01-01

    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. Pul...

  4. VENA RENAL IZQUIERDA RETRO-AÓRTICA. VENA RENAL IZQUIERDA RETRO-AÓRTICA

    Russo, Alejandro M.

    2013-01-01

    Understanding of the renal venous anatomy and its variations is essential to perform any procedure in the region. We report a variation of the left renal venous tree found during a cadaveric dissection, the retro-aortic left renal vein. It was a unique venous trunk that emerged from the left renal hilum and traveled dorsally to the abdominal aorta before reaching the inferior vena cava. The existence of this vessel is associated to the embryology of the inferior vena cava. We discuss the surg...

  5. 胎儿永存左上腔静脉和相关先天异常的产前MRI诊断%Prenatal Diagnosis of Persistent Left Superior Vena Cava and Its Associated Congenital Anomalies by MRI

    董素贞; 朱铭; 李奋; 钟玉敏

    2012-01-01

    Purpose: To evaluate the associated conditions and the appearances of persistent left superior vena cava (PLSVC) detected in fetal life by MRI. Methods: Twelve pregnant women with gestation from 21 to 35 weeks were studied on a 1.5 T superconductive MR unit within 24 to 48 hours after ultrasound studies. The imaging protocols included fast-imaging employing steady-state acquisition (FIESTA) or balanced fast field echo (B-FFE), single-shot fast spin echo (SSFSE) or single shot turbo spin echo (SSTSE) and non-gated cine FIESTA/ "real-time" B-TFE sequences in the axial, coronal, and sagittal planes relative to the fetal brain, thorax, abdomen, especially thorax and heart. Prenatal US and MR imaging findings were compared with postnatal diagnoses. Postnatal evaluation included postnatal imaging, surgery and autopsy. Results: All 12 cases were with bilateral superior vena cava, one of the cases accompanied the bridging vein. According to the associated congenital anomalies, ten cases accompanied cardiac malformations, one case accompanied oligohydramnios and one case with no associated condition. Four of ten cases with cardiac malformations also accompanied etracardiac malformations. For PLSVC, all 12 cases were diagnosed correctly by MRI, and by prenatal US five cases were accurately diagnosed and seven cases were missed. For associated cardiac malformations, Prenatal MRI provided accurate diagnosis in seven cases, misdiagnosis in one case and missed diagnosis in two cases, prenatal US with accurate diagnosis in seven cases, misdiagnosis in two cases and missed diagnosis in one case. Conclusion: Prenatal MRI is effective in the assessment of fetal PLSVC. The diagnostic accuracy of prenatal ultrasound for associated cardiac abnormalities was better than MRI, but the diagnostic accuracy of prenatal ultrasound for associated extracardiac abnormalities was not better than MRI.%目的:探讨胎儿永存左上腔静脉和相关畸形的产

  6. 冠状窦顶重建治疗无顶综合征合并心内膜垫缺损和永存左上腔静脉%Reestablishment the roof of coronary sinus in treating unroofed coronary sinus syndrome with endocardial cushion defect and persistent left superior vena cava

    范祥明; 闫军; 王强; 罗国华; 吕晓东; 刘迎龙

    2010-01-01

    目的 总结冠状静脉窦顶重建在无顶冠状静脉窦综合征合并心内膜垫缺损和永存左上腔静脉的外科治疗经验.方法 2000年1月至2008年1月共753例心内膜垫缺损病人行畸形矫治手术,15例(2%)同时合并永存左上腔静脉和无顶冠状静脉窦综合征,包括部分型心内膜垫缺损12例,完全型心内膜垫缺损3例.均在行心内膜垫缺损矫治术同期重建冠状静脉窦顶,1例直接结扎左上腔静脉,14例将左上腔静脉隔入右房,其中10例用自体心包补片,4例通过折叠左房后壁完成冠状静脉窦顶的重建,最后在重建的冠状静脉窦开口的左侧缝合修补房间隔缺损.结果 术后早期1例死于严重肺部感染.术后随访3个月~6年,无远期死亡病例.14例术后均未见腔静脉、肺静脉回流梗阻和心房水平残余分流.1例行左房后壁折叠分隔左上腔静脉者术后早期超声心动图提示左上腔静脉入左房顶处血流速度偏快.结论 合并心内膜垫缺损和永存左上腔静脉的无顶冠状静脉窦综合征外科治疗有难度,冠状窦顶重建技术能够取得良好的治疗效果.%Objective To summarize the surgical procedures of unroofed coronary sinus syndrome with endocardial cushion defect and persistent left superior vena cava.Methods From 2000 to 2008,753 cases of endocardial cushion defect underwent surgical repair.Among them 15 cages(2.0%)were associated with persistent left superior vena cava and unroofed coronary sinus syndrome.The drainage of the persistent left superior vena cava and coronary vein were corrected simultaneously during the operation by reestablishing the roof of the coronary sinus.The persistent left superior vena cava were drained to right atrium by intra-atrial tunnel with pericardial patch or left atrium folding in 14 cases and it was ligated in the remain one.Most of the coronary veins were drained into right atrium after the correction of cardiac defect.Results One patient

  7. Inferior Vena Cava Filter Placement and Removal

    ... a specially trained interventional radiologist in an interventional radiology suite or occasionally in the operating room. This ... page Additional Information and Resources Society of Interventional Radiology (SIR) - Patient Section top of page This page ...

  8. Effects of Excessive Intake of Iodine on Activation of Endothelial Cells of Inferior Vena Cava in Rats%高碘对大鼠下腔静脉内皮细胞活化的影响

    叶静; 王法娟; 张辉; 郭成浩

    2012-01-01

    Objective To observe the effect of excessive iodine on the activation of endothelial cells of inferior vena cava in rats. Methods A total of 32 outbreeding closed colony Wistar rats, about one month after stopping lactation, were randomly divided into four groups: normal control group (tap-water); 10- fold excessive Iodine group (10HI); 50- fold excessive Iodine group(50HI); 100- fold excessive Iodine group(100HI),with four males and four females in each group. The rats were treated with iodine through food at dosage of 6.15, 61.5, 307.5 and 615 μg/d, respectively. After 60 days of exposure,venous blood was collected and ICAM-1, vWF, vWFpp were determined. Results Compared with normal control group,vWF increased in 50HI male group, ICAM—land vWF significantly increased in 100HI male and female group. vWFpp showed no significant changes in each group. The endothelial cells appeared morphological change under optical microscope. Conclusion Excessive iodine may induce endothelial cell activation with dose—dependent manner.%目的 研究高碘对大鼠下腔静脉肝段内皮细胞活化的影响.方法 将32只断乳约1个月的远交封闭群SPF/VAF级Wistar大鼠随机分为4组,分别为正常对照(自来水)组、10倍碘组、50倍碘组和100倍碘组,每组8只,雌雄各半.采用自由饮水、摄食的方式进行染毒,各组大鼠碘摄入量分别为6.15、61.5、307.5、615 μg/d,连续染毒6个月.测定大鼠血浆细胞间黏附因子-1(ICAM-1)、血管性血友病因子(vWF)及血管性血友病因子前肽(vWFpp)含量.结果 与正常对照组相比,50倍碘组雄性大鼠血浆vWF含量显著升高,100倍碘组雄性和雌性大鼠血浆ICAM-1、vWF含量均显著升高;且随着摄入碘含量的升高,雄性和雌性大鼠血浆ICAM-1、vWF含量呈上升趋势.而各组雄性和雌性大鼠血浆vWFpp含量均未见显著变化.结论 高碘可导致大鼠内皮细胞活化,并在一定程度上呈剂量-效应关系.

  9. 生物可降解腔静脉滤器的制备及其性能研究%The preparation of biodegradable vena cava filter and the study of its properties

    张肖; 肖越勇; 杨杰; 马旭阳; 刘士榕; 任超; 王小平

    2012-01-01

    目的 对采用左旋聚乳酸(PLLA)制备生物可降解腔静脉滤器(BVCF)进行研究,并评估其机械力学性能、可输送性能、捕获血栓性能及其生物相容性.方法 利用三维设计软件设计BVCF外形,采用分子量为100 000 U的PLLA制作BVCF,通过体外实验,对其主要性能进行测试.采用中华小型猪12只,随机分为4组(每组3只),第1~3组为实验组,第4组为对照组.将9枚BVCF置入第1~3组实验小型猪下腔静脉内,1周后对所有小型猪行血栓注入实验.每组的3只小型猪下腔静脉分别注入2、5和8条血栓.注入血栓后l、6、12周行影像检查,观察滤器情况及小型猪肺动脉栓塞情况.每次影像检查后,牺牲1组实验组动物行病理检查.结果 制备出一种带中心线型的可降解滤器,通过体外实验测试滤器径向支撑力1.6N,能够捕获直径>5 mm的栓子,易于释放.通过动物实验证实该滤器能够捕获注入的致命性栓子,9只实验组小型猪均存活,其中2只栓子注入过程中出现轻度呼吸、心率加快;对照组小型猪注入血栓后不同程度地出现呼吸频率加快、气促等症状,注入8条血栓的小型猪,在血栓注入后当天死亡.术后影像及病理检查显示,实验组出现症状的小型猪发生周围性肺动脉栓塞,对照组死亡小型猪发生中央性肺动脉栓塞.显微镜下显示滤器置入术后1周,BVCF侧支部分被内膜覆盖;6周后完全被内膜覆盖,血管壁结构正常,未见明显炎性细胞浸润;术后12周BVCF侧支内膜情况无明显变化,滤器侧支部分降解.结论 BVCF具有良好的机械强度和可输送性能,对致命性大栓子有较高的捕获率,并具有良好的生物相容性,但其降解性能尚需进一步研究.%Objective To investigate the preparation of biodegradable vena cava filter(BVCF) with poly-l-lactic acid (PLLA),and to evaluate its mechanical properties,delivery performance,the ability of capturing thrombus

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

    Eun-Young Park

    2015-11-01

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

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

    Valary T. Raup

    2015-01-01

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

  12. Evaluation of diagnostic reliability of radionuclide phlebography using 99mTc-MAA to detect deep venous thrombosis; Its role in establishing indications for inferior vena cava filter implantation

    Radionuclide phlebography (RNP) of the lower extremities and pelvis was performed using 99mTc-MAA in 40 patients with pulmonary thromboembolism. Deep venous thrombosis (DVT) was found in all patients, more frequently in the right calf and in the left iliac veins in 20 patients (55%). RNP and contrast phlebography (CP) were performed in 18 patients and confirmed the presence of DVT in all cases. The greatest specificity of RNP was obtained in the left (92.4%) and in the right pelvis (80%). In 12 of 18 patients in whom a cava filter was implanted, specificity of RNP was 100% for the left thigh and 91.7% for other localizations. In establishing indications for cava filter implantation, RNP should be performed prior to CP and bilaterally, but in case of non-indicated CE, RNP findings should be sufficient. (orig.)

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

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

  14. Electrolytic Inferior Vena Cava Model (EIM) of Venous Thrombosis

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

    2011-01-01

    Animal models serve a vital role in deep venous thrombosis (DVT) research in order to study thrombus formation, thrombus resolution and to test potential therapeutic compounds (1). New compounds to be utilized in the treatment and prevention of DVT are currently being developed. The delivery of potential therapeutic antagonist compounds to an affected thrombosed vein has been problematic. In the context of therapeutic applications, a model that uses partial stasis and consistently generates t...

  15. Superior vena thrombosis with peripartum dilated cardiomyopathy

    A 30 years multiparous female with history of emergency caesarean section 10 days back was referred to us with cough, severe breathlessness at rest, orthopnea with pain in neck and arms. Clinical examination revealed signs of heart failure. Echocardiography showed ejection fraction of 15%, with no right ventricular strain. A diagnosis of peripartum cardiomyopathy was made. Doppler ultrasound of neck veins showed bilateral internal jugular vein thrombosis. Subsequent multislice CT examination showed thrombosis of superior vena cava and both internal jugular veins (with collateral formation) and pulmonary embolism. There were no mediastinal abnormalities on the CT scan. Her thrombophilia screen and CT scan brain was normal. She was managed in collaboration with cardiologist. Following treatment with subcutaneous enoxaparin therapy and warfarin her symptoms of upper limb pain improved. She responded very well to medical therapy for heart failure with marked improvement of NYHA functional class. (author)

  16. Comparison of superior vena caval and inferior vena caval access using a radioisotope technique during normal perfusion and cardiopulmonary resuscitation

    Recent studies of thoracic pressure changes during external cardiopulmonary resuscitation (CPR) suggest that there may be a significant difference in the rate of delivery of intravenous drugs when they are administered through the extrathoracic inferior vena cava (IVC) rather than the intrathoracic superior vena cava (SVC). Comparison of delivery of a radionuclide given using superior and inferior vena caval access sites was made during normal blood flow and during CPR. Mean times from injection to peak emission count in each ventricle were determined. There were no significant differences between mean peak times for SVC or IVC routes during normal flow or CPR. When peak times were corrected for variations in cardiac output, there were no significant differences between IVC and SVC peak times during normal flow. During CPR, however, mean left ventricular peak time, when corrected for cardiac output, was significantly shorter (P less than .05) when the SVC route was used. The mean time for the counts to reach half the ventricular peak was statistically shorter (P less than .05) in both ventricles with the SVC route during the low flow of CPR. This suggests that during CPR, increased drug dispersion may occur when drugs are infused by the IVC route and thus may modify the anticipated effect of the drug bolus. These results suggest that during CPR, both the cardiac output and the choice of venous access are important variables for drug delivery

  17. Alterações do diâmetro da veia cava caudal nas diferentes fases do ciclo respiratório, como um indicador não invasivo da volémia e correlação com a pressão venosa central

    Monteiro, Carla Alexandra Almeida

    2009-01-01

    ABSTRACT - Ultrasound evaluation of caudal vena cava diameter changes with breathing as an estimate of volemia and central venous pressure - Estimating volemia is essential for the care of critical patients. Traditionally this has been achieved through indirect parameters or invasive methods such as central venous pressure (CVP). Recently several human studies demonstrated that ultrasound (US) kinetic respiratory changes of caudal vena cava (CVC) can be a reliable indicator of the v...

  18. Application of catheter directed thrombolysis in the treatment of Budd-Chiari syndrome with inferior vena cava thrombosis%置管溶栓术在治疗布加综合征合并下腔静脉血栓中的应用

    党晓卫; 李素新; 李路豪; 李海; 徐韶凯; 许培钦

    2014-01-01

    Objective To investigate the feasibility and safety of catheter thrombolysis in the treatment of Budd-Chiari syndrome (B-CS) with inferior vena cava(IVC) thrombosis.Methods A retrospective analysis of the clinical data of 21 cases of B-CS with IVC thrombosis in the First Affiliated Hospital of Zhengzhou University from January 2011 to September 2014 was conducted.They were divided into 2 groups,12 cases of fresh thrombus group,while 9 cases of old thrombus group.All cases were couducted with catheter directed thrombolysis through the right femoral vein,then regularly with color doppler examination,evaluating thrombolytic effect.When thrombus disappearing,intervention or (and) operation treatment was conducted,then postoperative following-up.Results There were 16 cases in which thrombus dissolving completely within 15 days(9 cases of fresh thrombus and 7 cases of old thrombus,P =0.536).In 1 case,thrombosis dissolved completely 20 days later.There were 3 cases combined with pre-dilating technology (thrombosis dissolved completely).When thrombosis completely dissolved,the mean catheterization time of fresh thrombus group was (10.78 ± 2.97)d,while the old thrombus group was (14.13 ± 3.41)d(P =0.06).The short-term (less than 15 days) dissolution rate was 76.19% (16/21),and the total efficiency rate was 90.48% (19/21).Complications occurred in 4 cases.The incidence of severe complications was 4.76% (1/21).Postoperative follow-up with Color Doppler ultrasound in 1 to 12 months,1 case recurred after 5 months.The rest did not recurred.the recurrence rate was 4.76% (1/21) within following up time.Conclusions The catheter thrombolysis is an important link in the treatment of B-CS with thrombosis of IVC,which is simple,safe and effective,with low incidence of complications.It can be used as the preferred treatment for this type of B-CS.%目的 探讨置管溶栓术在治疗布加综合征合并下腔静脉血栓中的可行性及安全性.方法 回顾性分析

  19. 肥胖患者侧卧位微创经皮肾镜取石术导丝误入右心房及肾造瘘管误入腔静脉一例报告并文献复习%Misguiding the guide wire into right atrium and nephrostomy tube into the vena cava in obese patient with mininimally invasive percutaneous nephrolithotomy under lateral position: a case report and literature review

    李俊; 何银志; 邓观云; 旷淼; 韩斌; 卢俊锦; 毛兴会; 朱向会; 陈唐兵

    2015-01-01

    Objective To investigate the management of misguiding the guide wire into right atrium and nephrostomy tube into the vena cava in obese patient with mininimally invasive percutaneous nephrolithotomy under lateral position.Methods In May 2014,the clinic data of one 30 years old male case with left ureter stone and hydronephrosis was retrospectively studied.The patient was admitted to our hospital due to the repeated left flank pain for five years.The left kidney stones and hydronephrosis were found before admission.The patient has the history of alcohol abusing for drinking 3 years.A 6 months history of hypertension and diabetes mellitus were also recorded.His BMI index was 35.9 kg/m2.During physical examination,an obvious left kidney region percussion pain was noticed.The ultrasound examination showed that the high echo region (1.5 cm× 1.0 cm) existed in the left ureteropelvic junction with moderate hydronephrosis.The enhancement CT scan demonstrated the left upper ureteral calculi with moderate hydronephrosis.The CT value of left kidney cortex in enhanced phase was 100 HU.The patient was accepted the general anesthesia and the downlink lateral position MPCNL.During establishing the channel,the bleeding caused the poor vision,which could not continue the operation.Then the zebra guide wire and nephrostomy tube were left for second stage operation.Results 7 days after the operation,the CT scan showed that the guide wire located in the right atrium.And the nephrostomy tube was placed into the vena cava,which located at level of hepatic hilum.Under CT guidance,the guide wire was pulled out about 10 cm at each time and then observed for 5 min.If there was no adverse reaction,the procedure would be repeated.After repeating those procedures for five times,the guide wire was pulled back into nephrostomy tube.Then,the tube was pulled back into branched renal vein,which was 1cm close to the pelvis,and waiting for the thrombosis formation and healing of puncture site in

  20. Acute superior vena caval syndrome with airway obstruction following elective mediastinoscopy.

    Power, C K

    2012-02-03

    A 47-year-old female patient had a subclinical superior vena caval syndrome which developed into the \\'full blown\\' acute condition when she was placed into the left lateral position after mediastinoscopy. She developed airway obstruction requiring urgent re-intubation and subsequent admission to the intensive care unit. This subclinical condition might have been suspected pre-operatively if closer attention had been paid to the history, physical examination and review of the computerised axial tomography scan: she had a history of intermittent dysponea, wheeze and cough which was worse on waking and improved as the day progressed, she had a positive Pemberton\\'s sign and the computerised axial tomography scan showed that the lesion was encroaching on the superior vena cava.

  1. Thrombosis of right ovarian vein; Trombosis de la vena ovarica derecha

    Forner, J.; Talens, A.; Flores, M.; Mendez, M. [Hospital General Universitario de Valencia. Valencia (Spain)

    2001-07-01

    Ovarian vein thrombosis is a rare postpartum complication (0.1%). It can be fatal, since it can lead to sepsis, pulmonary thromboembolisms and inferior vena cava or renal vein thrombosis. Computed tomography and magnetic resonance imaging are the techniques of choice for its diagnosis, while the value of ultrasound is limited due to its low sensitivity and specificity. We report the case of a woman who, during puerperium, developed thrombosis of right ovarian vein that presented clinical, ultrasonographic and computed tomographic features of appendicitis. We describe the radiological sings and stress the fact that this diagnosis should be suspected in puerperal women. (Author) 9 refs.

  2. Acetylcholinesterase and Butyrylcholinesterase Inhibitory Compounds from Corydalis cava (Fumariaceae)

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

    2011-01-01

    Roč. 6, č. 5 (2011), s. 607-610. ISSN 1934-578X Institutional research plan: CEZ:AV0Z40720504 Keywords : corydalis cava * fumariaceae * alzheimer ´s disease Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 1.242, year: 2011

  3. CT imaging of hepatic veno-occlusive disease (an analysis 14 cases)

    Objective: To probe imaging characteristics of the hepatic veno-occlusive disease (VOD) based on clinical features and abdomen CT findings. Methods: Fourteen patients including 6 male and 8 female aged from 41 to 73 years were enrolled in this study. They all had previous trauma history and notoginseng was given as herbal remedy. Dynamic enhanced CT and color Dopplor ultrasound examinations were routinely used. Two of them received venous angiography and four cases were pathologically proved as VOD after CT guided needle biopsy. Results: Hepatic swelling and ascites were found on plain CT scan. Diffuse patchy areas without enhancement indicative of poorly hepatic perfusion were found. Hepatic veins were compressed and became thin, and inferior vena cava was flat and narrow without distal dilation or collateral circulation. No obstruction of hepatic veins and inferior vena cava was found on ultrasound and venography. Conclusion: Dynamic enhanced CT is highly valuable for early assessing VOD and imaging features of venous hepatic congestion found on CT was strongly suggestive of VOD if there's previous history of treatment of gynura segetum. (authors)

  4. Inferior vena cava tumor thrombus after partial nephrectomy for renal cell carcinoma

    Akatsuka, Jun; Suzuki, Yasutomo; Hamasaki, Tsutomu; Shindo, Takao; Yanagi, Masato; Kimura, Go; Yamamoto, Yoichiro; Kondo, Yukihiro

    2014-01-01

    Background Partial nephrectomy is now the gold standard treatment for small renal tumors. Local recurrence is a major problem after partial nephrectomy, and local recurrence in the remnant kidney after partial nephrectomy is common. Case presentation A 77-year-old man underwent right partial nephrectomy for a T1 right renal cell carcinoma. Microscopic examination revealed a clear cell renal carcinoma, grade 2, stage pT3a. Although the surgical margin was negative, the carcinoma invaded the pe...

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

    Wenceslao M. Calonge, MD

    2015-02-01

    Full Text Available Summary: The upper limit of intra-abdominal pressure after closure of gastroschisis has been suggested around 20 mm Hg. An acute abdominal compartmental syndrome may produce intestinal ischemia with perforation and hepatic or renal failure. We present a case of a baby born with gastroschisis and ileal atresias 2 decades ago. The closure of the defect entailed a borderline abdominal compartmental syndrome with caval occlusion and development of collateral venous circulation. This was evidenced by a phlebographic study at the age of 8. At the age of 19, the patient continued to show a superficial, varicose net and some aesthetic concerns. This minor condition seems not previously reported. The authors intend to raise awareness about current methods for indirect assessment of intra-abdominal pressure when performing abdominal reconstruction for a gastroschisis defect.

  6. Failed Percutaneous Mitral Commisurotomy due to congenital anomaly of inferior vena cava

    Since its inception in 1982, percutaneous transvenous mitral commissurotomy (PTMC) has gained increasingly wide use internationally in patients with Rheumatic Mitral stenosis. PTMC offers an alternative to surgery in patients who have pliable mitral valve. Very few reasons were reported to abort the procedure when patient lies on the table. This study presents two case reports in which congenital venous anomalies were one of the reasons to terminate the procedure. (author)

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

    Pronio Annamaria

    2015-01-01

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

  8. Duodenal perforation by an inferior vena cava filter in a polyarteritis nodosa sufferer

    Anthony Dat

    2014-01-01

    CONCLUSION: Duodenal perforation is a rare complication of IVC filter insertion. This case however illustrates the potentially catastrophic consequences of a relatively common endovascular procedure. Caution should be taken when considering the insertion of IVC filters in patients with longstanding vasculopathies who are on immunosuppressants.

  9. Persistent Left Superior Vena Cava, The View of a Rare Case

    H.Volkan Kara

    2013-10-01

    Full Text Available The glenohumeral joint is the most commonly dislocated joint in the human body. Anterior dislocatin is the most common type and posterior dislocations account for <1% of shoulder dislocations.  A 68-yearold woman was brought to the emergency department by ambulance  with shoulder pain following a fall from stairs. On local physical examination, there was severe pain on the left proximal humerus. The left arm was in internal rotation in the adducted position. Active and passive movements of the left shoulder were painful and limited. The neurovascular examination of the left upper extremity revealed no deficit. Radiographs of her left shoulder were performed and no significant pathology was identified in the left shoulder anteroposterior (AP X-ray (Figure 1. Axillary radiography could not be performed because of painful arm movements. Therefore, CT was performed to clarify any existing shoulder pathology (Figure 2. Closed reduction under conscious sedation was performed with longitudinal and lateral traction on the arm to protect the humeral head. Control CT was performed and this revealed that reduction had improved the shoulder (Figure 3. She was then treated with an arm sling and discharged with an outpatient orthopaedic control visit.

  10. Persistent Left Superior Vena Cava, The View of a Rare Case

    H.Volkan Kara

    2013-01-01

    The glenohumeral joint is the most commonly dislocated joint in the human body. Anterior dislocatin is the most common type and posterior dislocations account for <1% of shoulder dislocations.  A 68-yearold woman was brought to the emergency department by ambulance  with shoulder pain following a fall from stairs. On local physical examination, there was severe pain on the left proximal humerus. The left arm was in internal rotation in the adducted position. Active and passive mo...

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

    Omer Dai; Harun Egemen Tolunay; Mehmet Murat Seval; Alper Kahraman; Korhan Kahraman; Acar Koç

    2014-01-01

    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 polyhydra...

  12. X-ray examination in diagnosis of hepatic segment deficiency of inferior cava

    Kiseleva, I.P.; Podzolkov, V.P.; Ivanitskij, A.V.; Mal' sagov, G.U. (Akademiya Meditsinskikh Nauk SSSR, Moscow. Inst. Serdechno-Sosudistoj Khirurgii; Tsentral' nyj Inst. Usovershenstvovaniya Vrachej, Moscow (USSR))

    Data on clinical and X-ray examination of 29 patients aged 2 weeks to 66 years with vena cava inferior hepatic segment deficiency are presented. The blood outflow from the lower part of the body was effected through the azygos vein in 17 patients, and through the hemiazygos one in 12 patients. The data obtained were in all cases correlated with the results of intracardiac research methods (the right and left heart cavities catherization and angiocardiography), with intraoperative and autopsy findings. An anomaly was found to prevail in patients (89.6%) with different types of abnormal heart position in the thoracic cavity. Along with examination of the cardiovascular system, the abdominal organs study was carried out: standard roentgenoscopy and radiography, both aiming to detect the liver position, gastrointestinal tract examination, and cholecystography.

  13. X-ray examination in diagnosis of hepatic segment deficiency of inferior cava

    Data on clinical and X-ray examination of 29 patients aged 2 weeks to 66 years with vena cava inferior hepatic segment deficiency are presented. The blood outflow from the lower part of the body was effected through the azygos vein in 17 patients, and through the hemiazygos one in 12 patients. The data obtained were in all cases correlated with the results of intracardiac research methods (the right and left heart cavities catherization and angiocardiography), with intraoperative and autopsy findings. An anomaly was found to prevail in patients (89.6%) with different types of abnormal heart position in the thoracic cavity. Along with examination of the cardiovascular system, the abdominal organs study was carried out: standard roentgenoscopy and radiography, both aiming to detect the liver position, gastrointestinal tract examination, and cholecystography

  14. Research progress in non-permanent vein cava filters

    Vein cava filter placement has already become one of the most effective measures for preventing pulmonary embolism which is usually secondary to deep vein thrombosis. With the development of research, non-permanent vein cava filter has been widely used. This paper aims to describe the recent progress in the research of non-permanent vein cava filters. (authors)

  15. Myocardial ischemia during intravenous DSA in patients with cardiac disease

    A prospective study was performed for 48 patients who had histories of angina and were referred for digital subtraction angiography (DSA). Cardiac disease was graded according to the American Heart Association (AHA) functional classification system. Each patient received 2-5 injections of 40-ml diatrizoate meglumine and diatrizoate sodium at 15 ml per second in the superior vena cava. Of the 28 patients in functional Classes I or II, 11% had angina and 32% had definite ischemic ECG changes after the DSA injections. Of the patients in functional Class III 63% had angina, and 58% had definite ischemic ECG changes after the injections. These observed cardiac effects following bolus injections of hypertonic ionic contrast media indicate that special precautions are necessary when performing intravenous DSA examinations on this group of high risk patients

  16. Toe Amputation After Minor Surgery in a Patient with Behçet's Disease: A Case Report.

    Özalp, Burhan; Akcay, Cemal; Aydinol, Mustafa; Selçuk, Caferi Tayyar

    2016-01-01

    Behçet's disease is a systemic autoimmune vasculitis. Although various clinical findings can be observed depending on the pathologic features caused by the blood vessels involved, the classic triad of the disease includes oral aphthae, genital ulcers, and uveitis. Although complications involving the aorta or the vena cava inferior can prove fatal, thrombophlebitis in the superficial veins of the lower extremities are more commonly observed. Some patients can remain asymptomatic for a long period after the diagnosis. In patients with positive pathergy test findings, trauma can trigger the inflammatory cascade. This case report presents a patient with vasculitis that occurred subsequent to minor surgery and led to amputation of the great toe in a female patient with a 14-year old history of Behçet's disease. PMID:26483163

  17. Estudo comparativo da biocompatibilidade da submucosa intestinal porcina e pericárdio bovino usados como enxertos na veia cava de cães Comparative study of the biocompatibility of the porcine intestinal submucosa and bovine pericardium used as grafts in the inferior cava vein of dogs

    Fernando Hintz Greca

    2005-08-01

    Full Text Available OBJETIVO: Comparar a biocompatibilidade entre submucosa de intestino delgado (SID porcino e o pericárdio bovino como enxerto no reparo de lesões criadas na veia cava inferior de cães. MÉTODOS: Dezesseis cães foram submetidos a laparotomia. Após a abertura da cavidade abdominal a veia cava foi identificada e em seguida procedeu-se com a retirada de um segmento elíptico de 1,5X3cm de sua parede anterior. Em 8 animais o defeito foi reparado com SID porcino (grupo A e nos 8 animais restantes o defeito foi reparado com pericárdio bovino (grupo B.No 30° dia de P.O. realizou-se uma ultra-sonografia e a eutanásia foi realizada no 40°dia de pós-operatório. RESULTADOS: Observou-se estenose da veia cava em 1 cão do grupo do grupo A e em 2 animais do grupo B além de trombose em 1 cão desse mesmo grupo. A análise microscópica revelou um processo inflamatório crônico moderado em ambos os grupos. A endotelização do enxerto, regeneração de fibras musculares lisas e depósito de colágeno também foi similar nos 2 grupos estudados. CONCLUSÃO: A SID provou ser um excelente substrato para a regeneração vascular quando implantado em veia cava superior, contudo os resultados encontrados não diferem daqueles observados com o uso de pericárdio bovino.PURPOSE: To compare the biocompatibility of the bovine pericardium and the small intestine submucosa (SIS when used to repair a created defect in the inferior vena cava of dogs. METHODS: Sixteen male mongrel dogs were submitted to a midline laparotomy incision. An elliptical segment (1,5 X 3,0 cm of the inferior vena cava, below the renal veins, was excised. In 8 dogs, the A group, a patch of porcine small bowel submucosa was used to repair the defect. In the 8 remaining dogs, the B group, a bovine pericardium was implanted in the vena cava. On the 30th post-operative day an ultrasound was performed in order to identify stenosis. The euthanasia was accomplished in the 40th post-operative day

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

    Feuerlein, Sebastian, E-mail: sfeuerlein@yahoo.com [Department of Diagnostic and Interventional Radiology, University of Ulm, Steinhoevelstrasse 9, 89075 Ulm (Germany); Stolz, Jochen [Department of Diagnostic and Interventional Radiology, University of Ulm, Steinhoevelstrasse 9, 89075 Ulm (Germany); Muche, Rainer [Institute of Biometry, University of Ulm (Germany); Hetzel, Martin [Dept. of Pulmonology, Red Cross Hospital Stuttgart (Germany); Klass, Oliver; Brambs, Hans-Juergen; Pauls, Sandra [Department of Diagnostic and Interventional Radiology, University of Ulm, Steinhoevelstrasse 9, 89075 Ulm (Germany)

    2011-08-15

    The purpose of this study was to investigate the potential correlation between the presence and size of the cisterna chyli (CC) on computed tomography (CT) and the presence of cardiovascular disease. Materials and methods: Out of a 3000-patient cohort 2599 patients who received a CT examination of the chest and/or abdomen with measurable inferior vena cava and azygos vein were included in this retrospective study. To assess the presence of cardiovascular disease the following parameters were recorded from the PACS or clinical information system: diameter of vena cava and azygos vein, presence of ascitis, serum creatinine, history of congestive heart failure, coronary artery disease or arterial hypertension and medication (diuretics, beta-blocker). In addition the volume of the CC and the presence or absence of malignant disease were recorded. Mean values (vessel diameters, creatinine) or percentages were calculated and compared for the groups with (n = 416) and without (n = 2183) a cisterna. Multivariate logistic regression analysis was performed for all parameters to identify the potential association with the presence and size of a cisterna. In addition the simultaneous influence of the parameter malignancy, cardiovascular disease and age on presence and size of the CC was analyzed in a logistic regression model. Results: The presence or absence of a CC was not associated with any of the measured parameter. Regarding the size of the CC, there was a positive correlation with the diameter of the azygos vein, the presence of ascitis and diuretic medication. The influences of malignancy, elevated central venous pressure and age on the development of a CC proved to be highly significant but could not be separated or quantified. Conclusion: The volume of the cisterna chyli is influenced by pathologic states with an increased central venous pressure, while the presence or absence of the cisterna seems to be independent of those factors.

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

    The purpose of this study was to investigate the potential correlation between the presence and size of the cisterna chyli (CC) on computed tomography (CT) and the presence of cardiovascular disease. Materials and methods: Out of a 3000-patient cohort 2599 patients who received a CT examination of the chest and/or abdomen with measurable inferior vena cava and azygos vein were included in this retrospective study. To assess the presence of cardiovascular disease the following parameters were recorded from the PACS or clinical information system: diameter of vena cava and azygos vein, presence of ascitis, serum creatinine, history of congestive heart failure, coronary artery disease or arterial hypertension and medication (diuretics, beta-blocker). In addition the volume of the CC and the presence or absence of malignant disease were recorded. Mean values (vessel diameters, creatinine) or percentages were calculated and compared for the groups with (n = 416) and without (n = 2183) a cisterna. Multivariate logistic regression analysis was performed for all parameters to identify the potential association with the presence and size of a cisterna. In addition the simultaneous influence of the parameter malignancy, cardiovascular disease and age on presence and size of the CC was analyzed in a logistic regression model. Results: The presence or absence of a CC was not associated with any of the measured parameter. Regarding the size of the CC, there was a positive correlation with the diameter of the azygos vein, the presence of ascitis and diuretic medication. The influences of malignancy, elevated central venous pressure and age on the development of a CC proved to be highly significant but could not be separated or quantified. Conclusion: The volume of the cisterna chyli is influenced by pathologic states with an increased central venous pressure, while the presence or absence of the cisterna seems to be independent of those factors.

  20. The preparation of biodegradable vena filter and the study of its properties

    Objective: To investigate the preparation of biodegradable vena cava filter (BVCF) with poly-l-lactic acid (PLLA), and to evaluate its mechanical properties, delivery performance, the ability of capturing thrombus and the degradation property. Methods: Three-dimensional design software was used to design the shape of BVCF. The BVCF was prepared by using PLLA with molecular weight of 100 000 unit. Twelve minipigs were used to test the feasibility of this BVCF. They were randomly divided into four groups. At first the BVCFs were placed into the inferior vena cava of pigs in three experimental groups. The fourth group was used as a blank control group. The thrombi were injected into all pigs after 1 week, and CT examinations were performed at different time points to observe the filter locations and pulmonary artery. The animals were sacrificed according to a fixed time table for histopathological assessment. Results: The BVCF was successfully designed and produced, which could expand by stretching the center-thread. In vitro test results showed the radial force of BVCF was approximately 1.6 N and could capture the thrombus more than 5 mm in diameter, and it was easy to release. Through the animal experiment confirmed that the filter could capture the lethal thrombus and all 9 pigs of experimental groups were survived, two of those had the symptoms of respiratory frequency and heartbeat accelerated slightly in the operation. In control group, the symptoms such as accelerate of respiratory rate, shortness of breath were observed in varying degree. The pig which was injected with 8 strips of thrombus died in the same day after surgery. Postoperative CT and pathological examinations showed that 2 pigs in the experimental group developed peripheral pulmonary embolism, while the dead pig in the control group developed central pulmonary embolism. Histological findings showed that the intima covered the BVCF lateral branch partly after one week,and thoroughly after six weeks

  1. Surgical treatment of unicentric plasma cell histological type Castleman's disease

    Marić Nebojša

    2011-01-01

    Full Text Available Introduction. Castleman’s disease or angiofollicular lymph hyperplasia is a rare disease with two identified clinical forms. Unicentric or localized form is characterized by isolated growth of lymph nodes, most often in mediastinum, and multicentric form is expressed as systemic disease with spread lymphadenopathy, organomegaly and presence of general symptoms of the disease. Histological types are hyalovascular, plasma-cell and transitive (mixed cell. Case report. This case report shows a woman, 59 years old, with unicentric form of plasma-cell type of Castleman’s disease. Unicentric form is usually shown as hyalovascular histological type, extremely rare as plasma-cell type, and transitive (mixed cell type was never described in literature as localized clinical form. The disease was manifested with chest pain, loss of body weight, exhaustion and weakness of legs. Further diagnostic procedures found the presence of enlarged lymph nodes paratracheally right, in a close contact with vena cava superior. The disease was confirmed by histopathological analysis of bioptated mediastinal lymph node after mediastinoscopy. Surgical treatment included extirpation of enlarged lymph nodes. After the regular postoperative condition, a full therapy effect was confirmed. Conclusion. Unicentric form of Castleman’s disease is expressed with enlarged lymph nodes on predilected places, usually in mediastinum. Surgical treatment is best method for the management of the disease and brings a full recovery of patient.

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

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

    2012-01-01

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

  3. The Castleman's Disease and Related Disorders - A Case Report.

    Khan, M K; Talukder, R H; Kamruzzaman, M

    2016-01-01

    Castleman's disease is a rare primary disease of the lymph nodes. Little is known about the management of the disease. Surgical treatment gives a very good result. What other modalities of treatment could be done is not yet established. The role of surgery gives good result and follow up evaluation is satisfactory. We found a solitary intra-abdominal mass of lymphoid hyperplasia with a histological diagnosis of Castlemans disease identified in the pathological data base. Unicentric disease was defined as it was a solitary mass. Clinical, Radiological and Laboratory data were analysed to evaluate treatment response. The patient also has related disorders as Acanthosis nigricans, Myoneuronal disorder as-MG and bronchiolitis. The patient diagnosed as angiofollicular hyperplasia (Castleman's disease). After evaluation patient under went surgical treatment, partial excision of tumor mass due to morbid adhesion with inferior vena cava. The patient becomes symptom free and lump disappears within 60 days of treatment. There was no recurrence of the disease after further evaluation. The author recommends that in Unicentric variant of Castlemans disease surgical resection of the tumor is curative. The unicentric tumour may be hyaline-vascular or hyaline-vascular/ plasma cell type. Partial resection, Radiotherapy or observation alone may avoid excessive aggressive therapy. PMID:26931270

  4. Anemia of Chronic Liver Diseases

    The pathogenetic mechanisms of anemia in patients with chronic liver disease were observed. Seventeen patients with moderate to advanced hepatic diseases were studied by various methods. Only patients without previous blood loss were included : 14 had cirrhosis, 2 had active chronic hepatitis, and one had inferior vena cava obstruction with associated liver cirrhosis. The followings were the results: 1. The anemia based on red blood cell count, Hb., and Ht. was found in 76.5-78.6% of the patients. 2. Red cell indices indicated that normo-macrocytic and normochromic anemia was present is the majority of the patients. 3. No evidence of megaloblastic anemia was found on the basis of the morphological examinations. 4. Serum iron, TIBC, % saturation and iron content in the bone marrow indicated that iron deficiency anemia was present in about half of the patients. 5. In the view of the erythrocyte dynamics, primary increase in the red cell destruction was ascribed to the cause of the anemia. 6. Decrease in the red cell survival time was not correlated with MCV, % saturation and S.L. ratio. Also, hemoglobin level was not correlated with MCV, % saturation and T50 Cr. Therefore, multiple causes may be involved in the pathogenesis of the anemia. 7. Anemia as determined by the red cell volume was found in only 60% of the patients. It may be possible that hemodilutional anemia is present.

  5. Radiodiagnostic methods in determining the structure of tumor thrombus in the inferior vena cava in kidney cancer

    N. B. Vikhrova

    2015-01-01

    Full Text Available Renal cell carcinoma (RCC is the most common primary tumor of the renal parenchyma. Venous involvement is one of the most important anatomic characteristics of tumor. It is known that venous spread influences the survival of patients with RCC. Tumor thrombosis of IVC in patients with renal cell carcinoma has been reported in 4–10 %. The reference standard for RCC with tumor thrombus remains surgical resection. The structure of thrombus determines some technical difficulties in the management of tumor. Spongeous thrombus correlate with higher risk of thrombus detachment during surgery resulting in PE. Therefore determination of IVC thrombus consistency is very important part of preoperative radiologic assessment of tumor in patients with RCC.

  6. Pusher curving technique for preventing tilt of femoral Geunther Tulip inferior vena cava filter: in vitro study

    Objective: To determine whether the adjustment of the pusher of GTF was useful to decrease the degree of tilting of the femoral Geunther Tulip filter (GTF) in an in vitro caval model. Methods: The caval model was constructed by placement of a 25 mm × 100 mm and two 10 mm × 200 mm Dacron graft inside a transparent bifurcate glass tube. The study consisted of two groups: left straight group (GLS) (n = 100) and left curved group (GLC) (n=100). In the GLC, a 10° to 20° angle was curved on the introducer. The distance (DCH) between the caval right wall and the hook was measured. The degree of tilting (DT) was classified into 5 grades and recorded. Before and after the GTF being released, the angle (ACM1,2) between the axis of IVC and the metal mount, the distance (DCM1) between the caval right wall and the metal mount, the angle (ACF) between the axis of IVC and the axis of the filter and the diameter of IVC (DIVC) were measured. The data were analyzed with Chi-Square test, t test, rank sum. test and Pearson correlation test. Results: The degree of GTF tilting in each group revealed a divergent tendency. In group LC, the apex of the filter tended to be grade Ⅲ compared in group LS (χ2 value 37.491, PLS and GLC were considered as statistical significance (16.60° vs. 3.05°, 20.60° vs. 3.50°, -3.90° vs. -0.40°, 2.98 mm vs. 10.40 mm, -10.95° vs. -0.485°, 13.17 mm vs. 10.06 mm, -1.70° vs. 0.70°, t or Z values -12.187, -12.188, -8.545, -51.834, -11.395, 9.562, -3.596, PCM1 and ACF, ACM1 - ACM2 and DCH1 - DCH2 in each group, respectively (r values 0.978, 0.344, 0.879, 0.627, PCH1 and ACF in each group, ACP and ACF in group LC (r values -0.974, -0.322, -0.702, PCM1 and ACF, ACM1 - ACM2 and DCH1 - DCH2 in each group, respectively (r values 0.978, 0.344, 0.879, 0.627, PCH1 and ACF in each group, ACP and ACF in group LC (r values -0.974, -0.322, -0.702, P<0.01). Conclusion: The technique of adjusting the orientation of filter pusher had minimized the incidence and extent of GTF filter tilting in vitro. (authors)

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

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

    2011-01-01

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

  8. Fibrosing mediastinitis with superior vena cava obstruction as the initial presentation of Langerhans' cell histiocytosis in a young child

    We present a 2-year-old girl with an unusual presentation of Langerhans' cell histiocytosis (LCH). Five months prior to admission to our hospital, she received IV steroids for bronchial obstruction. On admission, clinical signs of SVC obstruction were evident and a mediastinal mass was evident on the chest radiograph and MRI. Biopsy revealed fibrosing mediastinitis. Five months later, osteolysis was present on a skull radiograph. Surgical biopsy of the skull lesion revealed LCH. This case is unique because it demonstrates a rare initial manifestation of LCH that has not been previously reported. Furthermore, the primary, solitary mediastinal manifestation without calcifications was histologically interpreted as fibrosing mediastinitis, and the final diagnosis of LCH was only made after identifying the skull lesion. (orig.)

  9. Intracardiac Thrombosis in Sickle Cell Disease.

    Nikparvar, Marzieh; Evazi, Mohammad Reza; Eftekhari, Tasnim; Moosavi, Farzaneh

    2016-03-01

    In patients with sickle cell disease, thrombotic microangiopathy is a rare complication. Also in sickle cell disease, intracardiac thrombus formation without structural heart diseases or atrial arrhythmias is a rare phenomenon. We herein describe a 22-year-old woman, who was a known case of sickle cell-βthalassemia, had a history of recent missed abortion, and was admitted with a vaso-occlusive crisis. The patient had manifestations of microangiopathic hemolytic anemia, including laboratory evidence of hemolytic anemia, thrombocytopenia, respiratory distress, fever, jaundice, and abnormal liver function and coagulation tests, accompanied by clot formation on the Eustachian valve of the inferior vena cava in the right atrium and also a long and worm-like thrombus in the right ventricle. Therapeutic plasma exchange improved her clinical condition, and her intracardiac thrombus was completely resolved after 1 week. Echocardiography, as a simple and inexpensive imaging modality, had a significant role in the diagnosis and follow-up of this patient. PMID:26989287

  10. Intracardiac Thrombosis in Sickle Cell Disease

    Marzieh Nikparvar

    2016-03-01

    Full Text Available In patients with sickle cell disease, thrombotic microangiopathy is a rare complication. Also in sickle cell disease, intracardiac thrombus formation without structural heart diseases or atrial arrhythmias is a rare phenomenon. We herein describe a 22-year-old woman, who was a known case of sickle cell-βthalassemia, had a history of recent missed abortion, and was admitted with a vaso-occlusive crisis. The patient had manifestations of microangiopathic hemolytic anemia, including laboratory evidence of hemolytic anemia, thrombocytopenia, respiratory distress, fever, jaundice, and abnormal liver function and coagulation tests, accompanied by clot formation on the Eustachian valve of the inferior vena cava in the right atrium and also a long and worm-like thrombus in the right ventricle. Therapeutic plasma exchange improved her clinical condition, and her intracardiac thrombus was completely resolved after 1 week. Echocardiography, as a simple and inexpensive imaging modality, had a significant role in the diagnosis and follow-up of this patient.

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

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

    2010-01-01

    inherited FVII deficiency and chronic vena porta thrombosis. She presented at 32 weeks of gestation with spontaneously increased international normalized ratio, severe thrombocytopenia and very few unspecific symptoms. The extensive examination of the patient revealed cavernous transformation of the portal...

  12. Analysing Temporally Annotated Corpora with CAVaT

    Derczynski, Leon

    2012-01-01

    We present CAVaT, a tool that performs Corpus Analysis and Validation for TimeML. CAVaT is an open source, modular checking utility for statistical analysis of features specific to temporally-annotated natural language corpora. It provides reporting, highlights salient links between a variety of general and time-specific linguistic features, and also validates a temporal annotation to ensure that it is logically consistent and sufficiently annotated. Uniquely, CAVaT provides analysis specific to TimeML-annotated temporal information. TimeML is a standard for annotating temporal information in natural language text. In this paper, we present the reporting part of CAVaT, and then its error-checking ability, including the workings of several novel TimeML document verification methods. This is followed by the execution of some example tasks using the tool to show relations between times, events, signals and links. We also demonstrate inconsistencies in a TimeML corpus (TimeBank) that have been detected with CAVaT...

  13. Superior vena caval obstruction - decompression with chemotherapy and subsequent irradiation

    The clinical picture, pathogenesis and etiology of malignant vena caval obstruction are described. The importance of using modern methods to treat this critical condition is emphasized. Furthermore, the authors examine the principles of chemotherapeutic decompression followed by irradiation. A single dose of nitrogen mustard was applied intravenously, followed by irradiation, on 24 patients with malignant vena caval obstruction. The results of this treatment are presented. The effect of this treatment was controlled by measuring the venous blood pressure and with chest X-rays. The authors conclude, that this method of decompression is successful in the palliative treatment of this syndrom. (orig.)

  14. Leiomiossarcoma da veia cava inferior: relato de caso

    Rafael Lemos Nascif

    2014-12-01

    Full Text Available Relatamos um caso de paciente do sexo feminino, 48 anos, com quadro clínico de dor abdominal de moderada intensidade e abaulamento do abdome. Ao exame físico constatou-se massa abdominal palpável. A tomografia computadorizada mostrou volumosa massa retroperitoneal, com realce heterogêneo e íntima relação com a veia cava inferior. Realizou-se ressecção em bloco da massa e do segmento invadido da veia cava. A histologia revelou leiomiossarcoma.

  15. [Cardiovascular involvement in Behçet's disease].

    Desbois, A-C; Wechsler, B; Cluzel, P; Helft, G; Boutin, D; Piette, J-C; Cacoub, P; Saadoun, D

    2014-02-01

    Vascular involvement is a common complication of Behçet's disease (BD) and affects up to 40% of BD patients. These complications worsen the prognosis of BD. The concept of vasculo-Behçet has been adopted for cases in which vascular complications dominate the clinical features. Vascular manifestations affect particularly young men, during the first years following onset of the disease. Venous complications are the most frequent vascular complications, affecting 14 to 40% of BD patients. Superficial and deep lower limb thrombosis is the most frequent venous complications but one third of venous thrombosis concern large vessels (such as cerebral venous thrombosis, pulmonary embolism, and inferior or superior vena cava, etc.). Budd-Chiari syndrome is the worst prognostic factor increasing mortality by 9 times. Arterial complications (2 to 17% of BD patients) include aneurysms and occlusions/stenosis. Main locations of arterial lesions are aortic (abdominal and thoracic), femoral, pulmonary and iliac arteries. Aneurysms are the most severe arterial complications, particularly pulmonary aneurysms associated with a high risk of massive bleeding. Cardiac complications (up to 6% of BD patients) include pericarditis, endocardial lesions (aortic regurgitation and less often mitral insufficiency), myocardial lesions (myocardial infarction, myocarditis and endomyocardial fibrosis) and intracardiac thrombosis (right ventricle and atrium). Coronary lesions complicated to myocardial infarction are the most severe cardiac complications. Treatment is based on corticosteroids and immunosuppressive drugs. The use of anticoagulation in venous thrombosis is still controversial. PMID:24434015

  16. Caudal vena caval thrombosis following treatment of deep digital sepsis

    Simpson, Katharine M.; Streeter, Robert N.; Cramer, Sarah; Lamm, Catherine G.; Love, Brenda C.

    2012-01-01

    A diagnosis of caudal vena caval thrombosis was made by ultrasonography of a Holstein cow presented for lethargy and poor milk production. Medical treatment was unsuccessful and the cow was euthanized. The diagnosis was confirmed at necropsy and Fusobacterium necrophorum was isolated from the thrombus. This paper discusses potential novel sources of caval thrombosis in this case.

  17. Embolization of Collateral Vessels Using Mechanically Detachable Coils in Young Children with Congenital Heart Disease

    Our objective was to evaluate the usefulness of embolizing collateral vessels using mechanically detachable coils (MDCs) in children aged 3 years or younger with congenital heart disease. The subjects were 8 children with congenital heart disease featuring collateral vessels (age 18 days-3 years): 3 with a single ventricle, 2 with the tetralogy of Fallot, 2 with pulmonary atresia, and 1 with a ventricular septal defect. The embolized vessels were the major aortopulmonary collateral artery (MAPCA) in 5 patients, the persistent left superior vena cava in 2, and the coronary arteriovenous fistula in 1. A 4 or a 5 F catheter was used as the guiding device, and embolization was performed using MDCs and other conventional coils introduced through the microcatheter. One patient had growth of new MAPCAs after embolization, and these MAPCAs were also embolized with MDCs. Thus, a total of 9 embolization procedures were performed in 8 patients. Complete occlusion of the collateral vessels was achieved in 8 of 9 procedures (89%). Seven of 8 patients (88%) had uneventful courses after embolization, and MDC procedures appeared to play important roles in avoiding coil migration and achievement of safe coil embolization. One patient who underwent MAPCA embolization showed no improvement in heart function and died 2 months and 19 days later. Embolization of collateral vessels using MDCs in young children with congenital heart disease can be an effective procedure and a valuable adjunct to surgical management

  18. Successful management of acute thromboembolic disease complicated with heparin induced thrombocytopenia type II (HIT II: a case series

    Trellopoulos George

    2008-07-01

    Full Text Available Abstract Heparin-induced thrombocytopenia type II (HIT II is a rare immune-mediated complication of heparin. The diagnosis of HIT is considered in patients exposed to heparin, presenting with thrombocytopenia and thrombosis. We present two cases with massive pulmonary embolism and HIT, successfully treated with the administration of fondaparinux, an alternative anticoagulant, combined with the insertion of an inferior vena cava filter for the prevention of new thromboembolic events. The two cases supplement the available data of the use of fondaparinux in patients with HIT and pulmonary embolism, before further large studies establish its efficacy and safety in this group of patients. Moreover, the management of these patients reveals the need for future evaluation of the combined therapy of alternative anticoagulant agents with the placement of vena cava filters.

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

    Zenichi Morise

    2013-01-01

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

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

    Keeling, A N

    2008-08-01

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

  1. Quantitative measurement of hemodynamics of inferior vena in healthy volunteers with phase-contrast MR imaging at 3.0 T

    Objective: To explore the feasibility of quantitative hemodynamics measurement of inferior vena cava (IVC) in healthy volunteers with phase-contrast sequence on 3.0 T MR system (3.0 T PC-MRI), and to evaluate the relationship between IVC lumen area, blood flow, and velocity. Methods: Fifty healthy adult volunteers prospective underwent IVC PC-MRI at 3.0 T MR system. All volunteers were from our hospital for the routine chest or abdomen examinations, no heart disease and lung disease always, heart rate, blood pressure, electrocardiogram was in normal range, no abnormalities were found in clinical and abdominal imaging examinations, and IVC disease was excluded by ultrasonic examination. The area (A), mean velocity (MV), mean flux (MF), regurgitant fraction (RF) and time-flow curve of upper and middle segments of IVC during one cardiac cycle were observed. Independent samples t test was used to compare IVC lumen area and blood flow, velocity between different genders, different age groups (18 to 30 years old group, more than 30 years old group) and different phase velocity encoding value of IVC middle segment, one-way ANOVA was used to compare different phase velocity encoding value of IVC upper segment [(60, 80, 100)cm/s]. Pearson correlation coefficient and regression equation were used to evaluate the relationships between area, blood flow, and velocity. Results: Among 50 patients with successful completion of the examination, significant difference was found in A, MV, MF and RF between the different IVC segments. MF of the IVC middle segment were (37.94 ± 7.32) and (33.68 ± 6.65) ml/s in male (n=24) and female (n=26), respectively; significant difference was found in different genders (t=2.49, P=0.017). MF of upper segment and middle segments of IVC were (54.89 ± 10.98) and (38.29 ± 7.54) ml/s in 18 to 30 years old group (n=27), while MF of upper segment and the middle of IVC were (44.96 ± 8.49) and (32.65 ± 5.59) ml/s in older than 30 years old group (n=23

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

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

  3. Clinical experience with the percutaneously inserted Amplatz vena caval filter

    The Amplatz filter is a 14-F vena caval filter designed for percutaneous insertion and retrieval. Thirty filters were inserted. The indications for placement were anticoagulant failure (four cases) and contraindication to anticoagulation (26 cases). Radiologic, pathologic, or clinical follow-up (average, 10 months) was available in 27 patients. Results include one case of recurrent pulmonary embolism (4%), nine cases of caval thrombosis (33%), and two cases of deep venous thrombosis in the insertion leg (7%). Filter migration did not occur in any case. The Amplatz filter is easily inserted and well tolerated by the patient. Although effective in preventing recurrent pulmonary embolism, it has a relatively high incidence of caval thrombosis

  4. Estudi i millora d'una planta productora de cava

    Boza Macías, Marta

    2008-01-01

    El present projecte té com a objectiu principal l’automatització d’una part del procés productiu del cava. Concretament, la millora que es desitja realitzar consisteix en la instal·lació d’un autòmat programable que controli l’emplenat i buidat dels dipòsits d’emmagatzematge. Aquest control es realitzarà utilitzant sensors capacitius, encarregats de controlar els nivells, tant alt com baix, dels citats dipòsits. A part de controlar en tot moment l’estat en que es troben les ...

  5. Diagnostic imaging of venous disease. Pt. I. Methods in the diagnosis of veins and thrombosis; Bildgebende Diagnostik von Erkrankungen der Venen. T. 1. Methoden der Venendiagnostik und Diagnostik der Thrombose

    Krueger, K. [Vivantes Humboldt-Klinikum, Institut fuer Radiologie und Interventionelle Therapie, Berlin (Germany); Wildberger, J. [Helios Klinikum Berlin-Buch, Institut fuer Roentgendiagnostik, Berlin (Germany); Haage, P. [Helios Klinikum Wuppertal, Klinik fuer Diagnostische und Interventionelle Radiologie, Wuppertal (Germany); Landwehr, P. [Diakoniekrankenhaus Henriettenstiftung, Klinik fuer Diagnostische und Interventionelle Radiologie, Hannover (Germany)

    2008-10-15

    Diseases of the venous system are common. A variety of diagnostic imaging methods are available. Of these, ultrasound with color-coded duplex sonography is the preferred method in the diagnosis of vein diseases, especially in patients with suspected deep venous thrombosis (DVT) and varicosis. Compression sonography is a very accurate test in the diagnosis of DVT of the lower and upper extremities in symptomatic patients. Still today, phlebography is an important tool in the diagnosis of venous diseases. Computed tomography (CT) plays an important role in disorders of the superior and inferior vena cava and of the iliac vein. Today, the role of MR venography in vein diseases is limited. (orig.) [German] Erkrankungen des Venensystems betreffen grosse Teile der Bevoelkerung. Verschiedene bildgebende Verfahren stehen in der Diagnostik zur Verfuegung. Unter diesen ist die Sonographie, ergaenzt durch die farbkodierte Duplexsonographie, die Methode der Wahl. Dies gilt insbesondere fuer die haeufigsten Venenerkrankungen: die Phlebothrombose und die Varicosis. Die Kompressionssonographie weist bei symptomatischen Patienten eine hohe Sensitivitaet und Spezifitaet in der Diagnostik der Thrombose der tiefen Venen der oberen und unteren Extremitaet auf. Die Phlebographie stellt trotz der Bedeutung der Sonographie auch zum gegenwaertigen Zeitpunkt noch eine wichtige Methode in der Diagnostik von Venenerkrankungen dar. Die Computertomographie wird ueberwiegend fuer die Diagnostik der Koerperstammvenen eingesetzt. Die MR-Phlebographie hat bislang keinen breiten Einsatz in der Routinediagnostik der Venen finden koennen. (orig.)

  6. Abernethy malformation with multiple aneurysms: incidentally found in an adult woman with Caroli's disease.

    Kong, Yalin; Zhang, Hongyi; Liu, Chengli; Wu, Di; He, Xiaojun; Xiao, Mei; Zhao, Gang; Zhang, Hui

    2013-01-01

    Abernethy malformation is a rare anomaly with partial or complete congenital absence of the portal vein and subsequent development of extrahepatic portocaval shunts. We present the case of a 28-year-old woman who was incidentally diagnosed with type II Abernethy malformation and multiple aneurysms during an investigation for nonspecific abdominal pain and fever. The patient had been diagnosed with Caroli's disease at the age of 10 and liver cirrhosis, portal hypertension a few years before. To the best of our knowledge, this is the first case reported with all such congenital anomalies associated together. Ultrasound, computed tomography, including three-dimensional reconstruction, and magnetic resonance imaging were performed which revealed a side-to-side shunt between the extrahepatic portal vein and the inferior vena cava, multiple aneurismal cystic dilation of the spleen artery and left renal artery, and extensive intrahepatic bile duct cysitic dilation with calculus formation. Etiology, clinical significance and management strategies with regard to these abnormalities are discussed. PMID:23396746

  7. Comparison of tricuspid inflow and superior vena caval Doppler velocities in acute simulated hypovolemia: new non-invasive indices for evaluating right ventricular preload

    Duan Yun-You

    2006-05-01

    Full Text Available Abstract Background Assessment of cardiac preload is important for clinical management of some emergencies related to hypovolemia. Effects of acute simulated hypovolemia on Doppler blood flow velocity indices of tricuspid valve (TV and superior vena cava (SVC were investigated in order to find sensitive Doppler indices for predicting right ventricular preload. Methods Doppler flow patterns of SVC and TV in 12 healthy young men were examined by transthoracic echocardiography (TTE during graded lower body negative pressure (LBNP of up to -60 mm Hg which simulated acute hypovolemia. Peak velocities of all waves and their related ratios (SVC S/D and tricuspid E/A were measured, calculated and statistically analyzed. Results Except for the velocity of tricuspid A wave, velocities of all waves and their related ratios declined during volume decentralization. Of all indices measured, the peak velocities of S wave and AR wave in SVC correlated most strongly with levels of LBNP (r = -0.744 and -0.771, p Conclusion The S and AR velocities are of good values in assessing right ventricular preload. Monitoring SVC flow may provide a relatively noninvasive means to assess direct changes in right ventricular preload.

  8. Color flow imaging of the vena contracta in mitral regurgitation: technical considerations.

    Roberts, Brad J; Grayburn, Paul A

    2003-09-01

    Qualitative grading of mitral regurgitation severity has significant pitfalls secondary to hemodynamic variables, sonographic technique, blood pool entrainment, and the Coanda effect. Volumetric and proximal isovelocity surface area methods can be used to quantitate regurgitant orifice area, regurgitant volume, and regurgitant fraction, but have several limitations and can pose technical challenges. The vena contracta width method provides a rapid and accurate quantitative assessment of mitral regurgitation severity, but is clinically underused. This article is intended to generate an understanding of the flow mechanics of the vena contracta and the sonographic technique required to provide consistent and accurate measurements of vena contracta width in patients with mitral regurgitation. PMID:12931115

  9. The Role of Nasopharyngeal Temperature Monitoring in Detection of a Malpositioned Superior Vena Cava Cannula in an Emergency Coronary Artery Bypass in a Patient With Ventricular Septal Defect

    Dabbagh, A; M Shahzamani; M Foroughi; K Ghods; M Ghomeisi; Rahimian, H.

    2010-01-01

    A 55 year-old woman was admitted to the CCU ward of our university hospital due to typical chest pain. The patient received supportive care and was transferred to the operating room for an emergency repair of the ventricular septal defect (VSD) and myocardial revascularization. The surgical team was notified regarding the tolerance to cooling detected by the temperature monitoring and also, the congestion of eye and blanching of forehead. After a few maneuvers, the cannula was repositioned. I...

  10. The Role of Nasopharyngeal Temperature Monitoring in Detection of a Malpositioned Superior Vena Cava Cannula in an Emergency Coronary Artery Bypass in a Patient With Ventricular Septal Defect

    A Dabbagh

    2010-03-01

    Full Text Available A 55 year-old woman was admitted to the CCU ward of our university hospital due to typical chest pain. The patient received supportive care and was transferred to the operating room for an emergency repair of the ventricular septal defect (VSD and myocardial revascularization. The surgical team was notified regarding the tolerance to cooling detected by the temperature monitoring and also, the congestion of eye and blanching of forehead. After a few maneuvers, the cannula was repositioned. In a few seconds, the forehead was cooled, while the airlocking episodes were lifted completely and the blanching and chemosis in the face and eyes all resolved. The septal defect was approached through the left ventricle; a 15 in 20 mm foramen, due to the ischemic rupture of the superior portion of the anteroseptal wall, was repaired with a patch of hemoshield. The incision over the LV was then repaired with 2 parallel bands of felt. The patient was operated on and transferred to the intensive care unit.

  11. Fibrosing mediastinitis with superior vena cava obstruction as the initial presentation of Langerhans' cell histiocytosis in a young child

    Trusen, Andreas; Beissert, Matthias; Darge, Kassa [Department of Paediatric Radiology, Institute of Radiodiagnostics, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg (Germany); Hebestreit, Helge [University Children' s Hospital, University of Wuerzburg, Wuerzburg (Germany); Marx, Alexander [Institute of Pathology, University of Wuerzburg, Wuerzburg (Germany)

    2003-07-01

    We present a 2-year-old girl with an unusual presentation of Langerhans' cell histiocytosis (LCH). Five months prior to admission to our hospital, she received IV steroids for bronchial obstruction. On admission, clinical signs of SVC obstruction were evident and a mediastinal mass was evident on the chest radiograph and MRI. Biopsy revealed fibrosing mediastinitis. Five months later, osteolysis was present on a skull radiograph. Surgical biopsy of the skull lesion revealed LCH. This case is unique because it demonstrates a rare initial manifestation of LCH that has not been previously reported. Furthermore, the primary, solitary mediastinal manifestation without calcifications was histologically interpreted as fibrosing mediastinitis, and the final diagnosis of LCH was only made after identifying the skull lesion. (orig.)

  12. Ormond's disease or secondary retroperitoneal fibrosis? An overview of retroperitoneal fibrosis

    Retroperitoneal fibrosis represents a rare inflammatory disease. About two thirds of all cases seem to be idiopathic (= Ormond's disease). The remaining one third is secondary and may be ascribed to infections, trauma, radiation therapy, malignant diseases, and the use of certain drugs. Up to 15 % of patients have additional fibrotic processes outside the retroperitoneum. The clinical symptoms of retroperitoneal fibrosis are non-specific. In sonography retroperitoneal fibrosis appears as a retroperitoneal hypoechoic mass which can involve the ureters and thus cause hydronephrosis. Intravenous urography and MR urography can demonstrate the typical triad of medial deviation and extrinsic compression of the ureters and hydronephrosis. CT and MRI are the modalities of choice for the diagnosis and follow-up of this disease. The lesion typically begins at the level of the fourth or fifth lumbar vertebra and appears as a plaque, encasing the aorta and the inferior vena cava and often enveloping and medially displacing the ureters. In unenhanced CT, retroperitoneal fibrosis appears as a mass that is isodense with muscle. When using MRI, the mass is hypointense in T1-weighted images and of variable intensity in T2-weighted images according to its stage: it may be hyperintense in early stages, while the tissue may have a low signal in late stages. After the administration of contrast media, enhancement is greatest in the early inflammatory phase and minimal in the late fibrotic phase. Dynamic gadolinium enhancement can be useful for assessing disease activity, monitoring response to treatment, and detecting relapse. To differentiate retroperitoneal masses, diffusion-weighted MRI may provide useful information. (orig.)

  13. Ormond's disease or secondary retroperitoneal fibrosis? An overview of retroperitoneal fibrosis

    Heckmann, M.; Uder, M.; Kuefner, M.A.; Heinrich, M.C. [Universitaetsklinikum Erlangen (Germany). Radiologisches Inst.

    2009-04-15

    Retroperitoneal fibrosis represents a rare inflammatory disease. About two thirds of all cases seem to be idiopathic (= Ormond's disease). The remaining one third is secondary and may be ascribed to infections, trauma, radiation therapy, malignant diseases, and the use of certain drugs. Up to 15 % of patients have additional fibrotic processes outside the retroperitoneum. The clinical symptoms of retroperitoneal fibrosis are non-specific. In sonography retroperitoneal fibrosis appears as a retroperitoneal hypoechoic mass which can involve the ureters and thus cause hydronephrosis. Intravenous urography and MR urography can demonstrate the typical triad of medial deviation and extrinsic compression of the ureters and hydronephrosis. CT and MRI are the modalities of choice for the diagnosis and follow-up of this disease. The lesion typically begins at the level of the fourth or fifth lumbar vertebra and appears as a plaque, encasing the aorta and the inferior vena cava and often enveloping and medially displacing the ureters. In unenhanced CT, retroperitoneal fibrosis appears as a mass that is isodense with muscle. When using MRI, the mass is hypointense in T1-weighted images and of variable intensity in T2-weighted images according to its stage: it may be hyperintense in early stages, while the tissue may have a low signal in late stages. After the administration of contrast media, enhancement is greatest in the early inflammatory phase and minimal in the late fibrotic phase. Dynamic gadolinium enhancement can be useful for assessing disease activity, monitoring response to treatment, and detecting relapse. To differentiate retroperitoneal masses, diffusion-weighted MRI may provide useful information. (orig.)

  14. Tissue plasminogen activator in the treatment of superior vena caval thrombosis associated with parenteral nutrition.

    Barclay, G R; Allen, K.; Pennington, C R

    1990-01-01

    Two patients, one of whom was pregnant, developed superior vena caval thrombosis while receiving central parenteral nutrition. They were successfully treated with recombinant tissue plasminogen activator (t-PA).

  15. The Comparison of Pulse Oximetry and Cardiac Catheterization in Managing the Treatment of Children with Congenital Heart Disease

    R Abbasi

    2015-03-01

    Full Text Available Bachground & aim: Pulse oximetry and cardiac catheterization are concerned in the treatment of children with congenital heart disease. Diagnosis of arterial oxygen saturation in patients with congenital heart disease (CHD can be used to assess and manage their effecacy. The purpose of this study was to compare pulse oximetry and cardiac catheterizations in treatment manage of children with congenital heart disease. Methods: In the present cross sectional study, 110 patients with cyanic and non syani heart disease were studied undergoing right and left heart catheterization by pulse oximetry of index finger and simultaneously, oxygen saturation was measured by cardiac catheterization. Data were analyzed with SPSS software by using Pearson correlation and linear regression. Results: A significant correlation was seen between arterial oxygen saturation measured by pulse oximetry and arterial oxygen saturation (p<0.0001 as well as heart rate, electrocardiogram and pulse oximetry (p<0.0001 respectively. Furthermore, the presence of cyanosis (p=0.001, digital clubbing of the fingers ((p=0.001, low oxygen saturation in the superior vena cava and right atrium (p=0.002 can reduce the accuracy of pulse oximetry for detection of arterial oxygen saturation. The mean right atrial pressure can effect on accuracy of pulse oximetry to detect heartbeat (p=0.034. Maximum sensitivity and specificity for detection of pulse oximetry oxygen saturation was 88 % and 88 heart rate per minute. Conclusion: Pulse oximetric is a useful tool for estimating the arterial oxygen saturation and heart rate in children with congenital heart disease (CHD and is a non-invasive method in comparison with cardiac catheterization. Key words: Pulse oximeter, Congenital Heart Disease, Cardiac Catheterization

  16. Diagnostic Validity of RI Angiocardiography in Cardiac Diseases

    Kim, Kwan Yop; Koh, Chang Soon; Lee, Mun Ho [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1972-09-15

    The employment of gamma-ray scintillation camera with the use of short-lived radioisotopic pharmaceuticals, such as {sup 99m}Tc sodium pertechnetate, have enabled us to perform RI (radioisotopic) angiocardiography. Although conventional cardiac catheterization or angiocardiography using contrast media have been an important diagnostic tool, they may carry some risks or serious complications. The author investigated on RI angiocardiography in twelve normal and twenty five patients with cardiovascular diseases in an effort to evaluate its diagnostic value. The results obtained with this study are as follows; l. In normal subjects, the scintillation camera transit time of arm-to-right heart was found to be 2.1+-0.67 seconds, right heart-to-lung 1.5+-0.40 seconds and lung-to-left heart 3.5+-0.86 seconds. 2. Transformation or displacement of the heart and the great vessel are easily discriminated by RI angiocardiography. Both in the cases with tricuspid atresia and tetralogy of Fallot, ventricular septal defects are well recognized by sequential RI angiocardiography. 3. It is also helpful in determining the site and extent of obstruction, and estimating the postoperative course both in the cases with superior vena cava syndrome and pulmonary stenosis. 4. Pericarditis with effusion is readily diagnosed by RI angiocardiogram showing characteristic 'dead space' between intracardiac and intrapulmonary radioactivity. 5. It was found that the diagnostic accuracy of this study was 78.4%. It is concluded that above results obtained are useful and accurate enough for the diagnostic screening method for clinical practice.

  17. Diagnostic Validity of RI Angiocardiography in Cardiac Diseases

    The employment of gamma-ray scintillation camera with the use of short-lived radioisotopic pharmaceuticals, such as 99mTc sodium pertechnetate, have enabled us to perform RI (radioisotopic) angiocardiography. Although conventional cardiac catheterization or angiocardiography using contrast media have been an important diagnostic tool, they may carry some risks or serious complications. The author investigated on RI angiocardiography in twelve normal and twenty five patients with cardiovascular diseases in an effort to evaluate its diagnostic value. The results obtained with this study are as follows; l. In normal subjects, the scintillation camera transit time of arm-to-right heart was found to be 2.1±0.67 seconds, right heart-to-lung 1.5±0.40 seconds and lung-to-left heart 3.5±0.86 seconds. 2. Transformation or displacement of the heart and the great vessel are easily discriminated by RI angiocardiography. Both in the cases with tricuspid atresia and tetralogy of Fallot, ventricular septal defects are well recognized by sequential RI angiocardiography. 3. It is also helpful in determining the site and extent of obstruction, and estimating the postoperative course both in the cases with superior vena cava syndrome and pulmonary stenosis. 4. Pericarditis with effusion is readily diagnosed by RI angiocardiogram showing characteristic 'dead space' between intracardiac and intrapulmonary radioactivity. 5. It was found that the diagnostic accuracy of this study was 78.4%. It is concluded that above results obtained are useful and accurate enough for the diagnostic screening method for clinical practice.

  18. Sol İnferior Vena Kava'ya Eşlik Eden Nutcracker Fenomeni

    Şerife ULUSAN; KOÇ, Zafer

    2007-01-01

    Sol inferior kava, inferior vena kavanın sol renal veni verirken veya daha distal düzeyde sağdan, sol tarafa geçmesiyle karakterize konjenital vasküler bir malformasyondur. Nutcracker Fenomeni ise sol renal venin aorta ile superior mesenterik arter arasında sıkışması olarak tanımlanır. Nutckracker Fenomeni ile sol inferior vena kava birlikteliği daha önce tanımlanmamıştır. Bu yazımızda Nutckracker Fenomeni ile sol inferior vena kavanın klinik ve radyolojik bulgularını sunmayı amaçladık. ©2...

  19. Clinical application of nuclear magnetic resonance imaging (resistive type) on cardiovascular disease

    In order to evaluate the usefulness of Nuclear Magnetic Resonance (NMR) imaging in diagnosing cardiovascular disease, 27 subjects were examined using a 0.1-Tesla resistive type (ASAHI MARK-J). In 10 normal subjects, four cardiac chambers, interventricular septum, aorta, pulmonary vessels and vena cava were clearly identified in NMR imaging. In two patients with old anteroseptal myocardial infarction, anteroseptal wall thinning and left ventricular aneurysm with mural thrombi were demonstrated. In two cases of antrolateral and posterolateral myocardial infarction, however, infarcted areas were not identified in NMR imaging. In one patient with congestive cardiomyopathy, enlarged left ventricle without hypertrophy was recognized. In two patients with hypertrophic obstructive cardiomyopathy, NMR imaging disclosed thickened left ventricular wall associated with its narrowed cavity. A mural thrombus in the right ventricle was distinctly visualized in one patient with cardio-vascular Behcet's disease. In two patients with mitral valve stenosis, enlarged left atrium with a mural thrombus was clearly demonstrated in both cross and longitudinal sections. In three patients with thoratic aortic aneurysm, local dilatation of aorta and mural thrombi were recognized. In four patients with dissecting aortic aneurysm, double channels with an intimal flap in the aorta were visualized in NMR imaging. Mean T1 values and standard deviations of left ventricle, left ventricular wall, and thrombi were 593+-89, 341+-20, 316+-84 msec, respectively. Mean T1 values of thrombi were ordinally shorter than those of left ventricule. But some thrombi which might be expected fresh had longer T1 values. (J.P.N.)

  20. COLOR DOPPLER EVALUA TION OF HEPATIC VESS ELS AND PORTAL VENOUS SYSTEM IN LIV ER DISEASES WITH PAT HOLOGICAL CPRRELATION

    Sanjeev

    2015-10-01

    Full Text Available Color Doppler sonography is an important noninvasive procedure for detecting abnormalities in hepatic vasculature in various liver diseases. Ultrasound findings associated with portal hypertension include enlarged diameter of the portal vein, lack of respiratory variation in the portal vein or its tributaries, hepatofungal portal flow direction, decreased portal velocity or volume, and the presence of collaterals or varices. Not only portal hypertension but various other liver diseases are associated with abnormalities noted in hepatic vasculature. An abnormal liver texture and ascites are also commonly seen and are usually related to accompanying cirrhosis. PORTAL VEIN : The portal vein is seen in about 97% of normal patients; failure to visualize it can suggest the presence of pathology, such as thrombosis. No intraluminal echoes with frequent echogenic border. HEPATIC ARTERY: Proximal hepatic artery is best seen at celiac trunk while distal hepatic artery is seen at the level of main portal vein. On Doppler assessment low resistant waveform pattern is seen with systolic and diastolic component. IVC ( INFERIOR VENA CAVA : Normal IVC has Low level intra luminal echoes within the lumen and changes occur during respiration. On Doppler assessment continuous triphasic waveform with respiratory variation. HEPATIC VEIN: Color Doppler is a key tool, since the hepatic veins may be difficu lt to visualize with B - mode imaging alone when the liver is enlarged or cirrhotic . AIM : To evaluate the abnormalities of hepatic vessels and portal vein in various liver diseases and role of colour Doppler in portal and hepatic vessels various liver diseas e with histopathological correlation. MATERIAL AND METHOD : A prospective study and is conducted in Department of Radiodiagnosis, N.S.C.B. Medical College, Jabalpur M.P., over a period of one year ( 2011 - 2012. To evaluate the colour Doppler of hepatic vess els and portal venous system in liver disease with

  1. Behçet disease in association with Budd-Chiari syndrome and multiple thrombosis - Case report Doença de Behçet em associação com Síndrome de Budd-Chiari e tromboses múltiplas - Relato de caso

    Maraya de Jesus Semblano Bittencourt

    2013-06-01

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

  2. Paracardioscopic Ex-Maze

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

  3. Estenosis de venas pulmonares post ablación por radiofrecuencia

    Marcelo Guzzi

    2011-06-01

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

  4. The CAVA corpus: synchronised stereoscopic and binaural datasets with head movements

    Arnaud, Elise; Christensen, Heidi; Lu, Yan-Chen; Barker, Jon; Khalidov, Vasil; Hansard, Miles; Holveck, Bertrand; Mathieu, Herve; Narasimha, Ramya; Taillant, Elise; Forbes, Florence; Horaud, Radu

    2008-01-01

    International audience This paper describes the acquisition and content of a new multi-modal database. Some tools for making use of the data streams are also presented. The Computational Audio- Visual Analysis (CAVA) database is a unique collection of three synchronised data streams obtained from a binaural microphone pair, a stereoscopic camera pair and a head tracking device. All recordings are made from the perspective of a person; i.e. what would a human with natural head movements see...

  5. Bullet embolisation from injured inferior cava vein to the right ventricle

    Zenelaj, A; M Brati; Kerci, M

    2010-01-01

    Gunshot injuries of the human body challenge surgical teams in the emergency department. Since such injuries do not follow any rule, every patient should be considered a special case. Our case, of bullet embolism from injured inferior cava vein to the right heart ventricle is a rare one. Such cases make us be more alert for diagnosis and treatment of this kind of injury. Well equipped hospitals and experienced medical teams are necessary for successful outcome.

  6. A sulfated polysaccharide of Ecklonia cava inhibits the growth of colon cancer cells by inducing apoptosis

    Ahna, Ginnae; Lee, WonWoo; Kim, Kil-Nam; Lee, Ji-Hyeok; Heo, Soo-Jin; Kang, Nalae; Lee, Seung-Hong; Ahnf, Chang-Bum; Jeon, You-Jin

    2015-01-01

    We investigated anticancer effects of the crude polysaccharides (CPs) isolated from Ecklonia cava enzymatic extracts using AMG, Viscozyme, Protamex, and Alcalase enzyme against a colon cancer cell line, CT26 cells. Among them, the CP of Protamex extract (PCP) contained the highest fucose and sulfated group contents and showed the highest growth inhibitory effect against CT-26 cells. In addition, PCP dose-dependently increased the formation of apoptotic body and the percentage of Sub-G1 DNA co...

  7. Ecklonia cava Inhibits Glucose Absorption and Stimulates Insulin Secretion in Streptozotocin-Induced Diabetic Mice

    Hye Kyung Kim

    2012-01-01

    Aims of study. Present study investigated the effect of Ecklonia cava (EC) on intestinal glucose uptake and insulin secretion. Materials and methods. Intestinal Na+-dependent glucose uptake (SGU) and Na+-dependent glucose transporter 1 (SGLT1) protein expression was determined using brush border membrane vesicles (BBMVs). Glucose-induced insulin secretion was examined in pancreatic β-islet cells. The antihyperglycemic effects of EC, SGU, and SGLT1 expression were determined in streptozotocin ...

  8. When the Left is left!

    Asha J Mathew

    2014-09-01

    Full Text Available Persistent left superior vena cava is an uncommon vascular anomaly; however it is the most common anomaly of the thoracic venous system. It may be stand alone or associated with other congenital heart diseases and even other extracardiac anomalies. It is due to a lack of regression and adsorption of the left anterior cardinal vein. The persistence of this vessel renders a left subclavian approach for interventions on the right heart a challenge. It may be responsible for arrthymiias. We present a report of a persistent left superior vena cava draining into the coronary sinus with a coexisting normal right superior vena cava. Keeping in mind its widespread implications on cardiac procedures and a causative factor of cardiac disturbances we have considered its course, embryological source and clinical significance.

  9. Risk factors for perioperative venous thromboembolism: A retrospective study in Japanese women with gynecologic diseases

    Yoshimatsu Misako

    2010-11-01

    Full Text Available Abstract Background Patients with gynecologic cancer have a high risk of venous thromboembolism (VTE like patients with other cancers. However, there is little information on risk factors for VTE during gynecologic surgery and no uniform preventive strategy. Our objectives were to identify risk factors for perioperative VTE in gynecologic patients and establish methods for prevention. Methods We analyzed 1,232 patients who underwent surgery at the Department of Obstetrics and Gynecology of St. Marianna University School of Medicine between January 2005 and June 2008. We investigated (1 risk factors for preoperative VTE, (2 use of an inferior vena cava (IVC filter, and (3 risk factors for postoperative VTE. Results There were 39 confirmed cases of perioperative VTE (3.17%, including 25 patients with preoperative VTE and 14 with postoperative VTE. Thirty-two patients had cancer and seven patients had benign diseases. Twenty-two of the 32 cancer patients (68.7% had preoperative VTE, while postoperative VTE occurred in 10 cancer patients. Multivariate analysis indicated that ovarian cancer, tumor diameter ≥10 cm, and previous of VTE were independent risk factors for preoperative VTE. Among ovarian cancer patients, multivariate analysis showed that an age ≥50 years, the presence of heart disease, clear cell adenocarcinoma, and tumor diameter ≥20 cm were independent risk factors for preoperative VTE. The factors significantly related to preoperative VTE in patients with benign disease included previous VTE, age ≥55 years, tumor diameter ≥20 cm, and a history of allergic-immunologic disease. Thirteen of the 25 patients (52% with preoperative VTE had an IVC filter inserted preoperatively. Postoperative screening (interview and D-dimer measurement revealed VTE in 14/1,232 patients (1.14%. Multivariate analysis indicated that cancer surgery, a history of allergic-immunologic disease, and blood transfusion ≥2,000 ml were independent risk

  10. Rare Anatomical Variation of Dual IVC with Left Sided IVC Draining into Hemiazygous Vein- A Case Report.

    Gandhi, Shruti P; Modi, Pranjal; Sutariya, Harsh; Patel, Kajal

    2016-03-01

    Congenital anomalies of the Inferior Vena Cava (IVC) result from the persistence of the embryonic venous system. Knowledge of such anomaly is of great importance during abdominal surgery, liver and kidney transplantation, renal venous sampling and in the treatment of thromboembolic diseases. Here, we report a rare anatomical variation of dual IVC with normal course of right sided IVC and hemiazygous continuation of left sided IVC with interiliac communication in potential renal donor. Congenital abnormalities of the inferior vena cava are easily identified on Computed Tomography (CT) and should be considered when interpreting any CT of the abdomen or chest. PMID:27134969

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

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

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

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

    2013-08-15

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

  13. Rapid Intra-Hepatic Dissemination of Hepatocellular Carcinoma with Pulmonary Metastases Following Combined Loco-Regional Therapy

    Pua, Uei

    2013-01-01

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

  14. Liver dysfunction assessed by model for end-stage liver disease excluding INR (MELD-XI scoring system predicts adverse prognosis in heart failure.

    Satoshi Abe

    Full Text Available AIMS: Liver dysfunction due to heart failure (HF is often referred to as cardiac or congestive hepatopathy. The composite Model for End-Stage Liver Disease excluding INR (MELD-XI is a robust scoring system of liver function, and a high score is associated with poor prognosis in advanced HF patients with a heart transplantation and/or ventricular assist device. However, the impact of MELD-XI on the prognosis of HF patients in general remains unclear. METHODS AND RESULTS: We retrospectively analyzed 562 patients who were admitted to our hospital for the treatment of decompensated HF. A MELD-XI score was graded, and patients were divided into two groups based on the median value of MELD-XI score: Group L (MELD-XI <10, n = 289 and Group H (MELD-XI ≥10, n = 273. We compared all-cause mortality and echocardiographic findings between the two groups. In the follow-up period (mean 471 days, 104 deaths (62 cardiac deaths and 42 non-cardiac deaths were observed. The event (cardiac death, non-cardiac death, all-cause death-free rate was significantly higher in group L than in group H (logrank P<0.05, respectively. In the Cox proportional hazard analysis, a high MELD-XI score was found to be an independent predictor of cardiac deaths and all-cause mortality in HF patients. Regarding echocardiographic parameters, right atrial and ventricular areas, inferior vena cava diameter, and systolic pulmonary artery pressure were higher in group H than in group L (P<0.05, respectively. CONCLUSIONS: The MELD-XI scoring system, a marker of liver function, can identify high-risk patients with right heart volume overload, higher pulmonary arterial pressure and multiple organ failure associated with HF.

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

    Radeleff Boris

    2008-10-01

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

  16. Estenosis de venas pulmonares post ablación por radiofrecuencia

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

    2011-01-01

    Es importante estar atento ante la aparición de síntomas respiratorios luego de la realización de un procedimiento de ablación por radiofrecuencia en el tratamiento de la fibrilación auricular, pues la estenosis de venas pulmonares (EVP) tiene una incidencia de entre 1 y 3% y puede aparecer hasta en los dos años posteriores al procedimiento1. Presentamos el caso de un paciente de 41 años de sexo masculino, que ingresó por un cuadro de hemoptisis y toracodinia de tres semanas de evolución, con...

  17. Inferior vena caval thrombosis complicating pyogenic liver abscess after pancreatoduodenectomy: a case report

    Kubo, Hidemasa; Taniguchi, Fumihiro; Shimomura, Katsumi; Nanishi, Kenji; Ueshima, Yasuo; Takahashi, Akiyuki; Shioaki, Yasuhiro; Otsuji, Eigo

    2015-01-01

    Pyogenic liver abscess (PLA) complicated by inferior vena caval (IVC) thrombosis is rare but life-threatening. We experienced a case of PLA complicated by an IVC thrombus close to the right atrium after pancreatoduodenectomy. A 75-year-old man had undergone pancreatoduodenectomy with modified-Child reconstruction for pancreatic cancer 3 years prior, and no recurrence was noted on follow-up. He was admitted to our hospital owing to fever and general fatigue. PLA and septic shock were diagnosed...

  18. On-and offshore tephrostratigraphy and -chronology of the southern Central American Volcanic Arc (CAVA)

    Schindlbeck, J. C.; Kutterolf, S.; Hemming, S. R.; Wang, K. L.

    2015-12-01

    Including the recently drilled CRISP sites (IODP Exp. 334&344) the deep sea drilling programs have produced 69 drill holes at 29 Sites during 9 Legs at the Central American convergent margin, where the Cocos plate subducts beneath the Caribbean plate. The CAVA produced numerous plinian eruptions in the past. Although abundant in the marine sediments, information and data regarding large late Cenozoic explosive eruptions from Costa Rica, Nicaragua, Honduras, El Salvador, and Guatemala remain very sparse and discontinuous on land. We have established a tephrostratigraphy from recent through Miocene times from the unique archive of ODP/IODP sites offshore Central America in which we identify tephra source regions by geochemical fingerprinting using major and trace element glass shard compositions. Here we present first order correlations of ­~500 tephra layers between multiple holes at a single site as well as between multiple sites. We identified ashes supporting Costa Rican (~130), Nicaraguan (17) and Guatemalan (27) sources as well as ~150 tephra layers from the Galápagos hotspot. Within our marine record we also identified well-known marker beds such as the Los Chocoyos tephra from Atitlán Caldera in Guatemala and the Tiribi Tuff from Costa Rica but also correlations to 15 distinct deposits from known Costa Rican and Nicaraguan eruptions within the last 4.1 Ma. These correlations, together with new radiometric age dates, provide the base for an improved tephrochronostratigraphy in this region. Finally, the new marine record of explosive volcanism offshore southern CAVA provides insights into the eruptive history of long-living volcanic complexes (e.g., Barva, Costa Rica) and into the distribution and frequency of large explosive eruptions from the Galápagos hotspot. The integrated approach of Ar/Ar age dating, correlations with on land deposits from CAVA, biostratigraphic ages and sediment accumulation rates improved the age models for the drilling sites.

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

    Adolfo Ferrero Guadagnoli

    2014-08-01

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

  20. El Aislamiento de las Venas Pulmonares como Tratamiento de la Fibrilación Auricular Refractaria

    Fernando Scazzuso

    2011-12-01

    Full Text Available Introducción. La fibrilación auricular (FA es la arritmia sostenida más común. En pacientes seleccionados, se realiza ablación por catéter a nivel de las venas pulmonares, en donde se genera actividad ectópica que la produce. Se presenta la experiencia en el tratamiento de la FA mediante el aislamiento de venas pulmonares en 152 casos consecutivos. Materiales y métodos. La población estuvo constituida por 152 pacientes (122 hombres, edad promedio de 55.58 años. El 81.9% de la población no presentaba cardiopatía estructural. La forma de presentación fue paroxística en el 65.95% de los casos, con una historia de arritmia de 7 años en promedio, habiendo cumplido tratamiento con 3 fármacos antiarrítmicos diferentes. Se realizó mapeo no fluoroscópico y ablación de la porción antral de cada vena pulmonar, en forma secuencial. Resultados. La tasa de éxito durante el procedimiento fue del 97.87%. Se presentaron 12 complicaciones, 4 de ellas derrame pericárdico; ninguno requirió cirugía correctiva. El seguimiento promedio fue de 18±6 meses. En 24 pacientes se presentó recurrencia de la FA después del tercer mes de seguimiento; es decir, la tasa de éxito global primario a 12 meses fue 84.04%, 88.32 para el grupo sin cardiopatía y del 64.8 para el grupo con cardiopatía. Conclusión. El aislamiento de las venas pulmonares es una modalidad de tratamiento con una aceptable tasa de éxito primario en casos seleccionadosIntroduction. Atrial fibrillation (AF is the most common sustained cardiac arrhythmia. In selected patients, catheter ablation was performed at the sites of the pulmonary veins where ectopic activity triggers AF. Our experience with AF treatment by pulmonary vein isolation in 152 consecutive cases is presented and discussed. Methods. Our population consisted mainly of men (122 of 152 patients, with an average age of 55.6 years. Paroxysmal AF was present in 65.9% of the cases and 81.9% of the population had a

  1. Transdiaphragnatic exposure for direct atrioatrial anastomosis in liver transplantation

    CHEN Zhe-yu; YAN Lü-nan; ZENG Yong; WEN Tian-fu; LI Bo; ZHAO Ji-chun; WANG Wen-tao; YANG Jia-yin; XU Ming-qing

    2010-01-01

    Background Liver transplantation in Budd-Chiari syndrome remains controversial; however, some improved techniques lead to better results. We report medium-term follow-up results of liver transplantation with atrioatrial anastomosis for Budd-Chiari syndrome and explore the indications of liver transplantation with atrioatrial anastomosis for patients with end stage liver disease.Methods Nine patients (six Budd-Chiari syndromes, one end stage hepatolithiasis, one hepatocellular carcinoma and one incurable alveolar echinococcosis) underwent liver transplantation with atrioatrial anastomosis in West China Hospital of Sichuan University from 1999 to 2006. Eight liver transplants used cadaveric orthotopic livers and one a living donor liver. The operative technique was transdiaphragmatic exposure for direct atrioatrial anastomosis and replacement of inferior vena cava by cryopreserved vena cava graft with the help of venovenous bypass.Results All liver transplantations were successful. Two patients contracted pulmonary infection and acute rejection took place in another case. With proper treatment, all patients recovered well and had good quality of life. To date, they have been followed up for more than 24 months. The only death followed recurrence of hepatic carcinoma three years after liver transplantation.Conclusions Transdiaphragmatic exposure for direct atrioatrial anastomosis and the cryopreserved vena cava graftreplacement of inferior vena cava are possible for patients with end stage liver disease thus extending the indications of liver transplantation.

  2. A prebiotic effect of Ecklonia cava on the growth and mortality of olive flounder infected with pathogenic bacteria.

    Lee, WonWoo; Ahn, Ginnae; Oh, Jae Young; Kim, Seung Min; Kang, Nalae; Kim, Eun A; Kim, Kil-Nam; Jeong, Joon Bum; Jeon, You-Jin

    2016-04-01

    Olive flounder (Paralichthys olivaceus), also known as the Japanese flounder in Japan, is one of the most important commercial marine finfish species cultured in Korea and Japan. The purpose of this study was to evaluate how a species of brown algae (Ecklonia cava, E. cava) affects the growth rate of olive flounder and its immune response to pathogenic bacteria. First, the experimental fish were divided into four groups: the control group was fed the diet containing only 1.0% Lactobacillus plantarum (L. plantarum), group I was fed 1.0% L. plantarum and 1.0% E. cava (EC), group II was fed 1.0% L. plantarum and 0.1% ethanol extract of EC (EE), and group III was fed 1.0% L. plantarum and 0.5% EE. The diets fed to the fish twice a day for 16 weeks. The results indicated that supplementation with 1.0% EC and 0.1% EE improved the growth and body weight of olive flounder, and decreased its mortality. This diet, however, did not significantly affect the biochemical profiles of the experimental flounder. The supplementation of 1.0% EC also enhanced the innate immune response of the fish, as evidenced by the high respiratory burst, and increased serum lysozyme and myeloperoxidase activity. The addition of 1.0% EC and either 0.1% or 0.5% EE also decreased the accumulative mortality of olive flounder infected by pathogenic bacteria (Edwardsiella tarda, Streptococcus iniae, and Vibrio harveyi). Overall, these results suggest that E. cava can act as a prebiotic by improving the innate immune response in fish infected with pathogenic bacteria as increased the growth of the probiotic. PMID:26921543

  3. Gas hazard assessment in a densely inhabited area of Colli Albani Volcano (Cava dei Selci, Roma)

    Carapezza, M. L.; Badalamenti, B.; Cavarra, L.; Scalzo, A.

    2003-04-01

    The northwestern flank of the Colli Albani, a Quaternary volcanic complex near Rome, is characterised by high pCO 2 values and Rn activities in the groundwater and by the presence of zones with strong emission of gas from the soil. The most significant of these zones is Cava dei Selci where many houses are located very near to the gas emission site. The emitted gas consists mainly of CO 2 (up to 98 vol%) with an appreciable content of H 2S (0.8-2%). The He and C isotopic composition indicates, as for all fluids associated with the Quaternary Roman and Tuscany volcanic provinces, the presence of an upper mantle component contaminated by crustal fluids associated with subducted sediments and carbonates. An advective CO 2 flux of 37 tons/day has been estimated from the gas bubbles rising to the surface in a small drainage ditch and through a stagnant water pool, present in the rainy season in a topographically low central part of the area. A CO 2 soil flux survey with an accumulation chamber, carried out in February-March 2000 over a 12 000 m 2 surface with 242 measurement points, gave a total (mostly conductive) flux of 61 tons/day. CO 2 soil flux values vary by four orders of magnitude over a 160-m distance and by one order of magnitude over several metres. A fixed network of 114 points over 6350 m 2 has been installed in order to investigate temporal flux variations. Six surveys carried out from May 2000 to June 2001 have shown large variations of the total CO 2 soil flux (8-25 tons/day). The strong emission of CO 2 and H 2S, which are gases denser than air, produces dangerous accumulations in low areas which have caused a series of lethal accidents to animals and one to a man. The gas hazard near the houses has been assessed by continuously monitoring the CO 2 and H 2S concentration in the air at 75 cm from the ground by means of two automatic stations. Certain environmental parameters (wind direction and speed; atm P, T, humidity and rainfall) were also

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

    Luiz Felippe Júdice

    1998-02-01

    mediastinum such as lymphoma. ln this study we analyze the medical reports of 125 patients in which mediastinoscopy was performed for the diagnosis of intrathoracic diseases. The procedure was performed with general anesthesia and orotracheal intubation in all patients out in two, submitted to mediastinoscopy with local anesthesia. The surgical approaches used were: cervical (n=103. anterior (n=7 and cervical + anterior (n=15. There were 80 male and 45 female patients. The age ranged from 13 to 75 years. Carcinoma was the most prevalent diagnosis obtained (36.8%, followed by lymphoma (16% and sarcoidosis (14.4%. In nine patients the exam was inconclusive, being responsible for a 7.2% failure index of the method. In eleven patients presenting superior vena cava syndrome, mediastinoscopy was performed without aditional complications, except in one case in which symptoms worsenned. We conclude that mediastinoscopy is a safe procedure and it is a valuable tool for the diagnosis of paratracheal mediastinal masses and lymphadenomegalies.

  5. Clinical analysis of venous thromboembolic disease during puerperium%产褥期静脉血栓栓塞性疾病37例临床分析

    罗明尧; 舒畅; 李全明; 姜晓华; 黎明

    2011-01-01

    回顾分析经保守治疗的37例产褥期合并深静脉血栓形成患者的临床资料.37例患者平均年龄(33±6)岁,发病平均时间为产后(10±6)d,其中经阴道产7例(19%)、剖宫产30例(81%);8例合并肺栓塞.急性期采用积极抗凝、祛聚、溶栓、下腔静脉滤器置入等治疗,慢性期长期抗凝和弹力袜压迫治疗.治愈5例,好转32例,有效率100%.随访(29±10)个月(12~60个月),发生血栓后遗综合征3例,症状轻.急性期抗凝、祛聚、溶栓、改善循环及慢性期弹力袜压迫治疗疗效明显,血栓后遗综合征发生率低.%Thirty seven patients with venous thromboembolic disease in puerperium were admitted to hospital from January 2005 to December 2008; the clinical data of patients were retrospectively analyzed.The average age of patients was (33 ± 6)years (21 -42 years); the average onset time was ( 10 ± 6) d( 1 -50 d) after delivery.Seven patients had vaginal birth and 30 by cesarean section.The risk factors included pregnancy,cesarean section,age,infection,thrombophilia.All were diagnosed by ultrasonography and treated by anticoagulant,antiplatelet and thrombolytic therapy in the acute phase,followed by wearing elastic compressive stockings for more than 2 years.Pulmonary embolism was diagnosed in 8 patients by CT angiography,in 7 of whom inferior vena cava filter was administrated emergently.The patients were followed up for (29 ± 10)months ( 12 -60 months); during the follow-up 3 developed deep vein post-thrombosis syndrome,while others kept in good condition.The results indicate that initial anticoagulant,antiplatelet and thrombolytic therapy followed by elastic compressive stockings administration is effective for venous thromboembolic disease during puerperium.

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

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

  7. Parotidectomía y vena facial Parotidectomy and facial vein

    F. Hernández Altemir

    2009-10-01

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

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

    Sérgio Pinter Garcia Filho

    2013-05-01

    Full Text Available A paca (Cuniculus paca é o segundo maior roedor da fauna brasileira. Apresenta carne de excelente qualidade, o que incentiva a criação comercial. Além disso, este animal pode tornar-se uma opção válida em experimentação embora poucas sejam as informações detalhadas sobre sua morfologia. Assim, objetivou-se descrever a morfologia, morfometria e ultraestrutura de segmentos das porções cranial e caudal da veia cava de quatro pacas (Cuniculus paca adultas excedentes do plantel do Setor de Animais Silvestres do Departamento de Zootecnia da FCAV-Unesp. Os segmentos venosos foram analisados à microscopia de luz e à microscopia eletrônica de varredura. Foram mensuradas as espessuras do complexo formado pelas túnicas íntima e média, além da túnica adventícia e analisou-se os resultados pela estatística descritiva, teste "T" pareado (p<0,05. Em relação à espessura das túnicas estudadas, comprovou-se que os valores da espessura das túnicas íntima, média e adventícia, para todos os animais, foram significativamente maiores no segmento cranial. As camadas das paredes dos vasos apresentaram variações entre si quanto à estrutura e espessura, supostamente devido a uma adaptação à exigência funcional.

  9. Seapolynol Extracted from Ecklonia cava Inhibits Adipocyte Differentiation in Vitro and Decreases Fat Accumulation in Vivo

    Hui-Jeon Jeon

    2015-12-01

    Full Text Available Seapolynol (SN is a polyphenol mixture derived from Ecklonia cava. We evaluated the effects of SN on lipid accumulation in adipocytes, zebrafish, and mice. SN effectively inhibited lipid accumulation in three experimental models by suppressing adipogenic factors. Triglyceride synthetic enzymes such as diacylglycerol acyltransferase 1 (DGAT1 and GPAT3 were also downregulated by SN. This SN-induced inhibition of adipogenic factors was shown to be due to the regulatory effect of SN on early adipogenic factors; SN downregulated the expression of Krueppel-like factor 4 (KLF4, KLF5, CCAAT-enhancer-binding protein β (C/EBPβ, C/EBPδ, and Protein C-ets-2 (ETS2, while KLF2, an anti-early adipogenic factor, was upregulated by SN. SN-mediated inhibition in early adipogenesis was closely correlated with the inhibition of mitotic clonal expansion via cell cycle arrest. SN inhibited cell cycle progression by suppressing cell cycle regulators, such as cyclin A, cyclinD, and pRb but increased p27, a cell cycle inhibitor. In a mouse study, SN effectively reduced body weight and plasma lipid increases induced by a high-fat diet; triglycerides, total cholesterol, and low-density lipoprotein (LDL levels were markedly reduced by SN. Moreover, SN remarkably improved high-fat-diet-induced hepatic lipid accumulation. Furthermore, SN activated AMP-activated protein kinase-α (AMPKα, an energy sensor, to suppress acetyl-coA carboxylase (ACC, inhibiting lipid synthesis. Our study suggests that SN may be an edible agent that can play a positive role in prevention of metabolic disorders.

  10. Seapolynol Extracted from Ecklonia cava Inhibits Adipocyte Differentiation in Vitro and Decreases Fat Accumulation in Vivo.

    Jeon, Hui-Jeon; Choi, Hyeon-Son; Lee, Yeon-Joo; Hwang, Ji-Hyun; Lee, Ok-Hwan; Seo, Min-Jung; Kim, Kui-Jin; Lee, Boo-Yong

    2015-01-01

    Seapolynol (SN) is a polyphenol mixture derived from Ecklonia cava. We evaluated the effects of SN on lipid accumulation in adipocytes, zebrafish, and mice. SN effectively inhibited lipid accumulation in three experimental models by suppressing adipogenic factors. Triglyceride synthetic enzymes such as diacylglycerol acyltransferase 1 (DGAT1) and GPAT3 were also downregulated by SN. This SN-induced inhibition of adipogenic factors was shown to be due to the regulatory effect of SN on early adipogenic factors; SN downregulated the expression of Krueppel-like factor 4 (KLF4), KLF5, CCAAT-enhancer-binding protein β (C/EBPβ), C/EBPδ, and Protein C-ets-2 (ETS2), while KLF2, an anti-early adipogenic factor, was upregulated by SN. SN-mediated inhibition in early adipogenesis was closely correlated with the inhibition of mitotic clonal expansion via cell cycle arrest. SN inhibited cell cycle progression by suppressing cell cycle regulators, such as cyclin A, cyclinD, and pRb but increased p27, a cell cycle inhibitor. In a mouse study, SN effectively reduced body weight and plasma lipid increases induced by a high-fat diet; triglycerides, total cholesterol, and low-density lipoprotein (LDL) levels were markedly reduced by SN. Moreover, SN remarkably improved high-fat-diet-induced hepatic lipid accumulation. Furthermore, SN activated AMP-activated protein kinase-α (AMPKα), an energy sensor, to suppress acetyl-coA carboxylase (ACC), inhibiting lipid synthesis. Our study suggests that SN may be an edible agent that can play a positive role in prevention of metabolic disorders. PMID:26690099

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

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

    2011-01-01

    Es importante estar atento ante la aparición de síntomas respiratorios luego de la realización de un procedimiento de ablación por radiofrecuencia en el tratamiento de la fibrilación auricular, pues la estenosis de venas pulmonares (EVP) tiene una incidencia de entre 1 y 3% y puede aparecer hasta en los dos años posteriores al procedimiento1. Presentamos el caso de un paciente de 41 años de sexo masculino, que ingresó por un cuadro de hemoptisis y toracodinia de tres semanas de evolución, con...

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

    Esteruelas Mireia

    2015-01-01

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

  13. DISEASES

    Pletscher-Frankild, Sune; Pallejà, Albert; Tsafou, Kalliopi;

    2015-01-01

    Text mining is a flexible technology that can be applied to numerous different tasks in biology and medicine. We present a system for extracting disease-gene associations from biomedical abstracts. The system consists of a highly efficient dictionary-based tagger for named entity recognition of...... human genes and diseases, which we combine with a scoring scheme that takes into account co-occurrences both within and between sentences. We show that this approach is able to extract half of all manually curated associations with a false positive rate of only 0.16%. Nonetheless, text mining should not...... stand alone, but be combined with other types of evidence. For this reason, we have developed the DISEASES resource, which integrates the results from text mining with manually curated disease-gene associations, cancer mutation data, and genome-wide association studies from existing databases. The...

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

    Marcelo Guzzi

    2011-06-01

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

  15. Análise de sensibilidade na otimização econômica de uma cava

    Belisario Ascarza Flores

    2008-12-01

    Full Text Available Uma das variáveis que torna um projeto de mineração mais vulnerável à instabilidade econômica é a variação dos preços de venda dos minérios. Nesse trabalho, procedeu-se a uma análise de sensibilidade de cavas ótimas em relação à variação do preço de venda de um bem mineral. Foi gerada uma série de contornos de cavas ótimas com diferente valor presente líquido (VPL e diferentes quantidades de minério e estéril, a partir da aplicação de fatores de desconto sobre um preço de venda de minério tomado como base. Análises desse tipo são úteis para o estabelecimento do planejamento de produção de uma mina. Para esse estudo, foram utilizados dados da mina Morro da Mina da Rio Doce Manganês S.A. e, para a geração das cavas otimizadas, utilizou-se o módulo Pit Optimiser do Gemcom Surpac 6.0.One of the variables that makes the economic stability of a mining project more vulnerable is the variation of ore sale prices. In this work, a sensitivity analysis of optimum pits in relation to the variation of the sale price of ore was performed. It generated a set of optimal pits shells with different net present values (NPV and different amounts of ore and waste, and the application of discount factors of the ore's sale price was taken as the base. Analyses of this type are useful for the establishment of production planning of a mine. For this study, data obtained from the manganese mine of Morro da Mina of Rio Doce Manganês S.A. was used, and the modulate Pit Optimiser of the Gemcom Surpac 6.0 was applied to generate the optimum pits.

  16. Magnetic resonance angiography (MRA) of the abdominal veins

    On the basis of the time-of-flight effect in 18 normal volunteers and 119 patients with different diseases of the abdominal veins (inferior vena cava, portosplenic systems, renal/hepatic/iliac veins) magnetic resonanced (MR) angiograms were compared with the DSA, CT and US results. The MR technique included a series of 2D gradient-echo (Flash) images obtained which the patients held their breath and projection angiograms (PA) (MIP algorithm). PA of the inferior vena cava and renal veins had a sensitivity of 90% and a specificity of 88.8%. The results demonstrate that in all cases diseases of the large veins could be detected using all the MR information available. It is suggested that this method is so far not satisfactory in the evaluation of small vessels and slow intravascular flow conditions. (orig.)

  17. Portal vein thrombosis and Budd-Chiari syndrome as onset of polycythemia vera.

    Aurelio Seidita; Delia Sprini; Accursia Bongiovì; Tiziana Catalano; Filippo Barbiera; Maria Accardi; Pasquale Mansueto; Antonio Carroccio

    2013-01-01

    Budd-Chiari syndrome may be defined as a heterogeneous group of vascular disorders characterized by obstruction of hepatic venous return to the level of hepatic venules, supra-hepatic veins, inferior vena cava or right atrium. The main cause of this syndrome is represented by myeloproliferative diseases and, in particular, by polycythemia vera. The latter may cause multiple splanchnic thrombosis, including portal vein thrombosis, particularly important for its clinical outcomes (ascites, coll...

  18. Adrenohepatic fusion: Adhesion or invasion in primary virilizant giant adrenal carcinoma? Implications for surgical resection. Two case report and review of the literature

    Antonio Alastrué Vidal

    2016-01-01

    Conclusion: We report two consecutive rare cases of adrenohepatic fusion in giant right adrenocortical carcinoma, not detectable by imaging, what has important implications for the surgical decision-making. As radical surgery is the best choice to offer a curative treatment, it has to be performed by a multidisciplinary well-assembled team, counting with endocrine and liver surgeons, and transplant surgeons in case of vena cava involvement, in order to maximize the disease-free survival.

  19. Palliative Procedures in Lung Cancer

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

    2013-01-01

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

  20. Radical Resection of a Late-Relapsed Testicular Germ Cell Tumour: Hepatectomy, Cavotomy, and Thrombectomy

    C. Ní Leidhin; Redmond, C. E.; Cahalane, A. M.; Heneghan, H. M.; R. Motyer; Ryan, E. R.; Hoti, E.

    2014-01-01

    Up to 3.2% of patients with testicular germ cell tumours represent with late-relapsing disease. Aggressive surgical resection confers the greatest chance of cure in this patient group. We present the case of a late and extensively relapsed nonseminomatous germ cell tumour with thrombus present along the entire length of the inferior vena cava, as well as in the right hepatic vein. Techniques practised in liver transplantation were used to achieve complete resection of the tumour thrombus. Thi...

  1. Hyperammonemia and Systemic Inflammatory Response Syndrome Predicts Presence of Hepatic Encephalopathy in Dogs with Congenital Portosystemic Shunts

    Tivers, Mickey S.; Ian Handel; Gow, Adam G.; Lipscomb, Vicky J; Rajiv Jalan; Mellanby, Richard J.

    2014-01-01

    Hepatic encephalopathy (HE) is an important cause of morbidity and mortality in patients with liver disease. The pathogenesis of he is incompletely understood although ammonia and inflammatory cytokines have been implicated as key mediators. To facilitate further mechanistic understanding of the pathogenesis of HE, a large number of animal models have been developed which often involve the surgical creation of an anastomosis between the hepatic portal vein and the caudal vena cava. One of the...

  2. An unusual presentation of venous thrombosis in a child with idiopathic membranous nephropathy

    Sreekanth Burri

    2015-01-01

    Full Text Available Venous thrombosis is one of the major complications associated with nephrotic syndrome. Among the primary glomerular diseases, membranous nephropathy is associated with a high incidence of thrombotic events. Although this is well described in adults, there is paucity of the literature regarding venous thrombosis in children. Herein, we report such a thrombotic event involving both the lower limb veins and the inferior vena cava in a child with membranous nephropathy.

  3. Caval variations in neurologically diseased patients

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

  4. Pulmonary artery catheter insertion in a patient of dextrocardia with anomalous venous connections

    Tripathi Mukesh

    2004-08-01

    Full Text Available In a young adult patient having situs solitus with dextrocardia the attempted pulmonary artery catheter placement for emergency mitral valve replacement required an unduly long length (50cm of catheter insertion to get into right ventricle and then into pulmonary artery. Although catheter coiling was suspected initially, chest x-ray taken after successfully placement revealed an uncommon congenital anomalous venous connection i.e. right internal jugular opening into left sided superior vena cava then into inferior vena cava after running all along the left border of the heart. With the result, it required to pass 50cm of PA catheter to get into right ventricle in our patient. This emphasizes the need to look for abnormal venous connections during echocardiography and x-ray screening in congenital heart disease. Fluoroscopy is recommended when an unusual length of pulmonary artery catheter insertion is required to enter the pulmonary artery.

  5. Evaluation of antioxidant properties of a new compound, pyrogallol-phloroglucinol-6,6'-bieckol isolated from brown algae, Ecklonia cava

    Kang, Sung-Myung; Lee, Seung-Hong; Heo, Soo-Jin; Kim, Kil-Nam; Jeon, You-Jin

    2011-01-01

    In this study, antioxidant and free radical scavenging activities of the natural antioxidative compound, pyrogallol-phloroglucinol-6,6'-bieckol (PPB) isolated from brown algae, Ecklonia cava was assessed in vitro by measuring the radical scavenging activities (DPPH, alkyl, hydroxyl, and superoxide) using electron spin resonance (ESR) spectrometry, intracellular reactive oxygen species (ROS) scavenging activity, and DNA damage assay. According to the results of these experiments, the scavengin...

  6. A prebiotic role of Ecklonia cava improves the mortality of Edwardsiella tarda-infected zebrafish models via regulating the growth of lactic acid bacteria and pathogen bacteria.

    Lee, WonWoo; Oh, Jae Young; Kim, Eun-A; Kang, Nalae; Kim, Kil-Nam; Ahn, Ginnae; Jeon, You-Jin

    2016-07-01

    In this study, the beneficial prebiotic roles of Ecklonia cava (E. cava, EC) were evaluated on the growth of lactic acid bacteria (LAB) and pathogen bacteria and the mortality of pathogen-bacteria infected zebrafish model. The result showed that the original E. cava (EC) led to the highest growth effects on three LABs (Lactobacillus brevis, L. brevis; Lactobacillus pentosus, L. pentosus; Lactobacillus plantarum; L. plantarum) and it was dose-dependent manners. Also, EC, its Celluclast enzymatic (ECC) and 100% ethanol extracts (ECE) showed the anti-bacterial activities on the fish pathogenic bacteria such as (Edwardsiella tarda; E. tarda, Streptococcus iniae; S. iniae, and Vibrio harveyi; V. harveyi). Interestingly, EC induced the higher production of the secondary metabolites from L. plantarum in MRS medium. The secondary metabolites produced by EC significantly inhibited the growth of pathogen bacteria. In further in vivo study, the co-treatment of EC and L. plantarum improved the growth and mortality of E. tarda-infected zebrafish as regulating the expression of inflammatory molecules such as iNOS and COX2. Taken together, our present study suggests that the EC plays an important role as a potential prebiotic and has a protective effect against the infection caused by E. tarda injection in zebrafish. Also, our conclusion from this evidence is that EC can be used and applied as a useful prebiotic. PMID:27192145

  7. Imaging sarcomas of the great vessels and heart.

    Bendel, Emily C; Maleszewski, Joseph J; Araoz, Philip A

    2011-10-01

    Primary sarcomas of the aorta, pulmonary artery, superior vena cava, inferior vena cava, and the heart are rare neoplasms. Aortic sarcomas are broadly categorized as either primarily luminal or primarily mural, with luminal sarcomas more likely to be misdiagnosed as thrombus. Pulmonary artery sarcomas are often mistaken for pulmonary embolism both clinically and at imaging. Vena caval sarcomas appear as intraluminal or extraluminal masses connecting to or filling the veins. The most common are leiomyosarcomas of the inferior vena cava. Primary sarcomas of the heart are rare and usually appear as heterogeneous aggressive masses. PMID:21963161

  8. GAMBARAN RISIKO TROMBOSIS VENA PROFUNDA (TVP PADA SALES PROMOTION GIRL (SPG BERDASARKAN KRITERIA WELLS DI KOTA DENPASAR

    Shelly Silvia Bintang

    2015-01-01

    Full Text Available Pekerjaan sebagai sales promotion girl (SPG menuntut berdiri dalam posisi statis dalam waktu kerja yang cukup lama. Dalam sebuah jurnal kesehatan masyarakat tahun 2013 mendapatkan hasil semakin lama SPG bekerja maka semakin lama juga durasi mereka memakai sepatu hak tinggi semakin besar risiko untuk mengalami gangguan kesehatan yang disebabkan sepatu hak tinggi. Gangguan dari aliran darah atau trombosis vena profunda (TVP merupakan dampak yang ditimbulkan. Tujuan dari penelitian ini untuk mengetahui angka tinggi pemakaian sepatu hak tinggi, angka pemakaian stocking dan gambaran SPG di Kota Denpasar yang memiliki risiko rendah, menengah dan tinggi mengalami TVP. Penelitian ini menggunakan metode deskriptif potong lintang. Subyek penelitian ini adalah 62 pegawai SPG yang bekerja di swalayan di Kota Denpasar. Skor kriteria Wells didapatkan untuk mengetahui gambaran risiko probabilitas TVP. Hasil gambaran risiko TVP pada SPG di Kota Denpasar berdasarkan kriteria Wells didapatkan 30 orang pekerja (48,38% menunjukan risiko ringan, dan 30 orang pekerja lainnya (48,38% menunjukan risiko menengah menderita TVP, sedangkan 2 orang pekerja (3,24% menunjukan risiko tinggi. Sebagian besar pegawai SPG di kota Denpasar memiliki risiko rendah dan sedang probabilitas TVP.

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

    Ki Cheon Kim

    2014-10-01

    Full Text Available This study investigated the protective mechanisms of triphlorethol-A, isolated from Ecklonia cava, against oxidative stress-induced DNA base damage, especially 8-oxoguanine (8-oxoG, in Chinese hamster lung fibroblast V79-4 cells. 8-Oxoguanine DNA glycosylase-1 (OGG1 plays an important role in the removal of 8-oxoG during the cellular response to DNA base damage. Triphlorethol-A significantly decreased the levels of 8-oxoG induced by H2O2, and this correlated with increases in OGG1 mRNA and OGG1 protein levels. Furthermore, siOGG1-transfected cell attenuated the protective effect of triphlorethol-A against H2O2 treatment. Nuclear factor erythroid 2–related factor 2 (Nrf2 is a transcription factor for OGG1, and Nrf2 combines with small Maf proteins in the nucleus to bind to antioxidant response elements (ARE in the upstream promoter region of the OGG1 gene. Triphlorethol-A restored the expression of nuclear Nrf2, small Maf protein, and the Nrf2-Maf complex, all of which were reduced by oxidative stress. Furthermore, triphlorethol-A increased Nrf2 binding to ARE sequences and the resulting OGG1 promoter activity, both of which were also reduced by oxidative stress. The levels of the phosphorylated forms of Akt kinase, downstream of phosphatidylinositol 3-kinase (PI3K, and Erk, which are regulators of OGG1, were sharply decreased by oxidative stress, but these decreases were prevented by triphlorethol-A. Specific PI3K, Akt, and Erk inhibitors abolished the cytoprotective effects of triphlorethol-A, suggesting that OGG1 induction by triphlorethol-A involves the PI3K/Akt and Erk pathways. Taken together, these data indicate that by activating the DNA repair system, triphlorethol-A exerts protective effects against DNA base damage induced by oxidative stress.

  10. Development of artificial model of caval syndrome in canine heartworm disease

    In order to develop an artificial model of caval syndrome (dirofilarial hemoglobinuria), heartworm-like silicone tubes were inserted into the tricuspid valve orifice and right atrium of dogs. Fifteen to 25 tubes with some knots were inserted through the posterior vena cava in 6 dogs (knot-tube group), 7 to 12 tubes without knot (small-number group) through the jugular vein in another 5 dogs, or 25 to 35 tubes (large-number group) in yet another 5 dogs. The tubes remained in the right atrium, and a part of them protruded into the tricuspid valve orifice. The number of tubes at the tricuspid valve orifice was the greatest in the large-number group. After tube insertion, the signs of so-called ''caval syndrome'', such as systolic cardiac murmur, jugular pulse, anemia, and so on, were observed in almost all cases of the 3 groups, the signs were severest in the large-number group. Urine hemoglobin was detected in almost all cases of the knot-tube and large-number groups, and in 1 case in the small-number group. Ascites was observed in 1 case of the knot-tube group at 6 weeks, in 1 case of the small-number group at 7 days and in 3 cases of the large-number group at 7 days after insertion

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

    S. Muñoz

    2004-06-01

    Full Text Available Objective: to analyze the epidemiology, associated risk factors, clinical presentation, diagnostic methods, treatment, and evolution of patients diagnosed with superior mesenteric venous thrombosis (SMVT at an university hospital in Madrid. Experimental design: retrospective and descriptive study. We review the medical records of patients with this diagnosis in our hospital from January 1998 to December 2002. Data were processed by using the SPSS vs. 11 software. Patients: all thirteen subjects diagnosed with SMVT in that period were included. Results: associated risk factors included tumoral conditions (5 patients, acute abdominal pathology (2, polyglobulia (1, prothrombin gene mutation (1, and anticardiolipin antibodies (1. No predisposing factor was found in 3 patients. Clinical presentation for all patients was abdominal pain, with nausea and vomiting being the second symptom in frequency (7. The diagnosis was reached by abdominal CT (9, arteriography (2, ultrasounds (1, and histology after intestinal resection (1. Treatment with only anticoagulation was initiated in 4 patients, whereas anticoagulation and surgery were performed in 5 cases. In 4 subjects no specific treatment was prescribed and only palliative measures were established due to a baseline end-stage condition. Five patients died, and four of them had a neoplasic condition as associated risk factor. Mortality in our series was 38.5%. Conclusions: SMVT is a very rare disease that is often associated with neoplasic pathology, which influences its high mortality. Due to non specific symptoms, imaging is essential for the diagnosis and the detection of associated risk factors. In our series, computed tomography imaging was the most profitable test.Objetivo: analizar la epidemiología, factores de riesgo asociados, presentación clínica, métodos diagnósticos, tratamiento y evolución en pacientes diagnosticados de trombosis de vena mesentérica superior (TVMS en un hospital

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

    Eduardo González-Bosquet

    2009-06-01

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

  13. Influences of irradiation on the anastomotic sites of artificial graft

    To examine the acute influences of irradiation on the anastomotic sites of EPTFE vascular grafts, experimental study was performed using canine dogs. After replacement of superior vena cava and bilateral femoral arteries with EPTFE grafts, a total of 20 to 100 Gy doses were given at the anastomotic sites of superior vena cava and right femoral artery. There were no degradation of grafts themselves or rupture in the anastomoses at cumulative anastomotic sites of superior vena cava, stenoses and/or overgrowth of granulation tissues were observed, although at those of right femoral artery, no remarkable differences were observed between dogs which received irradiation and those which did not receive. (author)

  14. Maxillectomy for malignant nasopharyngeal neurofibroma: Anesthetic considerations

    Shagun Bhatia Shah

    2015-01-01

    Full Text Available Neurofibromatosis-1 (NF-1 or von Recklinghausen′s disease is the most common disease inherited by a single gene and is multisystemic in nature. Anesthesia is required for excision of neurofibromas, which may cause cosmetic disfigurement, pressure effects (obstructive uropathy, hydronephrosis, kyphoscoliosis, hydrocephalus, proptosis, and superior vena cava syndrome and may undergo malignant change. We report here the anesthetic management of an NF-1 patient with a malignant change in a nasopharyngeal neurofibroma requiring left maxillectomy and split skin grafting.

  15. Full Text Available ... ventricle to the rest of the body. If we remove some of the tough fibrous coating of ... keep the blood flowing in one direction. If we inject dye into the superior vena cava, you ...

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

    Full Text Available ... be a disaster. There are several things can cause really big disasters like vena cava anastomosis if ... you can think of. Here there are general medicine social workers. With this particular family, we involved ...

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

    Full Text Available ... so we did a sharp dissection here to leave a little bit of vena cava wall onto ... those services, plus the pain service. Once we leave, or once she leaves from the unit, we ...

  18. SVC obstruction

    ... Lymphoma Metastatic lung cancer (lung cancer that spreads) Testicular cancer Thyroid cancer Thymus tumor Superior vena cava obstruction ... Complications are serious and can sometimes be fatal. Prevention Prompt treatment of other medical disorders may reduce ...

  19. Hypoxemia and Right-to-Left-Shunt in Patient with Antiphospholipid Syndrome: A Case Report with Multimodality Imaging Findings and Literature Review

    Bin Saeedan, Mnahi; Alrujaib, Mashael; Fathala, Ahmed L.

    2016-01-01

    This is a case report of an extremely rare cause of superior vena cava syndrome with systemic-to-pulmonary venous shunts, illustrated using different imaging modalities with successful SVC and IVC dilatation and stenting. PMID:27034877

  20. Whipple Procedure for Pancreatic Cancer

    Full Text Available ... the vena cava, and that's obviously an important structure that we do not want to disturb. And ... in this vicinity here are all the important structures that go between the intestines and the liver: ...

  1. Total Anomalous Systemic Venous Drainage with Heterotaxia Syndrome: A Rare Case

    Ali Yildirim

    2014-01-01

    Full Text Available Total anomalous systemic venous return is a very rare anomaly, where vena cava inferior, vena cava superior, and coronary sinus drain into left atrium. Two-day-old male baby was admitted with cyanosis and tachypnea after the birth. Left atrial isomerism with anomalous systemic venous drainage was found on echocardiographic examination. We present an unusual case of total anomalous systemic venous drainage in to the left atrium.

  2. Bioimpedance for assessing volume status in children with nephrotic syndrome

    ÖZDEMİR, KADRİYE; MİR, MAKBULE SEVGİ; DİNÇEL, NİDA; BOZABALI, SİBEL; BULUT, İPEK KAPLAN; YILMAZ, Ebru; SÖZERİ, BETÜL

    2015-01-01

    Background/aim: The effectiveness of assessing volume load via bioimpedance in pediatric patients with nephrotic syndrome (NS) was investigated. Materials and methods: Patients with NS (n = 34) were compared with healthy controls (n = 20). The inferior vena cava index and inferior vena cava collapsibility index (IVCCI) scores were determined for all subjects. Bioimpedance measurements were used to directly determine volume load. Clinical findings, relative fluid load, and echocardiographic m...

  3. [症例報告]肝細胞癌を合併したBudd-Chiari症候群の一期的手術の1治験例

    伊波, 潔; 古謝, 景春; 金城, 治; 国吉, 幸男; 赤崎, 満; 久貝, 忠男; 安里, 義徳; 玉城, 守; 永吉, 盛司; 平安, 恒男; 松本, 直之; 与那覇, 俊美; 新屋, 瑛一; 大田, 守雄; 城間, 寛

    1989-01-01

    A 38-year- old Japanese man with Budd-Chiari syndrome combined with hepatocellular carcinoma was successfully treated by direct reconstruction with open endvenectomy of the occluded vena cava and partial hepatectomy. In preoperative CT scanning, a round low density lesion, approximately 6 cm in diameter,was found in the superior-posterior segment of the liver. Inferior cavography and right atriography performed simultaneously demonstrated a complete obstruction of the hepatic vena cava, 8 cm ...

  4. Difference in left renal vein pressure: an indicator for free of reconstruction after ligation in retroperitoneal tumor patients

    Chengli Miao; Mengmeng Xiao; Tengyan Li; Gang Liu; Xing Liu; Yue Kong; Chenghua Luo

    2015-01-01

    We hypothesized that the left renal vein pressure difference (ΔP) before and after the ligation can serve as an objective indicator for free of reconstruction after resection of a retroperitoneal tumor with renal segment of inferior vena cava and right kidney. After established a model of left renal vein compression, 45 miniature pigs were operated on experimental procedures including renal segment of inferior vena cava resection, right nephrectomy, and left renal vein ligation. The ΔPs of le...

  5. 促红细胞生成素对慢性肾脏疾病患者的肾保护作用研究%Protective Effect of Erythropoietin on Kidney in Patients with Chronic Kidney Disease

    于芳

    2012-01-01

    目的:研究患贫血的慢性肾脏疾病(CKD)患者,确定促红细胞生成素(EPO)是否影响肾血管和氧化应激生物标志物.方法:30例患有贫血的CKD患者采用重组人EPO治疗,每2周皮下注射1次12 000 U的EPO,治疗前和治疗后6个月测定各种参数.结果:6个月后,血清血红蛋白(Hbg)显著增加(P<0.05),尿蛋白水平、尿中肝型脂肪酸结合蛋白(L-FABP)、尿中8-羟基脱氧鸟苷(8-OHdG)、颈动脉内膜中层厚度(IMT)、臂踝脉搏波速度(baPWV)、血浆脑钠肽(BNP)和血清非对称二甲基精氨酸(ADMA)水平显著下降(P<0.05);血清肌酐、肾小球滤过率(eGFR)、左心室射血分数(LVEF)、心胸比(CTR)和下腔静脉尺寸(IVCD)差异不大.结论:重组人EPO可改善肾功能损伤、氧化应激和动脉粥样硬化进展,还可改善CKD患者贫血.%OBJECTIVE: To study the chronic kidney disease (CKD) with anemia, to determine whether erythropoietin (EPO) can influence renal vessel and oxidative stress biomarkers. METHODS: 30 CKD patients with anemia receiving subcutaneous injection of recombinant human EPO 12 000 U once every 2 weeks. The parameters were measured before and 6 months after treatment. RESULTS: After 6 months, serum hemoglobin (Hbg) increased significantly (P<0.05), and urinary protein, urinary liver-type fatty acid binding protein (L-FABP), urinary 8- hydroxy-deoxyguanosine (8-OHdG), carotid intima-media thickness (IMT) and brachial-ankle pulse wave velocity (baPWV) , plasma brain natriuretic peptide (BNP) and serum asymmetric dimethyl arginine (ADMA) levels were significantly decreased (P<0.05). The difference of serum creatinine, glomerular filtration rate (eGFR), left ventricular ejection fraction (LVEF), cardiothoracic ratio (CTR) and inferior vena cava size (PVCD) was not significant. CONCLUSION: Recombinant human EPO can improve renal function, oxidative stress and atherosclerosis progress; in addition, it can improve the anemia in patients with CKD.

  6. Fístula axilo-cava para hemodiálise: relato de caso Axillary arteriovenous fistula for hemodialysis: case report

    Yosio Nagato

    2009-12-01

    Full Text Available Na confecção de fístula arteriovenosa (FAV para hemodiálise, condutos venosos autógenos demonstram performance superior quando comparados com material protético em relação à perviedade primária ou secundária. A prótese de politetrafluoroetileno (PTFE é reservada para casos de falência de material autógeno e é geralmente utilizada em fístulas em membros superiores. Descrevemos o caso de uma paciente de 52 anos que, após falência de acessos para hemodiálise e impossibilidade de realização de diálise peritoneal em razão de peritonite bacteriana, foi submetida à confecção de FAV entre a artéria axilar direita e a veia cava inferior com prótese de PTFE de 6 mm. O acesso foi utilizado para hemodiálise 1 mês após sua criação e permanece pérvio após 24 meses. Até o momento, não houve complicações infecciosas, sinais de insuficiência cardíaca ou síndrome de roubo em membro superior direito.With regards to the creation of an arteriovenous fistula (AV fistula for hemodialysis, autogenous venous grafts clearly show high performance when compared with prosthetic material in terms of primary or secondary patency. Polytetrafluoroethylene (PTFE grafts for the reconstruction of AV fistulae must be restricted to cases of failure of the autogenous material, which is generally used in upper limb fistulae. We describe a case of a 52-year-old patient, who, after access failure for hemodialysis and the impossibility of performing peritoneal dialysis due to bacterial peritonitis, underwent the reconstruction of an AV fistula between the right axillary artery and the cava vein using a 6-mm PTFE prosthesis. One month after surgery, this AV fistula started to be used for hemodialysis. The AV fistula remains patent 24 months after its creation. No infectious complications, cardiac insufficiency symptoms, or steal syndromes of right upper limb were detected.

  7. Die Bedeutung einer Dilatation der Vena femoralis communis für die Pathophysiologie der chronischen Veneninsuffizienz und der Stellenwert einer Diameterbestimmung der Vena femoralis communis als diagnostisches und prognostisches Kriterium der CVI im Rahmen der degenerativen Venenerkrankungen

    Dyszynski, Tomasz

    2004-01-01

    Background: Chronic Venous Disease (CVD) is one of the most frequent illnesses in the industrialised countries. Its prevalence within adult population exceeds in some European countries 50%. This accounts for 1.5 till 2.0 % of health care expenditures. Varicose veins (vv) and CVD decrease the quality of life of patients and their families. Venous wall degeneration is common primary cause of CVD. However, the pathophysiologic role of degenerative venodilation has not yet been finally estab...

  8. The combined interventional treatment for lower extremity deep venous thrombosis

    Objective: To evaluate the clinical effectiveness of the combined interventional treatment for lower extremity deep venous thrombosis (LEDVT). Methods: 156 cases with LEDVT were treated by interventional thrombolysis. Among them, 39 cases were treated with placement of inferior vena cava filters, thrombosis of 18 cases were drawn by guiding catheter, 26 cases by PTA and 12 cases were placed with stents. Results: The total effective rate was 96.2%, ineffective rate was 3.8%. Average resident date was 10.5 days. Conclusions: The combined interventional treatment for LEDVT has better clinical effect and shorten the course of the disease

  9. Radical resection of a late-relapsed testicular germ cell tumour: hepatectomy, cavotomy, and thrombectomy.

    Ní Leidhin, C; Redmond, C E; Cahalane, A M; Heneghan, H M; Motyer, R; Ryan, E R; Hoti, E

    2014-01-01

    Up to 3.2% of patients with testicular germ cell tumours represent with late-relapsing disease. Aggressive surgical resection confers the greatest chance of cure in this patient group. We present the case of a late and extensively relapsed nonseminomatous germ cell tumour with thrombus present along the entire length of the inferior vena cava, as well as in the right hepatic vein. Techniques practised in liver transplantation were used to achieve complete resection of the tumour thrombus. This case illustrates the enhanced potential for tumour resection through a fusion of principles derived from surgical oncology and liver transplantation. PMID:25587480

  10. Radical Resection of a Late-Relapsed Testicular Germ Cell Tumour: Hepatectomy, Cavotomy, and Thrombectomy

    C. Ní Leidhin

    2014-01-01

    Full Text Available Up to 3.2% of patients with testicular germ cell tumours represent with late-relapsing disease. Aggressive surgical resection confers the greatest chance of cure in this patient group. We present the case of a late and extensively relapsed nonseminomatous germ cell tumour with thrombus present along the entire length of the inferior vena cava, as well as in the right hepatic vein. Techniques practised in liver transplantation were used to achieve complete resection of the tumour thrombus. This case illustrates the enhanced potential for tumour resection through a fusion of principles derived from surgical oncology and liver transplantation.

  11. Management of high-risk reentry sternotomy in an infant for repair of a giant pseudoaneurysm of the right ventricular outflow tract

    Bryan G Maxwell

    2014-01-01

    Full Text Available Improved survival from congenital heart disease has led to an increasing need for complex reoperation by reentrant sternotomy. Peripheral cannulation and initiation of cardiopulmonary bypass prior to sternotomy to avoid the risk of cardiac injury and massive hemorrhage is an option in adults and larger children, but femoral vessel size precludes this strategy in infants. We describe the management of a high-risk reentry sternotomy in an infant for repair of a giant pseudoaneurysm after prior homograft repair of tetralogy of Fallot, using surgical dissection for suprasternal cannulation of the innominate artery and subxyphoid cannulation of the inferior vena cava.

  12. Tumor thrombus

    Ravina, Mudalsha; Hess, Søren; Chauhan, Mahesh Singh; Jacob, Mattakorottu Joseph; Alavi, Abass

    2014-01-01

    PURPOSE: Thrombosis in cancer may manifest itself as venous thromboembolic disease or tumor thrombosis (TT). We present our experience with incidentally detected TT on FDG PET/CT in 21 oncologic patients. PATIENTS AND METHODS: We retrospectively reviewed all FDG PET/CT examinations during a 5-year......-one patients were included; the most common malignancies were renal cell carcinoma (n=6), hepatocellular carcinoma (n=3), and lung cancer (n=3). Indication for the scan was initial staging (n=15) and suspected recurrence (n=6). Several vessels were affected, the most common was the inferior vena cava (n=14...

  13. Manejo de lesión traumática de arteria femoral con injerto autólogo de vena safena en zona de operaciones

    M. Gascón Hove

    2015-03-01

    Full Text Available Tanto en el ámbito civil como en el militar, las lesiones vasculares de las extremidades inferiores son frecuentes y potencialmente mortales. Las medidas de soporte iniciales para combatir el shock, una actitud quirúrgica técnicamente correcta encaminada a reparar precozmente la vascularización del miembro y un control postoperatorio estricto y continuo son los pilares básicos del tratamiento. En condiciones óptimas, las tasas de amputación y de mortalidad se hallan por debajo del 10 y del 4%, respectivamente. Presentamos a continuación un caso de un militar afgano con una lesión con pérdida de substancia de la arteria femoral en el que se consiguió una revascularización inicial con un shunt temporal. Tras ser estabilizado y evacuado al ROLE 2 de Herat, se realizó un injerto autólogo de la vena safena contralateral.

  14. Quilotórax Chylothorax

    Marcelo Alexandre Costa Vaz

    2006-08-01

    Full Text Available O quilotórax, normalmente secundário a doenças malignas, trauma, doenças congênitas, infecções e trombose da veia cava superior, é uma causa pouco freqüente de derrame pleural. O diagnóstico e tratamento precoces são importantes no sentido de prevenir a mais temida conseqüência do quilotórax, a má nutrição e conseqüente comprometimento do estado imunológico.Chylothorax, an uncommon cause of pleural effusion, is usually secondary to malignancy, trauma, congenital diseases, infections and superior vena cava thrombosis. The early diagnosis and treatment are important to prevent the most fearful consequence of chylothorax, the malnutrition with a compromised immunological status.

  15. Factor V G1691A (Leiden is a major etiological factor in Egyptian Budd-Chiari syndrome patients

    Tawhida Y. Abdel Ghaffar

    2011-12-01

    Full Text Available Objective: Budd-Chiari syndrome is a multifactorial disease in which several prothrombotic disorders may predispose patients to the development of thrombosis at this uncommon location (hepatic veins. The aim of this study was to determine the prevalence and characteristics of inherited thrombophilia in Egyptian Budd-Chiari syndrome patients.Materials and Methods: The study included 47 Budd-Chiari syndrome patients (20 children and 27 adults. Genotyping of Factor V G1691A (Leiden, prothrombin G20210A (PT, and methylenetetrahydrofolate reductase C677T were performed using real-time PCR and fluorescence melting curve detection analysis.Results: Factor V Leiden was observed in 29 patients (61.7%. It is the only factor that caused Budd-Chiari syndrome in 18 of the patients and in 5 of the patients with inferior vena cava involvement. Myeloproliferative disease was noted in 12 (25.5% patients, antiphospholipid syndrome in 5 (10.6%, and Behcet’s disease in 3 (6.4%. Interestingly, 3 of the children with Budd-Chiari syndrome had lipid storage disease.Conclusion: Factor V Leiden was a major etiological factor in Egyptian Budd-Chiari syndrome patients, which may have been related to the high frequency of this mutation in the study region. Factor V Leiden was also a strong thrombophilic factor and the leading cause of inferior vena cava thrombosis in these patients. Lipid storage disease should be included as a risk factor for Budd-Chiari syndrome.

  16. Community Hospital of the Assumption, Thurles, Tipperary.

    Goh, Gerard S

    2012-12-01

    Optional inferior vena cava (IVC) filters are being increasingly used for protection against pulmonary embolism in patients with deep vein thrombosis where anticoagulation is contraindicated. We describe two cases during retroperitoneal surgery where the IVC filters were found to have perforated the cava wall and were subsequently removed intra-operatively. Cava wall penetration by filter limbs poses a significant danger during retroperitoneal lymph node dissection and filters should be removed preoperatively.

  17. IVC filter limb penetration of the caval wall during retroperitoneal surgery/lymph node dissection.

    Goh, Gerard S

    2012-12-01

    Optional inferior vena cava (IVC) filters are being increasingly used for protection against pulmonary embolism in patients with deep vein thrombosis where anticoagulation is contraindicated. We describe two cases during retroperitoneal surgery where the IVC filters were found to have perforated the cava wall and were subsequently removed intra-operatively. Cava wall penetration by filter limbs poses a significant danger during retroperitoneal lymph node dissection and filters should be removed preoperatively.

  18. IVC filter limb penetration of the caval wall during retroperitoneal surgery/lymph node dissection

    Optional inferior vena cava (IVC) filters are being increasingly used for protection against pulmonary embolism in patients with deep vein thrombosis where anticoagulation is contraindicated. We describe two cases during retroperitoneal surgery where the IVC filters were found to have perforated the cava wall and were subsequently removed intra-operatively. Cava wall penetration by filter limbs poses a significant danger during retroperitoneal lymph node dissection and filters should be removed preoperatively.

  19. Management and outcome of cardiac and endovascular cystic echinococcosis.

    Marta Díaz-Menéndez

    2012-01-01

    Full Text Available BACKGROUND: Cystic echinococcosis (CE can affect the heart and the vena cava but few cases are reported. METHODS: A retrospective case series of 11 patients with cardiac and/or endovascular CE, followed-up over a period of 15 years (1995-2009 is reported. RESULTS: Main clinical manifestations included thoracic pain or dyspnea, although 2 patients were asymptomatic. Cysts were located mostly in the right atrium and inferior vena cava. Nine patients were previously diagnosed with disseminated CE. Echocardiography was the diagnostic method of choice, although serology, electrocardiogram, chest X-ray, computed tomography/magnetic resonance imaging and histology aided with diagnosis and follow-up. Nine patients underwent cardiac surgery and nine received long-term antiparasitic treatment for a median duration of 25 months (range 4-93 months. One patient died intra-operatively due to cyst rupture and endovascular dissemination. Two patients died 10 and 14 years after diagnosis, due to pulmonary embolism (PE and cardiac failure, respectively. One patient was lost to follow-up. Patients who had cardiac involvement exclusively did not have complications after surgery and were considered cured. There was only one recurrence requiring a second operation. Patients with vena cava involvement developed PEs and presented multiple complications. CONCLUSIONS: Cardiovascular CE is associated with a high risk of potentially lethal complications. Clinical manifestations and complications vary according to cyst location. Isolated cardiac CE may be cured after surgery, while endovascular extracardiac involvement is associated with severe chronic complications. CE should be included in the differential diagnosis of cardiovascular disease in patients from endemic areas.

  20. Correlação entre os índices dopplervelocimétricos da veia cava inferior e ducto venoso e a concentração de hemoglobina do cordão em fetos de gestantes isoimunizadas

    Taveira Marcos Roberto

    2003-01-01

    Full Text Available OBJETIVO: o objetivo principal desse estudo foi verificar se existe correlação entre os índices dopplervelocimétricos da veia cava inferior e do ducto venoso e a concentração sérica da hemoglobina fetal. MÉTODOS: estudo transversal e prospectivo, realizado entre janeiro de 1998 e junho de 2001. Foram acompanhadas 31 gestantes isoimunizadas com resultado do teste de Coombs indireto maior que 1:8, que foram submetidas à pesquisa de hemólise fetal. Quando foram indicadas as transfusões intra-uterinas intravasculares, a hemoglobina do cordão foi dosada no início do procedimento. Nos demais casos, a hemoglobina do cordão foi mensurada no momento do parto, sempre por cesariana eletiva. Obteve-se um total de 74 procedimentos estudados, definidos como sendo cada transfusão intra-uterina precedida pela dopplervelocimetria venosa. A mensuração da concentração da hemoglobina fetal foi realizada no Hemocue® (B-Hemoglobin Photometer Hemocue AB; Angelholm, Sweden, dispositivo usado para a determinação quantitativa de hemoglobina no sangue. A dopplervelocimetria da cava inferior e do ducto venoso foi realizada antecedendo a coleta do sangue fetal, sempre em intervalo de tempo inferior a 24 horas. Os índices dopplervelocimétricos estudados foram o índice de pulsatilidade para veias (IPV, o índice do pico de velocidade para veias (IPVV e a relação entre o pico de velocidade durante a fase de contração atrial e o pico de velocidade na sístole ventricular (relação CA/SV ou índice de pré-carga, na veia cava inferior, e o IPV, IPVV e a relação entre os picos de velocidade da sístole ventricular e da contração atrial (relação SV/CA, no ducto venoso. Foi realizado estudo de correlação entre a dopplervelocimetria da veia cava inferior e do ducto venoso e a hemoglobina do cordão, pela técnica de regressão linear simples. Realizou-se também estudo de associação entre os índices dopplervelocimétricos do compartimento

  1. Produção de serapilheira em um fragmento adjacente a uma cava de mineração, Ribeirão Grande, SP

    Leandro S. Nascimento

    2015-09-01

    Full Text Available RESUMORealizou-se este estudo com o objetivo de avaliar a produção de serapilheira em um fragmento florestal adjacente a uma cava de mineração de calcário, Ribeirão Grande (SP. O material foi coletado mensalmente entre os meses de fevereiro de 2011 a janeiro de 2012. Foram utilizados 14 coletores de madeira (0,25 x 0,25 m, suspensos 20 cm acima da superfície do solo. Em laboratório o material interceptado nos coletores foi triado nas frações: folhas, caules, flores, frutos e sementes, ramos com até 2 cm de diâmetro e restos (material fecal, insetos e plântulas, secado em estufa a 70 °C e pesado em balança analítica. A produção anual média de serapilheira para a área foi de 2809,02 g m-2. Dentre as frações da serapilheira a que mais contribuiu para a produção total foi a fração folhas representando 73,86% do peso seco total (2074,74 g m-2, seguida da fração ramos, com 18,89% da serapilheira total (530,67 g m-2, frutos e sementes 3,39% (95,18 g m-2, restos 2,65% (74,48 g m-2 e flores com 1,21% (33,95 g m-2. Pelos resultados obtidos não há evidências de que a presença da mina esteja interferindo na produção de serapilheira haja vista que os dados alcançados se assemelham aos de outros trabalhos já publicados sobre o tema.

  2. Monocultivo de eucalipto e consórcio com sesbânia: crescimento inicial em cavas de extração de argila Eucalyptus monocropping and intercropped with sesbania: initial growth in clay mining diggings

    Anderson Ribeiro Santiago

    2009-02-01

    Full Text Available O consórcio de eucalipto com sesbânia na reabilitação de cavas de extração de argila pode representar uma forma de uso com benefícios ecológicos e econômicos, tendo em vista a sub-utilização a que essas cavas estão sendo submetidas. Este trabalho teve por objetivo avaliar a sobrevivência, o crescimento inicial e características fisiológicas de Eucalyptus camaldulensis, E. tereticornis, E. robusta e E. pellita, em monocultivos e plantios consorciados com Sesbania virgata. Foram instalados dois experimentos (monocultivo e plantio consorciado, numa cava de extração de argila, segundo o delineamento em blocos casualizados com quatro repetições. Os plantios consorciados favoreceram a sobrevivência das espécies. Os eucaliptos no monocultivo apresentaram maior crescimento inicial em diâmetro do colo e em área de copa. As espécies de eucalipto responderam aos efeitos do consórcio e das podas ao longo do tempo, exceto E. tereticornis.Intercropping of Eucalyptus and sesbania for the recovery of clay mining diggings can represent ecological and economic benefits. This work aimed to evaluate survival, initial growth and physiological characteristics of Eucalyptus camaldulensis, E. tereticornis, E. robusta and E. pellita, monocropped and intercropped with Sesbania virgata. Two experiments (monocropping and intercropped were set up in a clay mining digging, arranged in a randomized block design with 4 replicates. Intercropping favored the survival of the species. Eucalyptus monocropping presented a greater initial growth in soil level diameter and canopy area. The eucalyptus species responded to the effects of intercropping and pruning, along time, except for E. tereticornis.

  3. Comparison of CT scan and colour flow doppler ultrasound in detecting venous tumour thrombous in renal cell carcinoma

    Renal cell carcinoma has marked tendency to spread into renal vein, inferior vena cava and right side of heart. Extension of tumour thrombus into these veins will alter the surgical approach. We have compared the CT scan with Colour flow Doppler ultrasound in detecting venous tumour thrombus in renal vein and inferior vena cava. This cross-sectional study included 30 adult patients presenting with renal tumour. Patients of either gender were included in the study. Non probability convenience sampling was used. All patients underwent colour flow Doppler ultrasound and CT scan with contrast to asses the renal vein and inferior vena cava. The results were confirmed by intra operative findings and histopathology. The data was analyzed using SPSS version 12. Out of 30 patients, 20 (66%) were males and 10 (34%) female. The tumour was predominantly on the right side (60%), as was renal venous tumour thrombus (44%). Inferior vena cava was involved in 4 cases predominantly due to right sided tumours. The sensitivity of Doppler ultrasound in detecting renal venous tumour thrombus (88% on right and 100% on left side) was higher than CT scan (63% on right and 60% on left side). Doppler ultrasound was also superior to CT scan in detecting vena caval thrombus. The overall sensitivity of Doppler sonography was higher than CT scan in detecting tumour extension into renal veins and inferior vena cava. Therefore, it can be used as a complementary tool in equivocal cases. (author)

  4. Ultrasound and computed tomography description of the liver the Boa constrictor

    Ultrasound is a method for noninvasive diagnosis, their effectiveness in the diagnosis of liver disease has been described in snakes. The liver is the largest organ of the coelomic cavity of reptiles. Elongated and flattened. The caudal vena cava and portal vein divides the body into two lobes. The hepatic parenchyma is homogeneous hypoechoic echogenicity. The objective is to describe and to obtain reference images in the study of liver four snakes of Boa constrictor amarali, through an ultrasound and tomography. Physical restraint made for the ultrasound examination held in prone position, to compare the texture and mark the structures for the slices on CT. A linear multifrequency probe of 6-10 mHz was used. The anesthetic protocol for computed tomography consisted of isoflurane. In helical CT scanner, the animal was positioned in the prone position, and used continuous cross sections of 2 mm by 2. The ultrasound and CT examinations allowed the identification of liver contours as well as the definition and extension of the caudal vena cava and portal vein. Normal pattern recognition of CT aspect of the present study will be of help in the diagnosis of liver diseases in snakes (Boa constrictor amarali). (author)

  5. Leiomyosarcoma of the Adrenal vein: a novel approach to surgical resection

    Elefteriades John

    2007-10-01

    Full Text Available Abstract Background Leiomyosarcomas typically originate within smooth muscle cells. Leiomyosarcomas arising from the adrenal vein are rare malignancies associated with delayed diagnosis and poor prognosis. The most common vascular site of origin is the inferior vena cava. Case presentation This is a 64-year old woman who presented with a 13 × 6.5 × 6.6 cm heterogeneous mass arising in the region of the right adrenal gland and extending into the inferior vena cava (IVC and the right atrium. Biochemical evaluation excluded a functional tumor of the adrenal gland, and multiple tumor markers were negative. We present the novel use of deep hypothermic circulatory arrest (DHCA in the resection of an adrenal vein leiomyosarcoma extending into the right atrium. The patient remains free of disease ten months after surgery. DHCA afforded a bloodless operative field for optimal resection of disease from within the IVC. Conclusion The diagnosis of leiomyosarcomas of the adrenal vein is one of exclusion and involves preoperative radiological imaging and biochemical evaluation to exclude other functional tumors of the adrenal gland. Aggressive surgical resection is associated with improved survival and may be best achieved via collaboration among different surgical subspecialties.

  6. Ultrasound and computed tomography description of the liver the Boa constrictor; Descricao ultrassonografica e tomografica do figado de Boa constrictor

    Zulim, Rosalia Marina Infiesta; Geller, Felipe Foletto; Souza, Priscila Macedo de; Mamprim, Maria Jaqueline, E-mail: rosaliamarina@hotmail.com [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Faculdade de Medicina Veterinaria e Zootecnia . Dept. de Reproducao Animal e Radiologia Veterinaria; Cardoso, Guilherme Schiess; Teixeira, Carlos Roberto [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Faculdade de Medicina Veterinaria e Zootecnia . Dept. de Cirurgia e Anestesiologia Veterinaria; Andrade, Rafael Souza [Universidade Federal Rural da Amazonia (UFRA), Belem, PA (Brazil); Rossetti, Diogo Pascoal; Comerlato, Alexandra Tiso [Universidade Estadual Paulista Julio de Mesquita Filho (CEMPAS/UNESP), Botucatu, SP (Brazil). Faculdade de Medicina Veterinaria e Zootecnia. Centro de Medicina e Pesquisa de Animais Silvestres

    2012-07-01

    Ultrasound is a method for noninvasive diagnosis, their effectiveness in the diagnosis of liver disease has been described in snakes. The liver is the largest organ of the coelomic cavity of reptiles. Elongated and flattened. The caudal vena cava and portal vein divides the body into two lobes. The hepatic parenchyma is homogeneous hypoechoic echogenicity. The objective is to describe and to obtain reference images in the study of liver four snakes of Boa constrictor amarali, through an ultrasound and tomography. Physical restraint made for the ultrasound examination held in prone position, to compare the texture and mark the structures for the slices on CT. A linear multifrequency probe of 6-10 mHz was used. The anesthetic protocol for computed tomography consisted of isoflurane. In helical CT scanner, the animal was positioned in the prone position, and used continuous cross sections of 2 mm by 2. The ultrasound and CT examinations allowed the identification of liver contours as well as the definition and extension of the caudal vena cava and portal vein. Normal pattern recognition of CT aspect of the present study will be of help in the diagnosis of liver diseases in snakes (Boa constrictor amarali). (author)

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

    Coelho Antônio Roberto Barros

    1999-01-01

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

  8. Characterization and Formation of longitudinal pinch-out geometries in turbidite systems: the Pïera Cava syncline (Annot Sandstone Formation)

    Daghdevirenian, Laurent; Migeon, Sébastien; Rubino, Jean-loup; Gorini, Christian

    2014-05-01

    The Grès d'Annot sandstones of Late Eocene/early Oligocene is a well-known example of turbidite accumulations deposited in a foreland basin setting. In such settings, turbidite systems are usually laterally control by syntectonic activity generating lateral pinch-outs of the infilling accumulation against the basin walls. Such tectonic activity together with progradation and retrogradation stages of the whole turbidite system could also lead to local disconnection between the continental-slope and the basin deposits and to the formation of sealed potential sand-rich reservoirs. The aim of the work is to better constrain how turbidite systems pinch out longitudinally, in both upstream and downstream directions and to characterize some typical lithofacies evolutions. Our work focused on the Peîra Cava syncline (Maritime Alps, France) where particles are sourced from the Maures, Esterel and Corso-Sarde mountains and flow towards the north following structurally-controlled conduits. Thirty lithological logs 100-m thick were acquired following the western N170-trending side of the syncline. Correlations made between the various sections allowed reconstructing the topography of the top of the blue marls that existed before the emplacement of the turbidite accumulation. This reconstruction revealed the occurrence of two types of longitudinal pinch-out geometries against relatively high-slope angles, and trending either downcurrent or upcurrent. The strongest evolution of depositional facies is observed close to upstream pinch-out surfaces. Here, turbidite deposits thin and fine longitudinally while cohesive debris-flow deposits stop over distances as short as 200 m. Then, going upward in the serie above the pinch-out surface, both turbidite and debris-flow deposits are lesser affected and finally become continuous. These observations allowed defining a depositional model for gravity flows within a confined basin. It revealed similarities with the "fill and spill" model

  9. Lung Disease

    ... ePublications > Our ePublications > Lung disease fact sheet ePublications Lung disease fact sheet This information in Spanish (en ... disease? More information on lung disease What is lung disease? Lung disease refers to disorders that affect ...

  10. Deep reflection-mode photoacoustic imaging of internal organs

    Song, Kwang Hyun; Wang, Lihong V.

    2008-02-01

    A deep reflection-mode photoacoustic imaging system was developed and demonstrated to possess a maximum imaging depth up to 38 mm in chicken breast tissue. Using this system, structures in the thoracic cavity and vasculature in cervical area of rats were clearly imaged. Particularly, part of the heart was imaged. In the thoracic cavity, the right atrium imaged, which is one of deepest, was situated ~7 mm deep. In the cervical area, common carotid artery and jugular vein were imaged, which are appropriate for the study of oxygenation between artery and vein. In the abdominal cavity, the embedded structures of a kidney, spinal cord, and vena cava inferior were also clearly imaged in situ and in vivo. The depth of the vena cava inferior was as deep as ~15 mm in vivo. This study shows the depth capability of the system in animals. This imaging modality can be a useful tool to diagnose the disease of organs by assessing the morphological and functional changes in the blood vessels and the organs.

  11. Low-Grade Endometrial Stromal Sarcoma with Intravenous and Intracardiac Extension: A Multidisciplinary Approach

    Inafuku, Hitoshi; Nakamoto, Tomoko; Taira, Yusuke; Taira, Rie; Tsubakimoto, Maho; Totsuka, Yuichi; Kuniyoshi, Yukio; Tamaki, Tomoko; Aoyama, Hajime

    2016-01-01

    Background. A rare case of low-grade endometrial stromal sarcoma (LG-ESS) extending to inferior vena cava (IVC) and cardiac chambers. Case Report. A 40-year-old woman had IVC tumor, which was incidentally detected by abdominal ultrasonography during a routine medical checkup. CT scan revealed a tumor in IVC, right iliac and ovarian veins, which was derived from the uterus and extended into the right atrium and ventricle. The operation was performed, the heart and IVC were exposed, and cardiopulmonary bypass was initiated. A right atriotomy was performed, and the intracardiac mass was removed. Then the tumor in IVC and the right internal iliac vein were removed after longitudinal venotomies in the suprarenal and infrarenal vena cava, the right common iliac vein. Next the pelvis was explored. Tumors were found originating from the posterior wall of the uterus and continuing into both the right uterine and ovarian vein. The patient underwent total hysterectomy with bilateral salpingooophorectomy. Complete tumor resection was achieved. Histopathological analysis confirmed a diagnosis of LG-ESS. She showed no evidence of disease for 2 years and 3 months. Conclusions. Our case highlights the importance of a multidisciplinary approach in treating this rare cardiovascular pathological condition through preoperative assessment to final operation.

  12. Transperitoneal Laparoscopic Pyelopyelostomy for Retrocaval Ureter without Excision of the Retrocaval Segment: Experience on Three Cases

    Ghoundale, O.; Kasmaoui, E. H.; Touiti, D.

    2016-01-01

    Introduction. Retrocaval ureter is a rare congenital anomaly. Open surgery was the classic treatment for this condition. Laparoscopy is currently an admitted procedure to treat many urological diseases. The objective of our study is to present our experience and discuss the safety and the feasibility of transperitoneal laparoscopic pyelopyelostomy for treatment of retrocaval ureter (RCU). Materials and Methods. Three symptomatic patients underwent laparoscopic repair for RCU in our department. The diagnosis was suspected on the computed tomography scan (CT) and confirmed on ascending pyelography. After placement of a JJ stent, and, using the transperitoneal approach, the retro peritoneum was exposed; the ureter was identified in both sides of the vena cava. The retrocaval segment was entirely mobilized and pulled from behind of the vena cava after section of renal pelvis. A pyelopyelostomy was done in a normal anatomic position. Results. All operations were achieved laparoscopically without conversion to open surgery. The mean operative time was 140 minutes (110–190). No intraoperative complication occurred. Blood loss was less than 50 mL in all patients. The mean hospital stay was 5 days (4–6 days). All patients were symptom-free after surgery and had reduction of hydronephrosis in control imagery. Conclusion. Laparoscopy seems safe, feasible, and reproducible in managing retrocaval ureter. PMID:27403160

  13. Renal Vein Reconstruction for Harvesting Injury in Kidney Transplantation

    Birkan Bozkurt

    2014-03-01

    Full Text Available Kidney transplantation is the best treatment choice in the end-stage renal disease. In the renal transplantation, renal vein damage or shortness which occurs during cadaveric or living donor nephrectomy causes technical difficulties for surgeons. The lack of the donors already especially cadaveric, the acquirement of the graft, gets very much importance. In this report, it is aimed to share the clinical experiment by which it seen, how anastomosis can become appropriate by using the renal vein which is damaged in the way that anastomosis cannot be done anyway by using cadaveric vena cava graft. The renal vein brought to length for anostomosis which is repaired by using cadaveric vena cava graft, is anastomosed successfully by becoming an end-to-side of the external iliac vein of the recipient. Vascular anastomoses are applied easily in technique. The time of the warm ischemia was under 2 hours and the kidney was functional in the post-operative period. Renal vein trombosis was not observed. The renal vein damage occured during cadaveric or living donor nephrectomy, can be repaired by some methods. In the kidneys in which vein requirement is done, the success rates are rather high although acute tubular necrosis and delayed function can be seen more.

  14. Drenaje anómalo de la vena umbilical en la aurícula derecha: Presentación de 1 caso Abnormal entry of the umbilical vein into the right atrium: A case report

    Luis Raúl Martínez González; Analiz de Paula Paredes

    2001-01-01

    Se presentó 1 caso de malformación fetal rara en el que se diagnosticó un drenaje anómalo de la vena umbilical en la aur��cula derecha, se acompañaba de una eventración diafragmática con localización del lóbulo derecho hepático en el hemitórax. Se realizó, previo asesoramiento genético a la pareja, la interrupción del embarazo a las 20,5 sem por el método de Rivanol. Se obtuvo un feto femenino de 320 g y se corroboró anatomopatológicamente el diagnóstico ultrasonográfico prenatal.A rare case ...

  15. Abrahán Enseña astronomía: el prototipo bíblico del estudio del cómputo en las abadías Benedictinas de Cava de' Tirreni y Ripoll.

    Castiñeiras González, M. A.

    In two miscellanies of computus from the abbeys of Cava de' Tirreni (XI century) and Santa María de Ripoll (XII century) an interesting illumination with the patriarch Abraham teaching three Egyptian disciples in secrets of cosmos was represented. The image, not documented in the Vulgata, is derived from a Jewish-Hellenistic tradition that presented Hebrews preceding Egyptians and Greeks in scientific knowledge. The representation of this subject is related to the teaching of astronomy in the Benedictine abbeys to determine the times (horas canonicae) and dates of Easter. But the Isidore's text which accompanies the illumination explains its real meaning: thanks to astrology, that had even practiced by Abraham, magicians were able to determine the birth of Christ. However this event put an end to superstition and was the beginning of Christian time.

  16. Glomerular Diseases

    ... Research Training & Career Development Grant programs for students, postdocs, and faculty Research at NIDDK Labs, faculty, and ... diabetes, digestive and liver diseases, kidney diseases, weight control and nutrition, urologic diseases, endocrine and metabolic diseases, ...

  17. Kawasaki Disease

    ... Content Article Body What is Kawasaki disease? Kawasaki disease is a serious and perplexing disease, the cause of which is ... influenza) with aspirin has been linked with a serious disease called Reye syndrome. Always consult your pediatrician before ...

  18. Liver transplantation for polycystic liver with massive hepatomegaly: A case report

    Wei-Wei Jiang; Feng Zhang; Li-Yong Pu; Xue-Hao Wang; Lian-Bao Kong

    2009-01-01

    A previous study has shown that liver or combined liver-kidney transplantation can be a valuable surgical technique for the treatment of polycystic liver disease.Herein, we present the case of a 35-year-old woman with polycystic liver disease, who underwent orthotopic liver transplantation (OLT) on November 11, 2008.The whole-size graft was taken from a deceased donor (a 51-year-old man who died of a heart attack).Resection in a patient with massive hepatomegaly is very difficult. Thus, after intercepting the portal hepatic vein, left hepatectomy was performed, then the vena cava was intercepted, the second and third porta hepatic isolated, and finally, right hepatectomy was performed. OLT was performed successfully.The recipient did well after transplantation. This case suggested that OLT is an effective therapeutic option for polycystic liver disease and left hepatectomy can be performed first during OLT if the liver is over enlarged.

  19. Circumaortic Left Renal Vein-A Rare Case Report

    Panagar, Anupama Doddappaiah; Subhash, R. Lakshmi Prabha; Suresh, B.S.; Nagaraj, D.N.

    2014-01-01

    During routine dissection which was carried out for the medical students, a circumaortic left renal vein draining into inferior vena cava was observed. There were 2 renal veins through which the left kidney drained into the inferior vena cava, of which the larger one ran ventral to aorta and the other smaller one ran posterior to aorta and received lumbar veins before opening into inferior vena cava. This is a relatively rare condition which can result in left renal hypertension (LRVH) syndrome which is otherwise called as anterior and posterior nutcracker syndromes. This venous anomaly results from the errors of embryological development. It is of clinical significance, mainly during retroperitoneal surgeries and intra caval interventions. It is also important in conditions which warrant extensive venous dissections, venous reconstructions as in transplantations and invasion of veins by cancerous tissue, resulting in life threatening haemorrhage. PMID:24783096

  20. A case report of secondary Budd-Chiari syndrome due to chronic empyema diagnosed by NMR-CT

    A 34-year-old male patient complained of general fatigue, ascites, and edema of the lower extremities. A chest x-ray film showed atelectasis of the right lung and pleural effusion of the right side. Liver ultrasonography revealed stenosis of the middle and right hepatic veins. Venacavography revealed stenosis of the inferior vena cava and collateral circulation. Finally, abdominal NMR-CT clearly visualized lunate stenosis and antero-lateral deviation of the inferior vena cava. He was diagnosed as having secondary Budd-Chiari syndrome resulting from the deviation and stenosis of the inferior vena cava due to distortion of the surrounding tissues by the thickened pleura which was caused by chronic empyema. (Namekawa, K.)

  1. Ribbing disease

    Ribbing disease is a rare sclerosing dysplasia that involves long tubular bones, especially the tibia and femur. It occurs after puberty and is reported to be more common in women. In this article we describe how Ribbing disease can be differentiated from diseases like Engelmann-Camurati disease, van Buchem disease, Erdheim-Chester disease, osteoid osteoma, chronic osteomyelitis, stress fracture, etc

  2. Sonographic appearance of asplenia syndrome

    The findings of upper abdominal sonography in three patients with asplenia syndrome are reported. Beside the juxtaposition of the abdominal aorta and inferior vena cava, two additional signs of the asplenia syndrome are discussed: absent splenic vein in pancreatic sonography and midline portal vein. While upper abdominal sonography is not diagnostic in determining the absence or presence of splenic tissue, it seems to be helpful in the identification of upper abdominal vascular anatomy. By demonstrating juxtaposition of the abdominal aorta and inferior vena cava, absent splenic vein, and midline portal vein, upper abdominal sonography can play a significant part in the diagnosis of asplenia syndrome. Alternative diagnostic approaches are discussed. (orig.)

  3. Extracorporeal Lung Support as a Bridge to Airway Stenting and Radiotherapy for Airway-Obstructing Pancoast Tumor.

    McLenon, Melissa; Bittle, Gregory J; Jones, Kevin; Menaker, Jay; Pham, Si M; Iacono, Aldo T; Sachdeva, Ashutosh; Rajagopal, Keshava

    2016-07-01

    Venovenous (V-V) extracorporeal membrane oxygenation (ECMO) is used for respiratory failure that is suspected to be reversible (bridge to recovery), or as a bridge to lung transplantation. Patients with proximal airway obstruction due to endobronchial malignancy can develop acute respiratory failure, and may benefit from V-V ECMO as a bridge to airway intervention, further treatment, and eventual recovery. We describe a case of a superior sulcus tumor with tracheobronchial and superior vena cava invasion causing both respiratory failure and superior vena cava syndrome. This was treated successfully with V-V ECMO, bronchial stenting, and radiotherapy. PMID:27343540

  4. Adult polysplenia syndrome.CT findings

    We present a case of polysplenia in a 55-year-old patient that was diagnosed incidentally by CT. Chest X-ray disclosed a hooked prominence of the azygos vein over right hilum, left bronchial isomerism and the absence of the inferior vena cava in an X-ray of the right side. The abdominal CT findings included multiple spleens and stomach in upper right quadrant, centrally located liver and gallbladder, intestinal malrotation, interrupted inferior vena cava continued in the azygos system, and short pancreas. Echocardiography revealed mitral stenosis not associated with cardiac malformation. (Author)

  5. Association of a unique form of cor triatriatum with tetralogy of Fallot.

    Fuchigami, Tai; Koide, Masaaki; Kunii, Yoshifumi; Watanabe, Kazumasa

    2016-04-01

    Cor triatriatum is a rare cardiac anomaly sometimes associated with tetralogy of Fallot (TOF) and persistent left superior vena cava (PLSVC). We present the case of a 2-year-old girl who was diagnosed with a unique form of cor triatriatum that was associated with TOF and PLSVC. In this case, the abnormal membrane that arose from the posterior wall of the left atrium encircled the left superior vena cava (LSVC) in the left atrial cavity. Here, we discuss this rare case as well as the imaging studies and surgical strategy adopted. PMID:25673496

  6. Radiology today. Volume 4

    The book discusses the following contents: Advances in Cardiovascular Imaging: Digital Arteriography: Ongoing Developments. Magnetic Resonance Imaging of the Cardiovascular System. Comparison of Vascular CT and MRI. Characterization of Vascular Lesions by Ultrasound - Progress in Vascular Interventions: Laser Angioplasty: A Review. Fibrinolytic Therapy Combined with Clot Extraction. Drugs Useful in Angioplasty. Developments in Cardiovascular Imaging: Blood Flow Measurements with Digital Arteriography. Selection of Imaging Techniques for Venous Thromboembolic Disease. Clinical Usefulness of High-Verus Low-Osmolality Contrast Agents. Developments in Angiographic and Interventional Instrumentation. Progress in Cardiovascular Interventions. Inferior Vena Cava Filters: Types, Placement, and Efficiency. Transluminal Vascular Stenting and Grafting. Venography and Sclerotherapy of Varioceles in Children and Adolescents. A New Catheter System - Important Hip Problems: Radiologic and Pathologic Correlation and Hip Disease. Comparison of Imaging Modalities in Femoral Head Necrosis. Osteoartrosis and Arthritis (Synovitis) of the Hip. Hip Anthrography

  7. [ANEURYSMAL TYPE RENAL ARTERIOVENOUS FISTULA WITH GIANT VENOUS ANEURYSM, MIMICKING RENAL CELL CARCINOMA: A CASE REPORT].

    Nagumo, Yoshiyuki; Komori, Hiroka; Rii, Jyunryo; Ochi, Atsuhiko; Suzuki, Koichiro; Shiga, Naoki; Ota, Tomonori

    2015-04-01

    A 39-year-old man was referred to our clinic for a 7 cm tumor in the right kidney, found by simple CT scan. It was suspected as renal cell carcinoma accompanying tumor emboli in the inferior vena cava by enhanced CT scan. For further evaluation of the tumor emboli, color Doppler ultrasound and enhanced MRI was performed. They showed a large cystic lesion with high velocity turbulent flow and flow voids in T2-weighted imaging, it seemed as giant venous aneurysm of the right renal vein. Subsequently, angiography revealed aneurysmal type renal arteriovenous fistula (AVF), transarterial embolization (TAE) of the arterial feeder with coils was performed on the same day. After 6 months from embolization, there was no recurrences or reinterventions. Color Doppler ultrasound and MRI are beneficial in distinguishing vascular disease from neoplastic disease which may sometimes mimick in other diagnostic imaging studies. In addition TAE seems to be an effective treatment for the AVF. PMID:26415363

  8. Alzheimer's Disease

    Alzheimer's disease (AD) is the most common form of dementia among older people. Dementia is a brain disorder that ... higher if a family member has had the disease. No treatment can stop the disease. However, some ...

  9. Infectious Diseases

    Infectious diseases kill more people worldwide than any other single cause. Infectious diseases are caused by germs. Germs are tiny living ... to live NIH: National Institute of Allergy and Infectious Diseases

  10. Heart Disease

    ... Got Homework? Here's Help White House Lunch Recipes Heart Disease KidsHealth > For Kids > Heart Disease Print A A ... chest pain, heart attacks, and strokes . What Is Heart Disease? The heart is the center of the cardiovascular ...

  11. Lyme disease

    ... Causes Lyme disease is caused by bacteria called Borrelia burgdorferi ( B burgdorferi ). Blacklegged ticks and other species of ... Names Borreliosis; Bannwarth syndrome Images Lyme disease organism, Borrelia burgdorferi Tick, deer engorged on the skin Lyme disease - ...

  12. Huntington's Disease

    Huntington's disease (HD) is an inherited disease that causes certain nerve cells in the brain to waste ... express emotions. If one of your parents has Huntington's disease, you have a 50 percent chance of ...

  13. Krabbe disease

    ... for Krabbe disease. Some people have had a bone marrow transplant in the early stages of the disease, but ... counseling is recommended for people with a family history of Krabbe disease who are considering having children. ...

  14. Stargardt Disease

    ... Congenital Amaurosis Macular Degeneration Retinitis Pigmentosa Stargardt Disease Usher Syndrome Other Retinal Diseases Glossary News & Research News & ... for retinal degenerative diseases like retinitis pigmentosa (RP), Usher syndrome and macular degeneration . Back to top What ...

  15. Reportable diseases

    Notifiable diseases ... Centers for Disease Control and Prevention. National Notifiable Diseases Surveillance System (NNDSS). Last updated May 4, 2015. Available at: wwwn.cdc.gov/nndss . Accessed September 9, 2015.

  16. Crohn's Disease

    Crohn's disease causes inflammation of the digestive system. It is one of a group of diseases called inflammatory ... small intestine called the ileum. The cause of Crohn's disease is unknown. It may be due to an ...

  17. Wilson Disease

    ... Wilson disease. Health care providers do not use brain imaging tests to diagnose Wilson disease, though certain findings ... testing. [ Top ] Clinical Trials The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other ...

  18. Farber's Disease

    ... Awards Enhancing Diversity Find People About NINDS NINDS Farber's Disease Information Page Synonym(s): Ceramidase Deficiency Table of Contents ( ... Trials Related NINDS Publications and Information What is Farber's Disease? Farber’s disease, also known as Farber's lipogranulomatosis, describes ...

  19. Sandhoff Disease

    ... body. Sandhoff disease is a severe form of Tay-Sachs disease, the incidence of which had been particularly ... gene therapy seen in an animal model of Tay-Sachs and Sandhoff diseases for use in humans. NIH ...

  20. Legionnaires' Disease

    ... lung disease Have a weak immune system Legionnaires' disease is serious and can be life-threatening. However, most people recover with antibiotic treatment. Centers for Disease Control and Prevention