WorldWideScience
1

Double inferior vena cava.  

Science.gov (United States)

Venous anomalies involving the inferior vena cava are very rare. The case of a 74-year-old man with coronary artery disease is presented. Interestingly, a double inferior vena cava was incidentally discovered during coronary artery bypass grafting. Persistence of the left hepatic segment vein appeared as a left inferior vena cava-a very rare condition. PMID:22698610

Tirilomis, Theodor

2012-06-01

2

Vena cava replacement for malignant disease: is there a role?  

Science.gov (United States)

Resection and graft replacement of the vena cava for malignant disease is rarely performed, often because of the advanced tumor stage. Since August 1987 we have selectively performed caval replacement in conjunction with tumor resection in 11 patients. Three patients had superior vena cava reconstruction (SVCR) and eight had inferior vena cava replacement (IVCR). There were six males and five females whose mean age was 59.3 years (range 24 to 75 years). Two patients, each with superior vena cava obstruction, presented with symptoms from venous compression. Malignancies involving the superior vena cava were thyroid carcinoma in two patients and lymphoma in one. Cancers requiring IVCR were leiomyosarcoma in three patients, cholangiocarcinoma in two, and malignant fibrous histiocytoma, hepatocellular carcinoma, and colon carcinoma metastatic to the liver in one each. All IVCRs and two SVCRs were performed with expanded polytetrafluoroethylene grafts. The remaining SVCR was constructed with spiral saphenous vein. Six IVCRs involved replacement of the retrohepatic inferior vena cava in conjunction with major liver resection. Mean intraoperative blood transfusions were 5.3 units (range 0 to 10 units). There were no operative deaths. Complications occurred in four patients and included postoperative bleeding in two, myocardial infarction in one, and wound infection in one. There were no perioperative graft occlusions, but one patient developed graft occlusion 2 months after SVCR. All IVCR grafts have remained patent (mean follow-up of 8.8 months). Two patients with SVCRs have died from recurrent cancer at 3.2 and 3.4 years postoperatively. Six patients with IVCRs have developed tumor recurrence either locally (n = 1), at a distant site (n = 2), or both (n = 3). Importantly, eight of nine survivors have an excellent performance status. We conclude that vena cava reconstruction for malignancy can be performed safely, has few graft-related complications, and in some patients may offer the only possibility for tumor control. PMID:8518120

Bower, T C; Nagorney, D M; Toomey, B J; Gloviczki, P; Pairolero, P C; Hallett, J W; Cherry, K J

1993-01-01

3

The superior vena cava syndrome caused by malignant disease  

Energy Technology Data Exchange (ETDEWEB)

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

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

2006-07-15

4

Superior vena cava syndrome secondary to thyroid cancer  

OpenAIRE

It is uncommon for thyroid cancer to present with superior vena cava syndrome. Obstruction of superior vena cava can develop as a result of intrinsic and extrinsic spread of the thyroid cancer. The usual presentation of this disease entity is a neck mass with symptoms and signs suggestive of superior vena cava obstruction. Superior vena cava obstruction is commonly caused by lung cancer and lymphoma. However, thyroid cancer can cause superior vena cava obstruction by downward tumour spread in...

Bukhari, H.; Ayad, M.; Rosenthal, A.; Block, M.; Cortelli, M.

2011-01-01

5

Vena cava filter  

International Nuclear Information System (INIS)

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

6

Anomalies of the vena cava inferior  

International Nuclear Information System (INIS)

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

7

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

International Nuclear Information System (INIS)

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

8

Vena cava superior izquierda persistente / Persistent left superior vena cava  

Scientific Electronic Library Online (English)

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

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

2014-04-01

9

Inferior vena cava aneurysm. A case report  

International Nuclear Information System (INIS)

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

10

Inferior vena cava syndrome and morbid obesity.  

Science.gov (United States)

A case is reported of inferior vena cava syndrome in a patient with extreme obesity (BMI: >70 kg/m(2)), treated at a public hospital. The inferior vena cava obstruction was diagnosed during an attempt at inferior vena cava filter percutaneous insertion, in prebariatric surgery period. The diagnosis occurred after a hepatic scintillography, and was confirmed with a femoral venography and celiac trunk arteriography. The patient underwent a biliopancreatic diversion-duodenal switch and has lost weight. A venography 7 months after the surgery did not show any inferior vena cava rechanneling evidence. PMID:18574647

Meinhardt, Nelson Guardiola; Souto, Kátia Elisabete Pires; Knebel, Alexis Vasiluk; Stein, Airton Tetelbom

2008-12-01

11

Inferior Vena Cava Filters  

OpenAIRE

Venous thromboembolism (VTE) remains a common disease with significant clinical impact upon our patients. Diagnostic challenges occur because of the nonspecific nature of the presenting symptoms. The advent of multidetector computed tomography, methods to stratify patients into VTE risks (low, intermediate, high) along with serological assays (D-dimers), have helped direct patients through proper workup and into conclusive diagnosis. In most cases, standard medical therapy for VTE is anticoag...

Kinney, Thomas B.

2006-01-01

12

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

Directory of Open Access Journals (Sweden)

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

Fernando A. Díaz Couselo

2012-08-01

13

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

Scientific Electronic Library Online (English)

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

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

2012-08-01

14

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

Directory of Open Access Journals (Sweden)

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

Ahmet Kale

2006-01-01

15

Vena cava ?nvasion by adrenal leiomyosarcoma  

Directory of Open Access Journals (Sweden)

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

Hakan Öztürk

2014-05-01

16

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

International Nuclear Information System (INIS)

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

17

Superior vena cava syndrome in hemodialysis patient  

Directory of Open Access Journals (Sweden)

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.

Molhem Azeb

2011-01-01

18

Fibrosingmediastinitis and consequent superior vena cava syndrome - A case report  

Science.gov (United States)

Fibrosing mediastinitis is a rare, chronic inflammatory disease that has several implicated etiologies. We describe a case of a 41-year old woman who presented with the classic signs and symptoms of superior vena cava syndrome. Imaging revealed a diffuse infiltrative mediastinal process, which on biopsy was consistent with fibrosing mediastintis. PMID:22934147

Kant, Saumitra

2012-01-01

19

Fibrosingmediastinitis and consequent superior vena cava syndrome - A case report  

OpenAIRE

Fibrosing mediastinitis is a rare, chronic inflammatory disease that has several implicated etiologies. We describe a case of a 41-year old woman who presented with the classic signs and symptoms of superior vena cava syndrome. Imaging revealed a diffuse infiltrative mediastinal process, which on biopsy was consistent with fibrosing mediastintis.

Kant, Saumitra; Walsh, Garrett L.

2012-01-01

20

Migration of superior vena cava stent  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract There has been a recent increase in the use of endovascular prostheses resulting in complex surgical and interventional complications not previously recognised. We report a case of Superior vena cava stenosis treated with a wallstent which migrated to the right atrium, necessitating a combined radiological and surgical approach to retrieve it.

Menon Narayan J

2008-03-01

21

Migration of superior vena cava stent  

OpenAIRE

Abstract There has been a recent increase in the use of endovascular prostheses resulting in complex surgical and interventional complications not previously recognised. We report a case of Superior vena cava stenosis treated with a wallstent which migrated to the right atrium, necessitating a combined radiological and surgical approach to retrieve it.

Menon Narayan J; Moth Phillipa; Bagul Nitin B; Myint Fiona; Hamilton George

2008-01-01

22

Endovascular treatment of superior vena cava syndrome  

DEFF Research Database (Denmark)

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

Duvnjak, Stevo; Andersen, Poul Erik

2011-01-01

23

Experience with three percutaneous vena cava filters  

International Nuclear Information System (INIS)

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

24

Multiplanar imaging of inferior vena cava variants.  

Science.gov (United States)

Inferior vena cava (IVC) variants are rare and are usually detected incidentally. Even though, these variants are by themselves asymptomatic, they can have important clinical, radiological, and surgical implications. In this pictorial essay, we sensitize the reader to various IVC variants by presenting reports of actual patients. A succinct description of the embryological development of these anatomic variants is also provided. PMID:24981147

Awais, Muhammad; Rehman, Abdul; Baloch, Noor Ul-Ain; Salam, Basit

2015-01-01

25

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

Scientific Electronic Library Online (English)

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

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

2014-02-01

26

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

International Nuclear Information System (INIS)

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

27

Palliative treatment of superior vena cava syndrome with nitinol stents.  

Science.gov (United States)

This study aims to retrospectively evaluate the outcomes following nitinol stent placement for malignant superior vena cava syndrome. A total of 25 patients with thoracic malignancies were treated with self-expanding nitinol stents for superior vena cava syndrome (E*Luminexx [Bard GmbH/Angiomed, Karlsruhe, Germany], Sinus-XL [OptiMed Medizinische Instrumente GmbH, Ettlingen, Germany], and Zilver Vena [Cook Medical Inc., Bloomington, IN]). It was seen that the procedural success rate was 76% with all stents deployed as intended and no procedure-related complications but in five patients with 50% residual stenosis and one patient with stent occlusion within 48 hours after stent deployment. Stent occlusion occurred in further two patients during follow-up: one patient developed infection, thrombosis, and occlusion in the stent seen at 2-month follow-up, and one patient had stent occlusion at 4-month follow-up. The clinical success rate was 96%. Stent compression leading to a greater than 50% reduction in stent diameter was observed in three patients at follow-up. Overall 22 patients died at a mean follow-up of 3.5 months for reasons related to their underlying malignancy. It was concluded that the stent treatment for superior vena cava syndrome is a safe treatment with good clinical effect in patients with superior vena cava syndrome in the terminal phase of malignant disease. In this small patient population, no trends were observed which would suggest that outcomes vary by stent type, though additional, large-scale studies are needed. PMID:25484557

Andersen, Poul Erik; Duvnjak, Stevo

2014-12-01

28

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

Scientific Electronic Library Online (English)

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

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

2006-07-01

29

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

Directory of Open Access Journals (Sweden)

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

Michel Bergoeing R

2006-07-01

30

Magnetic resonance venography of double inferior vena cava.  

OpenAIRE

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

Ilkan Tatar; Tore, Huseyin G.; Celik, Hakan H.; Musturay Karcaaltincaba

2005-01-01

31

The leiomyosarcoma of the vena cava inferior  

International Nuclear Information System (INIS)

The leiomyosarcoma of the Vena cava inferior is a mesenchymal tumor originating from the smooth muscle fibers of the vascular wall. This tumor is usually slow-growing and of expansive growth. Prior to the sonographic and computer-tomographic era the tumor was usually only discovered during autopsy or surgery without any preoperative suspicion. Today, the most efficient imaging methods for exact localization, delineation or relation to the vascular lumen and local extent are sonography and computer tomography. Caudal cavography is called upon for preoperative demonstration of the venous collateral circulation and thrombotic vascular occlusion. (orig.)

32

Right superior vena cava draining into the left atrium  

International Nuclear Information System (INIS)

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

33

A new design of the retrievable vena cava filter.  

Science.gov (United States)

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

Chen, Zengsheng; Zhang, Xiwen; Deng, Xiaoyan

2012-11-01

34

Superior vena cava syndrome caused by embolisation of liquid Onyx  

OpenAIRE

Superior vena cava syndrome (SVCS) is usually caused by a malignancy or the presence of an intravascular device in a central vein. A 74-year-old male with a history of a superior vena cava (SVC) stent underwent embolisation of a brain arterio-venous malformation through the right meningeal artery with liquid Onyx. Two weeks later he presented with acute respiratory failure, upper airway obstruction, plethora, varices of the chest wall and stridor. He was intubated and placed on mechanical ven...

Crusio, Robbert; Ramachandran, Kishan; Ramachandran, Kavan; Kupfer, Yizhak; Tessler, Sidney

2011-01-01

35

Venous Thromboembolism After Removal of Retrievable Inferior Vena Cava Filters  

OpenAIRE

The purpose of this study was to examine the incidence of new or recurrent venous thromboembolism (VTE) after retrieval of inferior vena cava (IVC) filters and risk factors associated with such recurrence. Between March 2001 and September 2008, at our institution, implanted retrievable vena cava filters were retrieved in 76 patients. The incidence of new or recurrent VTE after retrieval was reviewed and numerous variables were analyzed to assess risk factors for redevelopment of VTE after fil...

Yamagami, Takuji; Tanaka, Osamu; Yoshimatsu, Rika; Miura, Hiroshi; Nishimura, Tsunehiko

2010-01-01

36

Injuries of the retrohepatic inferior vena cava and the liver  

OpenAIRE

Beckground. Injuries of the retrohepatic inferior vena cava, and the liver have mortality rate up to 71-78%. We presented a patient with combined injury of the retrohepatic inferior vena cava, liver, craniocerebral and thoracic traumas, inflicted in a traffic accident. Case report. Man, 20 years old has been injured in a traffic accident. At admission, 20 minutes after the injury, the patient was comatose and hypotensive. Bloody content was obtained by abdominal tracer. The patient underwent ...

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

2008-01-01

37

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

Directory of Open Access Journals (Sweden)

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

Camilo Boza W

2001-04-01

38

Retrieval of Gunther Tulip Vena Cava Filter with Thrombosed Hook and a Leg Incorporated into the Vena Cava Wall  

OpenAIRE

A Gunther tulip vena cava filter was implanted in a patient with pulmonary embolism from deep venous thrombosis. The filter became unnecessary after therapy. However, retrieval by the standard method employing a vascular sheath placed via the transjugular approach in combination with a snare device was impossible. A thrombus occupying the apical hook made it difficult to snare the hook, also one filter leg was incorporated into the inferior vena cava wall. Therefore we modified an existing me...

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

2009-01-01

39

Multicentric pheochromocytoma and involvement of the inferior vena cava  

Scientific Electronic Library Online (English)

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

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

2001-03-01

40

Leiomyosarcoma of the inferior vena cava--a case report.  

Science.gov (United States)

This paper presents a patient successfully treated for leiomyosarcoma of the vena cava, with no recurrence or symptoms on an 8-year follow-up. A 56-year-old woman presented with chronic and progressive periumbilical and right upper abdominal pain. Physical examination and laboratory tests revealed no abnormalities. Computed tomography showed a high-density image inside the vena cava. Cavography showed a filling defect with complete occlusion of the vena cava involving the renal veins and greatly developed collateral circulation through lumbar veins. Laparotomy was performed and a large caval mass involving the renal veins was dissected and resected. Venous reconstruction was undertaken using a 19-mm bovine pericardium prosthesis (Labcor, MG-Brazil) interposed as a substitute to the vena cava, and the renal veins were anastomosed to the side of the graft. Pathologic examination confirmed a leiomyosarcoma with free surgical margins. The postoperative course was uneventful and the patient was discharged on postoperative day 8. The venous flow through the inferior vena became normal, as confirmed by later cavography. This paper presents a case of successfully managed leiomyosarcoma of the vena cava with a thorough review of the literature. The treatment of such patients and the use of bovine pericardium are also discussed. PMID:12799733

Bonamigo, Telmo Pedro; Becker, Monica; Faccini, Felipe Puricelli; Cantisani, Guido Pio Gracco; Pereira, Wagner Michael; de Napoli, Gilberto; de Oliveira Ilha, Darcy

2003-01-01

41

[Embryogenetic malformations of the inferior vena cava, and their manifestations in adults].  

Science.gov (United States)

Five male patients with congenital anomalies of the inferior vena cava aged 20 to 43 were examined. The diagnosis and the level of aplasia were established on the basis of complex instrumental examination (duplex scanning of inferior extremity veins, pelvic veins, and retroperitoneal veins; computed and magnetic resonance tomography of the abdominal cavity; pelvic phlebography; retrograde cavagraphy). Together with inferior vena cava anomalies, other malformations such as pulmonary arterial stenosis or duplication of renal collector system were diagnosed in two patients. In three or 60% of the patients the disease had first manifested by the clinical picture of peripheral thrombosis (shin and femoral edema); fever, chill and subsequent edema of both legs had been first manifestations in two patients. Aplasia of the infrarenal segment of the inferior vena cava was revealed in two patients; in other two patients aplasia of the infrarenal, renal, and partly suprarenal segments of this magistral vessel was found; in one patient the whole vein was aplastic except a small part of the suprarenal segment, where the hepatic veins and the right suprapolar renal vein flew into. To establish an early diagnosis of a congenital inferior vena cava anomaly, the protocol of examination of patients with venous diseases should include ultrasound mapping of the suprarenal and infrarenal segments of the vena cava; in cases of agenesia it should include computed and magnetic resonance tomography and retrograde cavagraphy. PMID:17665606

Baeshko, A A; Romanovich, V P; Zhuk, G V; Orlovski?, Iu N; Ulezko, E A; Chuzh, G V; Biriulin, A P

2007-01-01

42

Leiomyosarcoma of the inferior vena cava.  

Science.gov (United States)

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

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

2014-05-01

43

[Unusual course of a pulmonary artery catheter through a persistent superior vena cava] .  

Science.gov (United States)

We report the unusual course of a pulmonary artery catheter through a persistent left-sided superior vena cava. After left subclavian vein cannulation and downward left-sided paramediastinum course, the Swan-Ganz catheter enters the right pulmonary artery. Haemodynamic monitoring was consistent with the diagnosis of septic shock developed by this 56-year-old woman, after cephalic duodenopancreatectomy. Persistent left-sided superior vena cava occurs in 0.5% of the population and 5-10% of patients with congenital heart diseases. It drains into the right atrium through the coronary sinus in 92% of cases and is associated with an absent right superior vena cava in 20% of cases. The left-sided superior vena cava persists when the caudal part of the left anterior cardinal vein does not degenerate. A persistent left superior vena cava may be medically relevant during implantation of pacemaker leads or radiofrequency ablation, during cardiac surgery for placement of a retrograde coronary sinus cardioplegia catheter and during transjugular intrahepatic portosystemic shunt placement. PMID:11200762

Ould-Ahmed, M; Mas, B; Hautbois, E; Garcia, J F; Caroff, P; Guiavarch, M

2000-12-01

44

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

OpenAIRE

This paper reports the clinical findings, surgical and medical management, and necropsy of a 6 year old cow with thrombosis of the cranial vena cava and thrombo embolic pneumonia following traumatic reticuloperitonitis. The clinical diagnosis was confirmed by necropsy. Thrombosis of the caudal vena cava is a well known disorder of cattle, whereas thrombosis of the cranial vena cava is relatively uncommon (1-7). Liver abscesses that break into the caudal vena cava are the most common cause of ...

Gerspach, C.; Wirz, M.; Knubben-schweizer, G.; Braun, U.

2011-01-01

45

Fatal Pericardial Tamponade After Superior Vena Cava Stenting  

International Nuclear Information System (INIS)

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

46

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

LENUS (Irish Health Repository)

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

Leong, S

2010-06-19

47

Síndrome de veia cava superior / Superior vena cava syndrome  

Scientific Electronic Library Online (English)

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

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

2002-09-01

48

Síndrome de veia cava superior Superior vena cava syndrome  

Directory of Open Access Journals (Sweden)

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

SAMUEL ZUÍNGLIO DE BIASI CORDEIRO

2002-09-01

49

Leiomyosarcoma of inferior vena cava - a case report  

International Nuclear Information System (INIS)

The previously diagnosis of vena cava inferior tumors has a great importance in the prognosis. The present report is about a 36-year-old woman who has an abdominal mass to be confirmed. The aspects observed in the ultrasonography and computed tomography are shown. The reviewed literature on the subject is also discussed. (author)

50

Renal Angiomyolipoma Associated with Inferior Vena Cava Thrombus  

OpenAIRE

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

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

2009-01-01

51

Advanced Techniques for Removal of Retrievable Inferior Vena Cava Filters  

Energy Technology Data Exchange (ETDEWEB)

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

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

2012-08-15

52

Advanced Techniques for Removal of Retrievable Inferior Vena Cava Filters  

International Nuclear Information System (INIS)

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.

53

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

Scientific Electronic Library Online (English)

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

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

2012-08-01

54

[Congenital anomalies of the inferior vena cava: diagnosis and medical treatment].  

Science.gov (United States)

Analyzed herein are the findings obtained following an examination and medical treatment of five 17-to-39-year-old male patients (average age 25.0+/-1.83 years) presenting with congenital abnormalities of the inferior vena cava. The diagnosis was made and the level of aplasia was determined based on the findings of a comprehensive instrumental examination (computed and magnetic resonance tomography of the abdominal cavity, duplex scanning of the veins of the lower extremities, of the pelvis and the retroperitoneal space, as well as on the data of pelvic phlebography, and retrograde cavography). In three of the five patients, the disease appeared to have for the first time manifested itself by a clinical picture of peripheral thrombosis (oedema of the crus and femur), and in the remaining two by an elevated body temperature and shivering, followed by oedema of the both lower limbs. Two patients were found to have aplasia of the infrarenal segment of the inferior vena cava, two subjects had aplasia of the infra-, renal and partially suprarenal portions of the vessel, and one patient suffered from aplasia of virtually the whole vena cava, excepting a small part of the suprahepatic portion, toward which converged the hepatic veins and the superior polar renal vein. With the purpose of early diagnosis of congenital abnormalities of the inferior vena cava, the protocol of examination of patients with venous diseases should include ultrasonographic mapping of the supra-, renal and infrarenal portions of the vena cava, and if agenesis is revealed, the use of computed or magnetic resonance tomography, retrograde cavography is strongly recommended. When the diagnosis of IVC aplasia is confirmed, primary medical treatment should consist in prescribing venotonic agents, elastic compression and in cases of deep veins thrombosis -anticoagulant therapy. PMID:17679979

Baeshko, A A; Zhuk, G V; Orlovski?, Iu N; Ulezko, E A; Savitskaia, T V; Goretskaia, I V; Egorova, V V; Somova, O A

2007-01-01

55

Radiographic evaluation of caudal vena cava size in dogs  

International Nuclear Information System (INIS)

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

56

Modeling Flow Past a Tilted Vena Cava Filter  

Energy Technology Data Exchange (ETDEWEB)

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

Singer, M A; Wang, S L

2009-06-29

57

Long term complications of inferior vena cava thrombosis  

OpenAIRE

AIM—To evaluate the long term outcome after paediatric inferior vena cava (IVC) thrombosis.?METHODS—A combined retrospective and prospective study on infants and children with IVC thrombosis treated at Aachen and Maastricht University Hospitals between 1980 and 1999.?RESULTS—Forty patients were enrolled, including four with preceding cardiac catheterisation, 18 with central venous saphenous lines, and an additional eight with umbilical venous catheters. Six patients d...

Hausler, M.; Hubner, D.; Delhaas, T.; Muhler, E.

2001-01-01

58

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

Scientific Electronic Library Online (English)

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

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

2010-09-01

59

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

Directory of Open Access Journals (Sweden)

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

Alberto Miranda Bravo

2010-09-01

60

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

Science.gov (United States)

Angiomyolipoma (AML) is generally considered to be benign and malignant angiomyolipoma is rare. This paper presents an extremely rare case of epithelioid AML with tumour thrombus invading inferior vena cava (IVC). We present the case of a 36-year-old woman with epithelioid AML with tumour thrombus invading inferior vena cava who underwent radical nephrectomy and IVC thrombectomy. As an adjunctive procedure, a temporary IVC filter was placed in suprarenal position before operation. One week after surgery, the temporary IVC filter was retrieved by femoral approach. Three months postoperatively, a computed tomography scan and abdominal ultrasonogaphy showed no evidence of thrombus in IVC or renal vein and no sign of tumour recurrence. Epithelioid AML is extremely rare and can be malignant, with invasion of the IVC or renal vein. Implanting temporary filter can prevent fatal pulmonary complication and avoid potential the side effects of permanent filter. PMID:25210566

Li, Xiang; Liu, Runming; He, Dalin

2014-07-01

61

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

International Nuclear Information System (INIS)

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

62

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

OpenAIRE

Se estudió un paciente de 57 años de edad, de tez negra, con edemas en miembros inferiores relevantes por su volumen y extensión. Se realizó la discusión clínica la cual orientó hacia la búsqueda de una lesión o tumor retroperitoneal asociado a un síndrome de compresión u obstrucción de vena cava inferior y se comprobó imagenológicamente. La confirmación histológica se obtuvo por vía quirúrgica.We studied a 57 year-old patient of black complexion, with swelling of the lo...

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

2010-01-01

63

Morphofunctional characterization of decellularized vena cava as tissue engineering scaffolds.  

Science.gov (United States)

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

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

2014-08-01

64

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

Scientific Electronic Library Online (English)

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

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

2010-12-01

65

An uncommon course of the right superior vena cava in a patient with heterotaxy syndrome.  

Science.gov (United States)

We present the case of an infant with congenital heart disease which includes a partial atrioventricular canal defect with the absence of the atrial septum (common atrium) and an extremely uncommon course of the right-sided superior vena cava (SVC) including an intra-atrial segment coursing intramurally along the right posterolateral atrial wall, with an intracardiac orifice situated low within the right side of the atrium, close to the atrial orifice of the right hepatic veins. This feature of the anatomy was discovered intraoperatively at the time of surgical repair. Systemic venous anatomy also included interrupted inferior vena cava (IVC) with azygos continuation to a left-sided SVC draining directly into the left side of the atrium. The successful surgical procedure included tunneling of the left-sided SVC to the right side of the common atrium and atrial septation with a patch. PMID:23804697

Chenu, Caroline; Fouilloux, Virginie; Kreitmann, Bernard; Metras, Dominique

2012-01-01

66

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

International Nuclear Information System (INIS)

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

67

Aneurysm of the abdominal aorta ruptured to the retroperitoneal space and inferior vena cava. Case report.  

Science.gov (United States)

Case of sixty-six year old male with abdominal aortic aneurysm rupturing into the retroperitoneal space and inferior vena cava is presented because of its rarity. Patient was operated upon with initial success but died probably due to pulmonary embolism with thrombus originating from the inferior vena cava narrowed at surgery. PMID:1842605

Rogowski, J; Landowski, S; Trenkner, M

1991-01-01

68

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

Energy Technology Data Exchange (ETDEWEB)

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

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

1997-06-01

69

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

International Nuclear Information System (INIS)

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

70

[Deep vein thrombosis as the manifestation of congenital anomaly of inferior vena cava].  

Science.gov (United States)

Results of examination of 5 male patients aged 20 to 43 years with congenital anomaly of inferior vena cava are analyzed. Complex special examination (CT, MRI, duplex scanning, pelvic phlebography, retrograde cavagraphy) was used for correct diagnosis. Primary treatment of agenesis of inferior vena cava should consist of elastic compression and phlebotonics; in cases of deep vein thrombosis anticoagulants must be used. PMID:16883239

Baeshko, A A; Zhuk, G V; Orlovski?, Iu N; Ulezko, E A; Savitskaia, T V; Goretskaia, I V

2006-01-01

71

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

International Nuclear Information System (INIS)

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

72

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

Science.gov (United States)

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

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

2014-01-01

73

Stenting of superior vena cava and inferior vena cava for symptomatic narrowing after repeated atrial surgery for D-transposition of the great vessels.  

OpenAIRE

Double venous stenting of the superior vena cava and inferior vena cava was successfully performed after failed balloon angioplasty in a young woman who had venoatrial narrowing and kinking after repeated Mustard procedure for D-transposition of great vessels. Self-expanding metallic stents were used. Angiography showed that the first stent was fully patient after six months when a second stent was implanted. This operation was followed by sustained clinical improvement. The present report sh...

Chatelain, P.; Meier, B.; Friedli, B.

1991-01-01

74

Concomitant Persistent Left Superior Vena Cava and Horseshoe Kidney  

Science.gov (United States)

Persistent left superior vena cava (PLSVC) and horseshoe kidney (HSK) are common congenital abnormalities; however presence of both in the same person is extremely rare. A patient with hepatitis C cirrhosis awaiting transplant presented with worsening liver dysfunction, diagnosed with acute renal failure secondary to hepatorenal syndrome, and required X-ray fluoroscopy guided tunneled venous catheter placement for hemodialysis. Review of imaging studies demonstrated coexistence of PLSVC and HSK. PLSVC in adulthood is usually incidental with the most common drainage pattern being without physiologic dysfunction. Isolated horseshoe kidney is still the most common of renal fusion anomalies; however etiology of coexistent PLSVC remains unknown.

Jaffer, Faraz; Chandiramani, Vijay

2015-01-01

75

Complex hybrid suprarenal inferior vena cava filter retrieval.  

Science.gov (United States)

The exponential rise in inferior vena cava (IVC) filter placement is associated with increased complications both during implantation and retrieval. In this report, a 64-year-old man was transferred from an outside hospital with cardiac tamponade secondary to a snare eroding into the right atrium. This complication occurred after attempted suprarenal IVC filter removal. The filter, entangled with the snare, was retrieved by a hybrid technique of mobilizing the liver to expose the suprarenal IVC, followed by using a snare and sheath to compress and extrude the filter. This is the first reported hybrid retrieval of a suprarenal IVC filter. PMID:25304904

Chou, Elizabeth L; Sgroi, Michael D; Fujitani, Roy M; Kabutey, Nii-Kabu

2015-01-01

76

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

Scientific Electronic Library Online (English)

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

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

2010-01-01

77

Comparison of superior vena cava and femoroiliac vein pressure according to intra-abdominal pressure  

OpenAIRE

UNLABELLED: ABSTRACT: BACKGROUND: Previous studies have shown a good agreement between central venous pressure (CVP) measurements from catheters placed in superior vena cava and catheters placed in the abdominal cava/common iliac vein. However, the influence of intra-abdominal pressure on such measurements remains unknown. METHODS: We conducted a prospective, observational study in a tertiary teaching hospital. We enrolled patients who had indwelling catheters in both superior vena cava (doub...

Ait-oufella, Hafid; Boelle, Pierre-yves; Galbois, Arnaud; Baudel, Jean-luc; Margetis, Dimitri; Alves, Mikael; Offenstadt, Georges; Maury, Eric; Guidet, Bertrand

2012-01-01

78

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

International Nuclear Information System (INIS)

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

79

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

Directory of Open Access Journals (Sweden)

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

Butera James N

2008-12-01

80

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

International Nuclear Information System (INIS)

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

81

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2013-08-01

82

[Hypoxemia secondary to inferior vena cava return into left atrium].  

Science.gov (United States)

The case of a right-to-left shunt-induced hypoxemia with an abnormal return of the inferior vena cava (AIVCR) into the left atrium (LA) is reported in a 30-year-old male with cyanosis and polycythemia. The chest X ray and the lung CT scan was normal. Spirometry was normal but the transfert-CO coefficient (KCO) was lowered. Hypoxemia was observed at rest and worsening during exercise. The alveolo-arterial oxygen tension difference under hyperoxia was increased (56 kPa). Contrast echocardiography (CEch) suggested the presence of an AIVCR with a right-to-left shunt only observed by the inferior route. The inferior vena cava (IVC) angiography and the magnetic resonance imaging demonstrated an AIVCR characterized by a direct drainage of IVC in the left atrium. The good tolerance can be explained by the association of AIVCR with an inter-auricular septal defect resulting in a left-to-right shunt which partially corrected the right-to-left shunt. After surgical treatment, arterial blood gases normalized, KCO remained low and CEch became negative. PMID:11924187

Nassiri, A H; Gentil, B; Barthelet, M; Revel, D; Ninet, J; Cordier, J F; Bayle, J Y

2001-12-01

83

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

Directory of Open Access Journals (Sweden)

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.

Soheila Chamanian

2014-11-01

84

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

Directory of Open Access Journals (Sweden)

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

Dante Antonelli

2007-10-01

85

Heart Transplantation in a Patient with Persistent Left Superior Vena Cava  

Science.gov (United States)

A 56-year-old male presented with severe exertional dyspnea and pitting edema in the lower extremities. The pre-operative evaluation demonstrated biventricular dysfunction associated with severe tricuspid valve regurgitation and a persistent left superior vena cava. He was registered as a transplantation candidate, and orthotopic heart transplantation was performed using the standard bicaval technique. The left superior vena cava was connected to the right atrial appendage after the construction of a conduit using the recipient’s autologous coronary sinus tissue. One-month postoperatively, computed tomography imagery demonstrated a patent conduit between the left superior vena cava and right atrial appendage. PMID:25551075

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

2014-01-01

86

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

International Nuclear Information System (INIS)

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

87

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

OpenAIRE

OBJECTIVE: To study the immediate and late results obtained from the implantation of vena cava filters in cancer patients with deep vein thrombosis concomitant with neoplasia. METHODS: This was a retrospective evaluation of 50 patients with an association of cancer and deep venous thrombosis who underwent interruption of the inferior vena cava and the insertion of permanent vena cava filters. The indications for the procedure, filter implantation technique, early and late complications relate...

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

2005-01-01

88

Superior vena cava thrombosis with peripartum dilated cardiomyopathy.  

Science.gov (United States)

A 30 years multiparous female with history of emergency caesarean section 10 days back was referred to us with cough, severe breathlessness at rest, orthopnea with pain in neck and arms. Clinical examination revealed signs of heart failure. Echocardiography showed ejection fraction of 15%, with no right ventricular strain. A diagnosis of peripartum cardiomyopathy was made. Doppler ultrasound of neck veins showed bilateral internal jugular vein thrombosis. Subsequent multislice CT examination showed thrombosis of superior vena cava and both internal jugular veins (with collateral formation) and pulmonary embolism. There were no mediastinal abnormalities on the CT scan. Her thrombophilia screen and CT scan brain was normal. She was managed in collaboration with cardiologist. Following treatment with subcutaneous enoxaparin therapy and warfarin her symptoms of upper limb pain improved. She responded very well to medical therapy for heart failure with marked improvement of NYHA functional class. PMID:24613121

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

2014-03-01

89

[Malignant neoplasms invading into the inferior vena cava. Surgical indications].  

Science.gov (United States)

Clinical conditions requiring resection and replacement of the inferior vena cava (IVC) are rare and have included tumors, traumatic or iatrogenic injuries. Intraluminal extension or direct mural involvement of the IVC is seen with a variety of tumors: renal cell carcinomas, adrenal cortical tumors, leiomyosarcomas and pheochromocytomas. Surgical treatment requires tumor resection with simultaneous en bloc resection of the involved IVC. Resection of the lower and middle segments of IVC is possible in nearly all cases and surgical reconstruction is generally made with a polytetrafluoroethylene (PTFE) tube graft. Resection at suprahepatic vein level is indicated only rarely: tumor invasion of the suprahepatic veins require liver transplantation. Venous bypasses have lower patency rates than prosthetic replacement because of the low pressure and lower-flow of the venous system. PMID:7609894

Boneschi, M; Miani, S; Erba, M; Giuffrida, G F; Giordanengo, F

1995-03-01

90

Clinical Sequelae of Thrombus in an Inferior Vena Cava Filter  

International Nuclear Information System (INIS)

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

91

Venous Thromboembolism After Removal of Retrievable Inferior Vena Cava Filters  

International Nuclear Information System (INIS)

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

92

A case of leiomyoma of the oesophagus complicated by superior vena cava obstruction and associated eosinophilia.  

OpenAIRE

Superior vena cava obstruction occurring as a complication of leiomyoma of the oesophagus has not been reported before. Such a case is recorded which was associated with striking eosinophilia, a feature previously noted in cases of uterine leiomyomas.

Hickling, P.; Buksh, K.; Beck, P.

1980-01-01

93

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

Science.gov (United States)

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

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

2014-08-01

94

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2014-03-15

95

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

OpenAIRE

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...

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

2014-01-01

96

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

International Nuclear Information System (INIS)

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

97

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

Science.gov (United States)

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

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

2014-10-01

98

Successful Treatment of Malignant Superior Vena Cava Syndrome Using a Stent-Graft  

OpenAIRE

We report successful outcomes after endovascular placement of a stent graft in a 74- and a 77-year-old men, both of whom had malignant superior vena cava syndrome caused by squamous cell carcinoma. In each patient, successful palliation of the malignant superior vena cava syndrome was achieved by placement of a stent graft. No procedure-related complications were observed. The patients were asymptomatic until their deaths, seven and 14 months after stent graft placement, respectively.

Gwon, Dong Il; Paik, Sang Hyun

2012-01-01

99

Successful Treatment of Malignant Superior Vena Cava Syndrome Using a Stent-Graft  

Energy Technology Data Exchange (ETDEWEB)

We report successful outcomes after endovascular placement of a stent graft in a 74- and a 77-year-old men, both of whom had malignant superior vena cava syndrome caused by squamous cell carcinoma. In each patient, successful palliation of the malignant superior vena cava syndrome was achieved by placement of a stent graft. No procedure-related complications were observed. The patients were asymptomatic until their deaths, seven and 14 months after stent graft placement, respectively.

Gwon, Dong IL [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of); Paik, Sang Hyun [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

2012-03-15

100

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

Scientific Electronic Library Online (English)

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

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

2014-12-01

101

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

Scientific Electronic Library Online (English)

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

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

1535-15-01

102

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

International Nuclear Information System (INIS)

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

103

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

International Nuclear Information System (INIS)

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

104

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2012-01-15

105

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

International Nuclear Information System (INIS)

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

106

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

Scientific Electronic Library Online (English)

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

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

2009-06-01

107

Mesoaortic entrapment of a left inferior vena cava  

Directory of Open Access Journals (Sweden)

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

Gupta Ashish

2010-01-01

108

Implantation of inferior vena cava interposition graft in mouse model.  

Science.gov (United States)

Biodegradable scaffolds seeded with bone marrow mononuclear cells (BMCs) are often used for reconstructive surgery to treat congenital cardiac anomalies. The long-term clinical results showed excellent patency rates, however, with significant incidence of stenosis. To investigate the cellular and molecular mechanisms of vascular neotissue formation and prevent stenosis development in tissue engineered vascular grafts (TEVGs), we developed a mouse model of the graft with approximately 1 mm internal diameter. First, the TEVGs were assembled from biodegradable tubular scaffolds fabricated from a polyglycolic acid nonwoven felt mesh coated with ?-caprolactone and L-lactide copolymer. The scaffolds were then placed in a lyophilizer, vacuumed for 24 hr, and stored in a desiccator until cell seeding. Second, bone marrow was collected from donor mice and mononuclear cells were isolated by density gradient centrifugation. Third, approximately one million cells were seeded on a scaffold and incubated O/N. Finally, the seeded scaffolds were then implanted as infrarenal vena cava interposition grafts in C57BL/6 mice. The implanted grafts demonstrated excellent patency (>90%) without evidence of thromboembolic complications or aneurysmal formation. This murine model will aid us in understanding and quantifying the cellular and molecular mechanisms of neotissue formation in the TEVG. PMID:24961688

Lee, Yong-Ung; Yi, Tai; Tara, Shuhei; Lee, Avione Y; Hibino, Narutoshi; Shinoka, Toshiharu; Breuer, Christopher K

2014-01-01

109

Doppler ultrasonographic imaging of obstruction of inferior vena cava  

International Nuclear Information System (INIS)

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

110

Inferior vena cava filters: What radiologists need to know  

International Nuclear Information System (INIS)

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

111

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

International Nuclear Information System (INIS)

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

112

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

Scientific Electronic Library Online (English)

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

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

113

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

Directory of Open Access Journals (Sweden)

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

Adelmar Afonso de Amorim Júnior

2002-01-01

114

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

International Nuclear Information System (INIS)

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

115

Vena Cava 3D Contrast-Enhanced MR Venography: A Pictorial Review  

International Nuclear Information System (INIS)

Three-dimensional contrast-enhanced magnetic resonance venography (CE MRV) is a sensitive and accurate method for diagnosing vena cava pathologies. The commonly used indirect approach involves a nondiluted gadolinium contrast agent injected into an upper limb vein or, occasionally, a pedal vein for assessment of the superior or inferior vena cava. In our studies, a coronal 3D fast multi-planar spoiled gradient-echo acquisition was used. A pre-contrast scan was obtained to ensure correct coverage of the region of interest. We initiated contrast-enhanced acquisition 15 sec after the start of contrast agent injection and performed the procedure twice. The image sets were obtained during two 20-30-sec breath hold, with a breathing rest of 5-6 sec, to obtain the first-pass and delayed arteriovenous phases. For patients with Budd-Chiari syndrome, a third acquisition coinciding with late venous phase was collected to visualize the hepatic veins, which was carried out by one additional acquisition after a 5-6-sec breathing time. This review describes the clinical application of 3D CE MRV in vena cava congenital anomalies, superior and inferior vena cava syndrome, Budd-Chiari syndrome, peripheral vein thrombosis extending to the vena cava, pre-operational evaluation in portosystemic shunting and post-surgical follow-up, and road-mapping for the placement and evaluation of complications of central venous devices

116

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

Scientific Electronic Library Online (English)

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

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

2013-07-01

117

Primitive neuroectodermal tumor of the kidney with inferior vena cava tumor thrombus.  

Science.gov (United States)

Primitive neuroectodermal tumor (PNET) of the kidney is an extremely rare disease with high aggressive tendency, considered to have a poor prognosis. We report the case of a 41-year-old man with a PNET arising from the kidney with inferior vena cava thrombus. This case was presumptively diagnosed of renal cell carcinoma prior to surgery. The diagnosis of PNET was made on the basis of findings of histopathology and immunohistochemistry. Postoperative computed tomography demonstrated residual disease. Subsequently, multidrug chemotherapy and radiotherapy were administrated. The patient is still alive with no evidence of disease 9 months after initial diagnosis. This presentation of a PNET is noteworthy because of its unusual location, the kidney being an extraordinary rare site for the tumor. PMID:20070019

Zhang, Liling; Wang, Tao; Zheng, Liduan; Wu, Gang

2009-12-01

118

Isolated persistent left-sided superior vena cava, giant coronary sinus, atrial tachycardia and heart failure in a child.  

Science.gov (United States)

Persistence of a left-sided superior vena cava (PLSVC) with absent right superior vena cava (isolated PLSVC) is a very rare venous malformation and commonly associated with congenital heart disease or alterations of the cardiac situs. We describe an unusual case of a young boy presenting with persistent atrial tachycardia and congestive heart failure. He was detected to have unexplained grossly dilated right atrium, right ventricle with systolic dysfunction and a giant coronary sinus (CS). The dilated CS closely mimicked a pseudo cor-triatriatum on echocardiography. Contrast echocardiography from both arms revealed opacification of the CS before the right atrium. Bilateral upper limb venography confirmed the presence of absent right SVC and isolated persistent left SVC draining into the giant coronary sinus. PMID:24206885

Moorthy, Nagaraja; Kapoor, Aditya; Kumar, Sudeep

2013-01-01

119

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

International Nuclear Information System (INIS)

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

120

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

International Nuclear Information System (INIS)

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

121

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

International Nuclear Information System (INIS)

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

122

Retrievable Inferior Vena Cava Filters: Factors that Affect Retrieval Success  

International Nuclear Information System (INIS)

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

123

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2012-09-15

124

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

International Nuclear Information System (INIS)

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

125

[Vena cava filter for prevention of pulmonary embolism].  

Science.gov (United States)

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

Winkler, W B; Slany, J

1999-11-01

126

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

Scientific Electronic Library Online (English)

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

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

2009-04-01

127

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2009-12-03

128

Design optimization of vena cava filters: an application to dual filtration devices.  

Science.gov (United States)

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 a trapped model thrombus in the inferior vena cava. The location and shape of the thrombus are parametrized, 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 the thrombus trapped along the cava wall reduces the disruption to the flow but increases the area exposed to low wall shear stress. Computer-based design optimization is a useful tool for developing vena cava filters. Characterizing and parametrizing 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. PMID:20887016

Singer, Michael A; Wang, Stephen L; Diachin, Darin P

2010-10-01

129

'RecoveryTM' Vena Cava Filter: Experience in 96 Patients  

International Nuclear Information System (INIS)

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

130

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

Science.gov (United States)

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

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

2013-08-01

131

Scimitar sign with normal pulmonary venous drainage and anomalous inferior vena cava.  

OpenAIRE

A case of the scimitar sign due to an anomaly of the right sided pulmonary vein with normal drainage into the left atrium was associated with an azygos continuation of the inferior vena cava. Digital subtraction angiography allows the identification of these rare congenital vascular malformations.

Herer, B.; Jaubert, F.; Delaisements, C.; Huchon, G.; Chretien, J.

1988-01-01

132

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

International Nuclear Information System (INIS)

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.

133

CT diagnosis of tumor thrombus in the inferior vena cava: avoiding the false-positive diagnosis  

International Nuclear Information System (INIS)

The detection of tumor thrombus in the inferior vena cava (IVC) has important prognostic and therapeutic implications. Recent reports have suggested that computed tomographic (CT) scanning can accurately and noninvasively detect IVC tumor thrombus. The potential limitations of CT in evaluating IVC tumor thrombus have not been stressed. In this report, these limitations are discussed and illustrative cases are presented

134

[Theoretical bases of a cardio-synchronised jet injection system into the vena cava].  

Science.gov (United States)

Aim of this paper is to present a procedure aimed at raising the flow rate in the vena cava. To this purpose some fluid is injected at high speed in the vessel, accelerating the flow and dragging the stagnating flow upstream the catheter. In order to raise the efficiency of the system and to avoid damage to heart valves, the injection is synchronised with the diastole. A prototype of an injection system has been designed and built, in order to reach these goals. The injection times are controlled by the electrocardiogram track of the patient, in such a way that the maximum flow rate occurs when the tricuspid valve is open. A "dragging effect" index, that is the ratio between overall flow rate induced by any injection (injected flux plus dragged flux) and injected flux flow rate has been evaluated, both theoretically and experimentally. An experimental model of the lower vena cava has been built and used to measure the velocity profile in the vessel. The dragging effect at the confluence between the two iliac and the vena cava has been verified. By making the catheter sections smaller and/or raising the feeding pressure it is possible to have the injection of small volumes at high speed, capable of moving the blood in the vena cava with a minor contribution of external fluid, thus reducing risks of volume overload and overdiluition of blood. PMID:11981520

Banetta, L; Santini, E; Banetta, S

2002-03-01

135

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

Directory of Open Access Journals (Sweden)

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.

Mahua Roy

2010-04-01

136

Surgical management of an epithelioid hemangioendothelioma of the superior vena cava protruding into the right atrium.  

Science.gov (United States)

Epithelioid hemangioendothelioma (EH) is a rare malignant tumor of vascular origin that often involves soft tissues and visceral organs, and less commonly, large veins. We report a case of EH of the superior vena cava protruding into the right atrium and its surgical management. PMID:24893561

Allain, G; Hajj-Chahine, J; Lacroix, C; Tomasi, J; Corbi, P; Jayle, C

2014-11-01

137

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

Science.gov (United States)

This paper reports the clinical findings, surgical and medical management, and necropsy of a 6-year-old cow with thrombosis of the cranial vena cava and thrombo-embolic pneumonia following traumatic reticuloperitonitis. The clinical diagnosis was confirmed by necropsy. PMID:22547845

Gerspach, Christian; Wirz, Mirjam; Schweizer-Knubben, Gabriela; Braun, Ueli

2011-11-01

138

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

LENUS (Irish Health Repository)

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

Klop, B

2011-01-01

139

Vacuum-Assisted Inferior Vena Cava Thrombus Removal Using a Percutaneous Technique.  

Science.gov (United States)

We report a patient with a massive inferior vena cava (IVC) thrombus requiring immediate intervention. The patient underwent successful thrombectomy using a percutaneous catheter aspiration system. Percutaneous removal of an IVC thrombus is a safe and effective treatment option for severely ill patients. PMID:24862173

Wilner, Bryan R; Carrillo, Roger G

2014-05-26

140

"Acute pseudo-pericardial tamponade": the compression of the thoracal inferior vena cava – a case report  

Science.gov (United States)

We describe a case of 68-year-old woman which was admitted to our hospital for mitral valve replacement (MVR), in whom acute compresion of the vena cava inferior developed after repair of lacerated atrio-caval junction with hemostatic tissue sealant, biologic glue (BioGlue, Cryolife, ?nc, Kennesaw, Ga). Removal of the BioGlue relieved the unexpected problem. PMID:19239687

Cavolli, Raif; Kaya, Kaan; Elalmis, Altay Omer

2009-01-01

141

"Acute pseudo-pericardial tamponade": the compression of the thoracal inferior vena cava – a case report  

OpenAIRE

Abstract We describe a case of 68-year-old woman which was admitted to our hospital for mitral valve replacement (MVR), in whom acute compresion of the vena cava inferior developed after repair of lacerated atrio-caval junction with hemostatic tissue sealant, biologic glue (BioGlue, Cryolife, ?nc, Kennesaw, Ga). Removal of the BioGlue relieved the unexpected problem.

Kaya Kaan; Cavolli Raif; Elalmis Altay

2009-01-01

142

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

Energy Technology Data Exchange (ETDEWEB)

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

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

1991-05-01

143

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

International Nuclear Information System (INIS)

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

144

TEMPORARY PACEMAKER LEAD PLACEMENT IN PATIENT WITH PERSISTENT LEFT SUPERIOR VENA CAVA  

Directory of Open Access Journals (Sweden)

Full Text Available Persistent left superior vena cava represents a congenital vascular defect of the venous system, and is usually discovered accidentally. Temporary pacemaker lead placement should be performed under the fluoroscopy control, but also by using the ECG QRS morphology. Echocardiography also represents a reliable noninvasive diagnostic tool for the assessment of temporary pacemaker lead position.

Vladimir Mitov

2011-09-01

145

[Massive intrahepatic haemorrhage responsible for an inferior vena cava syndrome: an exceptional complication of hepatocellular carcinoma].  

Science.gov (United States)

Intralesional massive haemorrhage responsible for inferior vena cava syndrome is a very rare complication of hepatocellular carcinoma. A 36-year-old man with no past medical history was referred to hospital for abdominal pain with clinical and biological signs of internal bleeding. An abdominal CT scan showed a huge right liver mass, with regular margins and a fluid content, indicating a large intratumoral haemorrhage complicating hepatocellular carcinoma. Due to haemodynamic stability and the signs of inferior vena cava compression conservative management was chosen prior to surgical treatment of the tumour. Three months later, the huge liver mass remained unchanged but the inferior vena cava syndrome had decreased and the patient's condition improved. After evaluation of liver function and the extent of the tumour, a surgical procedure was performed via a subcostal incision with midline extension and sternotomy to control the intrapericardial inferior vena cava and perform a veno-venous bypass with the technique used for orthotopic liver transplantation. Then, right hepatectomy (segments V to VIII) was performed with an anterior approach. The postoperative course was uneventful. This two-step strategy allowed successful surgery for this rare complication of a hepatocellular carcinoma on a normal liver and could be recommended for the management of any unruptured intratumoral haemorrhages. PMID:16633318

Ettorre, Giuseppe Maria; Douard, Richard; Santoro, Roberto; Vidiri, Antonello; Vennarecci, Giovanni; Carboni, Fabio; Boschetto, Arianna; Corazza, Valerio; Maritti, Michela; Antonini, Mario; Santoro, Eugenio

2006-03-01

146

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

International Nuclear Information System (INIS)

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

147

The tactics of treatment for superior vena cava syndrome in Ivano-Frankivsk Regional Clinical Cancer Hospital  

International Nuclear Information System (INIS)

The authors present the tactics of treatment for superior vena cava syndrome at various forms of malignant tumors. It was shown that application of this tactics can improve the efficacy and quality of inductive treatment in this group of patients

148

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

International Nuclear Information System (INIS)

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

149

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2013-06-15

150

Blood supply to the cranial venae cavae and the heart in the laboratory shrew (Suncus murinus).  

OpenAIRE

The blood supply to the cranial venae cavae on both sides and to the heart was studied macroscopically in 40 adult laboratory shrews (Suncus murinus) of both sexes injected either with Neoprene latex into the abdominal aorta (25 animals) or with Mercox into the left ventricle (15 animals). The 1st branch of the left subclavian artery in 23 animals of the 1st group ramified caudal to the aortic arch and descended between the aorta and the trachea to supply mainly the large left cranial vena ca...

Isomura, G.

1993-01-01

151

Transjugular intrahepatic portosystemic shunt with accidental diagnosis of persistence of the left superior vena cava.  

Science.gov (United States)

Transjugular intrahepatic portosystemic shunt (TIPSS) is considered a valid therapeutic option for the treatment of portal hypertension and its complications. The guidelines for this procedure have already been established on the basis of the normal vascular anatomy and of various technical radiological aspects. In some few rare cases, diagnosis of a congenital vascular anomaly can be made accidentally by interventional radiologists, making the procedure of the TIPSS placement extremely difficult or in some cases technically impossible. This report describes a rare vascular malformation characterized by the absence of the right superior vena cava and persistence of the left superior vena cava in a patient with a diagnosis of advanced liver cirrhosis who needed a TIPSS placement in order to control refractory ascites. PMID:20205290

Petridis, Ioannis; Miraglia, Roberto; Marrone, Gianluca; Gruttadauria, Salvatore; Luca, Angelo; Vizzini, Giovanni Battista; Gridelli, Bruno

2010-03-01

152

Transjugular intrahepatic portosystemic shunt with accidental diagnosis of persistence of the left superior vena cava  

Directory of Open Access Journals (Sweden)

Full Text Available Transjugular intrahepatic portosystemic shunt (TIPSS is considered a valid therapeutic option for the treatment of portal hypertension and its complications. The guidelines for this procedure have already been established on the basis of the normal vascular anatomy and of various technical radiological aspects. In some few rare cases, diagnosis of a congenital vascular anomaly can be made accidentally by interventional radiologists, making the procedure of the TIPSS placement extremely difficult or in some cases technically impossible. This report describes a rare vascular malformation characterized by the absence of the right superior vena cava and persistence of the left superior vena cava in a patient with a diagnosis of advanced liver cirrhosis who needed a TIPSS placement in order to control refractory ascites.

Ioannis Petridis, Roberto Miraglia, Gianluca Marrone, Salvatore Gruttadauria, Angelo Luca, Giovanni Battista Vizzini, Bruno Gridelli

2010-03-01

153

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2013-04-15

154

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

Directory of Open Access Journals (Sweden)

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

Andrea Mancuso

2013-01-01

155

Incidentally Detected Pediatric Case with Absent Right Superior Vena Cava During Transcatheter VSD Closure  

Directory of Open Access Journals (Sweden)

Full Text Available Persistent left superior vena cava (PLSVC with an absent right superior vena cava (RSVC is an extremely rare congenital anomalie in normal atrial situs. Isolated cases are diagnosed incidentally during catheterization. In patients with PLSVC, due to frequent drainage of upper extremity, head and neck veins into coronary sinus, patients with enlarged coronary sinus should be suspected to have absence of the RVCS. In this report, we presented a 7-year-old girl who was diagnosed perimembranous VSD (ventricular septal defect, apparently enlarged coronary sinus, PLSVC with transthoracic echocardiography, and incidentally was recognized absence of RSVC during percutaneouse VSD closure. Consequently, we wanted to draw attention to echocardiographic and angiocardiographic findings of this rare venous anomaly.

Abdullah Ozyurt

2014-02-01

156

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

International Nuclear Information System (INIS)

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

157

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

International Nuclear Information System (INIS)

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

158

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

Directory of Open Access Journals (Sweden)

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

Omer Dai

2014-04-01

159

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

Directory of Open Access Journals (Sweden)

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

Nseir W

2011-06-01

160

Extensive pulmonary embolism after severe postpartum haemorrhage: management with an inferior vena cava filter.  

Science.gov (United States)

We report the case of a 36-year-old woman with an inferior vena cava thrombosis and extensive pulmonary embolism six days after a severe postpartum haemorrhage. She had undergone caesarean section with bleeding managed by massive transfusion, hysterectomy, and two attempts at uterine artery embolization. Systemic thrombolysis and catheter-directed thrombolysis in intensive care were abandoned due to recent and incomplete uterine artery embolization. A temporary inferior vena cava filter was chosen because of significant risk of massive pulmonary embolism. This was a controversial decision because guidelines from different professional groups offer conflicting recommendations. The therapeutic options for the management of massive postpartum pulmonary embolism when thrombolysis is contraindicated are discussed. PMID:25223642

Bilger, A; Pottecher, J; Greget, M; Boudier, E; Diemunsch, P

2014-11-01

161

Endovascular retrieval of an inferior vena cava filter with simultaneous caval, aortic, and duodenal perforations.  

Science.gov (United States)

A 47-year-old female presented to the emergency department complaining of diffuse abdominal pain and melena. She previously had a Bard G2X inferior vena cava filter placed before undergoing a laparoscopic Roux-en-Y gastric bypass 3 years before her current presentation. She had a history of an anastomotic ulcer that was treated medically. A repeat endoscopic evaluation revealed no evidence of a recent bleed and the ulcer was healed. Computed tomography revealed evidence of multiple filter struts penetrating through the caval wall into the duodenum and aorta. The filter was successfully removed using an En Snare without complications. Reviewing the current literature, open surgical repair has been the treatment of choice for similar patient presentations. We present a successful case of the endovascular retrieval of an inferior vena cava filter with simultaneous caval, aortic, and duodenal penetrations. PMID:23129585

Caldwell, Edward H; Fridley, Todd L; Erb, Edward L; Fleischer, Stephen R

2012-11-01

162

Surgical Stapler for Right Renal Vein Elongation Using the Inferior Vena Cava in Kidney Transplant.  

Science.gov (United States)

Elongation of the right renal vein with the inferior vena cava (caval patch) using a vascular stapler offers a safe means of extending the deceased-donor right renal vein, while minimizing the ischemic time of the kidney during preparatory dissection. The aortic patch of the right renal artery also can be preserved, which minimize the danger of arterial stenosis, kinking, and dissection. PMID:25233447

Di Cocco, Pierpaolo; Kandilis, Apostolos; Rajagopal, Poyyamozhi; Herbert, Paul; Hassen, Yasmin; Hakim, Nadey

2014-09-17

163

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

International Nuclear Information System (INIS)

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.)

164

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

International Nuclear Information System (INIS)

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

165

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

OpenAIRE

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

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

2011-01-01

166

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

International Nuclear Information System (INIS)

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

167

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

OpenAIRE

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

Kim, Dong Hun; Seo, Hye-sun; Seo, Jon; Kim, Hee Kyung; Her, Keun; Suk, Eun Ha

2010-01-01

168

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

International Nuclear Information System (INIS)

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

169

Superior vena cava flow in newborn infants: a novel marker of systemic blood flow  

OpenAIRE

BACKGROUND—Ventricular outputs cannot be used to assess systemic blood flow in preterm infants because they are confounded by shunts through the ductus arteriosus and atrial septum. However, flow measurements in the superior vena cava (SVC) can assess blood returning from the upper body and brain.?OBJECTIVES—To describe a Doppler echocardiographic technique that measures blood flow in the SVC, to test its reproducibility, and to establish normal ranges.?DESIGN—SVC ...

Kluckow, M.; Evans, N.

2000-01-01

170

"Acute pseudo-pericardial tamponade": the compression of the thoracal inferior vena cava – a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract We describe a case of 68-year-old woman which was admitted to our hospital for mitral valve replacement (MVR, in whom acute compresion of the vena cava inferior developed after repair of lacerated atrio-caval junction with hemostatic tissue sealant, biologic glue (BioGlue, Cryolife, ?nc, Kennesaw, Ga. Removal of the BioGlue relieved the unexpected problem.

Kaya Kaan

2009-02-01

171

Transcatheter thrombolytic therapy for symptomatic thrombo-occlusion of inferior vena cava filter  

OpenAIRE

Thrombus within an inferior vena cava (IVC) filter reduces filter patency and venous return from the lower extremities, and may progress to complete IVC occlusion. The clinical experiences and outcomes of transcatheter thrombolytic therapy for symptomatic IVC thrombosis following filter implantation have not been widely reported. The aim of the current study was to evaluate the efficiency and safety of trans-catheter thrombolysis for the treatment of symptomatic IVC thrombosis in patients wit...

Xiao, Liang; Shen, Jing; Tong, Jia-jie; Zhang, Zhe; Mu, Xiao-lin; Yi, Zheng-jia; Bai, Shuo; Xu, Ke

2013-01-01

172

Surgical Treatment of Inferior Vena Cava Tumor Thrombus in Patients with Renal Cell Carcinoma  

OpenAIRE

Radical nephrectomy with inferior vena cava (IVC) thrombectomy remains the most effective therapeutic option in patients with renal cell carcinoma and IVC tumor thrombus. Cephalic extension of the thrombus is closely related to perioperative morbidity. We purposed to design a safe and successful surgical strategy through a review of our surgical experience and treatment results in 35 patients (male:female=28:7, mean age=56 yr [32-77]) who underwent IVC thrombectomy with radical nephrectomy be...

Kwon, Tae-won; Kim, Hyangkyoung; Moon, Ki-myung; Cho, Yong-pil; Song, Cheryn; Kim, Chung-soo; Ahn, Hanjong

2009-01-01

173

Thrombectomy under Cardiopulmonary Bypass for Inferior Vena Cava Thrombosis Induced by Liver Injury  

OpenAIRE

Inferior vena cava thrombosis (IVCT) caused by liver injury is a rare and challenging condition. A 32-year-old man sustained a severe liver injury in a traffic accident. Emergent thromboembolic procedure for the affected hepatic arteries was performed for hemostasis, resulting in hemodynamic stabilization of the patient. One month later, however, computed tomography (CT) showed liver congestion caused by IVCT from the suprahepatic IVC to the bilateral common iliac veins. As liver function det...

Hamamoto, Masaki; Kobayashi, Taira; Kodama, Hiroshi; Nakamitsu, Atsushi; Sasaki, Masaru; Kuroo, Yuta

2013-01-01

174

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

OpenAIRE

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

Adrien Riviere; Thomas Bessede; Jean-Jacques Patard

2014-01-01

175

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

OpenAIRE

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

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

2011-01-01

176

Characterization of the 5-HT receptor mediating endothelium-dependent relaxation in porcine vena cava.  

OpenAIRE

1. 5-Hydroxytryptamine (5-HT) relaxes rings of neonatal porcine isolated vena cava by both an endothelium-dependent and an endothelium-independent mechanism. The receptor mediating the latter response has been shown to be a 5-HT1-like receptor (positively coupled to adenylyl cyclase) located on the vascular smooth muscle. The features of the endothelium-dependent response to 5-HT in this preparation are now described. 2. In ring preparations contracted with the stable thromboxane-A2-mimetic, ...

Sumner, M. J.

1991-01-01

177

Extra-adrenal retroperitoneal paraganglioma associated with duplication of inferior vena cava  

OpenAIRE

Retroperitoneal paragangliomas arise from specialized neural crest cells symmetrically distributed along the aorta in association with the sympathetic chain. If this tissue aggregates in the adrenal medulla pheochromocytoma may arise. When it remains in the paraaortic sites it could develop into extra-adrenal, retroperitoneal paraganglioma. We report a case of extra-adrenal paraganglioma in the renal hilum intimately related to the left side of a double inferior vena cava. To the best of our ...

Chatterjee, Parangama; Singh, Ashish; Ayyappan, Anoop; Nair, Aravindan

2008-01-01

178

Extra adrenal retroperitoneal paraganglioma associated with duplication of inferior vena cava  

OpenAIRE

Retroperitoneal paragangliomas arise from specialized neural crest cells symmetrically distributed along the aorta in association with the sympathetic chain. If this tissue aggregates in the adrenal medulla pheochromocytoma may arise. When it remains in the paraaortic sites it could develop into extra-adrenal, retroperitoneal paraganglioma. We report a case of extra-adrenal paraganglioma in the renal hilum intimately related to the left side of a double inferior vena cava. To the bes...

parangama chatterjee

2008-01-01

179

Primary extraosseous ewing sarcoma of the kidney with level III inferior vena cava thrombus.  

Science.gov (United States)

Ewing sarcoma typically presents as a skeletal-based tumor, with rare instances of peripheral primitive neuroectodermal tumor (PNET) arising in the soft tissues. Few examples of organ-based PNETs have been previously described in the literature. These tumors are exceedingly rare as a primary renal neoplasm. To our knowledge, this is the first report documenting a primary extraskeletal Ewing sarcoma of the kidney with thrombus extending into the intrahepatic inferior vena cava thrombus (level III). PMID:19815490

Fergany, Amr F; Dhar, Nivedita; Budd, G Thomas; Skacel, Marek; Garcia, Jorge A

2009-10-01

180

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2010-02-15

181

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

OpenAIRE

A 22-year-old female presented with back pain and was discovered to have a right-sided abdominal mass. Computed tomography (CT) scan revealed a 9?cm enhancing right upper pole renal mass with suspicion for tumor thrombus into the right renal vein and possibly the inferior vena cava (IVC). Magnetic resonance imaging (MRI) confirmed tumor thrombus into the inferior vena cava approximately 3?cm below the hepatic venous confluence. Open right radical nephrectomy with inferior vena cava thromb...

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

2013-01-01

182

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

Directory of Open Access Journals (Sweden)

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

Wang Quan

2012-06-01

183

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

International Nuclear Information System (INIS)

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

184

Surgical management of anomalous pulmonary venous connection to the superior vena cava - early results  

Science.gov (United States)

Background The anatomical variability in patients with anomalous pulmonary venous connection to superior vena cava presents a surgical challenge. The problem is further compounded by the common occurrence of postoperative complications like arrhythmias and obstruction of the superior vena cava or pulmonary veins. We present our experience of managing this subset using the two patch and Warden's techniques. Patients and methods Between June 2011 and September 2012, 7 patients with APVC to the SVC were operated in our institute. After delineating the anatomy, five of them had a two patch repair and two were managed with Warden's technique. Results There was no in-hospital mortality or early mortality over a mean follow-up of 9.66 ± 3.88 months (range 6–15 months). All the patients on follow-up had unobstructed pulmonary venous and SVC drainage on echocardiography and all of them were in normal sinus rhythm. Conclusions Anomalous pulmonary venous connection to superior vena cava is a challenging subset of patients in whom the surgical management needs to be individualized. The detailed anatomy must be delineated using echocardiography with or without CT angiography before deciding the surgical plan. This entity can be repaired with excellent immediate and early results. However, these patients must be closely followed up for complications like systemic and pulmonary venous obstruction and sinus node dysfunction. PMID:24206880

Chandra, Dinesh; Gupta, Anubhav; Nath, Ranjit K.; kazmi, Aamir; Grover, Vijay; Gupta, Vijay K.

2013-01-01

185

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

OpenAIRE

Clear cell sarcoma of the kidney (CCSK) is a rare renal neoplasm of childhood. While CCSK is more common in children, it is extremely rare in adults. In CCSK, a tumor thrombus is sometimes formed in the inferior vena cava. Herein, we describe a rare case of an 18-year-old female with CCSK with vascular tumor thrombus extending to the inferior vena cava that was managed successfully by excision of the renal mass and vena caval thrombus, and pulmonary metastasectomy using cardiopulmonary bypass...

Yunus Nazl?; Necmettin Çolak; Özgül Malçok Gürel; Dilek Kösehan; Umran Y?ld?r?m; Mehmet Erol Y?ld?r?m

2014-01-01

186

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

Directory of Open Access Journals (Sweden)

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

Yunus Nazl?

2014-06-01

187

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

Scientific Electronic Library Online (English)

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

Jorge, Vega; Rienzi, Díaz.

1473-14-01

188

Role of inferior vena cava filter implantation in preventing pulmonary embolism  

International Nuclear Information System (INIS)

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

189

Superior vena cava syndrome induced by bronchogenic carcinoma: is this an oncological emergency?  

International Nuclear Information System (INIS)

This study was initiated to assess the validity of the traditional view that superior vena cava syndrome (SVCS) induced by bronchogenic carcinoma is a life-threatening condition requiring immediate treatment without necessarily obtaining a tissue diagnosis. A retrospective review of 6504 patients diagnosed to have lung cancer and treated at the Queensland Radium Institute between 1979 and 1991 was performed. From this group, 249 patients with well-documented SVCS treated with radiotherapy were identified. An analysis with respect to duration of symptoms, time to treatment, degree of response and overall survival was performed. Although deaths did occur in this series due to associated tracheal obstruction, deaths due to venous compression per se were not seen. The response to radiotherapy was generally poor, with only 19% of patients achieving a complete resolution of their symptoms and signs while 30% of patients had no demonstrable response. The overall survival of patients in the study group was 5% at two years. The median survival for complete responders was 6 months while for non-responders it was 1 month. This study found little evidence to support the concept that SVCS is an oncological emergency. Patients survived despite unrelieved obstruction and the data suggest that the poor prognosis of patients with this condition appears to more closely correlate with the prognosis of the underlying disease. It is suggested that intravascular thrombosis may be an import intravascular thrombosis may be an important factor in the pathogenesis of this syndrome. 16 refs., 5 tabs., 5 figs

190

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish El trasplante cardíaco está indicado en pacientes con insuficiencia cardíaca terminal sin opción de tratamiento médico, intervencionista o quirúrgico y puede realizarse utilizando fundamentalmente tres variantes técnicas. El beneficio de la técnica bicava en términos de parámetros hemodinámicos y cl [...] ínicos la ha convertido en la más utilizada, aunque es técnicamente más demandante y puede tener algunas consecuencias, como estenosis en las anastomosis de las venas cavas. En esta presentación se describe el caso de un paciente sometido a trasplante cardíaco ortotópico con técnica bicava que en el primer día del posoperatorio desarrolló el síndrome de la vena cava superior. Durante el segundo día posoperatorio y ante sintomatología progresiva, a pesar de haberse administrado anticoagulación, se decidió realizar una flebografía diagnóstica y al mismo tiempo tratamiento endovascular. En ese procedimiento se recanalizó la vena cava superior y se implantaron tres stents autoexpandibles, con lo que se logró permeabilidad de la anastomosis entre las venas cavas donante y receptora, la vena cava superior y la subclavia derecha. La evolución fue favorable con alivio inmediato de la sintomatología. El paciente fue dado de alta sin complicaciones.

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

2011-10-01

191

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

Scientific Electronic Library Online (English)

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

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

2011-09-01

192

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  

Directory of Open Access Journals (Sweden)

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

David Ibáñez Muñoz

2011-09-01

193

Retrievable Vena Cava Filters in Major Trauma Patients: Prevalence of Thrombus Within the Filter  

International Nuclear Information System (INIS)

The purpose of this study was to report the prevalence of thrombus within a retrievable vena cava filter inserted prophylactically in major trauma patients referred for filter extraction. Between November 2002 and August 2005, 80 retrievable inferior vena cava filters (68 Optease and 12 Gunther-Tulip) were inserted into critically injured trauma patients (mean injury severity score 33.5). The filters were inserted within 1 to 6 (mean 2) days of injury. Thirty-seven patients were referred for filter removal (32 with Optease and 5 with Gunther-Tulip). The indwelling time was 7 to 22 (mean 13) days. All patients underwent inferior vena cavography prior to filter removal. There were no insertion-related complications and all filters were successfully deployed. Forty-three (54%) of the 80 patients were not referred for filter removal, as these patients continued to have contraindications to anticoagulation. Thirty-seven patients (46%) were referred for filter removal. In eight of them (22%) a large thrombus was seen within the filters and they were left in place, all with the Optease device. The other 29 filters (36%) were removed uneventfully.We conclude that the relatively high prevalence of intrafilter thrombi with the Optease filter may be explained by either spontaneous thrombus formation or captured emboli.

194

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

Scientific Electronic Library Online (English)

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

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

2005-09-01

195

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

Scientific Electronic Library Online (English)

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

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

2012-01-01

196

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

Directory of Open Access Journals (Sweden)

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

Yuan Li-Jun

2006-04-01

197

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

International Nuclear Information System (INIS)

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

198

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

Directory of Open Access Journals (Sweden)

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

Ching-Hwa Yang

2006-08-01

199

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

Directory of Open Access Journals (Sweden)

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

Alexander Alves da Silva

2009-12-01

200

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

International Nuclear Information System (INIS)

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

201

Early Onset of Periaortic Inflammation after EVAR with Inferior Vena Cava Involvement: A Case Report.  

Science.gov (United States)

Endovascular treatment of abdominal aortic aneurysm (EVAR) represents a good alternative to open surgery, also in patients who present inflammatory abdominal aortic aneurysm, resulting in reduction of the inflammatory process in many cases. Instead, the onset of periaortic inflammation after EVAR is a rare event with an unclear pathogenesis, time of onset, and clinical presentation. This is a case report of a very early onset of periaortitis after EVAR with inferior vena cava involvement and stretching, resulting in lower limb swelling and back pain, treated by corticosteroid drug with a good remission of the pathology. PMID:25304907

Mansour, Wassim; Capoccia, Laura; Garofano, Roberta; Pranteda, Chiara; Speziale, Francesco

2015-01-01

202

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

International Nuclear Information System (INIS)

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

203

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

2013-06-15

204

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

International Nuclear Information System (INIS)

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

205

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

Energy Technology Data Exchange (ETDEWEB)

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

Sofue, Keitaro, E-mail: keitarosofue@yahoo.co.jp; Takeuchi, Yoshito, E-mail: yotake62@qg8.so-net.ne.jp; Arai, Yasuaki, E-mail: arai-y3111@mvh.biglobe.ne.jp [National Cancer Center Hospital, Department of Diagnostic Radiology (Japan); Sugimura, Kazuro, E-mail: sugimura@med.kobe-u.ac.jp [Kobe University, Department of Radiology, Graduate School of Medicine (Japan)

2013-02-15

206

Percutaneous silicon catheter insertion into the inferior vena cava, following percutaneous nephrostomy exchange.  

Science.gov (United States)

Percutaneous nephrostomy (PCN) has been widely used to drain an infected, obstructed kidney. Few major complications have been associated with it. Few publications have reported the misplacement of nephrostomy tube into the inferior vena cava (IVC), following percutaneous nephrolithotomy. We report a case of a misplaced silicon catheter, through the left renal vein, extending into the IVC, following nephrostomy tube exchange. Our case was safely managed, and we concluded that although PCN and nephrostomy tube exchange are relatively simple procedures, they should be done cautiously, by a well-trained urologist, and preferably under ultrasound or fluoroscopic guidance. PMID:23914270

Kotb, Ahmed Fouad; Elabbady, Ahmed; Mohamed, Khaled Refaai; Atta, Mohamed Adel

2013-01-01

207

Surgically discovered xanthogranulomatous pyelonephritis invading inferior vena cava with coexisting renal cell carcinoma.  

Science.gov (United States)

Xanthogranulomatous pyelonephritis (XGP) is a chronic inflammatory process that results in replacement of renal and/or perirenal tissue with a diffuse infiltrate of inflammatory cells referred to as xanthoma cells. We present a case of a 49-year-old man with an incidentally discovered renal mass with inferior vena cava (IVC) thrombus, who was found intraoperatively to have a significant inflammatory process involving the posterior wall of his IVC and right renal vein consistent with XGP surrounding a focus of clear cell renal cell carcinoma in the midportion of his right kidney. PMID:19151892

Rosevear, Henry M; Meier, Melissa M; Gallagher, Brian L; Joudi, Fadi N

2009-01-01

208

Primary Pulmonary Ewing’s Sarcoma: Rare Cause of Superior Vena Cava Syndrome in Children  

OpenAIRE

Ewing’s sarcoma is a common malignant bone tumour presenting in children and young adults. Rarely extra- skeletal soft tissues and visceral organs can also be the site of origin of Ewing’s sarcoma. Primary pulmonary Ewing’s sarcoma is an extremely rare malignancy which occurs in the paediatric population. We report an unusual case of primary pulmonary Ewing’s sarcoma in a nine year old girl who presented with features of superior vena cava syndrome in the emergency department. The dia...

Mehra, Shibani; Atwal, Swapndeep Singh; Garga, Umesh Chandra

2014-01-01

209

Right varicocele associated with inferior vena cava malformation in situs inversus: percutaneous treatment with retrograde sclerotherapy.  

Science.gov (United States)

Isolated right varicocele is a rare condition. It could be secondary to a retroperitoneal neoplastic mass involving the right internal spermatic vein, but sometimes, an anatomic variant must be considered. We present a case of a young man with situs inversus and right varicocele, a mirror image of the normal condition, associated with inferior vena cava malformation, who was treated successfully with retrograde selective percutaneous sclerotherapy of the right internal spermatic vein. Selective sclerotherapy of the internal spermatic vein at the time of venography has proved to be a valuable therapeutic option in right-sided varicocele associated with anatomic abnormalities. PMID:11789975

Preziosi, P; Miano, R; Bitelli, M; Ciolfi, M G; Micali, S; Micali, F

2001-12-01

210

Thoracic duct ligation as treatment of chylothorax due to vena cava superior thrombosis.  

Science.gov (United States)

Thrombosis is a well known complication of subclavian vein catheterization. As collateral circulation develops, consequences are usually limited to the fact that this vein is no longer usable as an access route. However, one of the possible complications of a superior vena cava thrombosis is the development of a chylothorax. We describe an infant developing a chylothorax caused by a SVC thrombosis after subclavian vein catheterization for parenteral nutrition. The chylothorax did not resolve following conservative management, but was successfully treated by surgical ligation of the thoracic duct. PMID:21837932

Van Biervliet, S; De Waele, K; Vande velde, S; Van Renterghem, K; François, C; Verrijkt, A; De Jaegher, A; Van Winckel, M

2011-01-01

211

Extra adrenal retroperitoneal paraganglioma associated with duplication of inferior vena cava  

Directory of Open Access Journals (Sweden)

Full Text Available

Retroperitoneal paragangliomas arise from specialized neural crest cells symmetrically distributed along the aorta in association with the sympathetic chain. If this tissue aggregates in the adrenal medulla pheochromocytoma may arise. When it remains in the paraaortic sites it could develop into extra-adrenal, retroperitoneal paraganglioma. We report a case of extra-adrenal paraganglioma in the renal hilum intimately related to the left side of a double inferior vena cava. To the best of our knowledge such an association has never been described before. The clinical significance of this venous anomaly is reviewed.

parangama chatterjee

2008-09-01

212

Successful Thrombolysis of Occluded Inferior Vena Cava Filter withIVC Syndrome  

Directory of Open Access Journals (Sweden)

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

BC Srinivas

2012-10-01

213

Extrinsic compression of superior vena cava: an analysis of 41 patients  

International Nuclear Information System (INIS)

A retrospective analysis was made of 41 patients with extrinsic compression of the superior vena cava who were treated at the University of Illinois Hospital, Mercy Hospital and Columbus Hospital between 1967 and 1977. Small cell carcinoma was the predominant histological variety. The mode of presentation (acute versus subacute) was found to be an important prognostic factor: 47% of patients with acute presentation responded to treatment compared to 79% of patients with subacute onset. Chemotherapy given concomitantly with radiotherapy did not produce better results than radiotherapy alone

214

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

Science.gov (United States)

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

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

2013-09-01

215

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

International Nuclear Information System (INIS)

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

216

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

Directory of Open Access Journals (Sweden)

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

Vu?i?evi?-Trobok Jadranka

2002-01-01

217

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

International Nuclear Information System (INIS)

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

218

Novel Use of AngioVac System to Prevent Pulmonary Embolism during Radical Nephrectomy with Inferior Vena Cava Thrombectomy  

OpenAIRE

Venous tumor thrombus occurs in 5-10% of patients with renal cell carcinoma. Surgical excision offers the best chance for survival, but is technically difficult. Risk of pulmonary embolism from venous thrombus or tumor thrombus is high, especially with tumors located higher in the inferior vena cava. Cardiopulmonary bypass may be used when a tumor extends above the diaphragm, but carries significant risk. We present an 86-year-old woman with a 7 cm renal mass extending into the inferior vena ...

Brown, Robert J.; Uhlman, Matthew A.; Fernandez, Joss D.; Collins, Thomas; Brown, James A.

2013-01-01

219

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

Directory of Open Access Journals (Sweden)

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

Hikmat Abdel-Razeq

2011-03-01

220

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

International Nuclear Information System (INIS)

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

221

Initial experience in 115 patients with the retrievable Cook Celect vena cava filter.  

Science.gov (United States)

The aim of this study was to evaluate our experience with the retrievable Cook Celect inferior vena cava (IVC) filter (William Cook, Europe) with regard to insertion, efficiency, ease of retrieval, and any associated complications. A retrospective review was performed of 115 patients (41 female, 74 male, mean age 47.97 years) who underwent Cook Celect IVC filter insertion between December 2005 and October 2007. Filter insertion was successful in all patients. Of the 115 filters inserted, 57 have been successfully retrieved (49.6%) to date. The successful retrieval rate from attempted retrieval was 93.4%. The mean dwell time of successfully retrieved filters was 114.9 days (range 14-267 days). Failed retrievals were due to a thrombosed vena cava (n = 1) and endothelialisation of the filter (n = 3). In the failed retrieval group the mean implantation time was 142 days (range 78-211 days). While this is the first retrospective clinical study on the Cook Celect filter, results to date are promising. We demonstrated an efficacious filter with a high successful retrieval rate of 93.4% and a low complication rate. The filter was assessed with extended dwell times (range 14-267 days). Failed retrieval secondary to hook endothelialisation continues to be an issue with this filter. We recognize that a limitation of our study was the lack of systematic follow-up for clinically silent complications. Further studies to evaluate longer term outcomes and effectiveness of this filter are warranted. PMID:19453530

Doody, O; Given, M F; Kavnoudias, H; Street, M; Thomson, K R; Lyon, S M

2009-02-01

222

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

Scientific Electronic Library Online (English)

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

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

2014-04-01

223

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

Directory of Open Access Journals (Sweden)

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

Antonio Eduardo Zerati

2005-10-01

224

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

Scientific Electronic Library Online (English)

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

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

2005-10-01

225

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

International Nuclear Information System (INIS)

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

226

[Anomalous right upper pulmonary venous drainage into the superior vena cava with coexistence sinus venosus atrial septal defect (ASD)].  

Science.gov (United States)

Article presents a case of a 71-year old woman with pulmonary right upper venous drainage into the superior vena cava and with coexistence sinus venous type Atrial Septal Defect (ASD) which was revealed as interesting finding in multislices computed tomography angiography during estimation of coronary arteries. PMID:23944110

Laskowicz, Bartosz; Urba?czyk-Zawadzka, Ma?gorzata; Krupi?ski, Maciej; Konieczy?ska, Ma?gorzata; Irzyk, Ma?gorzata; Bany?, Robert Pawe?; Machnik, Roman; Urbanik, Andrzej

2013-01-01

227

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

International Nuclear Information System (INIS)

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

228

Partially unroofed coronary sinus, persistent left superior vena cava and cortriatriatum: a rare combination of interruption in normal embryogenesis.  

Science.gov (United States)

A 48-year-old male with a history of secundum type atrial septal defect (ASD) closure in childhood presented to our outpatient clinic complaining of palpitation for six months. Interestingly, transthoracic and transesophageal echocardiography exams showed an undiagnosed partially unroofed coronary sinus associated with persistent left superior vena cava (LSVC) and Cor triatriatum. PMID:25478530

Peighambari, Mohammadmehdi; Esmaeilzadeh, Maryam; Alizadehasl, Azin; Akiash, Nehzat; Motamedzadeh, Mahmoodreza

2014-02-01

229

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

Scientific Electronic Library Online (English)

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

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

2005-12-01

230

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

Directory of Open Access Journals (Sweden)

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

Jose C. Baptista-Silva

2005-12-01

231

CT demonstration of the extracardiac anastomoses of the coronary veins in superior vena cava or left brachiocephalic vein obstruction  

International Nuclear Information System (INIS)

CT scans in four cases of chronic superior vena cava or left brachiocephalic vein obstruction demonstrate a systemic-to-cardiac collateral venous pathway through anastomoses between the pericardial branches of systemic veins and the presumed adventitial veins of the ascending aorta and pulmonary trunk. These adventitial veins then drain into tributaries of the anterior cardiac veins or ventricular coronary veins.

232

"Acute pseudo-pericardial tamponade": the compression of the thoracal inferior vena cava--a case report.  

Science.gov (United States)

We describe a case of 68-year-old woman which was admitted to our hospital for mitral valve replacement (MVR), in whom acute compression of the vena cava inferior developed after repair of lacerated atrio-caval junction with hemostatic tissue sealant, biologic glue (BioGlue, Cryolife, inc, Kennesaw, Ga). Removal of the BioGlue relieved the unexpected problem. PMID:19239687

Cavolli, Raif; Kaya, Kaan; Elalmis, Altay Omer

2009-01-01

233

Optease Vena Cava Filter Optimal Indwelling Time and Retrievability  

International Nuclear Information System (INIS)

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

234

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

Energy Technology Data Exchange (ETDEWEB)

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.)

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

235

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

International Nuclear Information System (INIS)

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

236

[Superior vena cava thrombosis in patients with mediastinal large B-cell lymphoma: Two pediatric cases].  

Science.gov (United States)

We report two pediatric cases of superior vena cava thrombosis (VTE) in patients treated for primary mediastinal large B-cell lymphoma (PMBCL). PMBCL is a rare entity in children and adolescents and no thrombosis has been described in this population. Thrombosis in lymphoma is frequently asymptomatic, detected as an incidental finding in the first months following diagnosis. The thrombosis mechanisms are often multifactorial based on veinous compression by the mass, elevated risk of thrombosis in neoplasia, and/or presence of a central catheter. The risk factors of venous thromboembolism (VTE) in lymphoma are high-grade lymphoma, comorbidities, central nervous system lymphoma, and mediastinal mass. Because thrombosis has an impact on prognosis and treatment, it seems important to improve knowledge in order to improve the diagnosis and prevention of thrombosis in lymphoma. PMID:25267192

Gonzales, F; Abou Chahla, W; Pagniez, J; Nelken, B

2015-01-01

237

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

International Nuclear Information System (INIS)

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

238

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

Directory of Open Access Journals (Sweden)

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

Verma Gita

2008-10-01

239

Catheter-Related Superior Vena Cava Syndrome Complicated by Chylothorax in a Premature Infant.  

Directory of Open Access Journals (Sweden)

Full Text Available A premature infant experienced respiratory distress due to chylothorax. Contrastenhancedchest computed tomography showed superior vena cava (SVC obstruction withcollaterals, and surgery confirmed an obstruction of the SVC by intravascular fibrotic tissueand thrombi caused by placement of a central venous catheter. The respiratory distressimproved after surgical intervention. In the differential diagnosis of acute respiratory distress,it is necessary to consider catheter-related chylothorax and SVC syndrome when a previouslystable patient has an acute change in cardiopulmonary status, regardless of the durationof catheter use. Although often considered safe and easy, central venous catheter placementmay result in complications. Using appropriate catheters and choosing proper insertionsites can minimize these events. Early diagnosis and treatment can be life-saving shouldcomplications occur.

Hui-Fang Hsu

2003-10-01

240

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

International Nuclear Information System (INIS)

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

241

Segmental variants of the inferior vena cava - typical findings correlated with embryological development for differential diagnosis  

International Nuclear Information System (INIS)

The vast variability of the overall rare congenital anomalies of the inferior vena cava (IVC) are mostly detected by accident through different imaging modalities. These cannot be classed as pathological findings, and should not be confused with lymphomas and has to differ from secondary collateral venous pathways. Based on 656 CT examinations 10.5% known forms of IVC anomalies were found. According to the embryological development three main groups of IVC variants could be nosologically classified: agenesis of the suprarenal IVC, anomalies of the pars renalis and anomalies of the infrarenal IVC. Additionally three unusual anomaly complexes were found. For the understanding details of the embryology based on a simplified depiction are presented. (orig.)

242

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

International Nuclear Information System (INIS)

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

243

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

Directory of Open Access Journals (Sweden)

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

Neema Praveen

2009-01-01

244

Primary malignant pericardial mesothelioma-a rare cause of superior vena cava thrombosis and constrictive pericarditis.  

Science.gov (United States)

Primary malignant pericardial mesothelioma (PMPM) is an extremely rare, highly lethal and often misdiagnosed tumor. We report a 60-year-old woman complaining of dry cough, shortness of breath and exertional dyspnea due to a large pericardial effusion. The pericardial fluid volume declined after pericardiocentesis; analysis of the fluid revealed malignant cells and was negative for tuberculosis. Subsequently, the patient developed a compression of the superior vena cava and pericardial constriction. The patient's symptoms marginally improved after partial pericardiectomy, and a diagnosis of pericardial mesothelioma was made on pathology. However, her symptoms continued to aggravate, and she died 8 months after presentation. Pericardial mesothelioma should be discovered earlier to treat patients who develop repeatedly pericardial effusion after pericardiocentesis and pericardial tamponade or those develop constrictive pericarditis. PMID:25590007

Gong, Wenhui; Ye, Xiaofeng; Shi, Kaihu; Zhao, Qiang

2014-12-01

245

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

Science.gov (United States)

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

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

2014-11-01

246

Primary Pulmonary Ewing’s Sarcoma: Rare Cause of Superior Vena Cava Syndrome in Children  

Science.gov (United States)

Ewing’s sarcoma is a common malignant bone tumour presenting in children and young adults. Rarely extra- skeletal soft tissues and visceral organs can also be the site of origin of Ewing’s sarcoma. Primary pulmonary Ewing’s sarcoma is an extremely rare malignancy which occurs in the paediatric population. We report an unusual case of primary pulmonary Ewing’s sarcoma in a nine year old girl who presented with features of superior vena cava syndrome in the emergency department. The diagnosis was confirmed pathologically both by light microscopy and immunohistochemistry. The patient was put on chemotherapy and surgery was planned but the patient expired within three days of starting chemotherapy. PMID:25302247

Atwal, Swapndeep Singh; Garga, Umesh Chandra

2014-01-01

247

Inferior vena cava thrombosis causing acute cauda equina syndrome. Case report.  

Science.gov (United States)

The authors report a case of a 16-year-old girl who presented with a 1-week history of progressive low-back pain, buttock paresthesias, and bilateral lower extremity pain and weakness. Magnetic resonance (MR) imaging and MR venography studies of her lumbar spine revealed engorgement of the epidural venous plexus and mild compression of the cauda equina. A lower extremity and pelvic venogram revealed occlusive thrombosis of the femoral and iliac veins as well as of the inferior vena cava (IVC). The patient required an IVC thrombectomy due to progressive symptoms, after which she improved and returned to baseline status in 1 week. Imaging studies afterwards showed resolution of the venous engorgement and decompression of the cauda equina. This is the second published report of an association between IVC thrombosis and cauda equina syndrome. PMID:16509481

Mohit, A Alex; Fisher, David J; Matthews, Dana C; Hoffer, Eric; Avellino, Anthony M

2006-01-01

248

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

International Nuclear Information System (INIS)

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

249

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

Directory of Open Access Journals (Sweden)

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

Iqbal Javaid

2008-02-01

250

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Um paciente portador de marcapasso definitivo bi-atrial-ventricular por fibrilação atrial paroxística e bradicardia sinusal, em uso crônico de anticoagulante oral, apresentou sinais clínicos da síndrome da veia cava superior. A venografia por subtração digital mostrou obstrução total do tronco braqu [...] iocefálico venoso direito e grande dificuldade de fluxo sangüíneo da veia inominada para a veia cava superior. A abordagem terapêutica constou da remoção completa do sistema transvenoso seguida de reimplante do sistema bi-atrial-ventricular por técnica epimiocárdica pela via subxifóide assistida por fluoroscopia. Abstract in english A patient with a bi-atrial-ventricular permanent pacemaker due to paroxystic atrial fibrillation associated to sinus bradycardia, in chronic use of oral anticoagulant, presented clinical signs of superior vena cava syndrome. Digital subtraction venography showed total obstruction of the right brachi [...] ocephalic venous trunk and severe stenosis of the connection of the left trunk to the superior vena cava. The therapeutic approach consisted of complete removal of transvenous system followed by re-implant of the bi-atrial-ventricular system using an epicardial subxiphoid access with fluoroscopic assistance

Roberto, Costa; Maria Inês de Paula, Leão; Kátia Regina da, Silva; Paulo Roberto, Camargo; Regina Valéria, Costa.

2006-10-01

251

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

Directory of Open Access Journals (Sweden)

Full Text Available Um paciente portador de marcapasso definitivo bi-atrial-ventricular por fibrilação atrial paroxística e bradicardia sinusal, em uso crônico de anticoagulante oral, apresentou sinais clínicos da síndrome da veia cava superior. A venografia por subtração digital mostrou obstrução total do tronco braquiocefálico venoso direito e grande dificuldade de fluxo sangüíneo da veia inominada para a veia cava superior. A abordagem terapêutica constou da remoção completa do sistema transvenoso seguida de reimplante do sistema bi-atrial-ventricular por técnica epimiocárdica pela via subxifóide assistida por fluoroscopia.A patient with a bi-atrial-ventricular permanent pacemaker due to paroxystic atrial fibrillation associated to sinus bradycardia, in chronic use of oral anticoagulant, presented clinical signs of superior vena cava syndrome. Digital subtraction venography showed total obstruction of the right brachiocephalic venous trunk and severe stenosis of the connection of the left trunk to the superior vena cava. The therapeutic approach consisted of complete removal of transvenous system followed by re-implant of the bi-atrial-ventricular system using an epicardial subxiphoid access with fluoroscopic assistance

Roberto Costa

2006-10-01

252

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

International Nuclear Information System (INIS)

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

253

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

OpenAIRE

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

Koh Ghee; Ai, Mokthar Sharifah; Hamzah Amir; Kaur Jasvinder

2009-01-01

254

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

Directory of Open Access Journals (Sweden)

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

Koh Ghee

2009-01-01

255

Accidental implantation of hemodialysis catheter in persistent left superior vena cava  

International Nuclear Information System (INIS)

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

256

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2008-02-04

257

Isolated left superior vena cava to the left atrium with situs solitus and dextrocardia: extracardiac repair facilitated by juxtaposition of the atrial appendages.  

Science.gov (United States)

We describe an extremely unusual case, with isolated left superior vena cava to the left atrium, normal intracardiac anatomy, and left juxtaposition of the atrial appendages. Surgical repair was performed without cardiopulmonary bypass by anastomosing the left superior cava to the superior aspect of the right atrial appendage, and was facilitated by the ectopic location of the appendage. PMID:9388124

McElhinney, D B; Mishaly, D A; Moore, P; Brook, M M; Reddy, V M; Hanley, F L

1997-11-15

258

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

International Nuclear Information System (INIS)

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

259

Double-vein jugular/inferior vena cava clamp technique for long-term in vivo studies in rats.  

Science.gov (United States)

We present a step-by-step manual for chronic cannulation of rats using a simple technique. This concept facilitates repeated clamping of the same rat over a 6-10-week period, providing a completely separate infusion route from blood sampling access which is placed into mixed venous blood in the inferior vena cava. Permanent catheters implanted into the left external jugular vein and the inferior vena cava were used for miniature blood sampling and recycling. The design and running of clamp experiments and other physiological research models are detailed. Long-term reliable venous access, simple installation, and easy after-care of the rats' cannulas are the principal advantages of the procedure described. PMID:9523892

Burvin, R; Zloczower, M; Karnieli, E

1998-02-15

260

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

International Nuclear Information System (INIS)

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

261

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

Science.gov (United States)

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

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

2014-12-01

262

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

Directory of Open Access Journals (Sweden)

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

Patel Nehal

2009-01-01

263

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

OpenAIRE

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

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

2013-01-01

264

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

OpenAIRE

Aneurysms of the major thoracic veins are rare. They are usually asymptomatic and thus treated conservatively. We report an extremely rare case of rapidly progressing superior vena cava (SVC) aneurysm complicated by thrombosis and acute pulmonary thromboembolism (PTE) with right ventricular dysfunction. Thrombolytic therapy for hemodynamically significant acute PTE was harmful to the patient in the present case, because it induced further thrombosis and mobilization of the thrombi within the ...

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

2011-01-01

265

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

International Nuclear Information System (INIS)

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.

266

Obstruction of superior vena cava flow during transcatheter atrial septal defect closure with the Atriasept ASD occluder.  

Science.gov (United States)

In this paper, we describe a patient with a large secundum atrial septal defect ASD (26 mm) with adequate rims that were suitable for percutaneous closure. While closing this ASD, the superior vena cava (SVC) was occluded with the right atrial disc of the Atriasept ASD occluder (Cardia) and thus the device was retrieved before its release. After retrieval of this device, an Amplatzer ASD occluder was successfully implanted without disturbing the caval flow. PMID:23666302

Kahya Eren, Nihan; Kocaba?, U?ur; Nazl?, Cem; Ergene, Oktay

2013-03-01

267

Transcatheter Treatment of Patent Foramen Ovale Combined with Abnormal Drainage of Left Superior Vena Cava to Left Upper Pulmonary Vein  

OpenAIRE

Patent foramen ovale (PFO) has been known to be the cause of transient ischemic attacks or stroke, and transcatheter device closure has been the treatment of choice for these defects. Combined defect of abnormal drainage of left superior vena cava (LSVC) to left superior pulmonary vein (LSPV) in PFO patients is an uncommon combination, and both can act as a pathway for paradoxical embolism. We report a successful closure of PFO, using Amplatzer® PFO occluder (St. Jude Medical, St. Paul, MN, ...

Kim, Do Hoon; Park, Su-jin; Jung, Jo Won; Kim, Nam Kyun; Choi, Jae-young

2013-01-01

268

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

Directory of Open Access Journals (Sweden)

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

Singh Iqbal

2010-01-01

269

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

OpenAIRE

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

Sarah Gordon; Tamie Kerns; William Londeree; Brian Ching

2013-01-01

270

Refractory Cerebrospinal Fluid Rhinorrhea Secondary to Occult Superior Vena Cava Syndrome and Benign Intracranial Hypertension: Diagnosis and Management  

OpenAIRE

Objective: This study is designed to describe the association between benign intracranial hypertension (BIH) and spontaneous cerebrospinal fluid (CSF) rhinorrhea and address the effect of extracranial venous flow dynamics on intracranial pressure (ICP). Methods: We present a 58-year-old woman with refractory spontaneous CSF rhinorrhea who was later found to have superior vena cava syndrome. The patient had undergone two prior transnasal endoscopic repair attempts. In retrospect, a preoperativ...

Bledsoe, Jonathan M.; Moore, Eric J.; Link, Michael J.

2009-01-01

271

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

Scientific Electronic Library Online (English)

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

Cristina, Quicios Dorado; Antonio, Allona Almagro.

2008-04-01

272

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

International Nuclear Information System (INIS)

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

273

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

International Nuclear Information System (INIS)

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

274

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

International Nuclear Information System (INIS)

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

275

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: O objetivo do estudo foi avaliar a eficácia de um novo filtro de veia cava, de baixo perfil, na retenção de coágulos em modelo in vitro. MÉTODO: O filtro consiste em dois cones opostos pelo ápice. O cone distal é formado por oito hastes de aço inoxidável, que têm a função de retenção dos ê [...] mbolos. O cone proximal é constituído de quatro hastes, cuja função é ancorar e centralizar. Os filtros foram introduzidos e fixados no interior de um tubo de PVC transparente de 25, 30 e 35 mm de diâmetro interno, em posição vertical, e conectados com um sistema pulsátil de fluxo (bomba peristáltica). Foi utilizado, para veículo, um reservatório com solução salina (0,9%) com 40% de glicerina, mantido em temperatura ambiente. Confeccionaram-se trombos com sangue bovino em tubos plásticos de 3, 4,5 e 6 mm de diâmetro e, posteriormente, foram segmentados nas medidas de 10, 15, 20 e 30 mm de comprimento, totalizando 12 diferentes tamanhos. Realizaram-se 100 liberações para cada tipo de êmbolo e tamanho das cânulas, totalizando 3.600 eventos. Foram feitos lançamentos seqüenciais com cinco êmbolos, sendo 10 para cada tamanho de êmbolo e cânulas, totalizando 360 eventos. Fez-se avaliação da capacidade de retenção dinâmica utilizando os três diferentes tamanhos de cânulas com 100 eventos cada, totalizando 300 eventos. RESULTADOS: Detectou-se que o diâmetro e comprimento dos êmbolos, assim como diâmetros da cânula, podem comprometer a eficácia do filtro. A média de captura de êmbolos pelos filtros foi de 80,5% nas cânulas de 35 mm, 88,7% para cânulas de 30 mm e 86,6% para cânulas de 25 mm. CONCLUSÃO: Conclui-se que a eficácia desse filtro sofre interferência relacionada ao tamanho dos êmbolos e diâmetro da cânula. Abstract in english OBJECTIVE: The objective of the current study was to evaluate the efficacy of a new low-profile vena cava filter in the retention of emboli in an in vitro model. METHOD: The filter consists of two cones connected at the apexes. The distal cone is comprised of eight stainless steel arms with a purpos [...] e of retaining emboli and the proximal cone, made of four arms, acts as an anchor to centralize the filter. Filters were installed and fixed inside three systems using transparent PVC tubes of different sizes (internal diameters of 25, 30 and 35 mm) that were held in a vertical position and connected to a pulsating flow system (peristaltic pump). A reservoir of 0.9% saline solution with 40% glycerin at room temperature was used as the vehicle. Thrombi were made from bovine blood in 3-mm, 4-mm, 5-mm and 6-mm plastic tubes and later the thrombi were sectioned into 10-mm, 15-mm, 20-mm and 30-mm lengths. Each of the 12 sizes of thrombi was assessed 100 times in each of the three systems, with a total of 3,600 events. Five emboli were sequentially released, 10 for each size of embolus and tube, with a total of 360 events. An evaluation of the capacity of the three systems - 100 events each, total of 300 events - to dynamically retain the emboli was made. MRESULTS: The diameter and length of the emboli, as well as tubes greater than 35 mm in diameter can negatively affect the efficacy of the filter. The average of emboli capture for the filters was 80.5% in 35-mm tubes, 88.7% for 30-mm tubes and 86.6% for 25-mm tubes. CONCLUSION: We conclude that the efficacy of this filter is influenced by the size of the emboli and the diameter of the PVC tubes.

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

276

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

Scientific Electronic Library Online (English)

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

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

277

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

Scientific Electronic Library Online (English)

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

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

2013-03-01

278

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

Directory of Open Access Journals (Sweden)

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

Winston B. Yoshida

2008-09-01

279

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

Scientific Electronic Library Online (English)

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

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

2008-09-01

280

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

International Nuclear Information System (INIS)

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

281

Percutaneous transluminal angioplasty in a patient with chronic cerebrospinal venous insufficiency and persistent left superior vena cava.  

Science.gov (United States)

Chronic cerebrospinal venous insufficiency (CCSVI) is a syndrome characterized by stenoses of the internal jugular veins (IJVs) and/or azygos veins and formation of collateral venous channels. A case of a 57-year-old patient with CCSVI in whom the venous outflow from the left IJV to the right atrium occurred through a venous anomaly, the persistent left superior vena cava (PLSVC), is reported. PLSVC is caused by persistence of the left anterior cardinal vein that drains blood from the limb effluent from the left and the left side of head and neck into coronary sinus (Type a), or in the left atrium (Type b). PLSVC can be associated either with innominate vein hypoplasia or other congenital heart abnormalities. Because of evidence of left innominate vein hypoplasia, angioplasty was not performed using the ordinary route but passing with the balloon directly through the PLSVC up to the left IJV. Finally, angioplasty was carried out in a standard manner in the right IJV as well as in the azygous vein. Confirmation angiogram revealed complete reopening of all treated vessels with no evidence of peri- and postoperative complications. The patient was discharged home the following day in good general conditions. PLSVC is a rare congenital vein anomaly but in case of concomitant innominate vein hypoplasia may prove to be a valuable alternative to treat patients with IJV diseases. PMID:23155131

Lupattelli, T; Benassi, F; Righi, E; Bavera, P; Bellagamba, G

2014-04-01

282

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

Directory of Open Access Journals (Sweden)

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

Masato Katagiri

2012-07-01

283

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

International Nuclear Information System (INIS)

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

284

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

International Nuclear Information System (INIS)

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

285

Interventional treatment of lung cancer complicated with superior vena cava syndrome  

International Nuclear Information System (INIS)

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

286

[Infiltration of the superior vena cava in NSCLC: Results of Surgical Intervention.  

Science.gov (United States)

The benefits of surgical therapy of locally advanced non-small cell lung cancer (NSCLC) with infiltration of the superior vena cava (SVC) remains controversial. Here we describe our therapeutic approach and results of our intervention.A retrospective analysis of 22 patients with NSCLC who underwent SVC replacement (n?=?17) or reconstruction (n?=?5) between 1998 and 2013 was performed. Pneumonectomy was necessary in 16 patients, lobectomy in 8. Preoperative chemotherapy was administered to 3 patients, 16 received postoperative radiation treatment. The clinical course and survival were analyzed.Major postoperative morbidities were found in 13 patients. Graft thrombosis did not occur. Thirty-day mortality was 7?% in pneumonectomy patients and 0?% following lobectomy. Local recurrence was found in 4.5?%, distant metastases developed in 54.5?% of the patients (p?=?0.0008). One- and five-year survival probabilities for all patients were 63.6 and 27.9?%. Five-year survival probability was 33?% for patients with SVC reconstruction and 25?% for patients with SVC replacement (p?=?0.22). Five-year survival rates after pneumonectomy and lobectomy were 21.4?% and 37.5?%, respectively (p?=?0.18).Radical resection involving the SVC in carefully selected patients with NSCLC results in excellent local tumor control. Due to the high rate of distant metastases, application of induction and adjuvant chemotherapy should be carefully assessed. PMID:25377229

Windisch, T; Fischer, J R; Vega, A; Decker, S; Held, M; Graeter, T P

2014-11-01

287

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

International Nuclear Information System (INIS)

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

288

Pelvic Venous Variations in Patients with Congenital Inferior Vena Cava Anomalies: Classification with Computed Tomography  

International Nuclear Information System (INIS)

Background: Pelvic venous variations of congenital inferior vena cava (IVC) anomalies that have the potential to cause problems during related surgery and interventional radiology are not fully appreciated. Purpose: To classify pelvic venous variations of congenital IVC anomalies using computed tomography (CT). Material and Methods: CT images for 36 patients with congenital IVC anomalies were retrospectively reviewed. Pelvic venous variations were classified with regard to the relationship with the iliac veins and the presence of interiliac communication. Results: Pelvic venous variations were classified into eight types. One azygous continuation displayed normal connection with the bilateral common iliac veins (CIV) (type 1). Of 28 double IVCs, 11 (39.3%) displayed no interiliac communication (type 2a), five (17.9%) displayed interiliac communication from the left CIV (type 2b), one (3.6%) had communication from the right CIV (type 2c), six (21.4%) had communication from the left internal iliac vein (IIV) (type 2d), and five (17.9%) had communication from the right IIV (type 2e). Six left IVCs displayed symmetrical-to-normal connection with the bilateral CIV (type 3). One absence of infrarenal IVC displayed no connection with the CIV (type 4). Conclusion: Eight types of pelvic venous variations of congenital IVC anomalies were classified using CT

289

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

Directory of Open Access Journals (Sweden)

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

Papandrinopoulou Dimitra

2010-06-01

290

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

International Nuclear Information System (INIS)

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

291

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

Directory of Open Access Journals (Sweden)

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

Bünyamin Serto?ullar?ndan

2012-03-01

292

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

International Nuclear Information System (INIS)

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

293

Challenging diagnostic and therapeutic modalities for leiomyosarcoma of inferior vena cava.  

Science.gov (United States)

Leiomyosarcoma of the inferior vena cava (IVCL) is a rare malignant tumour originating from the smooth muscle cells of the media with intra- or extra-luminal growth. The type of the lesion is further divided into three levels in relation to hepatic and renal veins respectively. The aim of this review was to evaluate the results of surgical treatment of IVCL with special reference to the extent of its histological spread and to analyse the recent literature in order to provide an update on the current concepts of diagnostic and therapeutic management of this entity. IVCL's patients may present with non-specific complaints such as dyspnoea, malaise, weight loss, nausea, vomiting, fever and abdominal pain. Haematogenous metastasis is frequent. At a later stage, IVCL may also spread through lymphatic. Multiple diagnostic imaging techniques have been proposed for accurate preoperative diagnosis, including Doppler ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI), individually or in combination with cavography echocardiography or CT-guided biopsy. Despite recent research on the therapeutic strategies against IVCL, surgical resection appears the only potentially curative approach. Unfortunately, a mere minority of patients is eligible to undergo surgical intervention. In addition, surgical removal of IVCL does not necessarily guarantee patient's long-term survival. Alternative therapies, such as radio- and chemo-therapy often proved insufficient. Debate continues regarding the optimal management of the IVC after tumour resection, with primary repair, ligation and IVC reconstruction all have been utilized with varying success. PMID:25489949

Mastoraki, Aikaterini; Leotsakos, George; Mastoraki, Sotiria; Papanikolaou, Ioannis S; Danias, Nikolaos; Smyrniotis, Vasilios; Arkadopoulos, Nikolaos

2015-01-01

294

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

International Nuclear Information System (INIS)

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

295

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Anomalias da veia cava inferior são incomuns, ocorrendo em até 8,7% da população, quando consideradas as anomalias da veia renal esquerda. A veia cava inferior se desenvolve da sexta à oitava semanas de gestação, originada de três veias embrionárias pareadas: veias subcardinais, supracardinais e pós [...] -cardinais. A complexidade da ontogenia da veia cava inferior, com numerosas anastomoses entre essas três veias embrionárias, pode levar a uma grande variedade do retorno venoso do abdome e membros inferiores. Algumas dessas anomalias têm implicações clínicas e cirúrgicas significativas, associadas a outras anomalias congênitas, e em alguns casos, associadas a trombose venosa de membros inferiores, principalmente em pacientes adultos jovens. Foram revistos os exames de dez pacientes com anomalias da veia cava inferior, três deles com trombose venosa profunda de membros inferiores. Foram salientados os principais aspectos das anomalias da veia cava inferior, nos exames de tomografia computadorizada multidetectores e ressonância magnética, correlacionados com a embriologia e demonstrando as principais vias alternativas de drenagem venosa. O conhecimento das anomalias da veia cava inferior é fundamental na avaliação dos exames de imagem do abdome, evitando erros de interpretação e indicando a possibilidade de anomalias associadas, implicações clínicas e cirúrgicas. Abstract in english Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and post [...] cardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications.

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

2013-07-01

296

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

Scientific Electronic Library Online (English)

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

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

2010-06-01

297

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

Scientific Electronic Library Online (English)

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

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

2009-05-01

298

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

Directory of Open Access Journals (Sweden)

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

Michael B. Streiff

2011-12-01

299

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

International Nuclear Information System (INIS)

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

300

Treatment of Budd-Chiari syndrome with inferior vena cava thrombosis  

Science.gov (United States)

The aim of this study was to evaluate the initial results of 41 patients with Budd-Chiari syndrome (BCS) with inferior vena cava (IVC) thrombosis, with regard to the clinical safety and feasibility of the therapeutic approaches selected according to the classification of the condition. Forty-one patients with BCS and IVC thrombosis were admitted for retrospective analysis. All 41 patients were classified as having one of three types of BCS. Interventional therapy was used successfully in 28 patients (68.3%), 7 patients (17.1%) were given conservative treatment and 6 patients (14.6%) were treated with surgical shunts. The interventional approach was used in 29 patients in total and was successful in 28 patients (all those of types I and II, and 3 of the 4 patients of type III with acute thrombosis; 96.6%). None of these 28 patients had pulmonary embolism, pericardial tamponade or intra-abdominal bleeding. After 1–5 years, 4 patients (9.8%) had a second dilation of the IVC. In the 7 cases treated in a conservative manner, 2 cases succumbed to upper gastrointestinal bleeding and 1 case succumbed to liver and kidney failure. This study indicates that the classification of BCS patients with IVC thrombosis is helpful in selecting a therapeutic approach. Interventional therapy is the first therapeutic choice for BCS patients with IVC thrombosis of type I, type II or type III with acute thrombosis. For the patients of type III with an obsolete thrombus, surgical shunts or conservative treatment are the main therapeutic methods. PMID:23596497

WANG, RUIHUA; MENG, QINGYI; QU, LIFENG; WU, XUEJUN; SUN, NIANFENG; JIN, XING

2013-01-01

301

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

International Nuclear Information System (INIS)

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

302

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

International Nuclear Information System (INIS)

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

303

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

International Nuclear Information System (INIS)

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

304

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

Directory of Open Access Journals (Sweden)

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

M. Vahedian

2011-10-01

305

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

Scientific Electronic Library Online (English)

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

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

2014-10-01

306

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

International Nuclear Information System (INIS)

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

307

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2013-12-15

308

Ectopic drainage from the inferior vena cava to the left atrium together with a partial anomalous pulmonary venous connection.  

Science.gov (United States)

We report a case of a 44-year-old male patient with ectopic drainage from the inferior vena cava to the left atrium accompanied by partial anomalous pulmonary venous drainage. After the patient was hospitalized, his diagnosis was confirmed by Doppler echocardiography and angiography. A pericardial patch was used to divert the blood to the atrium. The surgical procedure was successful, and the patient began a rehabilitation program 8 days later. This type of ectopic drainage pattern is an unusual and infrequent clinical finding. The definitive diagnosis should be made by Doppler ultrasound combined with angiography. PMID:24333195

Wu, Yuan; Xu, Shuangyue; Guo, Hongwei; Yan, Guoliang; Qi, Zhongquan; Shan, Zhonggui

2014-07-01

309

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

Directory of Open Access Journals (Sweden)

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

Robinson RA

2013-05-01

310

Inferior vena cava thrombectomy in a patient with heparin-induced thrombocytopenia via inflow occlusion technique on beating heart  

Science.gov (United States)

Anticoagulation management of a patient complicated by heparin-induced thrombocytopenia is one of the challenging situations in open heart surgery. A 40-year old male receiving warfarin for anticoagulation was admitted to our clinic with a history of heparin-induced thrombocytopenia and a diagnosis of inferior caval thrombosis. He was scheduled for inferior vena cava thrombectomy via the inflow occlusion technique on the beating heart. Warfarin sodium was stopped three days prior to the operation while fondaparinux sodium was begun twice a day. The operation was successfully performed and no postoperative complications were observed. PMID:22821651

Cingoz, Faruk; Tavlasoglu, Murat; Ali Sahin, Mehmet; Kurkluoglu, Mustafa

2012-01-01

311

The strategy for treatment of small-cell lung cancer aggravated with superior vena cava obstruction syndrome  

International Nuclear Information System (INIS)

A non-randomized study was carried out to evaluate the immediate and end results of chemo-radiation therapy of 44 cases of small-cell lung cancer aggravated with superior vena cava obstruction syndrome. Both radiation and chemotherapy proved effective in urgent combatting said syndrome. The best results were reliably secured when chemotherapy was supported with radiotherapy at an earlier possible stage. Due to gravity of their condition such cases require the therapy as an urgent measure. The treatment proved effective as 40% of patients with localized small-cell lung tumors and the syndrome survived 12 months

312

Unusual cause of acute right ventricular dysfunction: rapid progression of superior vena cava aneurysm complicated by thrombosis and pulmonary thromboembolism.  

Science.gov (United States)

Aneurysms of the major thoracic veins are rare. They are usually asymptomatic and thus treated conservatively. We report an extremely rare case of rapidly progressing superior vena cava (SVC) aneurysm complicated by thrombosis and acute pulmonary thromboembolism (PTE) with right ventricular dysfunction. Thrombolytic therapy for hemodynamically significant acute PTE was harmful to the patient in the present case, because it induced further thrombosis and mobilization of the thrombi within the aneurysm, subsequently causing de novo PTE. Surgical aneurysmectomy combined with pulmonary artery embolectomy would be a treatment of choice in patients with SVC aneurysm complicated by acute PTE. PMID:21532864

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

2011-05-01

313

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

Science.gov (United States)

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

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

2013-01-01

314

Be aware of wires in the veins: a case of superior vena cava syndrome in a patient with permanent pacemaker  

Directory of Open Access Journals (Sweden)

Full Text Available Superior vena cava (SVC syndrome is an unusual complication of pacemaker and implantable cardioverter–defibrillator implantation. It is believed to be due to SVC thrombosis with or without stenosis induced by endothelial disruption from repeated mechanical trauma by the leads. A 58-year-old man presented with gradual swelling of his face, neck, and upper extremities of 10 days duration. A pacemaker had been implanted for symptomatic bradycardia over 5 years ago. Venous Doppler and venogram revealed thrombosis and stenosis of the SVC. He was treated with multimodal therapy and was discharged with complete resolution of his symptoms.

Agegnehu T. Gebreyes

2012-10-01

315

Tricuspid valve obstruction and right heart failure due to a giant right atrial myxoma arising from the superior vena cava.  

Science.gov (United States)

Myxomas are the most common primary cardiac tumors. The cardiac myxomas are mostly diagnosed within the atria, and only a few such tumors are reported to have arisen from atrioventricular valves or pulmonary vessels. The authors here present a case of 59-year-old Chinese woman who was hospitalized for exacerbating symptoms of tricuspid stenosis and right heart failure. Echocardiography revealed a giant right atrial myxoma arising from an extremely rare site, the anterior wall of the superior vena cava. With the aid of transesophageal echocardiography, the surgical resection was performed successfully with the patient achieving complete recovery. PMID:24172033

Xiao, Zheng-hua; Hu, Jia; Zhu, Da; Shi, Ying-kang; Zhang, Er-yong

2013-01-01

316

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

Scientific Electronic Library Online (English)

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

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

2009-09-01

317

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

Scientific Electronic Library Online (English)

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

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

2010-12-01

318

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

Scientific Electronic Library Online (English)

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

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

2014-06-01

319

Intra-atrial rerouting and maze procedure for an adult patient in cor triatriatum, persistent left superior vena cava, and atrial fibrillation.  

Science.gov (United States)

A combination of cor triatriatum and persistent left superior vena cava without communication to the coronary sinus is uncommon. A 62-year-old male with this diagnosis in conjunction with atrial fibrillation underwent successful intracardiac repair done with a unique method. After a maze procedure and enlargement of the route from the pulmonary veins to the mitral valve, a GoreTex graft was used to reroute the left superior vena cava into the right atrium and to close two thirds of the circumference of the patient's atrial septal defect; the rest of the defect was closed with another GoreTex patch. PMID:22632505

Sughimoto, Koichi; Matsuo, Kozo; Ohba, Masanao

2012-06-01

320

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2000-09-01

321

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

LENUS (Irish Health Repository)

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.

Moran, M

2012-02-01

322

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

Science.gov (United States)

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

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

2013-10-01

323

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

International Nuclear Information System (INIS)

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

324

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

International Nuclear Information System (INIS)

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

325

Predicting preload responsiveness using simultaneous recordings of inferior and superior vena cava diameters.  

Science.gov (United States)

IntroductionEchocardiographic indices based on respiratory variations of superior and inferior vena cava diameters (¿SVC and ¿IVC, respectively) have been proposed as predictors of fluid responsiveness in mechanically ventilated patients but they have never been compared simultaneously in the same patient sample. The aim of this study was to compare the predictive value of these echocardiographic indices when concomitantly recorded in mechanically ventilated, septic patients.MethodsSeptic shock patients requiring hemodynamic monitoring were prospectively enrolled over a 1-year period in a mixed medical surgical ICU of a University Teaching Hospital (Toulouse, France). All patients were mechanically ventilated. Predictive indices were obtained by transesophageal and transthoracic echocardiography and were calculated as follows: (Dmax-Dmin) / Dmax for ¿SVC and (Dmax-Dmin) / Dmin for ¿IVC where Dmax and Dmin are the maximal or minimal diameter of SVC and IVC. Measurements were performed at baseline and after a 7 ml/kg volume expansion using a plasma expander. Patients were separated into responders (increase in cardiac index¿¿¿15%) and non-responders (increase in cardiac index¿<¿15%).ResultsAmong 44 included patients, 26 (59%) patients were responders (R). ¿SVC was significantly more accurate than ¿IVC to predict fluid responsiveness (the area under the ROC curve for ¿SVC and ¿IVC regarding assessment of fluid responsiveness were significantly different (0.74 (95% confidence interval (CI): 0.59 to 0.88) and 0.43 (95% CI: 0.25 to 0.61) respectively with P¿=¿0.012)). No significant correlation between ¿SVC and ¿IVC was found (r¿=¿0.005, P¿=¿0.98). The best threshold value to discriminate R from NR was 29% for ¿SVC with a 54% sensitivity and 89% specificity, and 21% for ¿IVC with a 38% sensitivity and 61% specificity.Conclusions¿SVC was better in predicting fluid responsiveness than ¿IVC in our cohort. It is worth noting that the sensitivity and specificity of ¿SVC and ¿IVC to predict fluid responsiveness were lower than those reported in the literature, highlighting the limits of using these indices in a heterogeneous sample of medical and surgical septic patients. PMID:25189403

Charbonneau, Hélène; Riu, Béatrice; Faron, Matthieu; Mari, Arnaud; Kurrek, Matt M; Ruiz, Jean; Geeraerts, Thomas; Fourcade, Olivier; Genestal, Michèle; Silva, Stein

2014-09-01

326

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2013-12-15

327

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

International Nuclear Information System (INIS)

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

328

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

Scientific Electronic Library Online (English)

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

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

2008-04-01

329

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

Directory of Open Access Journals (Sweden)

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

FRANCO INNOCENTI C

2008-04-01

330

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Para o presente trabalho utilizou-se 25 animais, fetos de búfalos da Raça Murrah, com idades variando entre 5 e 9 meses, sendo 15 fêmeas e 10 machos, com vistas à dissecação e sistematização dos vasos em estudo. Os animais foram coletados em abatedouro e fixados em solução aquosa de formol 10%. Obti [...] veramse para a Veia Cava Caudal os seguintes afluentes de origem: as veias ilíacas comuns direita e esquerda, e seus afluentes colaterais; veia sacral mediana; veias frênicas; veias lombares (1-5); veias circunflexas profunda do ílio direita e esquerda; 3-4 veias hepáticas; veia genital direita (testicular ou ovárica); veias adrenais e veias renais direita e esquerda. Abstract in english Twenty-five animals, Murrah, buffaloes fetus, with 5 to 9 months of age (15 females and 10 males) was analyzed by dissection after injected with latex substance. The fetuses were collected in a slaughterhouse and fixed in aqueous formol solution 10%. In the Caudal Vena Cava the following origin trib [...] utaries were observed: the common right and left iliac veins and collateral tributaries; the median sacral vein; frenic vein; 1-5 Lumbar veins; the circumflex deep veins of the right and left ileum; 3-4 hepatic veins; right genital vein (testicular or ovarian); adrenal vein and renal right and left veins.

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

331

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

Scientific Electronic Library Online (English)

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

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

332

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

Scientific Electronic Library Online (English)

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

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

2007-09-01

333

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

Scientific Electronic Library Online (English)

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

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

2003-06-01

334

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

Scientific Electronic Library Online (English)

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

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

2012-06-01

335

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

OpenAIRE

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

Keeble, William; Mohiaddin, Raad

2008-01-01

336

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

International Nuclear Information System (INIS)

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

337

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

OpenAIRE

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

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

2014-01-01

338

[Inferior vena cava thrombosis reaching the right atrium after removal of the central venous catheter at femoral vein in a patient with diabetic ketoacidosis].  

Science.gov (United States)

A 19-year-old male was admitted with diabetic ketoacidosis. A central venous catheter for fluid loading and insulin administration was inserted from the right femoral vein. The catheter was placed for 4days and was removal. Three days after removal thrombus was pointed out with echocardiography. Cardiac ultrasound revealed floating thrombi in the right atrium. Venography demonstrated a large thrombus from the right femoral vein to the end of the inferior vena cava. Emergency surgery was performed. A tubular thrombus was trapped from the inferior vena cava departure at the right atrium under cardiopulmonary bypass. The surgeon also implanted an inferior vena caval filter. The patient was weaned from ventilator assist next day and was discharged from the hospital 13 days later. This case suggests that deep vein thrombosis should be checked in diabetic ketoacidosis even after removal of a central venous catheter implanted at the femoral vein. PMID:24864582

Morita, Yoko; Ariyama, Jun; Mieda, Tsutomu; Terao, Kazuhisa; Ueshima, Hironobu; Imanishi, Hirokazu; Kitamura, Akira

2014-05-01

339

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

Scientific Electronic Library Online (English)

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

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

2012-12-01

340

Puerperal ovarian vein thrombophlebitis with clot protrusion into the inferior vena cava. Evaluation with US, CT and MR imaging  

International Nuclear Information System (INIS)

To assess US, CT, and MR findings in women having puerperal ovarian vein thrombosis with clot protrusion into the inferior vena cava. We retrospectively reviewed the duplex US (n = 9), CT (n = 5) and MR (n = 5) examinations of 9 patients with 8 right ovarian vein thrombosis, and one left ovarian vein thrombosis. US findings allowed for the diagnosis of ovarian vein thrombosis in all showing enlarged tubular echogenic thrombus within the retroperitoneum with clot protrusion in the IVC in all cases. CT scan and MRI demonstrated ovarian vein thrombosis in all the cases in which it was performed but failed to show a mobile thrombus within the IVC in one patient. Duplex US is a reliable technique to show puerperal ovarian vein thrombosis and its extension to the IVC. CT scan and MR imaging can be used to precise the extension to the IVC. (author)

341

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

International Nuclear Information System (INIS)

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

342

Agitating thrombolysis technique for the treatment of inferior vena cava fresh thrombus in patients with budd-chiari syndrome  

International Nuclear Information System (INIS)

Objective: To evaluate the therapeutic efficacy of agitating thrombolysis technique for Budd-Chiari syndrome complicated with inferior vena cava (IVC) fresh thrombus. Methods: From August 2004 to March 2009, 5 patients of Budd-Chiari syndrome (four males and one female, aged 36-48 years) with IVC fresh thrombus were treated with agitating thrombolysis technique. After angiography of IVC the recanalization of IVC was performed, which was followed by agitating thrombolytic therapy. Finally, IVC was dilated with percutaneous transluminal balloon angioplasty. Clinical follow-up of IVC patency was conducted by color Doppler sonography. Results: After agitating thrombolysis, the thrombi were completely disappeared in all 5 patients without single occurrence of pulmonary embolism. In all patients, IVC remained patency on color Doppler ultrasonograph after following up for a mean period of 23.8 months. Conclusion: Agitating thrombolysis technique is a safe and effective treatment for Budd-Chiari syndrome complicated with IVC fresh thrombus. (authors)

343

The hangman technique: a modified loop snare technique for the retrieval of inferior vena cava filters with embedded hooks.  

Science.gov (United States)

The loop snare technique is a method for inferior vena cava (IVC) filter retrieval that creates a wire loop between the filter legs; this technique may fail in cases with an embedded hook. This report describes the hangman technique, a modified loop snare technique for filter retrieval that creates a wire loop between the filter neck and IVC wall for release of embedded filter hooks. The hangman technique was attempted in 11 cases complicated by tilt (mean tilt, 13.3 degrees ± 3.9) and an embedded hook (mean dwell time, 194.5 d) with a retrieval success rate of 81.8% (9 of 11 cases) and no associated complications. PMID:25541448

Al-Hakim, Ramsey; McWilliams, Justin P; Derry, William; Kee, Stephen T

2015-01-01

344

Modified liver hanging maneuver during orthotopic liver transplantation with inferior vena cava preservation: results after 120 consecutive applications.  

Science.gov (United States)

The outflow venovenous anastomosis represent a crucial aspect during orthotopic liver transplantation (OLT) with inferior vena cava (IVC) preservation. The modified Belghiti liver hanging maneuver applied to the last phase of hepatectomy, lifting the liver, provides a better exposure of the suprahepatic region and allows easier orthogonal clamping of the three suprahepatic veins with a minimal portion of IVC occlusion. The outflow anastomosis constructed with a common cloacae of the three native suprahepatic veins is associated with a lower incidence of graft related venous outflow complications. The procedure planned in 120 consecutive OLT was achieved in 118 (99%). The outflow anastomosis was constructed on the common cloaca of the three hepatic veins in 111/120 cases (92.5%). No major complications were observed (bleeding during tunnel creation, graft outflow dysfunction, etc) except in one patient with acute Budd-Chiari, who successfully underwent retransplantation. PMID:17692641

Ettorre, G M; Vennarecci, G; Santoro, R; Boschetto, A; Miglioresi, L; Corazza, V; Mancini, P; Lorusso, R; Spoletini, D; Antonini, M; Tacconi, G; Santoro, E

2007-01-01

345

Diabetes alters vascular mechanotransduction: pressure-induced regulation of mitogen activated protein kinases in the rat inferior vena cava  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Diabetes mellitus is an important risk factor for increased vein graft failure after bypass surgery. However, the cellular and molecular mechanism(s underlying vessel attrition in this population remain largely unexplored. Recent reports have suggested that the pathological remodeling of vein grafts may be mediated by mechanically-induced activation of the mitogen activated protein kinase (MAPK signaling pathways and the MAPK-related induction of caspase-3 activity. On the basis of these findings, we hypothesized that diabetes may be associated with alterations in how veins "sense" and "respond" to altered mechanical loading. Methods Inferior venae cavae (IVC from the non-diabetic lean (LNZ and the diabetic obese (OSXZ Zucker rats were isolated and incubated ex vivo under basal or pressurized conditions (120 mmHg. Protein expression, basal activation and the ability of increased pressure to activate MAPK pathways and apoptosis-related signaling was evaluated by immunoblot analysis. Results Immunoblot analyses revealed differential expression and activation of extracellular signal-regulated kinase (ERK1/2, p38 and c-Jun NH2-terminal kinase (JNK MAPKs in the IVCs of diabetic rats as compared to non-diabetic rats. In particular, the expression and basal phosphorylation of p38?- (52.3 ± 11.8%; 45.8 ± 18.2%, JNK 1- (21.5 ± 9.3%; 19.4 ± 11.6% and JNK3-MAPK (16.8 ± 3.3%; 29.5 ± 17.6% were significantly higher (P Conclusion These data suggest that diabetes is associated with significant alteration in the ability of the vena cava to activate MAPK- and apoptosis-related signaling. Whether these changes are associated with the increased vein graft attrition seen in the diabetic population will require further investigation.

Preston Deborah L

2006-09-01

346

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

Scientific Electronic Library Online (English)

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

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

2001-08-01

347

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

International Nuclear Information System (INIS)

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

348

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

OpenAIRE

BACKGROUND: Liver vascular isolation is essential for the treatment of the retrohepatic vena cava and hepatic veins. Triple vessel occlusion (TVO - occlusion of the portal triad, the inferior vena cava above the renal veins and within the pericardium) is the easiest isolation method for the surgeon. Unfortunately, this technique cannot be applied to hypovolemic and/or shock (cardiac arrest) patients as it compromises venous return. OBJECTIVES: Our objective is to demo...

Wilson Luiz Abrantes

2001-01-01

349

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

Directory of Open Access Journals (Sweden)

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

Ivette Arriagada J

2007-03-01

350

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

Scientific Electronic Library Online (English)

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

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

2007-03-01

351

Mechanical Thrombectomy in Inferior Vena Cava Thrombosis After Caval Filter Placement: A Report of Three Cases  

International Nuclear Information System (INIS)

Inferior vena caval (IVC) filter thrombosis inpatients with contraindications to anticoagulant therapy is a difficult and challenging clinical problem. We report our experience in treating three such patients using a mechanical thrombectomy device, which resulted in rapid symptomatic relief until anticoagulant therapy could be safely introduced

352

Occlusion of the left superior vena cava-coronary sinus connection in a child with Glenn dysfunction by the transcatheter approach.  

Science.gov (United States)

A 14-year-old male patient presented with cyanosis and tiredness. The patient had undergone a Glenn procedure at age 12 following the echocardiographic determination of a double inlet left ventricle, ventriculoarterial discordance, moderate valvular-subvalvular pulmonary artery stenosis, non-restrictive inlet ventricular septal defect and right ventricle hypoplasia; his oxygen saturation was 70%. Echocardiography evaluation showed retrograde flow from the vena cava superior to the innominate vein and a left superior vena cava (LSVC) opening into the coronary sinus (CS). Here, we report the case of a patient evaluated for Glenn dysfunction in whom an increase in oxygen saturation was observed following transcatheter occlusion of the LSVC-CS connection using an Amplatzer septal occluder. PMID:25490305

Sayg?, Murat; Tola, Hasan Tahsin; Güzelta?, Alper; Odemi?, Ender

2014-10-01

353

Septic Pulmonary Embolism Case Report: Optimal Outcome after Insertion of an Inferior Vena Cava Filter in a Patient with Staphylococcus aureus Bacteraemia  

Directory of Open Access Journals (Sweden)

Full Text Available A 14-year-old patient presented with bilateral pneumonia and pleural effusions, septic arthritis of the hip, deep venous thrombosis, and pulmonary thromboembolism. Methicillin-sensitive Staphylococcus aureus (S. aureus containing the Panton Valentine Leukocidin (PVL genes was isolated. Contraindication to anticoagulation prompted inferior vena cava filter placement. He completed 4 weeks of treatment with flucloxacillin, with good clinical outcome. S. aureus containing PVL genes should be sought in cases of necrotizing pneumonia as it seems to increase the risk of severe multifocal infection and thrombotic complications. There are few reports of placement of filters during S. aureus sepsis and bacteraemia. This case highlights that when anticoagulation is not feasible, an inferior vena cava filter can be inserted safely, even in patients with active sepsis and high risk for seeding of the filter. Long-term follow-up confirmed a successful outcome with sterilization of the septic thrombosis with no further pulmonary embolism or additional sepsis episodes.

Dinis da Gama

2010-01-01

354

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

Scientific Electronic Library Online (English)

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

Carlos Alberto, Solís-Olivares.

2014-03-01

355

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

International Nuclear Information System (INIS)

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

356

Interrupted inferior vena cava combined with partial anomalous pulmonary venous return drainage to the IVC in a 67-year-old adult.  

Science.gov (United States)

A 67-year-old woman presented with lower body edema and was found to have a suprarenal inferior vena cava (IVC) obstruction without hepatic vein obstruction and partial anomalous pulmonary venous return (PAPVR) draining the right pulmonary veins to the IVC below the obstructed IVC on CT angiography. The patient underwent retrohepatic cavoatrial bypass with a polytetrafluoroethylene (PTFE) 16-mm ringed graft via a posterolateral thoracotomy and retroperitoneal approach. PMID:23216330

Jun, Hee Jae

2013-01-01

357

Interrupted Inferior Vena Cava Combined with Partial Anomalous Pulmonary Venous Return Drainage to the IVC in a 67-Year-Old Adult  

OpenAIRE

A 67-year-old woman presented with lower body edema and was found to have a suprarenal inferior vena cava (IVC) obstruction without hepatic vein obstruction and partial anomalous pulmonary venous return (PAPVR) draining the right pulmonary veins to the IVC below the obstructed IVC on CT angiography. The patient underwent retrohepatic cavoatrial bypass with a polytetrafluoroethylene (PTFE) 16-mm ringed graft via a posterolateral thoracotomy and retroperitoneal approach.

Jun, Hee Jae

2012-01-01

358

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

International Nuclear Information System (INIS)

The usefulness of low-cost, three-dimensional (3D) images reconstructed from magnetic resonance (MR) imaging for investigating persistent left superior vena cava was assessed and compared to the diagnostic accuracy of chest radiography. MR imaging by the spin-echo technique and MR angiography were performed in 10 patients with this anomaly diagnosed previously by contrast echocardiography and radionuclide angiocardiography. Four patients had complicating cardiac anomalies, one with postoperative atrial septal defect, one with postoperative ventricular septal defect, one with atrial septal defect and partial anomalous pulmonary venous return, and one with aortic coarctation and patent ductus arteriosus. Multisectional and multiphasic MR images were used for the 3D-reconstruction of the cardiovascular and mediastinal structures with a NeXT workstation and a 3D-kit. The 3D-reconstructed MR imaging clearly showed the persistent left superior vena cava and the anatomical relationship with the other cardiovascular and mediastinal structures in all 10 patients. Vascular shadows were observed outside the upper left border of the aortic arch on the chest radiographs in seven patients, and the 3D-reconstructed MR images revealed these shadows to be compatible with superior caval vein. The ratios of the diameter between the left and right superior venae cavae with and without the left innominate vein were 0.63±0.14 (mean±SD) and 0.94±0.08, respectively. Three-dimensional reco8, respectively. Three-dimensional reconstructed MR imaging is a useful method for recognizing persistent left superior vena cava and precise examination of the chest radiographs often allowed detection of the vascular shadows caused by this anomaly. (author)

359

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

International Nuclear Information System (INIS)

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

360

Transjugular Intrahepatic Portosystemic Shunt Creation in Budd-Chiari Syndrome: Percutaneous Ultrasound-Guided Direct Simultaneous Puncture of the Portal Vein and Vena Cava  

International Nuclear Information System (INIS)

Budd-Chiari syndrome (BCS) is an uncommon disorder that can be life-threatening, depending on the degree of hepatic venous outflow obstruction. Transjugular intrahepatic portosystemic shunt (TIPS) provides decompression of the congested liver but the hepatic vein obstruction makes the procedure more difficult. We describe a modified method that involved a single percutaneous puncture of the portal vein and inferior vena cava simultaneously for TIPS creation in a patient with BCS

361

Septic Pulmonary Embolism Case Report: Optimal Outcome after Insertion of an Inferior Vena Cava Filter in a Patient with Staphylococcus aureus Bacteraemia  

OpenAIRE

A 14-year-old patient presented with bilateral pneumonia and pleural effusions, septic arthritis of the hip, deep venous thrombosis, and pulmonary thromboembolism. Methicillin-sensitive Staphylococcus aureus (S. aureus) containing the Panton Valentine Leukocidin (PVL) genes was isolated. Contraindication to anticoagulation prompted inferior vena cava filter placement. He completed 4 weeks of treatment with flucloxacillin, with good clinical outcome. S. aureus containing PVL genes should ...

Dinis da Gama; Manuela Correia; Marisa Vieira; Cristina Camilo; Francisco Abecasis; Sofia Vidal Castro; Isabel Esteves

2010-01-01

362

Computed Tomography Imaging of Vena Cava Filter Complications: A Pictorial Review  

Energy Technology Data Exchange (ETDEWEB)

Caval filters are widely used in the prevention of pulmonary embolism. Filters have proved to be effective, but the complication rate is not negligible. Computed tomography (CT) provides a complete evaluation of the filter, including both caval and extracaval complications. In this review, we describe the normal CT aspect of cava filters, the classification of complications and their CT findings. Technical considerations for adequate CT imaging are also highlighted.

Cina, A.; Masselli, G.; Stasi, C. Di; Natale, L.; Cotroneo, A. R.; Cina, G.; Bonomo, L. [Univ. Cattolica del Sacro Cuore, Rome (Italy). Policlinico ' Agostino Gemelli'

2006-03-15

363

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

OpenAIRE

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

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

2006-01-01

364

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

Energy Technology Data Exchange (ETDEWEB)

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

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

365

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

International Nuclear Information System (INIS)

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

366

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

International Nuclear Information System (INIS)

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

367

[A case of a giant ovarian cyst anesthetized with the use of an inferior vena cava filter].  

Science.gov (United States)

An intraperitoneal giant tumor can form deep venous thrombosis (DVT), leading to pulmonary embolism (PE) when it is removed. We report a case of a giant ovarian cystic tumor with possible DVT. A 52-year-old woman (149 cm in height, 85 kg in weight, and 150 cm in ventral girth) underwent the laparoscopic resection of the cyst. Preoperative angiography showed the obstruction of the inferior vena cava (IVC) just below the level of the right renal vein due to the compression by the tumor, and computed tomography suggested the existence of distal DVT. Anesthesia was induced with propofol and fentanyl, and the trachea was intubated using rocuronium. A permanent type IVC filter was placed near the obstruction site to prevent PE. Transesophageal echocardiography (TEE) was employed to detect the thrombotic echogram at the right atrium. Anesthesia was maintained with inhalation of sevoflurane and intravenous infusion of remifentanil. The content of the cyst (40.5 l) was suctioned slowly in about 50 min to avoid reexpansion pulmonary edema and circulatory collapse. Neither thrombotic echogram nor the acute decrease in end-tidal carbon dioxide pressure was observed throughout the anesthesia. Operation was performed uneventfully, and she recovered from anesthesia. We consider that IVC filters and TEE are useful to manage surgical patients with a huge ovarian cyst. PMID:23544338

Kameyama, Naomitsu; Mishima, Yasunori; Niiyama, Shuhei; Yamamoto, Yohsuke; Fukugasako, Hisato; Ushijima, Kazuo

2013-03-01

368

Massive pulmonary embolism caused by internal iliac vein thrombosis with free-floating thrombus formation in the inferior vena cava.  

Science.gov (United States)

Nowadays, compression ultrasonography (CUS) is the gold standard for the routine diagnosis of deep venous thrombosis (DVT). The drawback of CUS is the low sensitivity concerning the diagnosis of isolated pelvic vein thrombosis, especially referring to isolated internal iliac vein and ovarian vein thromboses. Therefore, magnetic resonance (MR) venography has become a valuable alternative. We present the case of a 45-year-old female patient with a massive pulmonary embolism with the indication for thrombolytic therapy due to severe right ventricular overload. We were not able to detect a DVT in the lower limbs of this patient with CUS. However, further DVT workup by MR venography showed a free-floating thrombus formation originating from the right internal iliac veins into the inferior vena cava. Owing to the fact that this thrombus was free floating, surgical removal of the thrombus was scheduled and performed successfully. In some patients it might be important to look for so-called rare causes of pulmonary embolism, even when CUS of the lower limbs does not reveal any DVTs. The diagnostic procedure of choice for these patients seems to be MR phlebography, as iliac and pelvic veins can be evaluated without radiation exposure with this procedure. PMID:22285351

Brodmann, Marianne; Gary, Thomas; Hafner, Franz; Tiesenhausen, Kurt; Deutschmann, Hannes; Pilger, Enrst

2012-04-01

369

Endovascular Treatment of Ruptured Abdominal Aneurysm into the Inferior Vena Cava in Patient After Stent Graft Placement  

International Nuclear Information System (INIS)

We report the case of a patient who underwent endovascular repair and then reintervention as a result of the presence of a persistent endoleak complicated by an aortocaval fistula. A 76-year-old patient with a history of endovascular treatment for abdominal aortic aneurysm 2 years earlier had a palpable abdominal mass, high-output cardiac failure, and renal failure. A computed tomographic scan and angiography revealed bending of the right iliac limb, a type I endoleak, and rupture of the aneurysm into the inferior vena cava with aortocaval fistula formation. An iliac extension was positioned in the right external iliac artery. The procedure was finished successfully. Control angiography showed normal flow within the endoprosthesis, and both iliac arteries were without signs of endoleakage and aortocaval fistula. Ectatic common iliac artery may lead to a late distal attachment site endoleak. The application of a stent graft in cases of secondary aortocaval fistula after stent graft repair is a good option, particularly in emergency cases.

370

Topographic anatomy of the fetal inferior vena cava, coronary sinus, and pulmonary veins: Variations in Chiari's network.  

Science.gov (United States)

To understand anomalies in Chiari's network better, we assessed the topographical anatomy of the fetal inferior vena cava (IVC), coronary sinus, and atria. We examined sagittal serial paraffin sections of 15 human fetuses of crown-rump length 24-36 mm, corresponding to a gestational age of 8 weeks. Although their outflow tract morphologies were similar, these 15 specimens could be classified into two groups. In eight specimens, the left common cardinal vein reached the body wall, whereas in the other seven the vein was obliterated near the left pulmonary vein. Irrespective of the group in which the specimen was included, the anteroposterior arrangement of the coronary sinus, the sinus septum (septum), and the right sinus valve (right valve) could be classified into three types: the right valve-septum-coronary sinus arrangement in seven specimens; the right valve-coronary sinus-septum arrangement in five; and the coronary sinus-right valve-septum arrangement in three. Depending on differences in topographical anatomy, the sinus septum separated the coronary sinus opening from either the right or the left atrium. Likewise, the coronary sinus opening was either adjacent to or distant from the IVC terminal. Rather than the counter-side position of the right valve being at the IVC terminal, the left sinus valve protruded leftward, forming an incomplete interatrial septum. Fetal variations seemed to be closely connected with individual variations and a high frequency of Chiari's network anomalies in adults. Clin. Anat., 2014. © 2014 Wiley Periodicals, Inc. PMID:25425533

Naito, Michiko; Yu, Hee Chul; Kim, Ji Hyun; Rodríguez-Vázquez, José Francisco; Murakami, Gen; Cho, Baik Hwan

2014-11-25

371

Predilation technique for the treatment of old inferior vena cava thrombus in patients with BuddChiari syndrome  

International Nuclear Information System (INIS)

Objective: To evaluate the therapeutic efficacy of predilation technique in treating BuddChiari syndrome complicated with old inferior vena cava (IVC) thrombus. Methods: From Dec. 2006 to Aug. 2009, nine patients of Budd-Chiari syndrome(seven males and two females, aged 39-74 years) with old IVC thrombus were treated with predilation technique. After angiography of IVC, predilation IVC were performed by a 12-16 mm diameter balloon catheter, which was followed by anticoagulant and thrombolytic therapy. When the thrombus was completely dissolved, IVC was dilated by a 25 mm or 30 mm diameter balloon catheter. Follow-up examination with sonography was performed at 1, 3, 6, 12 months, and then yearly after the procedure. Results: All nine patients of Budd-Chiari syndrome with old IVC thrombus were of membranous type occlusion of IVC. After the predilation management with small balloon, all patients showed no symptoms of pulmonary embolism, the thrombus was dissolved gradually and the balloon dilatation angioplasty was successfully accomplished, except one patient who developed IVC occlusion again and had to be treated with the implantation of retrieval stent filter. Postoperative follow-up showed that one patient had recurrent IVC occlusion and the remaining eight patients kept a patent IVC with no recurrence of thrombus. Conclusion: The predilation technique in a safe and effective treatment for Budd-Chiari syndrome complicated with old IVC thrombosis. (authors)th old IVC thrombosis. (authors)

372

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

373

Membranous obstruction of inferior vena cava(MOIVC): treatment with percutaneous transluminal angioplasty(PTA) and self expandable metallic stent  

International Nuclear Information System (INIS)

Percutaneous transluminal angioplasty(PTA) with a balloon catheter is a standard method of treatment for membranous obstruction of inferior vena cava(MOIVC). But, correct therapeutic approach has not been established for MOIVC patients whose lesion is associated with extensive thrombotic IVC occlusion. We tried to treat MOIVC associated with or without thrombus. We treated 13 cases of MOIVC(associated with thrombus in 7 cases, no thrombus in 6 cases) with PTA, thrombolysis and self-expandable metallic stents. PTA was successful in 8 cases, but failed in 5 cases. The recurred cases were retreated with PTA, but follow-up study revealed recoiling restenosis in 4 cases and intimal hyperplasia in 1 case at previous PTA site which could be overcome with a self-expandable metallic stent. The complication were occurred in 3 cases which were hemothorax, hemopericardium, and hemoperitoneum respectively. However, those were resolved by conservative treatment only. Recanalization and dilatation could be done in MOIVC patients with or without thrombosis for improvement of patient's symptom. Gianturco self-expandable metallic stent is useful in treatment of recurred MOIVC after balloon dilatation and preventing reocclusion of the IVC after PTA

374

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

International Nuclear Information System (INIS)

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)

375

Home-made self-expandable metallic stent therapy for benign or malignant segmental inferior vena cava obstruction  

International Nuclear Information System (INIS)

Objective: To investigate the clinical value of home-made self-expandable metallic stent therapy for benign or malignant segmental obstruction of inferior vena cava (IVC). Methods: 48 patients, including 30 cases of benignancy and 18 of malignancy, were underwent the home-made self-expandable metallic stent endovascular implantation of IVC. Results: Of 48 patients, the average obstructive length of IVC was 5.3 ± 2.8 cm. The IVC pressure below the obstruction varied from 21.4 ± 5.1 mmHg of preoperation to 8.4 ± 3.3 mmHg of postoperation (P<0.01). After once successful procedure, no serious procedure-related complications occurred. During 3-36 month follow-up, the patency of IVC stents reached 83.3%, the relative clinical symptoms and signs disappeared in 38 patients and markedly improved in 10. Conclusions: Home-made self-expandable metallic stenting is an effective therapeutic method for benign or malignant segmental obstruction of IVC. (authors)

376

The image diagnosis of uterine leiomyomatosis extending through the inferior vena cava into the right cardiac cavities  

International Nuclear Information System (INIS)

Objective: To explore the clinical and image features of uterine leiomyomatosis extending through the inferior vena cava (IVC) into the right cardiac cavities. Methods: A retrospective study was performed in 5 patients with uterine leiomyomatosis extending through IVC into the right cardiac cavities. All 5 cases underwent the examination of chest X-ray and UCG. 3 patients underwent the examination of EBCT. 2 patients underwent the examination of MRI and angiography. Results: Uterine leiomyosarcoma extending through IVC into the right cardiac cavities was diagnosed in 2 patients and uterine leiomyomatosis extending through IVC into the right cardiac cavities was diagnosed in 1 case on EBCT. Uterine leiomyomatosis extending through IVC into the right cardiac cavities was diagnosed in 2 patients on MRI and angiography. In 3 of the 5 patients, the diagnosis of uterine leiomyomatosis was demonstrated by surgery-pathology. Conclusion: Uterine leiomyoma extending through IVC into the right cardiac cavities is rare, and this situation is called uterine leiomyomatosis. Clinical and imaging findings have some specific features and combined imaging examinations are necessary. (authors)

377

Inferior vena cava filters in trauma patients: a national practice patterns survey of u.s. Trauma centers.  

Science.gov (United States)

Inferior vena cava filters (IVCFs) for thromboprophylaxis in trauma patients are being increasingly used despite a lack of strong clinical data in support of their efficacy and conflicting clinical practice guidelines. This national survey elucidates practice patterns of IVCF use across U.S. trauma centers. A web-based survey was administered to members of the Eastern Association for the Surgery of Trauma between September 2011 and October 2011. The survey queried: 1) background and professional practice; 2) trauma patient population; 3) IVCF placement; 4) IVCF retrieval and follow-up; and 5) pharmacologic prophylaxis. Two hundred eighty-one of 1059 eligible providers completed the survey (27%). Respondents were from a wide spectrum of training backgrounds and clinical practice settings. IVCFs were used by 98.9 per cent of respondents. IVCFs in patients without known venous thromboembolism were considered by 93.2 per cent of respondents. Indications and timing of IVCF retrieval vary. Follow-up care of patients with IVCFs was not uniform. An IVCF registry was maintained by 38 per cent of trauma programs. Adjunctive pharmacologic prophylaxis was used by 96.8 per cent of respondents. This study elucidates the gaps and variations in contemporary practices of IVCF use in trauma patients. Identification of best practices in IVCF use and retrieval awaits well-designed comparative effectiveness studies. PMID:25513923

Rajasekhar, Anita; Elmariah, Hany; Lottenberg, Lawrence; Beyth, Rebecca; Lottenberg, Richard; Ang, Darwin

2014-12-01

378

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

Science.gov (United States)

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

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

2014-11-01

379

Oclusão percutânea da veia cava superior esquerda persistente conectada anomalamente no teto do átrio esquerdo / Percutaneous occlusion of the left superior vena cava with an anomalous connection to the left atrium roof  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Relatamos um caso raro de veia cava superior esquerda persistente conectada anomalamente no teto do átrio esquerdo associada a pequena comunicação interatrial do tipo seio venoso, em criança cianótica de 9 anos, com história pregressa de abscesso cerebral. O vaso anômalo foi ocluído com sucesso no l [...] aboratório de cateterismo, utilizando-se uma prótese Amplatzer. Abstract in english A rare case of persistent left superior vena cava anomalously connected to the roof of the left atrium associated with a small coronary sinus type atrial septal defect in a cyanotic 9-year-old child with a previous history of cerebral abscess is reported. The anomalous vessel was successfully occlud [...] ed in the catheterization laboratory using an Amplatzer device.

Daniel Guilherme, Arnoni; Jean Marcelo Ferreira da, Silva; Valmir Fernandes, Fontes; Roberto Reyes, O' Connor; Carlos Augusto Cardoso, Pedra.

380

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

LENUS (Irish Health Repository)

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.

Miletin, J

2012-02-01

381

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

Directory of Open Access Journals (Sweden)

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

Reissfelder Christoph

2009-10-01

382

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

International Nuclear Information System (INIS)

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

383

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

International Nuclear Information System (INIS)

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 ? 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)

384

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

International Nuclear Information System (INIS)

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

385

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

International Nuclear Information System (INIS)

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

386

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

387

Coincidence of total anomalous pulmonary venous drainage to the superior vena cava, common atrium, and single ventricle: a very rare condition.  

Science.gov (United States)

Single ventricle defects, including inflow emptying into 1 ventricle, occur at an incidence of 0.05-0.1 per 10,000 live births. The association of total anomalous pulmonary venous drainage (TAPVD) with single ventricle defects is a risk factor for poor outcome. Conversely, common atrium, a rare congenital anomaly, is an endocardial cushion defect. We present a rare case of an unoperated patient with coincidence of a single ventricle defect, TAPVD with direct drainage from the pulmonary veins into the superior vena cava, and common atrium. To the best of our knowledge, such a case has not been previously reported in the literature. PMID:23360092

Nabati, Maryam; Bagheri, Babak; Habibi, Valiolla

2013-04-01

388

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

Science.gov (United States)

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

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

2009-02-01

389

Search for the azygos: a lesson learnt from a case with left superior vena cava, esophageal atresia and tracheo-esophageal fistula.  

Science.gov (United States)

The azygos vein is of superior importance during the operation for esophageal atresia with tracheo-esophageal fistula (EA; TEF). Its location helps the surgeon to locate the fistula. Newborns with persistent left superior vena cava (LSVC) may have alterations in the location of the azygos, and since LSVC is not uncommon in EAs with fistulae, it is important to locate the azygos during a pre-operative echocardiogram. Foreknowledge of a possible absent azygos may avoid morbidity while trying to locate the fistula. We present a case of a newborn with EA, TEF, and LSVC in which the azygos vein was absent. PMID:19052754

Arbell, Dan; Golender, Julius; Khalaileh, Abed; Gross, Eitan

2009-01-01

390

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

Science.gov (United States)

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

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

2014-01-01

391

Modified loop snare technique for the removal of bard recovery, G2, G2 express, and eclipse inferior vena cava filters.  

Science.gov (United States)

The present work describes the preliminary results of the use of a novel technique for the removal of tilted and apex-embedded Recovery, G2, G2 Express, and Eclipse inferior vena cava filters. A retrospective review was performed of 33 filters removed in 32 patients by using the described modified loop snare technique. All filters were successfully removed with the use of the technique. The average duration of filter implantation for the devices removed with the technique was 556 days (range, 11-2,437 d; median, 268 d). No filter fractures occurred related to the removal technique. No procedure-related complications occurred. PMID:22525025

Lynch, Frank C

2012-05-01

392

Results of a multicenter study of the retrievable Tulip vena cava filter: Early clinical experience  

International Nuclear Information System (INIS)

Purpose. To evaluate clinically a new, retrievable vena caval filter in a multicenter study. Methods. The Tulip filter is a stainless steel half-basket that is suitable for antegrade or retrograde insertion via an 8.5 Fr introducer sheath. The filter can be retrieved via the jugular approach using an 11 Fr coaxial retrieval system. Forty-eight filters were implanted via the femoral approach and 38 via the jugular approach in 83 patients. Follow-up examinations (plain films, colorcoded duplex sonography) were performed up to 3 years after filter insertion (mean 136 days) in 75 patients. Twenty-seven patients were screened by colorcoded duplex sonography for insertion site thrombosis. Results. An appropriate filter position was achieved in all cases. Insertion problems occurred in 3 cases; these were not due to the filter design but to an imperfect prototype insertion mechanism that has now been modified (n=2) or a manipulation error (n=1). In 2 of these cases the filters were replaced percutaneously; 1 patient required venotomy for filter removal. No further complications due to filter insertion occurred. Two filters were used as temporary devices and were successfully removed after 6 and 11 days, respectively. There was 1 fatal recurrent pulmonary embolism (PE) and 2 non-fatal PE, 5 complete and 3 partial caval occlusions, and 3 caudal migrations of the filter. Insertion site venous thrombosis was not seen in the 27 patients monitored for this complication. Conclusiononitored for this complication. Conclusion. Precise placement of the Tulip filter is feasible by either access route and the device appears mechanically stable. Further observations are needed to confirm that safe filter removal is practical up to 10 days after its insertion

393

Novel rescue procedure for inferior vena cava reconstruction in living-donor liver transplantation using a vascular graft recovered 25 h after donors' circulatory death and systematic review.  

Science.gov (United States)

Liver transplantation is a lifesaving treatment for patients suffering from end-stage liver disease. Rarely, acute congestion of the inferior vena cava (IVC) is being encountered because of tumor compression. MELD allocation does not reflect severity of this condition because of lack of organ failure. Herein, a patient is being presented undergoing urgent living-donor liver transplantation (LDLT) with IVC reconstruction for a fast-growing hepatic epithelioid hemangioendothelioma (HEH). IVC reconstruction using a venous graft recovered from a 25-h after circulatory-death prior transplantation became necessary to compensate severe venous congestion. Additionally, a systematic review of the literature searching MEDLINE/PubMed was performed. Protocol and eligibility criteria were specified in advance and registered at the PROSPERO registry (CRD42013004827). Published literature of IVC reconstruction in LDLT was selected. Two reports describing IVC reconstruction with cryopreserved IVC grafts and one IVC reconstruction using a deceased after-circulatory-death-donor IVC graft were included. Follow-up was at 12 and 13 months, respectively. Regarding the graft recovery in the setting of living-related donation, this graft remained patent during the nine-month follow-up period. This is the first report on the use of a venous graft from a circulatory-death-donor, not eligible for whole organ recovery. We demonstrate in this study the feasibility of using a size and blood-group-compatible IVC graft from a cold-stored donor, which can solve the problem of urgent IVC reconstruction in patients undergoing LDLT. PMID:24289717

Palma, Adrian F; Oberkofler, Christian E; Raptis, Dimitri A; Eshmuminov, Dilmurodjon; de Rougemont, Olivier; Schnyder, Aurelia; Dimitroulis, Dimitrios; Lesurtel, Mickael; Dutkowski, Philipp; Clavien, Pierre-Alain

2014-02-01

394

Gamma-knife radiotherapy combined with stent placement for the treatment of cancerous thrombus in inferior vena cava: an analysis of effectiveness  

International Nuclear Information System (INIS)

Objective: To investigate the effectiveness of gamma-knife radiotherapy combined with stent placement for the treatment of cancerous thrombus in inferior vena cava (IVC) in patients with hepatic carcinoma. Methods: Stent placement was performed in 26 patients of hepatic carcinoma associated with cancerous thrombus in IVC, which was followed by gamma-knife radiotherapy for the treatment of thrombus. IVC angiography was reexamined at regular intervals to find out the patent situation and to measure the internal diameter of IVC. Results: The internal diameter of IVC was increased in different degree after the treatment. After stent placement the internal diameter of IVC was increased by (0.842 ± 0.283) cm, while the internal diameter of IVC was increased by (1.523 ± 0.195) cm after gamma-knife radiotherapy. The internal diameter of IVC after gamma-knife radiotherapy was significantly greater than that before stent placement (P < 0.001). The shortest follow-up time was 6 months. The patent rate of IVC at 3 and 6 months was 100% and 100% respectively. No serious complications related to stent placement or gamma-knife radiotherapy occurred. Conclusion: Gamma-knife radiotherapy combined with stent placement is safe and effective for the treatment of cancerous thrombus in inferior vena cava in patients with hepatic carcinoma. (authors)

395

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

International Nuclear Information System (INIS)

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

396

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

International Nuclear Information System (INIS)

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

397

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

Scientific Electronic Library Online (English)

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

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

2013-05-01

398

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

International Nuclear Information System (INIS)

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

399

Transcatheter closure of sinus venosus atrial septal defect with anomalous drainage of right upper pulmonary vein into superior vena cava--an innovative technique.  

Science.gov (United States)

Sinus venosus atrial septal defect (SVASD) is located high in the atrial septum where the right superior vena cava (RSVC) enters the right atrium, and is commonly associated with partial anomalous pulmonary venous return of right upper pulmonary vein (RUPV) into RSVC. Transcatheter closure of such defects has not been described in the literature. We have developed an innovative technique to close this defect by transcatheter means. We present here a 35-year old patient with SVASD and anomalous drainage of RUPV in RSVC in whom we closed the defect along with rerouting of RUPV to left atrium (LA) using a 12 mm × 61 mm adventa V12 covered stent in the RSVC with good outcome. PMID:24753393

Garg, Gaurav; Tyagi, Himanshu; Radha, Anil Sivadasan

2014-09-01

400

[Application of metallic stents for both inferior vena cava and biliary obstruction by lymph node involvement in a patient with recurrent hepatocellular carcinoma].  

Science.gov (United States)

The authors experienced a case with obstruction of the inferior vena cava (IVC) and the common bile duct due to a recurrent hepatocellular carcinoma. In order to improve severe edema of the lower extremities and obstructive jaundice, IVC metallic stent as well as biliary stent were applied. A Luminexx stent of 8 cm in length was placed in the bile duct via subcutaneous route after biliary drainage. A spiral zigzag stent of 8 cm in length was also inserted into the IVC through the femoral vein following balloon dilatation of the obstructed portion. Subsequently, jaundice and edema were dramatically improved in a short period of time, which resulted in patient discharge from the hospital. Although the patient died of the cancer in 2 months, the quality of life was well maintained until death. PMID:15553767

Tono, Takeshi; Matsushita, Masaki; Maeda, Munehiro; Murakami, Masahiro; Nakano, Yoshiaki; Takemoto, Hirotoshi; Imazato, Mitsunobu; Asaoka, Tadashi; Hoshino, Hiromitsu; Kanoh, Toshiyuki; Kimura, Yutaka; Iwazawa, Takashi; Ohnishi, Tadashi; Yano, Hiroshi; Okamura, Jun; Monden, Takushi

2004-10-01

401

Detection and diagnosis of iatrogenic inadvertent diversion of partial inferior vena cava into the left atrium by transesophageal echocardiography during large posteroinferior surgical atrial septal defect closure.  

Science.gov (United States)

Iatrogenic diversion of the inferior vena cava (IVC) into the left atrium (LA) is usually reported as a rare complication following large posteroinferior atrial septal defect (ASD) surgery. It may cause acute or chronic hypoxemia, and other potentially life-threatening complications such as stroke. We present a case in which the ASD patch straddled the IVC entrance diagnosed immediately by transesophageal echocardiography (TEE) during the period of patient separated from cardiopulmonary bypass, avoiding the related complications. Our report further underlines the important role of TEE to monitor and guide ASD surgical management, especially secundum ASD with inferior extension or inferior sinus venosus defects, for the early diagnosis of iatrogenic surgical errors. PMID:25315455

Zhang, Yanzi; Song, Haibo; Qiao, Xin; Xiao, Xijun; Liu, Jin; Wang, Xiao

2014-10-15

402

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

International Nuclear Information System (INIS)

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