Colapsibilidade da Veia Cava Inferior e sinais e sintomas de insuficiência cardíaca: novos insights e possíveis associações

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Renato De Vecchis

2012-06-01

Full Text Available FUNDAMENTO: Nos pacientes com Insuficiência Cardíaca Crônica (ICC foram propostas medidas ultrassonográficas do Índice de Colapsibilidade da Veia Cava Inferior (ICVCI para obter uma avaliação e classificação minuciosa da congestão hemodinâmica. OBJETIVO: A finalidade deste estudo era correlacionar os achados no exame físico com o ICVCI em pacientes com ICC. MÉTODOS: De acordo com um projeto de coorte retrospectivo, analisamos 54 pacientes com ICC, direita ou biventricular, classe NYHA III. O plano era determinar se alguma faixa de ICVCI basal poderia predizer uma persistência ou agravamento da congestão clínica achada no final do acompanhamento subsequente (isto é, após 1-2 meses do tratamento oral otimizado. Para essa finalidade, os pacientes foram subdivididos em três grupos de acordo com o valor de ICVCI basal: ≤ 15% (13 pts, 16 - 40% (21 pts e > 40% (20 pts. Diversos critérios clínicos de congestão foram comparados por meio dos três grupos e incorporados subsequentemente ao modelo multivariado de Cox. RESULTADOS: Preditores multivariados de alto escore de congestão foram distensão da veia jugular (FC: 13,38 95% IC: 2,13 - 84 p = 0,0059 e estertores (FC: 11 95% C.I : 1,45 - 83,8 p = 0,0213. O ICVCI ≤ 15% esteve sempre associado com um alto escore de congestão na segunda visita; todavia, o ICVCI o ≤ 15% não predisse um alto escore de congestão na segunda visita. CONCLUSÃO: No âmbito da ICC, um baixo ICVCI não predisse, em forma confiável, um elevado escore de congestão. Não obstante, o conjunto com ICVCI ≤ 15% sempre se achou associado com sinais e sintomas de uma ICC descompensada, tanto do lado direito como do esquerdo. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0

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

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Alexander Alves da Silva

2009-12-01

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

Endoprótese revestida de jugular preservada de bovino: estudo comparativo da resposta tecidual em aorta torácica descendente e veia cava inferior de suínos

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Celso Luiz Muhlethaler Chouin

Full Text Available OBJETIVO: Avaliar e comparar a resposta tecidual de uma endoprótese biosintetica implantada na aorta torácica descendente e veia cava inferior de suínos. MÉTODO: Foi implantada uma endoprótese auto-expansível composta de aço inoxidável, revestida por veia jugular de bovino, processada pelo método L-hydro, com auxilio de uma bainha de liberação Taheri-Leonhardt (Flórida, EUA na aorta torácica descendente, e a veia cava infra-renal de 10 suínos. Sessenta dias após, as endopróteses foram retiradas e analisadas sob o ponto de vista macro e microscópicos. Foram observados: perviedade, grau de incorporação a parede do vaso, tipo de reação inflamatória, e local de maior resposta, tanto em relação a camada do vaso quanto ao local de contato com o anel de aço RESULTADOS: Todas as endopróteses encontravam-se pérvias, e incorporadas à parede. No setor venoso, seis apresentaram traves fibrosas em sua luz, e quatro apresentaram fibrose perivascular. No setor arterial somente uma prótese apresentou discreta estenose, sem fibrose perivascular. A reação inflamatória crônica tipo corpo estranho ocorreu em 100% das peças, a camada média foi a mais acometida no setor venoso, enquanto a íntima foi mais constante na artéria, o grau de incorporação foi mais firme na veia em comparação a artéria. A reação tecidual mostrou maior tendência nas áreas em intimo contato com o anel de aço (intra-anelar, mais intensa na artéria do que na veia. CONCLUSÃO: A prótese apresentou baixa trombogenicidade em ambos os sistemas, houve maior reação tecidual e baixa biocompatibilidade no setor venoso.

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

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Cristina Ribeiro Riguetti Pinto

2006-06-01

Full Text Available OBJETIVO: Avaliar a resposta tissular a uma endoprótese, com cobertura biológica heteróloga, implantada em veia cava inferior de suínos. MÉTODO: Desenvolvemos uma endoprótese auto-expansível, revestida com um segmento de jugular bovina, conservada por processo L-hydro e suturada em um stent de aço inoxidável 316L. O dispositivo introdutor utilizado foi a bainha de liberação da endoprótese aórtica Taheri-Leonhardt (Flórida, EUA. Foram implantadas endopróteses em 10 suínos, todas na veia cava infra-renal. Os animais foram submetidos à flebografia peroperatória. À necropsia, após 2 meses, cada endoprótese foi retirada em bloco e analisada macroscopicamente, visando a avaliação da perviedade, aderência aos tecidos vizinhos e incorporação à parede venosa; e, histopatologicamente, visando a resposta histológica ao enxerto. RESULTADOS: Na análise macroscópica, todas as endopróteses encontravam-se pérvias e totalmente incorporadas à parede venosa, porém seis apresentavam trabeculações grosseiras no seu interior e quatro algum grau de fibrose perivascular. Três animais desenvolveram linfocele, uma retroperitoneal e as outras na parede abdominal. No estudo histopatológico, observamos reação inflamatória granulomatosa tipo corpo estranho em todos os casos, sendo predominante na camada média (80%. CONCLUSÃO: O modelo estudado apresentou baixa trombogenicidade, corroborando com a eficácia do meio de conservação e material escolhidos; porém, baixa biocompatibilidade, provavelmente pelo obstáculo imunológico dos xenoenxertos e resposta tissular exagerada do território venoso.OBJECTIVE: To evaluate tissue response to a bovine jugular vein covered stent when implanted in the swine inferior vena cava. METHOD: We developed a self-expanding stent, using a segment of L-hydro conserved bovine jugular vein, which was trimmed and sutured to a 316L stainless steel stent. We used the Taheri-Leonhardt delivery system for

Traumatismos de veia cava inferior

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Cleinaldo de Almeida Costa

Full Text Available OBJETIVO: Avaliar a incidência, o perfil clínico e as estratégias operatórias dos ferimentos de Veia Cava Inferior (VCI. MÉTODOS: Foram analisados retrospectivamente os prontuários de 76 doentes com ferimento de VCI atendidos nos dois prontossocorros de Manaus, no período de janeiro de 1997 a julho de 2002. Mecanismo de lesão, mortalidade, estado hemodinâmico, índice de trauma abdominal penetrante (PATI, achados intra-operatórios e conduta cirúrgica foram estudados. RESULTADOS: Quarenta e nove (65% doentes sofreram lesão por arma branca, 26 (34% por arma de fogo e um por traumatismo abdominal fechado. Quarenta e um (54% doentes sobreviveram. Quase todos chegaram acordados, entretanto 40% estavam hipotensos (pressão arterial sistólica < 70mmHg. O índice de trauma abdominal penetrante (PATI médio foi maior que 40. À laparotomia, todos demonstraram sangramento retroperitoneal ativo ou hematoma retroperitoneal em expansão. Vinte e um pacientes possuíam lesão de VCI retro-hepática, enquanto nos outros 55 a lesão era infra-hepática. O reparo operatório predominante foi a venorrafia lateral em 65 doentes. Houve necessidade de tóraco-freno-laparotomia em quatro doentes do total de oito doentes que foram à toracotomia direita por lesão retro-hepática. Foram realizados shunts átrio-cavais em seis doentes, dos quais três sobreviveram. CONCLUSÕES: O ferimento de VCI é uma lesão de alta letalidade e possui uma relação intrínseca com a violência urbana. A sobrevivência depende de uma imediata e vigorosa reposição de volume, um manejo operatório adequado e todo esforço em evitar-se hipotermia.

Drenagem anômala parcial de quatro veias pulmonares com septo interatrial íntegro: relato de um caso raro Partial anomalous return of four pulmonary veins with intact interatrial septum defect: a rare case report

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Edmar Atik

2008-07-01

Full Text Available É relatado caso raro de drenagem anômala parcial de quatro veias pulmonares no átrio direito e veia cava superior, com septo interatrial íntegro em criança de cinco anos de idade. Havia poucos sintomas, em contraste com débito ventricular esquerdo dependente do fluxo da veia lobar superior esquerda e da língula. Complacência diminuída à esquerda motivou quadro acentuado de hipertensão venocapilar pulmonar no pós-operatório imediato, aliviado por feitura de comunicação interatrial de 8 mm. A evolução posterior foi boa.We report on the rare case of partial anomalous return of four pulmonary veins in the right atrium and superior vena cava with intact interatrial septum in a five-year-old child. There were few symptoms in contrast with the left ventricular output dependent on the flow of the left upper lobe vein and from the lingula. Reduced compliance to the left led to a severe picture of pulmonary venocapillary hypertension in the immediate postoperative period, mitigated by an 8-mm interatrial septal defect. The patient progressed well after the intervention.

Artéria e veia lienais de bovinos da raça Nelore

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Roberto Carvalhal

2001-01-01

Full Text Available A artéria lienal mostra dois comportamentos antes de penetrar no hilo do baço, compondo o Grupo I (90% com um ramo extra-hilar e o Grupo II (10% com 2 destes ramos. Após penetrar, origina em média 13 ramos para a margem cranial e 10 para a margem caudal. A veia lienal freqüentemente (96,6% está representada por um único vaso de trajeto longitudinal no eixo dorsoventral, para onde confluem em média 13 vasos da margem cranial e 11 da margem caudal, e raramente (3,3% esta veia resulta da confluência de 2 vasos de calibres equivalentes.

Colapsibilidade da Veia Cava Inferior e sinais e sintomas de insuficiência cardíaca: novos insights e possíveis associações Inferior Vena Cava collapsibility and heart failure signs and symptoms: new insights about possible links

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Renato De Vecchis

2012-06-01

Full Text Available FUNDAMENTO: Nos pacientes com Insuficiência Cardíaca Crônica (ICC foram propostas medidas ultrassonográficas do Índice de Colapsibilidade da Veia Cava Inferior (ICVCI para obter uma avaliação e classificação minuciosa da congestão hemodinâmica. OBJETIVO: A finalidade deste estudo era correlacionar os achados no exame físico com o ICVCI em pacientes com ICC. MÉTODOS: De acordo com um projeto de coorte retrospectivo, analisamos 54 pacientes com ICC, direita ou biventricular, classe NYHA III. O plano era determinar se alguma faixa de ICVCI basal poderia predizer uma persistência ou agravamento da congestão clínica achada no final do acompanhamento subsequente (isto é, após 1-2 meses do tratamento oral otimizado. Para essa finalidade, os pacientes foram subdivididos em três grupos de acordo com o valor de ICVCI basal: ≤ 15% (13 pts, 16 - 40% (21 pts e > 40% (20 pts. Diversos critérios clínicos de congestão foram comparados por meio dos três grupos e incorporados subsequentemente ao modelo multivariado de Cox. RESULTADOS: Preditores multivariados de alto escore de congestão foram distensão da veia jugular (FC: 13,38 95% IC: 2,13 - 84 p = 0,0059 e estertores (FC: 11 95% C.I : 1,45 - 83,8 p = 0,0213. O ICVCI ≤ 15% esteve sempre associado com um alto escore de congestão na segunda visita; todavia, o ICVCI o ≤ 15% não predisse um alto escore de congestão na segunda visita. CONCLUSÃO: No âmbito da ICC, um baixo ICVCI não predisse, em forma confiável, um elevado escore de congestão. Não obstante, o conjunto com ICVCI ≤ 15% sempre se achou associado com sinais e sintomas de uma ICC descompensada, tanto do lado direito como do esquerdo. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0BACKGROUND: In chronic heart failure patients (CHF, ultrasound measurement of inferior vena cava collapsibility index (IVCCI has been proposed to yield careful assessment and grading of the hemodynamic congestion. OBJECTIVE: The

Anatomic study of portal vein: transpancreatic vessels injuries approach Estudo anatômico da veia porta-hepática: abordagem cirúrgica portal transpancreática

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Mario Mantovani

2002-08-01

Full Text Available Introduction: The commitment of the great blood-vessels make up a situation of great complexity and a high rate of the complications and mortality patients with abdominal trauma. The injury of the portal vein matters because of the difficulty on the diagnosis and the approach surgery. Objective: To set the standard on the transverse section of the pancreas looking for a safer surgical access to repair the portal vein injuries. Methods: A quantitative analysis was performed to characterize the anatomical relationship between the portal vein and their tributaries relating them to the pancreas. On these corpses, the measurements of a anatomical triangle were studied. It base was the upper limit of the superior mesenteric vein and the initial portion of the portal vein; the apex, a point located on the upper limit of the confluence of the splenic vein and superior mesenteric vein, situated at the middle line of the superior mesenteric_ vein. Results: The portal vein is formed 3.24cm from the internal border of the duodenal arc at a distance of 1.61cm and 1.07 from the inferior and superior pancreas borders, respectively. Conclusion: The present study allow us to conclude that, to have access to the origin of the portal vein, in case of trauma of this vessel, one should proceed a transverse section of the neck of the pancreas next to the superior mesenteric vein, because its confluence with splenic vein occur, on average, 1.07cm and 1.61cm from the superior and inferior border of the gland, respectively.Introdução: No trauma abdominal, o comprometimento dos grandes vasos constitui uma situação de grande complexidade com altos índices de complicações e mortalidade. Nestes pacientes, a lesão da veia porta-hepática tem interesse em razão da dificuldade no diagnóstico e na abordagem cirúrgica. Objetivo: Padronizar o plano de transecção do pâncreas visando o acesso cirúrgico mais seguro para os reparos das lesões da veia porta

Síndrome de veia cava superior Superior vena cava syndrome

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SAMUEL ZUÍNGLIO DE BIASI CORDEIRO

2002-09-01

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

Subdiaphragmatic venous stasis and tissular hypoperfusion as sources of metabolic acidosis during passive portal-jugular and caval-jugular bypasses in dogs Estase venosa subdiafragmática e hipoperfusão tissular como fontes de acidose metabólica durante desvios porta-jugular e cava-jugular passivos em cães

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Antônio Roberto de Barros Coelho

2000-06-01

Full Text Available Subdiafragmatic venous decompression during anhepatic stage of canine orthotopic liver transplantation attenuates portal and caval blood stasis and minimize hipoperfusion and metabolic acidosis observed with occlusion of portal and caval veins. During two hours, six dogs submitted to portal-jugular and caval-jugular passive shunts, with maintenance of arterial hepatic flow, were evaluated for pH, carbon dioxide tension (PCO2, base deficit (BD and oxygen tension (PO2 in portal, caval and systemic arterial blood, as well as for increments of BD (DBD in portal and caval blood. With a confidence level of 95%, the results showed that: 1. There were not changes of pH anDBD in portal and systemic arterial blood in the majority of studied times; 2. There was metabolic acidosis in caval blood; 3. The negative increments of BD (DBD were higher in caval blood than in splancnic venous blood at T10, T30 and T105; and, 4. Deoxigenation of portal and caval blood were detected. Acid-base metabolism and oxigenation monitoring of subdiaphramatic venous blood can constitute an effective way to evaluate experimental passive portal-jugular and caval-jugular bypass in dogs.A descompressão venosa subdiafragmática durante a fase anhepática do transplante ortotópico de fígado em cães atenua a estase de sangue nas veias Porta e Cava Inferior e minimiza a hipoperfusão tissular e a acidose metabólica observadas na oclusão dessas veias. Durante duashoras, seis cães submetidos a desvios porta-jugular e cava-jugular passivos, com permanência do fluxo arterial hepático, foram avaliados através de pH, PCO2, DB e PO2 no sangue portal, da Veia Cava Inferior e arterial sistêmico, bem como por incrementos de DB (DDB no sangue portal e da Veia Cava Inferior. Os resultados obtidos permitem concluir com uma confiança de 95% que: 1. Não foram constatadas alterações de pH e DB no sangue portal e arterial sistêmico na maioria dos tempos estudados; 2. Houve acidose

Veia gástrica posterior: hipertensão porta

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Alcino Lázaro da Silva

Full Text Available A veia gástrica posterior não é muito citada nos livros de anatomia e nos trabalhos sobre hipertensão porta. Estudou-se sua anatomia, freqüência e desembocadura. Ela foi encontrada em 54% dos casos e, em 100%, desembocava na veia esplênica. Discute-se a vantagem ou não de sua ligadura ou preservação no tratamento cirúrgico da hipertensão porta.

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

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Domingo Marcolino Braile

2005-01-01

Full Text Available OBJETIVO: O objetivo do estudo foi avaliar a eficácia de um novo filtro de veia cava, de baixo perfil, na retenção de coágulos em modelo in vitro. MÉTODO: O filtro consiste em dois cones opostos pelo ápice. O cone distal é formado por oito hastes de aço inoxidável, que têm a função de retenção dos êmbolos. O cone proximal é constituído de quatro hastes, cuja função é ancorar e centralizar. Os filtros foram introduzidos e fixados no interior de um tubo de PVC transparente de 25, 30 e 35 mm de diâmetro interno, em posição vertical, e conectados com um sistema pulsátil de fluxo (bomba peristáltica. Foi utilizado, para veículo, um reservatório com solução salina (0,9% com 40% de glicerina, mantido em temperatura ambiente. Confeccionaram-se trombos com sangue bovino em tubos plásticos de 3, 4,5 e 6 mm de diâmetro e, posteriormente, foram segmentados nas medidas de 10, 15, 20 e 30 mm de comprimento, totalizando 12 diferentes tamanhos. Realizaram-se 100 liberações para cada tipo de êmbolo e tamanho das cânulas, totalizando 3.600 eventos. Foram feitos lançamentos seqüenciais com cinco êmbolos, sendo 10 para cada tamanho de êmbolo e cânulas, totalizando 360 eventos. Fez-se avaliação da capacidade de retenção dinâmica utilizando os três diferentes tamanhos de cânulas com 100 eventos cada, totalizando 300 eventos. RESULTADOS: Detectou-se que o diâmetro e comprimento dos êmbolos, assim como diâmetros da cânula, podem comprometer a eficácia do filtro. A média de captura de êmbolos pelos filtros foi de 80,5% nas cânulas de 35 mm, 88,7% para cânulas de 30 mm e 86,6% para cânulas de 25 mm. CONCLUSÃO: Conclui-se que a eficácia desse filtro sofre interferência relacionada ao tamanho dos êmbolos e diâmetro da cânula.OBJECTIVE: The objective of the current study was to evaluate the efficacy of a new low-profile vena cava filter in the retention of emboli in an in vitro model. METHOD: The filter consists

Congenital anomalies of the inferior vena cava: importance of multiplanar imaging methods: an iconographic essay; Anomalias congenitas da veia cava inferior: valor dos metodos multiplanares em seu diagnostico - ensaio iconografico

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Viana, Sergio Lopes; Mendonca, Jose Luiz Furtado de; Freitas, Flavia Mendes Oliveira [Clinica Radiologica Vila Rica, Brasilia, DF (Brazil)] (and others). E-mail: radiolog@uol.com.br

2006-10-15

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)

Veias soleares: bases anatômicas e seu papel na origem da trombose venosa profunda em membro inferior Soleus veins: anatomic basis and their role in the origin of deep venous lower limb thrombosis

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Carlos Miguel Gomes Sequeira

2007-08-01

Full Text Available OBJETIVO: Estudar o número, a setorização e a terminação das veias soleares. MÉTODOS: Em 100 pernas de 50 cadáveres, excluídos aqueles com alterações congênitas ou adquiridas dos membros inferiores, foram realizadas, a fresco, na região crural posterior, dissecções anatômicas minuciosas, estratigráficas. Após o rebatimento da pele, foram realizadas a individualização das veias superficiais e perfurantes, rebatimento da tela subcutânea e da fáscia, individualização e rebatimento dos músculos gastrocnêmio e plantar, desinserção tibial do músculo sóleo, individualização das veias soleares e o estudo morfométrico. A região foi dividida em seis setores: súpero-medial, súpero-lateral, médio-medial, médio-lateral, ínfero-medial e ínfero-lateral. No estudo estatístico utilizaram-se os testes não-paramétricos Wilcoxon e Friedman. RESULTADOS: Foram encontradas 4.679 veias soleares. O setor com maior número de veias soleares foi o súpero-lateral com 1.529 veias (32,7%, seguido do médio-medial com 1.256 veias (26,8% e do médio-lateral com 975 veias (20,8%. As terminações ocorreram em veias comunicantes (1.207 veias - 25,8%, veias tibiais posteriores (964 veias - 20,6%, veias fibulares (709 veias - 15,2% e em mais 32 tipos (1799 veias - 38,4%. CONCLUSÃO: A drenagem venosa do músculo sóleo é realizada por um grande número de veias soleares, freqüentemente localizadas nos setores súpero-lateral, médio-medial e médio-lateral, terminando comumente em veias tibiais posteriores e fibulares e, em veias comunicantes.OBJECTIVE: Study of the number, sectorization and termination of the soleus veins. METHODS: Meticulous, stratigraphical, anatomical dissections were carried out in the posterior crural region of 100 legs of 50 fresh cadavers. Those belonging to subjects with congenital or acquired pathologies in the lower limbs were disregarded. After the skin was reflected on both sides, dissection of superficial

Veias do sistema porta-hepático em gansos domésticos Veins from hepatic portal vein system in domestic geese

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Tatiana C. Santos

2009-04-01

Full Text Available A distribuição intraparenquimal das veias porta-hepáticas foi estudada em 30 gansos domésticos. Latex Neoprene corado foi injetado pela veia isquiática e os animais forma fixados por imersão e injeção intramuscular com formol a 10% e dissecados. O fígado esteve composto por um grande lobo hepático direito e por um lobo hepático esquerdo menor, os quais estiveram conectados por uma ponte de parênquima. O lobo direito do fígado teve exclusivamente vasos do sistema porta-hepático formados pela distribuição intraparenquimal da veia porta-hepática direita, enquanto que no lobo esquerdo estes originaram-se da veia porta-hepática direita e de pequenas veias porta-hepáticas esquerdas. A veia porta-hepática direita emitiu o ramo caudal direito, que emitiu um pequeno ramo caudolateral direito e um grande ramo caudomedial direito. Cranialmente esta veia emitiu os ramos craniais direito e ramos lateral direito. A porção transversa da veia porta-hepática direita cruzou para o lobo hepático esquerdo, emitindo de 1 a 6 pequenos ramos craniais e caudais para a região média do fígado. No lobo esquerdo, o ramo esquerdo da veia porta-hepática direita emitiu o ramo cranial esquerdo, o ramo lateral esquerdo e o ramo medial. De 1 a 6 veias porta-hepáticas esquerdas foram identificadas desembocando ou no ramo esquerdo da veia porta-hepática direita ou em sua porção transversa, oriundos do ventrículo gástrico e do pró-ventrículo. Em 40% dos gansos uma veia porta-hepática própria oriunda da confluência de vasos venosos da face esquerda do ventrículo distribuiu-se na extremidade caudal do lobo esquerdo isoladamente.The intraparenchymal distribution of the hepatic portal veins in 30 domestic geese were studied. Stained Neoprene latex was injected into the isquiatic vessels, and the animals were fixed in 10% formaldehyde by immersion and intramuscular injection. The liver of geese was composed of a large right and a smaller left

Esplenectomia com ligadura da veia gástrica esquerda e desvascularização da grande curvatura do estômago no tratamento da esquistossomose hepatoesplênica: é necessária a escleroterapia endoscópica pós-operatória

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FERRAZ Álvaro Antônio Bandeira

2001-01-01

Full Text Available Objetivo - Com o intuito de avaliar a eficácia e a manutenção da esclerose endoscópica pós-operatória como rotina, em associação à esplenectomia com ligadura da veia gástrica esquerda e desvascularização da grande curvatura do estômago, foi realizado o presente estudo. Método - Entre 1992 e 1998 foram operados 131 pacientes no Hospital das Clínicas da Universidade Federal de Pernambuco, Recife, PE. O seguimento médio foi de 30 meses. Os pacientes foram solicitados a retornar ao ambulatório daquele hospital para realização de controle clínico e laboratorial. Dos 111 pacientes que retornaram ao ambulatório, apenas 80 realizaram endoscopia digestiva alta de controle. Destes 80, 36 seguiram a recomendação e realizaram esclerose endoscópica pós-operatória (grupo 1, enquanto 44 não a realizaram (grupo 2. Resultados - Observou-se de forma relevante e estatisticamente significativa, a diferença entre os dois grupos quando se analisou a erradicação das varizes de esôfago, com melhor resultado para o grupo 1 (52,7% do grupo 1 versus 18,2% do Grupo 2. Nos demais itens analisados (mortalidade, recidiva hemorrágica, trombose da veia porta, varizes de fundo gástrico e grau de fibrose periportal não se observou relevância estatística. Conclusão - Conclui-se que a associação da escleroterapia endoscópica pós-operatória à esplenectomia com ligadura de veia gástrica esquerda e desvascularização da grande curvatura do estômago, no tratamento da hipertensão portal esquistossomótica com antecedentes de hemorragia digestiva, deve ser mantida.

Estudo proteômico da interação do Aspergillus fumigatus com células endoteliais da veia umbilical humana (HUVECs)

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Nathália Curty Andrade

2012-01-01

O Aspergillus fumigatus é o principal agente etiológico da aspergilose invasiva, uma infecção fúngica oportunista que acomete, principalmente, pacientes de Unidades Hematológicas, como aqueles com neutropenia profunda e prolongada. Após a filamentação este fungo angioinvasivo é capaz de ativar e causar danos em células endoteliais de veia umbilical humana (HUVEC) que passam a expressar um fenótipo pró-trombótico. A ativação destas células, dependente de contato célulacélula, é mediada por ...

Viabilidade do baço de ratos após a ligadura simultânea da artéria e veia esplênicas

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Danilo Nagib Salomão Paulo

Full Text Available OBJETIVO: A ligadura simultânea da artéria e veia esplênicas, com preservação do baço, é realizada em seres humanos, na pancreatectomia caudal, mas o efeito exato dessa ligadura sobre o baço não é bem conhecido. O objetivo deste trabalho foi verificar o efeito da ligadura dos vasos esplênicos principais no baço de ratos. MÉTODO: Foram operados 58 ratos Wistar, machos, variando entre 230 e 408 g de peso. Os animais foram divididos aleatoriamente em dois grupos: grupo 1, simulação (N=23, submetido à laparotomia e manipulação do baço; grupo 2 (N=35 submetido à ligadura simultânea da artéria e veia esplênica. Todos os animais foram mortos 12 dias após a operação. O baço era retirado, pesado, fixado em formol a 4%, incluído em parafina, e os cortes foram corados pela hematoxilina e eosina para exame microscópico. RESULTADOS: O baço era normal em todos os animais do grupo 1 e em três dos 34 animais ( 8,82% do grupo 2. Ocorreu infarto branco parcial do baço em 91,18% dos animais do grupo 2. O percentual médio de massa esplênica viável nos baços com infartos foi de 56,9 + 21,8 %. O aspecto histopatológico mostrou arquitetura preservada na porção não infartada, e neoformação conjuntivo-vascular cicatricial substituindo as áreas necrosadas. CONCLUSÕES: A ligadura simultânea da artéria e veias esplênicas resultou em infarto branco parcial do baço em 91,2% dos animais, com preservação mínima de 35% e média de 56,9% de massa esplênica viável. Na maioria dos animais que sofreram ligadura, o infarto se localizou na porção inferior do baço.

Abdome agudo obstrutivo pela veia porta - relato de caso

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Celeste Gomes Sardinha Oshiro

2016-10-01

Full Text Available Introdução: A veia porta pré-duodenal é uma anomalia congênita rara, sintomática em apenas 50% dos casos, sendo que seu diagnóstico é feito por laparotomia exploradora. O tratamento de escolha é cirúrgico, com bom prognóstico. Objetivo: Relatar um caso de Abdome Agudo Obstrutivo por Veia Porta Pré Doudenal (VPPD no período neonatal no Conjunto Hospitalar de Sorocaba. Metodologia: Descrição do referido caso e revisão de literatura. Relato de Caso: Recém-nascido de F.S.S., feminino, de parto normal em 30/05/2016, cuja mãe com 21 anos, apresentou durante pré-natal Diabetes Mellitus Gestacional e polihidrâmnio; negou consanguinidade, vícios e infecções. Ao nascimento, idade gestacional 38 1/7 semanas, peso 2865g, comprimento 47 cm, Apgar 9/9. Durante rotinas de sala de parto, à aspiração gástrica, saída de 55 ml de líquido claro com grumos (LCCG. No 4o dia de vida, episódios de vômito com sangue e distensão abdominal. No 11° dia de vida, realizada Laparotomia Exploradora que identificou dilatação gástrica e duodenal, principalmente na 3° porção, onde passa anteriormente a Veia Porta, comprimindo parcialmente a borda antimesentérica duodenal, o que comprometia seu esvaziamento. Realizada anastomose duodeno-jejunal. Recebeu alimentação parenteral por 15 dias. RN apresentou infecções fúngica e bacteriana, tratadas durante internação. Recebe alta com 46 dias de vida em aleitamento materno e boa recuperação clínica. Conclusão: Existem poucos relatos sobre a formação anômala da veia porta e suas consequências. O diagnóstico pré-natal ou pré-operatório de VPPD raramente é feito. Boa evolução pós correção cirúrgica.

Tratamento cirúrgico de um aneurisma primário de veia ilíaca externa

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Márcio Luís Lucas

2015-09-01

Full Text Available ResumoAneurismas primários da veia ilíaca são extremamente raros e podem complicar com trombose, embolia pulmonar ou ruptura. Acredita-se que existam apenas 14 casos descritos na literatura. Neste artigo, descrevemos um caso de um jovem de 25 anos, que apresentava edema e cianose do membro inferior esquerdo. A ecografia vascular revelou uma massa cística em fossa ilíaca esquerda. A angiotomografia confirmou o diagnóstico de um aneurisma da veia ilíaca externa esquerda de 3,8 cm, no maior diâmetro. O paciente foi submetido ao tratamento cirúrgico através da ressecção do aneurisma seguida de venorrafia longitudinal. Teve boa evolução pós-operatória, com um seguimento clínico de 44 meses. Houve uma melhora do edema no membro inferior esquerdo, sem complicações tardias.

Estudo anatômico da veia braquial comum como via de drenagem colateral do membro superior Anatomic study of the common brachial vein as a collateral drainage channel of the upper limb

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Carlos Adriano Silva dos Santos

2011-03-01

Full Text Available CONTEXTO: Traumatismos ou tromboses que possam evoluir com alterações da drenagem venosa do membro superior, dependendo do território interrompido, podem ter como mecanismo compensatório uma via colateral de drenagem sem que haja prejuízo para o retorno venoso desse membro. A veia braquial comum apresenta-se como uma alternativa plausível e pouco conhecida. OBJETIVO: Descrever a anatomia da veia braquial comum como via de drenagem colateral no membro superior. MÉTODOS: Utilizamos 30 cadáveres do sexo masculino, cujos membros superiores estavam articulados ao tronco, não importando a raça, formolizados e mantidos em conservação com solução de formol a 10%. Utilizamos como critérios de exclusão cadáveres com um dos membros desarticulado ou alterações deformantes em topografia das estruturas estudadas. RESULTADOS: A veia braquial comum esteve presente em 73% (22/30 dos cadáveres estudados, sendo que em 18% (04/22 dos casos drenou para a veia basílica no seguimento proximal do braço e em 82% (18/22, para a veia axilar. CONCLUSÃO: A veia braquial comum está frequentemente presente e, na maior parte das vezes, desemboca na veia axilar.BACKGROUND: Trauma and thrombosis that can result in changes in the venous drainage of the upper limb, depending on the vascular territory interrupted, may have as a compensatory mechanism a collateral drainage channel that prevents damage to the venous return of that limb. The common brachial vein is a plausible and little known collateral channel for this purpose. OBJECTIVE: To describe the anatomy of the common brachial vein as a collateral drainage channel of the upper limb. METHODS: We have dissected 30 cadavers of people of different races, whose upper limbs were articulated to the trunk and preserved in a 10% formaldehyde solution. The exclusion criteria were disarticulated limbs or deformities in the topography of the studied structures. RESULTS: The common brachial vein was present in 73

Valor da Taxa de Eritroblastos no Sangue da Veia Umbilical de Recém-Nascidos como Marcador Hematológico da Hipóxia Perinatal

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Behle Ivo

2001-01-01

Full Text Available Objetivo: examinar se a taxa de eritroblastos, no sangue da veia umbilical de recém-nascidos, tem relação com a hipoxia perinatal, analisada pelos parâmetros que expressam o equilíbrio ácido-básico (EAB do sangue funicular. Métodos: de recém-nascidos vivos com pelo menos 37 semanas de gestação, assistidos no Hospital de Alvorada-RS, foram coletadas amostras de sangue da veia umbilical antes da instalação da respiração. Parte do sangue foi coletado em frasco contendo EDTA, determinando-se as séries vermelha e branca. No sangue coletado em seringa com heparina, foram determinados valores do pH, pO2, pCO2 e calculado o EAB. Em lâmina corada pelo corante panótico, procedeu-se à contagem manual do número de eritroblastos. A taxa de eritroblastos foi calculada em relação ao número de leucócitos. Resultados: dos 158 casos que compõem o estudo, em 55 as condições perinatais permitiram considerá-los como isentos de acometimento de processo hipóxico. A média da taxa de eritroblastos foi 3,9%, com o desvio-padrão de 2,8%. Os valores mínimo e máximo foram 0% e 10%, respectivamente. Dentre os 158 casos, a taxa dos eritroblastos foi 5,7%, com desvio-padrão de 5,3%. Os valores mínimo e máximo foram 0% e 28%, respectivamente. A aplicação do teste de Pearson a taxa dos eritroblastos e valores dos parâmetros do EAB mostrou correlação significativa para o pH e pCO2. A elaboração da curva ROC revelou que 5% de eritroblastos e pH de 7,25 representam pontos de corte que contrabalançam a sensibilidade e especificidade (54% e 56%, respectivamente. Dos 23 conceptos com taxa de eritroblastos maior que 10%, 7 (30,4% estavam acidóticos, 11 (48,7% eram grandes para a idade gestacional, 3 (13% eram pequenos para a idade gestacional, 7 (30,4% tinham anemia e em 3 (13% não foram constatadas anormalidades. Conclusões: em recém-nascidos de gestações e partos sem complicações, a taxa de eritroblastos ao nascimento foi menor do

Preditores não invasivos de varizes esofágicas em crianças e adolescentes com hepatopatia crônica ou obstrução extra-hepática da veia porta

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Roberta V. Alcantara

2012-08-01

Full Text Available OBJETIVO: Identificar preditores não invasivos de varizes esofágicas em crianças e adolescentes com hepatopatia crônica ou obstrução extra-hepática da veia porta. PACIENTES E MÉTODOS: Estudo transversal que incluiu 53 crianças e adolescentes com hepatopatia crônica ou obstrução extra-hepática da veia porta, sem antecedente de hemorragia digestiva ou tratamento de varizes esofágicas, com até 20 anos de idade. Dois grupos foram formados: grupo I (35 pacientes com hepatopatia crônica e grupo II (18 com obstrução extra-hepática da veia porta. Foram realizados hemograma, razão normalizada internacional, albumina, bilirrubina total, ultrassonografia de abdome e endoscopia digestiva alta. O índice esplênico foi determinado dividindo a dimensão esplênica pelo valor do limite superior da normalidade. As variáveis foram comparadas quanto à presença ou não de varizes esofágicas através de análise univariada (testes qui-quadrado, exato de Fischer e de Wilcoxon e multivariada (regressão logística. A acurácia foi determinada a partir da área sob a curva ROC. RESULTADOS: As varizes esofágicas foram observadas em 48,5% dos pacientes do grupo I e em 83,3% do grupo II. Plaquetopenia (p = 0,0015, esplenomegalia (p = 0,0003 e a razão plaquetas/índice esplênico (p = 0,0007 se mostraram indicadores preditivos de varizes esofágicas entre os pacientes do grupo I. Após análise multivariada, a plaquetopenia (odds ratio = 21,7 se manteve como um indicador independente da presença de varizes esofágicas entre os pacientes com hepatopatia crônica. CONCLUSÃO: O número de plaquetas, o índice esplênico e a razão plaquetas/índice esplênico se mostraram preditivos de varizes esofágicas em crianças e adolescentes com hepatopatia crônica. Não foram encontrados preditores de varizes esofágicas entre os pacientes com obstrução extra-hepática da veia porta.

A veia gástrica esquerda como alternativa de revasculariza��ão portal no transplante hepático

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Lacerda Cláudio Moura

2002-01-01

Full Text Available Trombose ou hipoplasia da veia porta não tem sido, ainda, considerados contra-indicações para o transplante ortotópico de fígado. Contudo, permanecem com obstáculos associados com aumento da freqüência de falha primária e a longo prazo do transplante de fígado. Existem alguns fatores de risco tais como: sexo masculino, cirrose avançada, doença hepática alcoólica e cirurgia prévia para hipertensão portal. Os autores relatam o caso de uma criança de 4 anos, do sexo feminino, que sofria de doença terminal do fígado resultante de atresia de vias biliares e que tinha submetido, sem sucesso, a uma operação de Kasai. Ela se submeteu a um transplante ortotópico de fígado por cirrose biliar secundária. Durante a cirurgia uma hipoplasia portal severa do receptor foi encontrada. Uma anastomose entre a veia gástrica esquerda do receptor e a veia porta do doador foi feita. Reperfusão hepática e subseqüente função do fígado foram excelentes. A paciente recebeu alta hospitalar no trigésimo dia. A veia gástrica esquerda pode ser uma alternativa para revascularização portal no transplante hepático.

Drenagem anômala total das veias pulmonares: terapêutica cirúrgica dos tipos anatômicos infracardíaco e misto

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Atik Fernando Antibas

2004-01-01

Full Text Available OBJETIVO: Estudar a evolução hospitalar em portadores de drenagem anômala total de veias pulmonares (DATVP, nas formas infracardíaca e mista, submetidos a tratamento cirúrgico. MÉTODOS: De 65 pacientes operados com o diagnóstico isolado de DATVP, de dezembro/1993 a março/2002, foram selecionados, retrospectivamente, 7 (10,8% pacientes das formas mista e infradiafragmática, sendo 5 (71,4% do sexo masculino, idades variando de 5 dias a 19 (média de 7 meses, com diagnóstico clínico feito pelo ecocardiograma bidimensional. Quatro (57,1% pacientes apresentavam formas mistas, em um, obstrutiva intrínseca, com estenose discreta da veia inferior esquerda. Os restantes três (42,9% apresentavam a forma infradiafragmática obstrutiva, extrínseca ao nível do diafragma. Todas as operações foram realizadas através de esternotomia mediana, sob circulação extracorpórea hipotérmica com parada circulatória total em 2 casos. RESULTADOS: Óbito hospitalar ocorreu em 1 paciente com DATVP infradiafragmática com conexão da veia vertical inferior com a veia porta. A causa mortis foi relacionada à falência de múltiplos órgãos e sistemas. O pós-operatório foi caracterizado pela presença de baixo débito cardíaco e hipertensão pulmonar em 4 (57,1% pacientes. CONCLUSÃO: O resultado da correção cirúrgica desta anomalia está associado à morbidade e mortalidade aceitáveis, na dependência do encaminhamento e tratamento cirúrgico precoces, sem progressão do quadro de hipertensão vascular pulmonar.

Dopplervelocimetria dos Compartimentos Arterial e Venoso da Circulação Fetal e Umbilical em Gestação de Alto-Risco: Análise dos Resultados Perinatais Dopplervelocimetry of the Arterial and Venous Compartments of the Fetal and Umbilical Circulation in High-Risk Pregnancy: Perinatal Results

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Joelma Queiroz Andrade

2002-01-01

Full Text Available Objetivos: estudar o perfil hemodinâmico fetal em gestantes de alto risco e avaliar a relação das suas alterações com os resultados perinatais. Métodos: realizou-se estudo prospectivo transversal em 108 gestantes atendidas no ambulatório de pré-natal da Clínica Obstétrica do HCFMUSP. Tais gestantes foram encaminhadas ao Setor de Avaliação de Vitalidade Fetal, onde foram submetidas à dopplervelocimetria das artérias umbilicais, cerebral média, aorta, ducto venoso e veia cava inferior. Os critérios de inclusão foram gestantes que apresentavam qualquer doença ou intercorrência na gravidez encaminhadas para avaliação da vitalidade fetal, nas quais a resolução da gestação ocorreu nas próximas 24 horas após os exames. Foram excluídas as pacientes com gestação gemelar ou com malformação fetal. Resultados: as repercussões hemodinâmicas na circulação fetal foram demonstradas pela observação de alterações na dopplervelocimetria das artérias umbilicais, aorta, artéria cerebral média, ducto venoso e veia cava inferior. Valores alterados do índice de pulsatilidade (IP da artéria umbilical foram observados em 25,9% dos casos, da aorta em 24,0% e da artéria cerebral média em 34,2%. O IPV do ducto venoso estava alterado em 18,2% dos casos e o da veia cava inferior em 46,6%. Os segmentos da circulação fetal que melhor se correlacionaram com os resultados perinatais foram a artéria umbilical e o ducto venoso. O IP alterado da artéria umbilical correlacionou-se significativamente com índices de Apgar de 1º minuto inferior a 7 em 42,8% e com necessidade de UTI neonatal em 50,0% dos casos. O IPV (indice de pulsatilidade para veias do ducto venoso alterado apresentou associação significativa com o índice de Apgar de 1º minuto inferior a 7 (52,6%, Apgar de 5º minuto inferior a 7 (15,7%, acidemia no nascimento (60,0%, necessidade de UTI neonatal (52,6% e óbito neonatal (21,1%. Os valores de predição da altera

Carcinoma de Células Renais com Envolvimento Venoso Renal Cell Carcinoma with Venous Involvement

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Sérgio Pereira

2011-03-01

Full Text Available Introdução: O Carcinoma de Células Renais (CCR representa 3% das neoplasias em adultos. É uma das neoplasias urológicas mais letais, com uma mortalidade específica de 40%. A invasão parietal ou a presença de trombo tumoral na veia cava inferior acontece em 4% a 10% dos doentes (= T3b com sobrevida estimada aos cinco anos entre 40% e 60%. A única estratégia curativa é a exérese em bloco do trombo tumoral e do rim. Material e Métodos: Avaliámos retrospectivamente os processos clínicos, incluindo dados imagiológicos e histopatol��gicos, de todos os doentes com CCR submetidos a nefrectomia radical entre 2008 e 2009 na nossa instituição. Resultados: Foi identificado o envolvimento venoso em 10,1% dos doentes (sete em 69, com idade média de 58 anos (32-72. Seis (85,7% apresentavam invasão da veia renal, quatro (57,1% trombo tumoral na veia renal e 3 (42,9% trombo tumoral na veia cava (dois no nível II e um no nível I. A três destes doentes foi realizada cavotomia com excisão do trombo, sem complicações. Um doente abandonou o seguimento médico; dois doentes faleceram no pós-operatório imediato ou precoce (três a sete dias; um doente faleceu por progressão da doença sistémica; os restantes três apresentam progressão da doença. Conclusões: O CCR acompanhado por trombo tumoral na veia cava apresenta uma história natural pouco favorável, mas que pode ser drasticamente alterada se a atitude cirúrgica for agressiva e completa. A constituição de equipas multidisciplinares é fundamental.Introduction: Renal Cell Carcinoma (RCC accounts for 3% of adult carcinomas. It is one of the most deadly urological cancers with disease specific mortality of 40%. Venous wall invasion or tumor thrombus is seen in 4% to 10% of patients (= T3b, with 5 years survival from 40% to 60%. The only curative treatment is tumor thrombus and kidney en bloc removal. Materials and Methods: All the clinical, radiological and pathological data

Trombose de veia central da retina em paciente usuária de interferon e ribavirina: relato de caso Central vein occlusion in a patient using interferon and ribavirin: case report

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John Helal Jr.

2006-08-01

Full Text Available O interferon alfa (INF alfa é droga atualmente utilizada no tratamento de várias doenças sistêmicas, como a hepatite C crônica. A ribavirina quando associada ao interferon alfa aumenta muito a resposta ao tratamento. Estima-se que a infecção crônica pelo vírus da hepatite C afete 170 milhões de pessoas no mundo, muitas delas em uso dessas medicações. A forma típica da retinopatia associada ao interferon alfa apresenta exsudatos algodonosos e hemorragias intra-retinianas. Há vários relatos de alterações oculares associadas ao uso do interferon alfa. Este trabalho descreve um caso de oclusão de veia central da retina em olho direito, com hemorragias no olho contralateral, em paciente usuária dessas medicações por dois anos. O caso descrito expõe em um dos olhos o quadro mais freqüente da retinopatia associada ao uso de interferon alfa (hemorragias de fundo e no olho contralateral, uma apresentação muito mais atípica (trombose de veia central da retina. O quadro fundoscópico apresentou melhora com a interrupção da medicação.Interferon and ribavirin are medications widely used in the treatment of some systemic diseases, mainly hepatitis C. Ribavirin when associated with interferon increases the rate of success of this treatment. There are about 170 million patients with chronic hepatitis C in the world, many in use of these medications. The classic associated retinopathy is described as cotton wool exudates and hemorrhages. Since the first reports, several different ocular disturbances were described in association with interferon. The present case shows a patient whose right eye presented with central retinal vein occlusion and whose left eye presented the typical findings of hemorrhages; prompt resolution after the medications were discontinued.

Válvulas da veia braquial comum: estudo anatômico Valves of the common brachial vein: anatomical study

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Carlos Adriano Silva dos Santos

2007-03-01

Full Text Available CONTEXTO: Boa parte das insuficiências venosas é devida à incompetência de suas válvulas. Como uma das alternativas cirúrgicas, temos os enxertos venosos valvulados no segmento insuficiente. OBJETIVO: Descrever a anatomia das válvulas da veia braquial comum. MÉTODOS: Foram selecionados 30 cadáveres do sexo masculino, independentemente de raça, que tinham seus membros superiores articulados ao tronco. Os mesmos estavam formolizados e foram mantidos em conservação com solução de formol a 10%. Utilizamos como critério de exclusão a existência de desarticulação de um dos membros ou de alterações deformantes em topografia das estruturas estudadas. RESULTADOS: O número total de válvulas identificadas foi de 28 em membro superior direito e de 33 em membro superior esquerdo, sendo 15 no segmento proximal direito e 21 no segmento proximal esquerdo. Mais de 91% das válvulas foram do tipo bicúspide e parietal. CONCLUSÃO: Conclui-se que a veia braquial comum apresenta freqüentemente válvulas do tipo bicúspide e parietal.BACKGROUND: A great part of venous insufficiencies is due to valve incompetence. Valved venous grafts in the insufficient segment are a surgical alternative. OBJECTIVE: To describe the anatomy of the common brachial vein valves. METHODS: We used 30 male corpses of varied races with their upper limbs articulated to the trunk. They were preserved in formol and fixed in a 10% formol solution. Exclusion criteria were presence of disarticulation in one limb or deforming alterations in the topography of assessed structures. RESULTS: The total number of identified valves was 28 in the right arm and 33 in the left arm, 15 of them in the right proximal segment and 21 in the left proximal segment. More than 91% of the valves were bicuspid and parietal. CONCLUSION: We conclude that the common brachial vein often presents bicuspid and parietal valves.

Artérias e veias placentárias em ovinos deslanados sem raça definida (Ovis aries, L. 1758

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Janicleide Maria de Almeida

2000-01-01

Full Text Available O suprimento sangüíneo da placenta de 30 ovelhas deslanadas sem raça definida foi estudado mediante análise de peças obtidas através de injeção vascular com Látex Neoprene 650 corado. Constataram-se no material casos de gestações únicas (53,3%, gemelares (46,7% e trigemelares (3,3%. Em todos os casos analisados, observaram-se 4 vasos umbilicais (2 artérias e 2 veias além do ducto alantóide, na constituição do funículo umbilical. Em apenas 1 caso (gestação trigemelar, as duas artérias umbilicais de um dos fetos fundiram-se na porção média do funículo umbilical, e neste caso integrava apenas uma veia umbilical. A área placentária hilar variava de 2,0 a 6,0 centímetros dependendo da fase de gestação. O número médio de placentônios por gestação foi igual a 96, com tamanhos e formas bastante diversificados, sendo que aqueles maiores que 1,5 centímetro eram predominantes, assim como aqueles de formato ovóide. Os placentônios eram irrigados e drenados por uma série diversificada de artérias e veias, constituindo arranjos arteriocotiledonários e venocotiledonários, perfazendo um total de 299 e 314 arranjos respectivamente.

Prevalência de marcadores de trombofilia em pacientes portadores da síndrome de May-Thurner e trombose de veia ilíaca comum esquerda Prevalence of thrombophilia factors in patients with May-Thurner syndrome and left common iliac vein thrombosis

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Marcos Arêas Marques

2010-12-01

Full Text Available CONTEXTO: A relação entre trombose venosa profunda e trombofilia tem sido pouco estudada em indivíduos portadores de compressão da veia ilíaca comum esquerda, conhecida clinicamente como síndrome de May-Thurner. OBJETIVO: Avaliar a prevalência de marcadores de trombofilia nos pacientes portadores de síndrome de May-Thurner e trombose de veia ilíaca comum esquerda. MÉTODOS: Entre março de 1999 e dezembro de 2008, 20 pacientes com síndrome de May-Thurner e trombose de veia ilíaca comum esquerda foram avaliados retrospectivamente quanto à presença de marcadores de trombofilia. RESULTADOS: Foi detectada a associação entre síndrome de May-Thurner e marcadores de trombofilia em 8 pacientes (40%. CONCLUSÃO: A presença de marcadores de trombofilia em pacientes com trombose de veia ilíaca comum esquerda e síndrome de May-Thurner é frequente, porém não difere da prevalência encontrada em pacientes portadores de trombose venosa profunda sem a síndrome associada.BACKGROUND: The relationship between deep venous thrombosis and thrombophilia has been little studied in patients with left common iliac vein compression, clinically known as May-Thurner syndrome. OBJECTIVE: To evaluate the prevalence of thrombophilia markers in patients with May-Thurner syndrome and left common iliac vein thrombosis. METHODS: From March 1999 to December 2008, 20 patients with May-Thurner syndrome and left common iliac vein thrombosis were retrospectively investigated for the presence of thrombophilia markers. RESULTS: The association between May-Thurner syndrome and thrombophilia markers was found in 8 patients (40%. CONCLUSION: There is a high prevalence of thrombophilia markers in patients with May-Thurner syndrome and left common iliac vein thrombosis. The prevalence, however, is not different from that found in patients with deep venous thrombosis without May-Thurner syndrome.

Novel Resuscitation from Lethal Hemorrhage - Suspended Animation for Delayed Resuscitation

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2002-09-01

a temperatura alvo emn doentes fora do hospital ou jA intemados permanece urn desaflo. Este estudo procurou testar a exequibilidade do arrefecimento...Durante a normotensiio espontfinea, o arrefecirniento veno-venoso forniecia sangue A veia cava a uma temperatura de 6.2 ’CC desvio padr~o (SID 1.4) e...dirninuiu a temperatura da membrana timpfinica (fly) de 37.5 para 34.0’C aos 5 min (SID 0.7) e para os; 32 ’C aos 7.9 min (SID 1.3). 0 arrefecimento da

Modelo experimental estável de aneurisma sacular em artéria carótida de suínos utilizando veia jugular interna

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Severino Lourenço da Silva Júnior

Full Text Available OBJETIVO: Desenvolver um modelo experimental estável de aneurisma sacular em carótida de suínos utilizando veia jugular interna. MÉTODOS: Em 12 suínos sadios, com peso variando entre 25 e 50kg, cinco machos e sete fêmeas, foi confeccionado aneurisma na artéria carótida comum direita. Após arteriotomia elíptica, foi realizada anastomose terminolateral com coto distal de veia jugular interna. O volume do aneurisma era calculado de maneira que o valor não excedesse em 27 vezes o valor da área da arteriotomia. Após seis dias, era realizada angiografia e análise microscópica do aneurisma para avaliar perviedade e trombose parcial ou total. RESULTADOS: Houve ganho de peso significante dos suínos no intervalo de tempo entre a confecção do aneurisma e a angiografia (p = 0,04. Foi observada perviedade aneurismática em dez suínos (83%. Ocorreram infecções de feridas operatórias em dois animais (16,6%, ambas com início de aparecimento em três dias após a confecção do aneurisma. Análise histológica dos aneurismas mostrou trombos ocluindo parcialmente a luz em nove suínos (75%. Nesses animais, observou-se que, em média, 9% da luz aneurismática estava preenchida por trombos. CONCLUSÃO: Pôde ser desenvolvido um modelo experimental estável de aneurisma sacular em carótida de suínos utilizando veia jugular interna.

Eventos catastróficos associados ao tratamento da comunicação interatrial tipo ostium secundum: razões para não se subestimar este tipo de cardiopatia congênita Catastrophic events associated to the surgical treatment of ostium secundum atrial septal defects: reasons for not underestimating this type of congenital cardiopathy

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Paulo Roberto B. Evora

2004-12-01

Full Text Available OBJETIVO: O presente trabalho clínico foi motivado pela frustrante experiência de quatro pacientes operados para o tratamento cirúrgico da comunicação interatrial tipo ostium secundum (CIA-II, que vieram a falecer em condições extremamente dramáticas. MÉTODO: Estudo retrospectivo embasado em dados de prontuários. As pesquisas bibliográficas incluíram: tromboembolismo paradoxal (cerebral, pulmonar ou mesentérico, malformações vasculares do sistema nervoso central e conexões anômalas das veias cavas. Estas pesquisas da literatura foram embasadas em possíveis eventos, inesperados e catastróficos, que levaram quatro pacientes ao óbito. RESULTADOS: Os quatros pacientes, todos do sexo feminino, foram submetidos a atriosseptorrafia com tempo de parada cardíaca isquêmica inferior a 20 minutos, em circulação extracorpórea. As causas de óbito foram: isquemia intestinal não-oclusiva, ruptura de aneurisma cerebral de artéria comunicante anterior, cor pulmonale com hipertensão arterial e tromboembolismo e um provável tromboembolismo cerebral em uma criança que precisou ser reoperada pela drenagem da veia cava inferior em átrio esquerdo. CONCLUSÃO: A lição final deste trabalho é: "Não subestime a comunicação interatrial em cirurgia cardíaca!".OBJECTIVE: The present article was motivated by the frustrating experiences with four patients who underwent surgical treatment of ostium secundum atrial septal defect (ASD-II and who died in extremely dramatic circumstances. METHOD: This is a retrospective study based on clinical data. The bibliographical researche included: paradoxical thromboembolism (cerebral, lung or mesenteric, central nervous system vascular malformations and anomalous vena cava connections. This research was based on possible events, unexpected and catastrophic, that could have directly caused the patients' deaths. RESULTS: All patients were female, the operations were performed under cardiopulmonary

Associação entre aplasia segmentar de veia safena magna e varizes em membros inferiores avaliada pelo ecocolor Doppler

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Amélia Cristina Seidel

2015-09-01

Full Text Available ResumoContextoHá diferenças individuais no diâmetro da veia safena magna (VSM em membros normais e doentes; sendo possível a identificação dessas alterações pelo ecocolor Doppler.ObjetivoAvaliar a associação da aplasia segmentar da VSM com a presença de varizes e/ou insuficiência da mesma em membros inferiores, usando o ecocolor Doppler em pacientes com clínica de doença venosa crônica (DVC.Métodos1.408 pacientes com queixas compatíveis de DVC de membros inferiores, sendo 1.286 do sexo feminino, com idade entre 17 e 85 anos, examinados com ecocolor Doppler. Foram incluídos aqueles com classificação CEAP clínica C0 a C4. Pela avaliação clínica, a amostra foi distribuída em grupo A, pacientes com varizes, e grupo B, aqueles sem varizes. O ecocolor Doppler determinou se havia aplasia da VSM pela análise do seu trajeto no compartimento safeno e presença de veias varicosas nos diferentes sítios. Para estatística, foram considerados os testes Qui-quadrado ou Exato de Fisher e uma análise de resíduos em tabelas, com nível de significância de 5%.ResultadosNo grupo A houve 479 (83,9% de VSM insuficientes, 169 (38,2% com aplasia e 71 (80,7% com insuficiência e aplasia associadas. No grupo B, houve 92 (16,1% de VSM insuficientes, 273 (61,8% com aplasia e 17 (19,3% com insuficiência e aplasia associadas.ConclusãoA aplasia segmentar da VSM ocorre mais em membros inferiores que não apresentam varizes e/ou insuficiência da mesma, mas considerando-se a presença da associação de aplasia e insuficiência, houve maior incidência no grupo de membros que apresentavam varizes.

Embolia atrial de trombo flutuante da veia safena magna após escleroterapia com microespuma ecoguiada Atrial embolism of floating thrombus of the great saphenous vein after microfoam ultrasound-guided sclerotherapy

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Rubens Pierry Ferreira Lopes

2010-12-01

Full Text Available A escleroterapia com microespuma vem sendo utilizada amplamente no tratamento da doença venosa varicosa. No entanto, a despeito da sua pouca invasividade e segurança, complicações potencialmente graves e letais já foram descritas, como o acidente vascular cerebral e parada cardiorrespiratória. Descrevemos um caso de embolia atrial tardia de trombo flutuante da junção safeno-femoral de veia safena magna varicosa, após escleroterapia com microespuma de polidocanol guiada por ultrassom, e o tratamento dessa complicação.Microfoam sclerotherapy has been widely used in the treatment of varicose vein disease. However, despite its low invasiveness and safety, potentially serious and lethal complications have been described, such as stroke and cardiorespiratory arrest. We describe a case of delayed atrial embolism of floating thrombus in the saphenofemoral junction of a great saphenous varicose vein after microfoam ultrasound-guided sclerotherapy, as well as the treatment of this complication.

Fatores de risco que afetam as complicações da dissecação da veia safena na revascularização cirúrgica do miocárdio The risk factors affecting the complications of saphenous vein graft harvesting in aortocoronary bypass surgery

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Monir Abbaszadeh

2008-09-01

Full Text Available OBJETIVO: O problema da cicatrização de feridas é comumente observado após procedimentos de revascularização do miocárdio. Nosso objetivo é determinar a prevalência e os indicadores de complicação na dissecação da veia safena após procedimentos de revascularização coronária. MÉTODOS: Após revisão e aprovação pelo comitê de ética da instituição, uma revisão retrospectiva de 4029 procedimentos de revascularização foi realizada com enxerto da veia safena durante um período de seis anos. Treze fatores de risco para aqueles que desenvolveram complicações extensas nas feridas da perna foram analisados e comparados com toda a coorte de pacientes submetidos a procedimentos de revascularização semelhantes durante o mesmo período. RESULTADOS: Complicações nas feridas do membro inferior ocorreram em 68 pacientes (1,7%, 43 deles precisaram de intervenção cirúrgica adicional. Foram realizados 17 desbridamentos de feridas, nove transplantes de pele, uma angioplastia, 11 fasciotomias, três procedimentos vasculares e duas transferências livre de tecidos. Das treze variáveis analisadas pela análise multivariada, sexo feminino, IMC, uso de enxerto de veia torácica interna, doença vascular periférica, o uso de balão intra-aórtico no pós-operatório e hiperlipidemia pré-existente foram identificados como indicadores independentes significativos de complicações extensas nas feridas a perna (pOBJECTIVE: Problem of wound healing is commonly observed after coronary artery bypass graft procedures. Our aim is to determine the prevalence and the predictors of saphenous vein harvesting complication after coronary revascularization procedures. METHODS: After institutional ethical committee review and approval, a retrospective review was undertaken of 4029 bypass procedures with saphenous vein graft performed over a period of six years is conducted. Thirteen risk factors for those who developed major leg wound

Symptomatic duodenal perforation by inferior vena cava filter.

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Baptista Sincos, Anna Pw; Sincos, Igor R; Labropoulos, Nicos; Donegá, Bruno C; Klepacz, Andrea; Aun, Ricardo

2017-01-01

Objectives Duodenal perforation by an inferior vena cava filter is rare and life threatening. Our objective is to find out number of occurrences and compare diagnosis and treatments. Method The reference list of Malgor's review in 2012 was considered as well as all new articles with eligible features. Search was conducted on specific databases: MEDLINE, Web of Sciences, and Literatura Latino-Americana e do Caribe em Ciências da Saúde. Results Most of the patients presented with upper abdominal pain and the use of radiologic studies was crucial for diagnosis. The most common treatment was laparotomy with filter or strut removal plus duodenum repair. However, clinical conditions of patients must be considered and the endovascular technique with endograft deployment into inferior vena cava may be an alternative. Conclusion Duodenal perforation by an inferior vena cava filter is uncommon and in high-risk surgical patients endovascular repair must be considered.

Relações cranioencefálicas das veias de Trolard e de Labbé: aplicações neurocirúrgicas Cranioencephalic relationships between Trolard and Labbé veins: neurosurgical applications

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Sebastião Gusmão

2001-03-01

Full Text Available Realizamos estudo anatômico das veias anastomóticas de Trolard e de Labbé em sete segmentos cefálicos com o objetivo de precisar o trajeto e as referências que facilitem a preservação destes vasos durante o procedimento cirúrgico. Estudamos também as relações da veia de Trolard com a área motora.We accomplished an anatomic study of the anastomotic veins of Trolard and Labbé in seven human cephalic segments with the objective to accurate its stretch and references to facilitate its preservation during surgical procedure. The relationship between the Trolard vein and motor cortex was also studied.

Tomographic anatomy of the vena cava and renal veins: features relevant to vena cava filter placement

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Thiago Melo do Espírito Santo

2015-03-01

Full Text Available BACKGROUND: There is a growing demand for invasive procedures involving the inferior vena cava, in particular for placement of vena cava filters. It is not always easy to identify the more distal renal vein with cavography, for safe release of filters. OBJECTIVES: To determine parameters for the relationships between the renal veins and the infrarenal vena cava and their corresponding vertebral bodies, their relationships with biotype and the occurrence of anatomic variations, the relationships between vertebral bodies and the bifurcation of the common iliac veins and the distance from this bifurcation to the outflow of the more distal renal vein, with reference to placement of vena cava filters. METHODS: A total of 150 abdominal computed tomography scans conducted from October to November 2011 were analyzed and classified according to the biotype exhibited (using Charpy's angle. Scans were performed at MEDIMAGEM and analyzed at the Integrated Vascular Surgery Service, both part of Hospital da Beneficência Portuguesa in São Paulo, Brazil. RESULTS: In 127 of the 150 scans analyzed (84.66%, the more distal renal vein emerged between the first lumbar intervertebral space (L1-L2 and the body of L2, irrespective of patient biotype. Just 23 patients (15.33% exhibited a more distal renal vein with outflow below the body of L2, i.e. in the projection of the space between L2 and L3. CONCLUSIONS: The radiological correlation between the confluence of the more distal renal vein and vertebral bodies exhibits little variation, irrespective of the biotype of the patient.

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

International Nuclear Information System (INIS)

Araujo Junior, Cyrillo Rodrigues de; Carvalho, Tarcisio Nunes; Fraguas Filho, Sergio Roberto; Costa, Marlos Augusto Bitencourt; Jacob, Beatriz Mahmud; Machado, Marcio Martins; Teixeira, Kim-Ir-Sen Santos; Ximenes, Carlos Alberto

2003-01-01

Persistent left superior vena cava absent right superior vena cava is a rare anomaly, with less than 150 cases reported in the literature. Congenitally persistent left superior vena cava is the most common variant of systemic venous return to the heart, resulting embryologically from failure of the left anterior cardinal vein to become obliterated. Its incidence varies from 0.3% in patients with otherwise normal heart to 4.3% in patients with congenital heart disease. In the majority of the patients, a right superior vena cava is present as well, but rarely the right anterior cardinal vein degenerates resulting in the absence of the normal right superior vena cava. The blood from the right side is carried by the persistent left superior vena cava to the right atrium through the coronary sinus. We report the case of a patient with a persistent left superior vena cava and absence of right superior vena cava identified by chance during a chest radiograph and computed tomography examination for investigation of chronic pulmonary obstructive disease. The patient had no congenital heart disease and the blood from the right side was drained by the persistent left superior vena cava into the right atrium through the coronary sinus. (author)

Estudo anatómico da válvula do seio coronário: válvula de Thebesius Anatomical study of the coronary sinus valve: Thebesius valve

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Fábio B Jatene

1989-08-01

Full Text Available Este estudo tem por objetivo esclarecer eventuais problemas causados pela presença da válvula de Thebesius durante a cateterização do seio coronário, quer pela cardioplegia retrógrada, estudo eletrofisiológico, ou eletrofulguração. Foram analisados 94 corações normais, de óbitos não cardíacos. O átrio direito era incisado ao nível da veia cava superior, em direção à veia cava inferior, percorrendo o sulco terminal, possibilitando adequada visibilização do seio coronário. As válvulas, classificadas de acordo com suas variações anatômicas, possibilitaram o seguinte resultado: ausente em 15 (16% casos; residual em 31 (33%; parcial em 40 (43%; trabeculada em sete (7% e dupla em um (1% caso. A cateterização do seio coronário não foi prejudicada quando este apresentava válvula ausente, residual ou dupla. Entretanto, em alguns dos casos onde havia válvula parcial (11 de 40 casos, 27% e válvula trabeculada (três de sete casos, 43%, esta cateterização foi mais trabalhosa e demorada. Estatisticamente, não houve correlação dos tipos de válvula com relação a sexo e raça, sendo inconclusiva com relação à idade.The knowledge of the different anatomical types of the Thebesius valve should clarify some problems observed in coronary sinus catheterization. Ninety-four human normal hearts were analysed by an incision in he right atrium from the inferior vena cavae through the terminal groove, allowing inspection of the coronary sinus. Based on the anatomical features of the Thebesius valve, we identify 5 different groups, i.e.: 1 absent valve (16% when no valve exists; 2 residual valve (33% when there was only a small membrane occluding less than 15% of the sinus diameter; 3 partial valve (43% when a membrane occludes more than 15% of the sinus diameter; 4 trabeculated valve (7% when there was no membrane but trabeculation over the sinus; 5 double valve (1% when there were 2 membranes over the sinus in different

Trashepatic left gastric vein embolization in the treatment of recurrent hemorrhaging in patients with schistosomiasis previously submitted to non-derivative surgery Embolização transhepática da veia gástrica esquerda no tratamento da recidiva hemorrágica em esquistossomóticos submetidos previamente a cirurgia não derivativa

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Paulo Fernandes Saad

2012-12-01

ópica das varizes gastroesofágicas tem o objetivo de prevenir e/ou tratar a recidiva hemorrágica, porém nem todos os doentes respondem ao tratamento. OBJETIVO: Avaliar o sucesso do tratamento de embolização da veia gástrica esquerda no controle da recidiva hemorrágica por varizes gastroesofágicas nos doentes esquistossomóticos submetidos previamente a cirurgia não derivativa. MÉTODOS: Foram estudadas, por meio de dados colhidos nos prontuários médicos e dos protocolos de seguimento ambulatorial, a incidência da recidiva hemorrágica e a diminuição quantitativa e qualitativa das varizes gastroesofágicas em detrimento das varizes gastroesofágicas dos doentes encaminhados para embolização transhepática da veia gástrica esquerda no período de dezembro de 1999 até janeiro de 2009. RESULTADOS: Sete doentes com média etária de 39,3 anos foram encaminhados para embolização percutânea transhepática da veia gástrica esquerda. O tempo médio decorrido entre a DAPE e a abordagem percutânea foi de 8,4 ± 7,3 anos e o número de episódios de hemorragia digestiva variou de um a sete neste período. Nenhum episódio de ressangramento foi verificado na população do estudo durante o período de acompanhamento, que variou de 6 meses a 7 anos. Após estudo endoscópico pós-embolização, todos os doentes apresentaram diminuição das varizes gastroesofágicas em comparação à endoscopia pré-embolização. CONCLUSÃO: A embolização percutânea transepática da veia gástrica esquerda nos doentes esquistossomóticos, previamente operados, determinou a redução das varizes gastroesofágicas e foi eficiente no controle do ressangramento para a população estudada.

Técnica para preparo angioarquitetônico hepático de ratos Preparation technique for angioarquitetonic liver model in rats

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Vitormauro Araújo da Silva

2000-09-01

Full Text Available Os métodos de injeção-corrosão são os principais métodos utilizados para o estudo da anatomia vascular do fígado. Alguns autores mencionam a técnica para estudo de fígado de cães, porcos, hamsters, coelhos e gatos, entretanto são escassos os trabalhos que mencionam o estudo da anatomia hepática de ratos. Desta forma é importante o conhecimento de novas técnicas de preparo para modelos angioarquitetônico de fígados, possibilitando um melhor conhecimento da anatomia e por conseguinte, aperfeiçoando significativamente a abordagem operatória deste órgão. Em função disso o objetivo do presente estudo é demonstrar a técnica para realização de angioarquitetura venosa do fígado de ratos. Foram utilizados 10 Rattus norvegicus albinus (Wistar, com massa corporal entre 250 e 300g, para verificar a funcionalidade do método. A técnica para preparo de modelo vascular apresenta três tempos fundamentais: cateterização da veia porta, veia cava intra-abdominal e veia cava intra-torácica; preparo e infusão da solução de acrílico; corrosão em ácido clorídrico e maceração da peça. Concluímos que, esta técnica é factível e apresenta como vantagem um baixo custo (30 dólares e com a utilização de duas cores diferentes de tinta pode-se separar o sistema vascular portal do sistema de drenagem supra-hepático, portanto sendo capaz de moldar a estrutura vascular hepática de ratos.The injection-erosion methods are the principal methods used for the study of the vascular anatomy of the liver. Some authors mention the technique for study of liver of dogs, pigs, hamsters, rabbits and cats, however they are scarce the works that mention the study of the hepatic anatomy of rats. This way it is important the knowledge of new preparation techniques for angioarquitetonic livers' models, making possible a better knowledge of the anatomy and consequently, improving the operative approach of this organ significantly. Due above of that

Aneurisma venoso na junção esplenomesentérica e emergência da veia porta: relato de caso Venous aneurysm at the splenomesenteric confluence at the level of portal vein emergence: a case report

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Mário Müller Lorenzato

2009-06-01

Full Text Available Os aneurismas no sistema esplenoportomesentérico são uma entidade clínica rara e de etiologia desconhecida, tendo como fatores contribuintes hipertensão portal, doença hepática crônica e trauma, entre outros. Os autores apresentam os achados de imagem de um caso de aneurisma na junção esplenomesentérica ao nível da emergência da veia porta, em uma paciente de 62 anos de idade sem fatores predisponentes.Aneurysms in the splenoportomesenteric system constitute a rare entity whose etiology is still to be determined. Predisponent factors include portal hypertension, chronic hepatic disease and trauma, among others. The authors present a case of an aneurysm at the splenomesenteric confluence where it joins the portal vein, in a female, 62-year-old patient with no predisponent factor.

Trombose de veia porta em crianças e adolescentes Portal vein thrombosis in children and adolescents

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Graziela C. M. Schettino

2006-06-01

Full Text Available OBJETIVO: Apresentar uma revisão atualizada de trombose de veia porta na infância e adolescência, enfatizando o diagnóstico, suas complicações e tratamento. FONTE DOS DADOS: Foi realizada revisão da literatura, dos últimos 10 anos, através de pesquisa bibliográfica na Internet nos principais sites de busca médica, como o PubMed e MEDLINE, com enfoque na doença trombose de veia porta e suas repercussões clínicas. As principais palavras-chave e expressões pesquisadas foram: portal vein thrombosis, extra-hepatic portal vein obstruction, prognosis, children, portal hypertension, esophagogastric varices. Além disso, foram consultados os artigos citados nas referências dos trabalhos selecionados na pesquisa inicial e dos livros textos. SÍNTESE DOS DADOS: A trombose de veia porta é uma das causas mais comuns de hipertensão porta na infância. A apresentação clínica inicial pode ser através de episódios de hemorragia digestiva ou da presença de esplenomegalia em exame clínico de rotina. As principais complicações são a hemorragia digestiva, hiperesplenismo secundário à esplenomegalia, retardo de crescimento e biliopatia portal. O diagnóstico é realizado através da ultra-sonografia abdominal com Doppler. O tratamento é direcionado para as complicações, incluindo profilaxia primária e secundária de hemorragia digestiva, conseqüente à ruptura de varizes esofágicas, e derivações porto-sistêmicas, em casos selecionados. CONCLUSÕES:A trombose de veia porta é uma das causas mais importantes de hemorragia digestiva em crianças. Esses episódios acarretam impacto importante na qualidade de vida dos pacientes acometidos. Dessa forma, uma abordagem diagnóstica e terapêutica adequada é desejável na tentativa de se reduzir a morbimortalidade.OBJECTIVE: To review the literature on portal vein thrombosis in children and adolescents, focusing on its diagnosis, complications and treatment. SOURCE OF DATA: The medical

Tratamento da síndrome de Budd-Chiari por meio da colocação de tips e de "stent" venoso supra-hepático Transjugular intrahepatic portosystemic shunt (TIPS and suprahepatic venous stenting in the management of Budd-Chiari syndrome

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Jurandi A. Bettio

2002-11-01

Full Text Available OBJETIVOS: Descrever o uso do "shunt" intra-hepático portossistêmico (TIPS e do "stent" venoso supra-hepático no manejo da síndrome de Budd-Chiari, enfocando suas indicações, aspectos técnicos e benefícios do procedimento. MATERIAIS E MÉTODOS: De janeiro de 1999 a março de 2002, nove casos de síndrome de Budd-Chiari foram encaminhados ao Serviço de Hemodinâmica do Hospital São Lucas, Porto Alegre, RS. A obstrução venosa supra-hepática foi constatada em todos os casos por meio de ultra-sonografia com Doppler em cores. A criação de TIPS foi realizada entre o sistema venoso supra-hepático ou a veia cava inferior e a veia porta, posicionando-se a endoprótese entre as duas abordagens. Doppler em cores pós-procedimento foi efetuado em todos os pacientes em períodos seriados. RESULTADOS: Três casos foram tratados inicialmente com inserção de "stent" venoso por apresentarem estenose preponderante em veias supra-hepáticas. Em dois desses casos ocorreu trombose do "stent", sendo necessária colocação de TIPS. Os demais seis casos foram tratados primariamente com TIPS. Dos oito "shunts" criados, trombose da endoprótese foi constatada em três casos, resolvidas com limpeza dos trombos e dilatação com balão em um caso e inserção de novas próteses nos demais. Embolização com molas de colaterais venosas ectasiadas foi efetuada em um paciente. CONCLUSÕES: A colocação de TIPS constitui-se numa estratégia terapêutica segura e efetiva na síndrome de Budd-Chiari, promovendo uma significativa melhora clínica e hemodinâmica dos pacientes, evitando procedimentos mais invasivos e podendo, em casos sem cirrose estabelecida, servir de tratamento definitivo da hipertensão portal.OBJECTIVE: To evaluate the use of transjugular intrahepatic portosystemic shunt (TIPS and suprahepatic venous stenting in the management of Budd-Chiari syndrome, emphasizing the indications, technical aspects and the advantages of the procedure

Avaliação da proteína acídica fibrilar glial como marcador da injúria por isquemia-reperfusão hepática

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Giuliano Ancelmo Bento

Full Text Available OBJETIVO: Avaliar a expressão da Proteína Acídica Fibrilar Glial após a injúria por isquemia-reperfusão. MÉTODOS: vinte e quatro ratos foram distribuídos em quatro grupos: Controle, submetidos à anestesia e biópsia hepática; Simulação, injeção de heparina através da veia cava e dissecção do pedículo hepático superior, biópsia após 24 horas; Isquemia 30 minutos, mesmo procedimento do grupo Simulação, acrescido de clampeamento do pedículo hepático superior por 30 minutos; Isquemia 90 minutos, mesmo procedimento do grupo Isquemia 30 minutos, porém com período de clampeamento de 90 minutos. Após 24 horas de observação, os animais foram submetidos à laparotomia e seus fígados avaliados macroscopicamente, microscopicamente, por coloração de Hematoxilina-Eosina (HE e submetidos à análise da expressão da GFAP por Western Blotting. RESULTADOS: Não se observou diferença no aspecto macroscópico dos fígados entre os diferentes grupos experimentais, tendo todos evidenciado morfologia normal. A análise por HE não evidenciou diferenças significativas, no que diz respeito à morfologia lobular. Por outro lado, nos grupos isquemia, foram encontrados infiltrados neutrofílicos e pequenas áreas de necrose. A expressão de GFAP foi semelhante em todos os grupos, seja qualitativamente quanto quantitativamente. CONCLUSÃO: A expressão da Proteína Acídica Fibrilar Glial não se alterou em nosso modelo de isquemia-reperfusão.

Toracoscopia em eqüinos: técnica e emprego como método de avaliação da cavidade pleural Thoracoscopy in horses: technique and its use as pleural cavity evaluation method

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André Luis do Valle De Zoppa

2001-10-01

Full Text Available Toracoscopia é o método de visibilização da cavidade torácica através de endoscópio rígido ou flexível, indicado como exame auxiliar para diagnóstico das diversas afecções do tórax. Pode ser realizada com o animal sob anestesia geral ou em posição quadrupedal através de anestesia local associada ou não a sedativos. Neste trabalho, foram utilizados seis eqüinos hígidos, que foram submetidos a toracoscopia, em posição quadrupedal, nos dois hemitórax, com intervalo de 15 dias entre cada procedimento. Durante o exame, pôde-se observar as diversas estruturas da cavidade torácica, tais como: músculo diafragma (porção muscular e tendínea, hiato esofágico, mediastino, aorta, troncos dorsal e ventral do nervo vago, ducto torácico, veia ázigos, veias intercostais, músculos intercostais, costelas, tronco nervoso simpático, tronco vascular toracocervical, traquéia, pulmão (lobo cranial e caudal, esôfago, pericárdio, veia cava caudal, nervo frênico e linfonodos aórticos. Discretas alterações foram observadas ao exame físico, laboratorial e ultra-sonográfico no período pós-operatório, sem que trouxessem prejuízos ao desenvolvimento do experimento e recuperação do animal. A toracoscopia mostrou ser exame de auxílio importante, pela facilidade, rapidez de execução, ampla visibilização da cavidade pleural e trauma mínimo ao paciente.Thoracoscopy is the technique based upon the thoracic cavity visualization by means of rigid or flexible endoscope. It is indicated as an additional diagnostic aid to better define thoracic diseases. It can be performed either in an animal subjected to general anesthesia or in a horse standing on stocks with local anesthesia with or without sedative. Six healthy horses were used in this study they were subjected to thoracoscopy in both hemithorax, standing on stocks, with a 15-day interval between each procedure. It was possible to visualize several thoracic structures through

Abordagem da valva do tronco pulmonar por desvio direito e uso de cânula bicaval: estudo experimental Approach of the pulmonary valve using right heart bypass and bicaval cannula: experimental study

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Ana Maria RochaPinto e Silva

2007-12-01

Full Text Available OBJETIVO: O objetivo deste estudo foi reproduzir a cirurgia de abordagem da valva do tronco pulmonar por desvio direito, avaliando-se uma nova cânula venosa bicaval com balonetes insufláveis para uso por miniacesso. MÉTODOS: Utilizaram-se 15 suínos da raça Large-White, sendo cinco para a padronização técnica das vias de acesso e monitorização hemodinâmica, nove submetidos ao experimento por meio de esternotomia, e um animal excluído da amostra, operado por mínimo acesso ao tórax. O desvio direito foi estabelecido pela drenagem bicaval, sendo a cânula introduzida pela veia jugular interna direita e locada nas veias cavas cranial e caudal. Os parâmetros medidos foram: Pressão Arterial Média (PAM; Freqüência Cardíaca (FC; Saturação O2 (SAT O2; Capnografia (PetCO2 e Temperatura (T. A análise estatística foi feita comparando-se os valores antes e durante o desvio direito. RESULTADOS: No momento pré-desvio direito, obtiveramse os seguintes valores médios: PAM = 90,8 mmHg, FC = 101,6 bat/min, SAT O2 = 93,8%, PetCO2 = 28,4 mmHg, T = 36,1ºC. Durante o desvio direito, obtiveram-se os seguintes valores médios: PAM = 88,1 mmHg, FC = 98,0 bat/min, SAT O2 = 93,1%, PetCO2 = 25,3 mmHg e T = 36,9ºC. Comparandose as médias obtidas entre os dois momentos, verificou-se não haver diferenças significantes para a PAM, FC e SAT O2 e diferenças significantes para a PetCO2 e a T. CONCLUSÃO: A cânula bicaval com balonetes promoveu drenagem eficaz de ambas as veias cavas, permitindo a manutenção dos parâmetros hemodinâmicos durante o desvio direito, sendo possível realizar a abordagem da valva pulmonar.OBJECTIVE: To reproduce the surgery for correction of pulmonary valve anomalies using right heart bypass and a new bicaval cuffed venous cannula for minimal access surgery. METHODS: Fifteen Large-White pigs were used for this study. The standard technique model was established with the first five pigs, the experiment was done with

Índices de onda P na predição de recorrência de fibrilação atrial após isolamento da veia pulmonar

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Ahmed Salah

2013-12-01

Full Text Available FUNDAMENTO: Índices de ondas P são marcadores interessantes para prever recorrências de fibrilação atrial (FA pós ablação. OBJETIVO: Esse estudo avalia o valor dos índices de onda P para prever recorrências após isolamento da veia pulmonar (IVP em pacientes com fibrilação atrial paroxística. MÉTODOS: Foram selecionados 198 pacientes (57 ± 8 anos, 150 homens com FA paroxística sintomática refratária a medicamentos submetidos ao IVP em nosso hospital. Um eletrocardiograma de 12 derivações foi utilizado para medir a duração da onda P na derivação II, a força terminal de P (FTP na derivação V1, o eixo e a dispersão da onda P. RESULTADOS: No acompanhamento de 9 ± 3 meses, as recorrências ocorreram em 60 (30,3% pacientes. Os pacientes que apresentaram recorrência de FA tiveram maior duração média de onda P (122,9 ± 10,3 versus 104,3 ± 14,2 ms, p 125 ms apresenta 60% de sensibilidade, especificidade de 90%, valor preditivo positivo (VPP de 72% e valor preditivo negativo (VPN de 83,7%, enquanto a dispersão da onda P > 40 ms tem 78% de sensibilidade, 67% de especificidade, PPV 51% e VPN de 87,6%. 48/66 (72,7% dos pacientes com FTP -0,04 mm/segundo tiveram recorrência de FA (p 125 ms, a dispersão da onda P > 40 ms e FTP em V1 < -0,04 mm/sec são bons preditores clínicos das recorrências de FA pós IVP em pacientes com fibrilação atrial paroxística; contudo, eles não foram independentes do tamanho do átrio esquerdo e da idade.

Migração Espontânea Tardia da Ponta de um Catéter Venoso Central

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Joao Miguel Caravs

2017-03-01

Neste caso clínico descrevemos a migração tardia da ponta de um CVC. Este fenómeno não é incomum e foram já descritos vários destinos anatómicos para estas migrações como a veia braquiocefálica oposta ou a veia jugular [1]. A incidência destas migrações espontâneas foi estimada em 0.9-1.8%, sendo que o mecanismo exato permanece obscuro. Algumas hipótese incluem variações extremas da pressão intratorácica por tosse, espilros ou levantamento de pesos por exemplo [2].

Treinamento de sobrecarga muscular não afeta o diâmetro das principais veias dos membros inferiores em mulheres adultas com insuficiência venosa

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Gigliola Cibele Cunha da Silva

2010-12-01

Full Text Available O exercício físico pode promover benefícios na funcionalidade do sistema venoso. Contudo, tratando-se de exercício com sobrecargas musculares, observa-se contraindicações quanto à sua prática diante da possibilidade da mesma estar relacionada ao agravamento das disfunções venosas. OBJETIVO: Analisar os efeitos da prática do exercício com sobrecargas musculares sobre o diâmetro venoso de mulheres fisicamente inativas portadoras de insuficiência venosa crônica de membros inferiores. MÉTODOS: Vinte e duas mulheres com idades entre 21 e 58 anos (34,27 ± 12 anos foram divididas aleatoriamente em dois grupos: experimental (n = 12 e controle (n = 10. O treinamento com cargas foi realizado por 16 semanas, e o diâmetro venoso foi medido nas veias safenas magna (em nível da coxa e perna e parva no membro inferior esquerdo por meio de ecodoppler colorido. Utilizou-se a ANOVA por dois fatores para avaliar as possíveis modificações dos diâmetros entre os grupos e ao longo do tempo (p < 0,05. RESULTADOS: Não foram encontradas alterações significativas nos diâmetros das veias safenas parva (porções superior, média e inferior: p = 0,80, 0,32 e 0,20, respectivamente, magna em nível da perna (p = 0,17, 0,74 e 0,96 e magna em nível da coxa (p = 0,57, 0,67 e 0,52. CONCLUSÃO: A prática do exercício com sobrecargas musculares pode ser considerada um meio de intervenção ou tratamento, uma vez que não promoveu alterações no diâmetro venoso de mulheres que apresentaram insuficiência venosa crônica nos membros inferiores.

Retroperitoneal arteriovenous malformation extending through the inferior vena cava into the heart and causing inferior vena cava dissection

International Nuclear Information System (INIS)

Sung, Yon Mi; Choe, Yeon Hyeon; Park, Seung Woo; Park, Pyo Won; Sung, Chang Ohk

2005-01-01

We present a case of retroperitoneal arteriovenous malformation extending through the inferior vena cava into the heart, which was associated with dissection of the inferior vena cava in a 32-year-old female. Computed tomography and magnetic resonance imaging showed a double-lumen inferior vena cava and a rod-like solid component attached to a sac-like lesion in the right heart chambers. Digital subtraction angiography showed an arteriovenous malformation draining to the inner lumen of the inferior vena cava. (orig.)

Eficiência do laser diodo 980 nm em comparação à da glicose a 75% na oclusão de veias da orelha de coelhos The efficiency of the diode laser 980 nm compared to glucose 75% in occlusion of the veins in rabbit ears

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Paulo Roberto da Silva Lima

2011-06-01

Full Text Available CONTEXTO: Por ser o laser um método novo no tratamento das varizes, há muitos mitos e dúvidas com relação à sua eficácia; assim, surgiu a necessidade de compará-lo a substância esclerosante mais utilizada em nosso meio (glicose hipertônica. OBJETIVO: Comparar a eficiência do laser diodo 980 nm à glicose 75% na oclusão de veias em orelha de coelho. MÉTODOS: Ensaio aleatório em animais de laboratório por 21 dias. A amostra consistiu de orelhas de coelhos machos adultos. Grupo L (laser: 15 orelhas tratadas com laser; grupo G (glicose 75%: 15 orelhas tratadas com glicose a 75%. Variáveis primárias: veias esclerosadas e/ou ocluídas. Variáveis complementares: volume da substância administrada, complicações e peso. O tamanho da amostra foi estimado em 30 orelhas. Foi realizado o teste exato de Fisher associado ao Risco Relativo (RR, calculando-se o intervalo de confiança (IC de 95% para as variáveis acima. RESULTADOS: A incidência de esclerose ou oclusão venosa no grupo G foi de 53% (8/15; IC95%: 27-79 e no grupo L, 20% (3/15; IC95%: 4-49. O p bicaudal foi de 0,1281, o RR usando a aproximação de Katz foi de 2,66; IC95%: 0,87-8,15. CONCLUSÃO: A eficiência do laser diodo 980 nm em comparação à da glicose 75% na oclusão de veias para o modelo experimental estudado foi equivalente.BACKGROUND: The laser is a new treatment to varicose veins and there is several myths and doubts in relation to its efficacy; then, there is the need to compare it with the most commonly sclerosing solution (hypertonic glucose used in our specialty. OBJECTIVE: To compare the efficiency of the diode laser 980nm to the glucose 75% in the occlusion of veins from the ear of rabbits. METHODS: Aleatory trial in laboratory animals during 21 days. The sample consisted of ears from male adult rabbits. Group L (laser: 15 ears treated with laser; group G (glucose 75%: 15 ears treated with glucose 75%. Primary variables: sclerotic and/or occluded veins

Accuracy of chest radiography for positioning of the umbilical venous catheter

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Adriana F.M. Guimarães

2017-03-01

distal do cateter venoso umbilical, utilizando ecocardiografia como padrão de referência. Métodos: Estudo transversal, observacional, com inclusão prospectiva de dados de todos os neonatos nascidos em uma maternidade pública de referência, entre abril de 2012 e setembro de 2013, submetidos à inserção de cateter venoso umbilical como parte do atendimento clínico. A posição da extremidade distal do cateter, determinada pela análise simultânea dos três marcos anatômicos radiográficos, foi comparada com a posição anatômica obtida pela ecocardiografia e sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo e acurácia foram calculados. Resultados: Dos 162 recém-nascidos avaliados por ecocardiografia, somente 44 (27,16% estavam com o cateter em posição ótima, na porção torácica da veia cava inferior ou na junção da veia cava inferior com o átrio direito. Os cateteres foram localizados no átrio esquerdo e septo interatrial em 54 (33,33%, no átrio direito em 26 (16,05%, intra-hepático em 37 (22,84% e na aorta em um recém-nascido (0,62%. A sensibilidade, especificidade e acurácia da radiografia para detectar cateter na zona alvo foi de 56%, 71% e 67,28%, respectivamente. Conclusão: A radiografia anteroposterior de tórax isolada não é capaz de definir com segurança a posição do cateter venoso umbilical. A ecocardiografia permite a visibilização direta da ponta do cateter em relação às estruturas vasculares e, sempre que possível, deve ser considerada para localização do cateter venoso umbilical. Keywords: Newborn, Umbilical veins, Central venous catheter, Chest radiography, Echocardiography, Palavras-chave: Recém-nascido, Veias umbilicais, Cateterismo venoso central, Radiografia torácica, Ecocardiografia

Total laparoscopic retrieval of inferior vena cava filter.

Science.gov (United States)

Benrashid, Ehsan; Adkar, Shaunak Sanjay; Bennett, Kyla Megan; Zani, Sabino; Cox, Mitchell Wayne

2015-01-01

While there is some local variability in the use of inferior vena cava filters and there has been some evolution in the indications for filter placement over time, inferior vena cava filters remain a standard option for pulmonary embolism prophylaxis. Indications are clear in certain subpopulations of patients, particularly those with deep venous thrombosis and absolute contraindications to anticoagulation. There are, however, a variety of reported inferior vena cava filter complications in the short and long term, making retrieval of the filter desirable in most cases. Here, we present the case of a morbidly obese patient complaining of chronic abdominal pain after inferior vena cava filter placement and malposition of the filter with extensive protrusion outside the inferior vena cava. She underwent successful laparoscopic retrieval of her malpositioned inferior vena cava filters after failure of a conventional endovascular approach.

Total laparoscopic retrieval of inferior vena cava filter

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Ehsan Benrashid

2015-08-01

Full Text Available While there is some local variability in the use of inferior vena cava filters and there has been some evolution in the indications for filter placement over time, inferior vena cava filters remain a standard option for pulmonary embolism prophylaxis. Indications are clear in certain subpopulations of patients, particularly those with deep venous thrombosis and absolute contraindications to anticoagulation. There are, however, a variety of reported inferior vena cava filter complications in the short and long term, making retrieval of the filter desirable in most cases. Here, we present the case of a morbidly obese patient complaining of chronic abdominal pain after inferior vena cava filter placement and malposition of the filter with extensive protrusion outside the inferior vena cava. She underwent successful laparoscopic retrieval of her malpositioned inferior vena cava filters after failure of a conventional endovascular approach.

Anomalies of the vena cava inferior

International Nuclear Information System (INIS)

Koen, F.R.; Bouwer, A.J.; Bornman, M.S.; Du Plessis, D.J.

1986-01-01

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

Spiral CT in aplasia of the pre-renal inferior vena cava as a cause of phlebothrombosis from the femoral veins to the inferior vena cava; Spiral-CT einer Aplasie der praerenalen Vena cava inferior als Ursache einer Phlebothrombose von den Oberschenkelvenen bis in die Vena cava inferior

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Schweiger, U. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Schedel, H. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Thiede, U. [Deutsches Herzzentrum Berlin (Germany). Arbeitsgruppe Digitale Bildbearbeitung; Felix, R. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany)

1994-12-31

The case report focuses on the computed tomography of the thrombotic okklusion of the inferior vena cava, venae iliacae and femorales communes due to congenital interruption of the prerenal inferior vena cava. The embryology of the abnormality was discussed. (orig.) [Deutsch] Anhand einer Fallstudie wurden die Moeglichkeiten der computertomographischen Diagnostik bei einer durch Teilplasie der `praerenalen` Vena cava inferior hervorgerufenen Thrombose der Vv. femorales superficiales et profundae, der grossen Beckenvenen und der Vena cava inferior erlaeutert. In der Diskussion wurde auf die Embryologie der Missbildung eingegangen. (orig.)

Trisegmentectomia hepática direita por videolaparoscopia

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Marcel Autran C. Machado

Full Text Available INTRODUÇÃO: Em 2007 os autores descreveram a primeira hepatectomia direita por videolaparoscopia realizada no Brasil. Hepatectomia direita ampliada, também conhecida como trisegmentectomia direita, é procedimento altamente complexo e implica em grande retirada do volume hepático. Os autores descrevem a primeira trisegmentectomia direita por videolaparoscopia realizada no Brasil. TÉCNICA: O paciente é colocado em posição supina em decúbito lateral esquerdo. O cirurgião se coloca entre as pernas da paciente. Utilizamos cinco trocartes, três de 12 mm e dois de 5 mm. Devido à embolização prévia da veia porta direita, o hilo hepático não é dissecado. O pedículo portal direito é seccionado com grampeador laparoscópico de carga vascular por meio de acesso intra-hepático, segundo técnica previamente descrita pelos autores. A seguir procede-se a mobilização do fígado direito seguido de dissecção da veia cava retro-hepática e secção da veia hepática direita. Estes passos são realizados sem manobra de Pringle. O fígado é seccionado com combinação de bisturi harmônico e grampeador endoscópico. O pedículo do segmento 4 é seccionado dentro do fígado. O espécime é retirado por meio de incisão supra-púbica e a área cruenta é revista para verificar hemostasia. O procedimento é encerrado e dreno de sistema fechado é posicionado junto à área cruenta. CONCLUSÃO: Trisegmentectomia hepática direita por videolaparoscopia é procedimento factível e seguro e deve ser considerado para pacientes selecionados. Este procedimento deve ser realizado em centros especializados e por cirurgiões com experiência tanto em cirurgia hepática como cirurgia laparoscópica avançada.

Disfunção endotelial causada pela pressão aguda de distensão em veias safenas humanas utilizadas para revascularização do miocárdio Endothelium dysfunction caused by acute pressure distension of human saphenous vein used for myocardial revascularization

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Fernanda Viaro

2007-06-01

Full Text Available OBJETIVO: Estudar as alterações morfofuncionais induzidas por pressão de distensão, em veias safenas humanas utilizadas para revascularização do miocárdio. MÉTODO: Foram estudadas veias safenas de 20 pacientes, distribuídas em quatro grupos experimentais: controle, 100, 200 e 300 mmHg, submetidos a distensões pressóricas com solução de Krebs por 15 segundos. A metodologia utilizada incluiu: 1 Imunohistoquímica do CD34; 2 Estudo in vitro da reatividade vascular em câmaras de órgãos. RESULTADOS: Os principais achados experimentais foram: 1 A partir da pressurização com 200 mmHg, observou-se uma tendência à diminuição da expressão do CD34, tornando-se estatisticamente significante com 300 mmHg; 2 Não houve comprometimento da contratilidade e dos relaxamentos estudados in vitro. CONCLUSÕES: Embora o estudo in vitro não tenha demonstrado comprometimento da reatividade vascular das veias estudadas, o estudo imunohistoquímico do CD34 mostrou que existe disfunção endotelial com pressurizações de 300 mmHg.OBJECTIVE: To study morphofunctional alterations induced by brief pressure increases in human saphenous veins utilized in coronary artery bypass grafting. METHOD: Saphenous veins of 20 patients undergoing coronary artery bypass grafting, were distributed into four experimental groups, control, 100 mmHg, 200 mmHg and 300 mmHg, and submitted to pressure distention over 15 seconds using Krebs solution. The evaluation included CD34 immunohistochemistry and an In vitro vascular reactivity study in organ chambers. RESULTS: The main experimental findings were 1 From pressures of 200 mmHg there was a tendency to reduce the CD34 expression which became statistically significant at 300 mmHg; 2 There was no impairment of the contraction and relaxation as evidenced by in vitro vascular reactivity tests. CONCLUSION: Although vascular reactivity impairment was not demonstrated in vitro, the CD34 expression, measured by

Endovascular management of inferior vena cava filter thrombotic occlusion.

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Branco, Bernardino C; Montero-Baker, Miguel F; Espinoza, Eduardo; Gamero, Maria; Zea-Vera, Rodrigo; Labropoulos, Nicos; Leon, Luis R

2018-01-01

Objective Inferior vena cava occlusion is a potentially life-threatening complication related to caval filters. We present our experience with filter-induced inferior vena cava occlusion in order to assess the feasibility, safety, and effectiveness of endovascular management. Methods A retrospective review of all patients undergoing inferior vena cava filter placement over a 60-month study period was performed. From this cohort, a total of 10 cases of inferior vena cava occlusion after filter placement were identified. Demographics, clinical data, procedures, and outcomes were extracted. Patients were followed to the last clinic visit or until they died. Results One-hundred eighty filters were placed by our group practice during the study period. Of those, a total of 10 patients were identified. Overall, there were 7 males; the mean age was 57.1 years (25-78 years). The median time between inferior vena cava filter placement and filter occlusion was 105 days (range 5-4745 days). All patients were clinically symptomatic at the time of their presentation. Nine out of 10 patients were successfully managed endovascularly. Trellis™-8 thrombectomy was the most common endovascular strategy performed ( n = 9). Four patients had balloon angioplasty, two of those with stent placement for chronically occluded inferior vena cava/iliac veins. No thromboembolic complications developed during a median follow-up period of 233 days (range 4-1083 days). Conclusions Endovascular management of inferior vena cava occlusion is feasible, safe, and effective in decreasing thrombus burden in the presence of an inferior vena cava filter. Further studies evaluating long-term inferior vena cava patency and optimal surveillance regimen after endovascular management of filter-related inferior vena cava occlusion are warranted.

Effect of the period of extrinsic mechanical compression following sclerotherapy in veins in rabbit ears Efeito do tempo da compressão mecânica extrínseca após escleroterapia em veias de orelhas de coelhos

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Cláudio Santana Ivo

2011-06-01

� suficiente para evitar reperfusão nas veias tratadas; se há relação entre a intensidade inflamatória na parede venosa e tecidos adjacentes e o tamanho do trombo venoso; se a intensidade da inflamação pós-escleroterapia varia com o tempo de compressão; se há relação entre a presença de hemossiderina nos tecidos adjacentes ao vaso esclerosado e coágulo venoso. MÉTODOS: Utilizaram-se 28 coelhos, machos, distribuídos em quatro grupos (0, 24, 72 e 120. Em todos os animais foram administrados 0,25 ml de solução de polidocanol 1% e, como controle, 0,25 ml de solução de cloreto de sódio 0,9% na veia marginal dorsal das orelhas direita e esquerda, respectivamente. Realizou-se compressão mecânica em trecho da veia perfundida, exceto nos animais do grupo 0. O tempo de compressão variou de 0 a 120 horas nos grupos. Realizou-se exame anatomopatológico de trecho das veias marginais dorsais direita e esquerda de todos os animais. RESULTADOS: Não houve diferenças significativas nos diversos tempos de compressão, tanto no grau de trombose venosa como na intensidade inflamatória, em ambas as orelhas, nos diversos grupos. Observou-se correlação positiva e significativa entre intensidade inflamatória e tamanho do trombo e na ocorrência de trombos e hemossiderina. CONCLUSÕES: O tempo de até 120 horas de compressão não é suficiente para evitar reperfusão nos vasos esclerosados. A intensidade da inflamação nos tecidos tem relação com o tamanho do trombo, mas não com o tempo de compressão. A presença de hemossiderina nos tecidos adjacentes ao vaso submetido à esclerose está relacionada com a presença de coágulo venoso.

Early hemodynamics and metabolic changes after total abdominal evisceration for experimental multivisceral transplantation Efeitos hemodinâmicos e metabólicos iniciais da evisceração abdominal total para transplante multivisceral experimental

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Ruy J. Cruz Junior

2009-04-01

ômago, duodeno, pancreas, fígado, baço, intestino delgado, e colon. Uma prótese vascular foi interposta entre a veia cava infra e supra-hepática. Efeitos hemodinâmicos foram avaliados por meio de um cateter de Swan-Ganz catheter e Doppler ultrassônico. As variáveis dependentes de oxigênio, e o metabolismo da glicose e lactato foram avaliados durante todo o experimento. RESULTADOS: A evisceração abdominal esteve associada a uma redução significativa do débito cardiaco e da pressão arterial média (57% and 14%, respectivamente. Duas horas após a reconstrução vascular da veia cava inferior observou-se uma redução significativa do pH e da glicose arterial. O consumo de oxigênio se manteve inalterado nas primeiras duas horas do experimento, com um significativo aumento dos níveis séricos de lactato (1.4±0.3 vs. 7.6±0.4, p<0.05. Três animais morreram antes de 180 minutos após a reperfusão. CONCLUSÃO: A evisceração abdominal total esteve associada com graves repercussões hemodinâmicas e metabólicas sistêmicas. Estas graves alterações hemodinâmicas estam associadas, provavelmente, a combinação de vários fatores incluindo: acidose metabólica, hiperlactemia, hipoglicemia e redução do volume de sangue circulante. A cuidadosa monitorização hemodinâmica e metabólica deve ser realizada durante o MVTx experimental com a finalidade de promover um aumento das taxas de sobrevida deste complexo procedimento.

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

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Jorge García Egea

2011-03-01

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

Peso do baço como fator prognóstico do tratamento cirúrgico de pacientes portadores de esquistossomose mansônica

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Álvaro Antônio Bandeira Ferraz

Full Text Available OBJETIVO: Analisar pré-operatoriamente o peso do baço como fator prognóstico do tratamento cirúrgico de pacientes portadores de esquistossomose mansônica. MÉTODOS: Foram analisados 114 pacientes, portadores de esquistossomose mansônica com antecedentes de hemorragia digestiva, submetidos a tratamento cirúrgico. Os pacientes foram divididos em três grupos: Grupo 1 - baço menor que 500 gramas (17; Grupo 2 - baço entre 500 e 1.000 gramas (58; Grupo 3 - baço acima de 1.000 gramas (39. RESULTADOS: No Grupo 1 a recidiva hemorrágica foi de 17,6%, trombose da veia porta de 5,9% e não houve mortalidade. A incidência de hiperesplenismo pré-operatório foi de 29,4% e o calibre da veia porta foi de 1,1cm. No Grupo 2 a recidiva hemorrágica foi de 15,5%, trombose da veia porta de 10,3% e a mortalidade de quatro pacientes (6,9% (dois pacientes no período pós-operatório e dois no seguimento tardio, hepatocarcinoma e hemorragia digestiva. A incidência de hiperesplenismo foi de 53,4% e o calibre médio da veia porta foi de 1,4cm. No Grupo 3 a recidiva hemorrágica foi de 12,8%, trombose da veia porta de 5,1% e uma mortalidade tardia de dois pacientes (linfoma e infarto agudo do miocárdio. A incidência de hiperesplenismo foi de 76,9% e o calibre da veia porta foi de 1,5cm. CONCLUSÕES: O peso do baço apresenta relação com o hiperesplenismo pré-operatório, calibre da veia porta e permanência hospitalar pós-operatória. Não encontramos relação com a incidência de varizes de fundo gástrico, recidiva de sangramento digestivo, trombose da veia porta, grau de fibrose periportal e dados bioquímicos.

O papel da oxigenação hiperbárica na estrutura do fígado e baço após ligadura das veias hepáticas: estudo em ratos The role of hyperbaric oxygenation in the liver and spleen structure after hepatic vein ligation: study in rats

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Ricardo Costa-Val

2006-03-01

Full Text Available OBJETIVO: Avaliação morfológica do fígado e baço de ratos submetidos à oxigenoterapia hiperbárica após a ligadura das veias hepáticas. MÉTODO: Foram utilizados 30 animais machos adultos da espécie Holtzman, distribuídos aleatoriamente em dois grupos de 15 animais cada, assim designados: grupo 1 - ligadura das veias hepáticas; grupo 2 - ligadura das veias hepáticas associada à oxigenoterapia hiperbárica. Todos os animais foram submetidos à anestesia geral por meio de solução contendo cloridrato de cetamina (40 mg/ml e cloridrato de meperidina (10 mg/ml na dose de 50 mg/kg/peso, laparotomia mediana e ligadura das veias hepáticas. A oxigenoterapia hiperbárica foi aplicada nos animais do grupo 2, a partir da oitava hora do pós-operatório, por 120 minutos, sendo 90 minutos sob pressão de 2,5 atmosferas e 15 minutos no início e final da terapêutica, para promover a compressão e descompressão gradativa no período de 20 dias consecutivos. No 21° dia de pós-operatório, os animais foram mortos por inalação de éter e submetidos à laparotomia e extirpação dos fígados e baços para exame histológico. Foram comparados os resultados da histologia hepática e esplênica aplicando-se o teste exato de Fisher, considerando-se a diferença significante de P OBJECTIVE: Liver and spleen morphologic evaluation of rats submitted to hyperbaric oxygen therapy after hepatic vein ligation. METHOD: Thirty Holtzman adult male rats were used, distributed into two groups of 15 animals: group 1 - hepatic vein ligation; group 2 - hepatic vein ligation associated with hyperbaric oxygen therapy. All animals received general anesthesia by a solution composed of ketamine chloride (40 mg/ml and meperidine chloride (10 mg/ml in a dose of 50/mg/weight, and were submitted to median laparotomy and hepatic vein ligation. Group 2 animals were submitted to hyperbaric oxygen therapy, 8 hours after the operation, 90 minutes at 2.5 atmosphere pressure

Forças mecânicas e veias safenas humanas: implicação na revascularização do miocárdio Mechanical forces and human saphenous veins: coronary artery bypass graft implications

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Rafael Angelo Tineli

2007-03-01

Full Text Available As células endoteliais vasculares estão expostas a uma variedade de forças mecânicas in vivo, resultantes do fluxo sangüíneo pulsátil. Dentre essas forças, destacam-se: forças de cisalhamento, tangenciais à parede do vaso, produzidas pelo atrito com o fluxo sangüíneo viscoso, tensão de complacência da parede vascular e a pressão hidrostática do conteúdo sangüíneo no interior da vasculatura. Diversos autores estudaram as alterações hemodinâmicas, funcionais e morfológicas em veias safenas humanas causadas por esses tipos de forças com resultados conflitantes. A motivação dessa revisão foi analisar dados da literatura e alguns dados experimentais do nosso laboratório. Os aspectos revistos são: 1 Respostas endoteliais e regulação gênica causadas pelo shear stress; 2 Efeitos da pressão hidrostática na morfologia da célula endotelial, expressão gênica da superfície celular endotelial e proliferação das células endoteliais, 3 Efeitos da tração no endotélio de veias safenas humanas.Vascular endothelial cells are exposed to a variety of in vivo mechanical forces, specifically, shear stress for the blood flow, tensile stress from the compliance of the vessel wall and the hydrostatic pressure from containment of blood within inside the vasculature. Many authors studied hemodynamic, functional and morphological human saphenous veins alterations caused by these different forces with conflictant results. This review text was motivated with the specific aim of analyze literature data and some experimental data carried out in our laboratory. The adopted review subjects were: 1 Endothelial responses and gene regulation to shear stress; 2 Effects of the hydrostatic pressure in the endothelial cell morphology, gene expression of the endothelial cellular surface and proliferation of endothelial cells; 3 Effects of the traction on the human saphenous vein endothelium.

Ligadura da veia porta associada à bipartição do fígado para hepatectomia em dois estágios (ALPPS: experiência brasileira Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS: the Brazilian experience

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Orlando Jorge Martins Torres

2013-03-01

Full Text Available RACIONAL: Insuficiência hepática pós-operatória devido à remanescente hepático pequeno tem sido complicação temida em pacientes que são submetidos à ressecção hepática extensa. A ligadura da veia porta associada à bipartição do fígado para hepatectomia em dois estágios (ALPPS foi desenvolvida recentemente com a finalidade de induzir rápida e significante regeneração do fígado para pacientes em que o tumor é previamente considerado irressecável. OBJETIVO: Apresentar a experiência brasileira com o ALPPS. MÉTODO: Foram analisados 39 pacientes submetidos ao procedimento ALPPS em nove hospitais. Ele foi realizado em duas etapas. A primeira operação consistiu em ligadura do ramo direito da veia porta e bipartição hepática. Na segunda, os ramos direito da artéria hepática, via biliar e veia hepática foram ligados e o lobo hepático direito estendido foi removido. Foram 22 pacientes do sexo masculino (56,4% e 17 do feminino (43,6%. A média de idade foi 57,3 anos (variando de 20 a 83 anos. RESULTADOS: A indicação mais comum foi metástase hepática em 32 pacientes (82,0%, seguida por colangiocarcinoma em três pacientes (7,7%. Dois morreram neste intervalo e não foram submetidos à segunda operação. O intervalo médio da primeira para a segunda operação foi de 14,1 dias (variando de 5-30 dias. O volume do segmento lateral esquerdo apresentou aumento de 83% (variando de 47-211,9%. Morbidade significante foi observada em 23 pacientes (59,0%. A mortalidade foi de 12,8% (cinco pacientes. CONCLUSÃO: O procedimento ALPPS permite ressecção hepática em pacientes com lesões consideradas previamente irressecáveis por induzir rápida hipertrofia do fígado evitando a insuficiência hepática na maioria dos pacientes. Porém ainda apresenta elevada morbidade e mortalidade.BACKGROUND: Postoperative liver failure consequent to insufficiency of remnant liver is a feared complication in patients who underwent extensive

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

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Miguel Angel Maluf

1994-06-01

Full Text Available No período de março de 1990 a janeiro de 1994, 17 pacientes com idades de 1 a 13 anos (média: 7 anos, portadores de cardiopatias congênitas com câmara ventricular única funcionante, foram submetidos a operação de derivação cavo-pulmonar bidirecional. Nove pacientes tinham atresia tricúspide (AT, 7 do tipo lb, 1 tipo le e 1 tipo Mb. Cinco pacientes tinham dupla via de entrada ventricular tipo ventrículo direito (DVEVD; 2 com comunicação interventricular(CIV múltipla+hipoplasiado VD; 1 com atresia pulmonar com septo interventricular íntegro (APc/SIVI. Nove (52,9% pacientes tinham operações paliativas prévias. A operação foi realizada com auxílio da circulação extracorpórea (CEC em 12 (70,5% casos e mediante derivação do fluxo sangüíneo da veia cava superior (VCS para o átrio direito (AD em 5 (29,5% casos. Em todos os casos a VCS foi anastomosada à artéria pulmonar direita (APD, interrompendo o fluxo sangüíneo para o pulmão, fechando a valva pulmonar e ligando a derivação de Blalock-Taussig pérvio. Houve 3 (17,6% óbitos no pós-operatório imediato (POI e 2 (14,2% no pós-operatório tardio (POT. Doze (70,5% pacientes estão em acompanhamento clínico, com um tempo de evolução de 2 a 46 meses. Um paciente foi submetido ao 2º tempo da operação, tunelizando a veia cava inferior (VCI para a APD, com sucesso. A avaliação do fluxo da derivação cavo-pulmonar bidirecional está sendo realizada pela ecodopplercardiografia e ressonância nuclear magnética e a perfusão pulmonar mediante cintilografia radioisotópica. A indicação do 2º tempo da operação obedece à própria evolução clínica e avaliação da saturação arterial durante a cicioergometria. A derivação cavo-pulmonar bidirecional permite uma adaptação progressiva do fluxo venoso para o pulmão, diminuindo a sobrecarga de volume do ventrículo, preparando o paciente para a derivação venosa total.From March 1990 to January 1994, 17

Fatal pericardial tamponade after superior vena cava stenting.

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Ploegmakers, M.J.M.; Rutten, M.J.C.M.

2009-01-01

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

Preservação da veia safena magna na cirurgia de varizes dos membros inferiores Varicose vein surgery in lower limbs with preservation of the great saphenous vein

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Hamilton Almeida Rollo

2009-06-01

Full Text Available A veia safena magna autóloga é o melhor substituto arterial nas revascularizações dos membros inferiores, importante na revascularização do miocárdio e pode ser utilizada nas cirurgias do sistema venoso e nos traumas das extremidades. A fleboextração aumenta os riscos de lesões linfáticas e neurológicas. Assim, no tratamento das varizes primárias dos membros inferiores por meio da cirurgia ou de outras técnicas, a preservação da safena é recomendável se ela for normal ou apresentar alterações que ainda permitam sua preservação pela correção da causa desencadeante. Tal correção pode ser feita por técnicas cirúrgicas. Entre elas, a cura hemodinâmica da insuficiência venosa em ambulatório (CHIVA tem mostrado bons resultados. Recentemente, um ensaio clínico randomizado e controlado foi publicado comprovando sua eficácia. Outra técnica bastante utilizada é a da ligadura rasante da junção safenofemoral + crossectomia + ligadura das tributárias de crossa, com a qual se tem obtido resultados contraditórios. Finalmente, as técnicas que corrigem a insuficiência da safena reparando as valvas ostial e pré-ostial (valvoplastia externa são mais fisiológicas. Um ensaio clínico internacional multicêntrico, randomizado e controlado, testando um novo dispositivo, está sendo realizado, com resultados iniciais favoráveis. Este estudo pretende fazer uma revisão sobre as técnicas utilizadas na preservação da safena magna.The autologous great saphenous vein is the most effective bypass choice for lower limb revascularization, playing an important role in myocardial revascularization, and can be used in venous system surgeries and extremity traumas. Stripping increases the risk of lymphatic lesions and nerve damage. Therefore, when surgery or other techniques are used to treat primary varicose veins in the lower limbs, preservation of the saphenous vein is a desirable objective whenever the vein remains healthy or

An unusual cause of an inferior vena cava syndrome

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Regoort, M.; Reekers, J. A.; Kromhout, J. G.

1989-01-01

Two patients are presented with an occlusion of the infrarenal vena cava caused by a vena cava aneurysm. This rare congenital vena caval anomaly may mimic retroperitoneal lymphadenopathy, especially on CT- imaging without contrast enhancement

Anastomosis cava-pulmonar en el tratamiento quirúrgico de la tetralogía de Fallot

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José Félix Patiño

1965-01-01

Full Text Available Se informa sobre la aplicación clínica exitosa de la técnica de anastomosis cava-pulmonar, originalmente descrito por Glenn y Patiño, en un caso de Tetralogía de Fallot. Representa este caso el primer paciente tratado en esta forma en la literatura médica occidental. La anastomosis cava-pulmonar es un procedimiento técnicamente muy sencillo que permite mejorar notablemente la oxigenación en pacientes que presentan ciertas anomalías en el corazón derecho o en la arteria pulmonar. La anastomosis cava-pulmonar parece ser una operación fisiológica fácil de realizar, bien tolerada, que da como resultado buena oxigenación de la sangre venosa desembocada al pulmón derecho, y que en el caso de la Tetralogía de Fallot, presenta notables ventajas sobre las operaciones paliativas clásicas de Blalock y Potts. La anastomosis cava-pulmonar es un procedimiento que puede ser usado en el tratamiento quirúrgico de la Tetralogía de Fallot como operación paliativa definitiva, o como la primera etapa que mejora las condiciones generales del paciente para permitir que más tarde pueda ser llevado a corrección definitiva. Esta anastomosis, que disminuye trabajo al corazón, no necesariamente tiene que ser deshecha a tiempo de la corrección definitiva, a diferencia de las operaciones clásicas de Blalock y Pott, que sí añaden trabajo al corazón al crear un ductus artificial y una hipertensión pulmonar. Se propone el uso clínico de la anastomosis cava-pulmonar en aquellos casos de Tetralogía de Fallot que requieran una operación paliativa extra-cardíaca o como la primera etapa antes de ser sometidos a la corrección definitiva por circulación extracorpórea.

Fístula Arteriovenosa após Nefrectomia Radical: A Propósito de um Caso Clínico Arteriovenous fistula after Radical Nephrectomy:: a case report

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Nádia Duarte

2011-09-01

Full Text Available Existem três tipos diferentes de fístulas arteriovenosas (FAV renais, as congénitas, as idiopáticas e as adquiridas, sendo as últimas as mais frequentes. Dentro destas, as resultantes da nefrectomia são uma raridade. A FAV entre a artéria renal e a veia cava inferior (VCI é uma complicação rara após nefrectomia, estando descritos cerca de 10 casos na literatura. Os autores descrevem um caso de um homem de 51 anos, insuficiente renal crónico (IRC em hemodiálise, enviado à consulta de Urologia por nódulo sólido do rim direito sugestivo de neoplasia, detectado em ressonância magnética (RMN. Foi submetido a nefrectomia radical direita, tendo sido efectuada laqueação conjunta do pedículo renal, sem intercorrências cirúrgicas. Quatro meses depois, inicia clínica de sobrecarga hídrica, de difícil controlo com a hemodiálise e surge um sopro abdominal localizado no flanco direito, contínuo. O estudo por eco-doppler abdominal e angiografia demonstrou a presença de fístula entre a artéria renal e a veia cava inferior. Foi submetido a embolização da FAV com coils, tendo-se registado migração dos mesmos para a artéria pulmonar. A sua recolha foi efectuada imediatamente com basket, sem outras intercorrências. Posteriormente, foi submetido a laparotomia com laqueação simples da artéria renal justa-aórtica, com resolução e estabilização do quadro clínico. A propósito deste caso clínico os autores discutem a abordagem diagnóstica e a hierarquia terapêutica da FAV reno-VCI nomeadamente na cirurgia directa e endovascular.There are three different types of renal arteriovenous fistula (AVF, congenital, idiopathic and acquired, being the latter the most frequent. Within these, those resulting from nephrectomy are rare. The AVF between the renal artery and the inferior vena cava (IVC is a rare complication, with about 10 cases described in literature. The authors describe the case of a 51 year old man, with chronic

Esplenectomia e ligadura da veia gástrica esquerda na esquistossomose mansônica: efeito sobre a pressão das varizes de esôfago aferida por tecnica não-invasiva

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Claudio Moura Lacerda

Full Text Available Em ambos os hospitais universitários de Pernambuco, o tratamento de escolha para portadores de esquistossomose hepatoesplênica (EHE com antecedente de hemorragia digestiva alta (HDA por rotura de varizes de esôfago (VE é a esplenectomia associada à ligadura da veia gástrica esquerda (ELGE; porém, o impacto desta cirurgia sobre a pressão das VE, provavelmente, o parâmetro que melhor se correlaciona com o risco de recidiva hemorrágica, ainda não foi estudado. Com a introdução, em nosso meio, de técnica não-invasiva de medição da pressão das VE, isto tornou-se possível, com mínimos riscos, tomando-se o objetivo do presente estudo. A ELGE foi empregada em vinte portadores de EHE com antecedentes de HDA. A pressão das VE foi medida através do método endoscópico não-invasivo do balão pneumático, antes da cirurgia, e estes valores comparados com novas medições realizadas cinco a oito dias após. A pressão nas VE no pré-operatório variou entre 20,0 e 28,7mmHg (média de 24,35± 2,36 mmHg. Não houve correlação da pressão com o calibre das VE. No pós-operatório (PO, observou-se uma queda significante na pressão das VE, que variou entre 14,6 e 21,5 mmHg (média 17,29± 1,75 mmHg, p<0,001. Os resultados do presente trabalho confirmam as idéias que fundamentam a indicação da ELGE em portadores de EHE com antecedente de HDA. Esta cirurgia determina, pelo menos a curto prazo e na ampla maioria dos casos, uma redução na pressão das VE reduzindo o risco de recidiva de HDA.

Aspectos morfológicos da ultra-sonografia hepática de ovinos Morphologic aspects of hepatic ultrasonography in sheep

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Pedro B. Néspoli

2009-04-01

Full Text Available A ultra-sonografia (US é uma das técnicas de exame complementar eletivas para o diagnóstico de enfermidades hepáticas de diversas espécies domésticas. Em ovinos, no entanto, existem poucos relatos sobre o aspecto ultra-sonográfico de enfermidades hepáticas e não há definição precisa dos padrões anatômicos da US normal do fígado. Neste estudo foram utilizados 58 ovinos da raça Santa Inês: n1=8 machos, n2=10 fêmeas não gestantes e n3=40 fêmeas gestantes. Os animais foram escaneados do 12º ao 8º espaços intercostais (EI para se observar a localização da veia cava caudal (VC, veia porta (VP e vesícula biliar (VB e para se aferir a espessura do fígado sobre a VC e VP no 11º e 10º EI. O fígado foi examinado de forma satisfatória do 12º até o 8º EI. Nesta área, tanto a VC como a VP, foram observadas do 12º ao 9º EI, porém a VC não foi examinada de forma adequada em 11 animais, 10 com peso acima de 50kg. Entre os dois grupos de fêmeas, a VC e a VP foram observadas com maior freqüência no 11º e 10º EI e em todos os machos examinados do 12º ao 10º EI. A localização da vesícula biliar oscilou entre o 10º e o 8º EI, com maior incidência a nível do 9º e 8º EI nas fêmeas gestantes e não gestantes, e sobre o 9º EI nos machos. Comparativamente, a ecogenicidade do parênquima hepático foi mais intensa do que a do córtex renal. Houve correlação significativa entre o peso do fígado e a espessura hepática sobre a veia porta no 11º e o 10º EI no grupo de fêmeas gestantes. A US forneceu informações importantes quanto a topografia e ecogenicidade do fígado e mostrou ser uma ferramenta útil para estimar o peso do órgão.The ultrasonography (US is a complementary technique of choice for the diagnostic of hepatic diseases in many domestics' species. In sheep however there are few reports about ultrasonography in hepatic diseases and there is not precise definition about the anatomic standards of

Right superior vena cava draining into the left atrium

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Calcagni, Giulio; Sidi, Daniel; Bonnet, Damien [University Rene Descartes-Paris 5, Department of Paediatric Cardiology, Hopital Necker-Enfants Malades, Paris (France); Batisse, Alain [Institut de Puericulture et de Perinatalogie, Paris (France); Vouhe, Pascal [University Rene Descartes-Paris 5, Department of Paediatric Cardiac Surgery, Hopital Necker-Enfants Malades, Paris (France); Ou, Phalla [University Rene Descartes-Paris 5, Department of Paediatric Cardiology, Hopital Necker-Enfants Malades, Paris (France); University Rene Descartes-Paris 5, Department of Pediatric Radiology, Hopital Necker-Enfants Malades, Paris (France)

2008-08-15

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.)

Right superior vena cava draining into the left atrium

International Nuclear Information System (INIS)

Calcagni, Giulio; Sidi, Daniel; Bonnet, Damien; Batisse, Alain; Vouhe, Pascal; Ou, Phalla

2008-01-01

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.)

Estudo da regeneração de nervos tibiais de ratos Wistar em sutura primária com "gap" e sem "gap", cobertos por segmentos de veia Study of tibial nerve regenration in Wistar rats in primary neurorrhaphy with and without gap, wrapped in vein segments

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Ewerton Bastos dos Santos

2012-01-01

Full Text Available OBJETIVO: O presente estudo comparou, em ratos da raça Wistar, a regeneração nervosa nas suturas epineurais com espaçamento de 1,0mm (com "gap" e sem espaçamento (sem "gap", ambos cobertos com tubo de veia jugular externa, através da contagem de motoneurônios no nível da medula espinhal entre L3 e S1, marcados por meio de exposição do nervo tibial ao Fluoro - Goldâ (FG. MÉTODO: Os nervos tibias de ambos os lados foram seccionados e foram realizadas suturas epineurais com "gap" e, no lado contralateral, sem "gap" sendo que as suturas foram cobertas com tubo de veia. Após quatro meses do procedimento cirúrgico, os nervos tibias foram expostos ao FG, perfundidos e realizada a contagem dos motoneurônios na medula espinhal. RESULTADOS: Para a análise estatística foi utilizado o teste de Wilcoxon pareado, onde obtivemos um resultado estatisticamente significante entre o número de motoneurônios do grupo com "gap" em relação ao sem "gap" (p= 0,013. CONCLUSÃO: Obtivemos melhores resultados na contagem de motoneurônios daqueles nervos onde haviam sido realizadas as suturas primárias sem "gap", quando comparados com as suturas com "gap". Nível de Evidência: Estudo Experimental.OBJECTIVE: This study compared nerve regeneration in Wistar rats, using epineural neurorrhaphy with a gap of 1.0 mm and without a gap, both wrapped with jugular vein tubes. Motor neurons in the spinal cord between L3 and S1 were used for the count, marked by exposure of the tibial nerve to Fluoro-Gold (FG. METHOD: The tibial nerves on both sides were cut and sutured, with a gap on one side and no gap in the other. The sutures were wrapped with a jugular vein. Four months after surgery the tibial nerves were exposed to Fluoro-Gold and the motor neuron count performed in the spinal cord. RESULTS: The results were statistically analyzed by the paired Wilcoxon test. There was a statistical difference between the groups with and without gap in relation to the

Avaliação ultrassonográfica da involução das estruturas umbilicais extra e intracavitárias em bezerros sadios da raça Nelore concebidos naturalmente e produtos de fertilização in vitro

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Tiago Torrecillas Sturion

2013-08-01

Full Text Available Esse trabalho foi desenvolvido com o objetivo de caracterizar a involução das estruturas umbilicais em bezerros sadios da raça Nelore ao longo dos primeiros 35 dias de vida, e de comparar esse processo em bezerros concebidos por métodos naturais ou por fertilização in vitro (FIV. Quarenta bezerros foram distribuídos em dois grupos (n=20 de acordo com o método de concepção (natural ou FIV e cada grupo foi composto por dez machos e dez fêmeas. A ultrassonografia (transdutor microconvexo de 7,5 MHz foi empregada para examinar o conjunto das estruturas remanescentes do cordão umbilical que compõem o umbigo externo e as estruturas abdominais (veia umbilical, artéria umbilical esquerda e ducto alantóide, mensurando-se os seus diâmetros em locais definidos. Os exames foram realizados entre 24 e 36 horas de vida e aos 7, 14, 21, 28 e 35 dias de idade. Testaram-se os efeitos do sexo, da idade e do método de concepção por meio da análise de variâncias de medidas repetidas. O exame ultrassonográfico provou-se adequado para a avaliação das estruturas umbilicais extra e intracavitárias permitindo a caracterização do processo fisiológico de involução das mesmas. No umbigo externo, as veias umbilicais foram observadas como imagem individualizada até os 14 dias de vida e um conjunto de estruturas em processo de atrofia era visualizado após essa idade. No abdômen, a veia e a artéria umbilicais foram visualizadas até os 35 dias de idade e o ducto alantóide somente durante a primeira semana de vida. Essas estruturas apresentaram-se com parede hiperecóica regular e contínua e lúmen homogeneamente anecóico. O diâmetro de todas as estruturas umbilicais estudadas se reduziu continuamente ao longo do primeiro mês de vida (p0,05. Comparados aos bezerros concebidos por métodos naturais, os produtos de FIV nasceram com os vasos umbilicais e o ducto alantóide um pouco mais calibrosos (diâmetros 1 a 3 mm maiores. Distintamente

Experience with three percutaneous vena cava filters

International Nuclear Information System (INIS)

McCowan, T.C.; Ferris, E.J.; Harshfield, D.L.; Hassell, D.R.; Baker, M.L.

1987-01-01

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

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

International Nuclear Information System (INIS)

Gong Peiyou; Liu Fengli; Ma Xianying; Zhao Li; Wang Liping; Li Xuehua; Li Jian

2010-01-01

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

Symplastic Leiomyoma in the Suprarenal Inferior Vena Cava

International Nuclear Information System (INIS)

Kahveci, Volkan; Ogur, Torel; Cipe, Gokhan; Ozdemir, Sevim; Hazinedaroglu, Selcuk

2012-01-01

Leiomyomas are benign tumors of the soft tissue and may develop in any location where smooth muscle is present. Leiomyoma in the inferior vena cava is a rarely seen pathology, and symplastic leiomyoma is also a rare histological variant of leiomyoma. In this case, we present a rare histological variant of symplastic leiomyoma in the inferior vena cava (IVC). This is the first radiologically reported case of a symplastic leiomyoma of the IVC

Fístula axilo-cava para hemodiálise: relato de caso Axillary arteriovenous fistula for hemodialysis: case report

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Yosio Nagato

2009-12-01

Full Text Available Na confecção de fístula arteriovenosa (FAV para hemodiálise, condutos venosos autógenos demonstram performance superior quando comparados com material protético em relação à perviedade primária ou secundária. A prótese de politetrafluoroetileno (PTFE é reservada para casos de falência de material autógeno e é geralmente utilizada em fístulas em membros superiores. Descrevemos o caso de uma paciente de 52 anos que, após falência de acessos para hemodiálise e impossibilidade de realização de diálise peritoneal em razão de peritonite bacteriana, foi submetida à confecção de FAV entre a artéria axilar direita e a veia cava inferior com prótese de PTFE de 6 mm. O acesso foi utilizado para hemodiálise 1 mês após sua criação e permanece pérvio após 24 meses. Até o momento, não houve complicações infecciosas, sinais de insuficiência cardíaca ou síndrome de roubo em membro superior direito.With regards to the creation of an arteriovenous fistula (AV fistula for hemodialysis, autogenous venous grafts clearly show high performance when compared with prosthetic material in terms of primary or secondary patency. Polytetrafluoroethylene (PTFE grafts for the reconstruction of AV fistulae must be restricted to cases of failure of the autogenous material, which is generally used in upper limb fistulae. We describe a case of a 52-year-old patient, who, after access failure for hemodialysis and the impossibility of performing peritoneal dialysis due to bacterial peritonitis, underwent the reconstruction of an AV fistula between the right axillary artery and the cava vein using a 6-mm PTFE prosthesis. One month after surgery, this AV fistula started to be used for hemodialysis. The AV fistula remains patent 24 months after its creation. No infectious complications, cardiac insufficiency symptoms, or steal syndromes of right upper limb were detected.

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

International Nuclear Information System (INIS)

Chen Guoping; Gu Jianping; Lou Wensheng; He Xu; Chen Liang; Su Haobo

2007-01-01

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

A new Nitinol stent for use in superior vena cava syndrome

DEFF Research Database (Denmark)

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

2015-01-01

AIM: The aim of the study was to assess the early clinical experience with the Zilver Vena stent in treating patients with malignant superior vena cava syndrome. METHODS: Demographic, procedural, and follow-up data of 12 patients (seven women; mean age 69 years) treated for superior vena cava...... syndrome with in all 21 Zilver Vena stents between March 2012 and October 2013 were retrospectively reviewed. All cavographies and contrast enhanced CT related to the treatment and during follow-up were evaluated and the patients had clinical follow-up until dead. They were all in terminal state...... at the time of stent deployment. RESULTS: All patients had superior vena cava obstruction and clinical superior vena cava syndrome caused by malignant expansive mediastinal disease (eight patients non-small cell lung cancer and four small cell lung cancer). The technical success with deployment of the stents...

Implante de stent dentro de stent recém-implantado em ponte de veia safena para otimização do resultado angiográfico Stenting a stent in saphenous vein graft to optimize the angiographic result

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Antonio Esteves Fº

1998-03-01

Full Text Available Mulher de 60 anos, com angina progressiva e revascularização do miocárdio, há oito anos, com ponte de veia safena para coronária direita e anastomose de artéria mamaria esquerda para artéria descendente anterior. Submetida a implante de stent Gianturco-Roubin II em terço proximal da ponte de veia safena para artéria coronária direita, com resultado insatisfatório pela persistência de lesão residual, provavelmente, decorrente de prolapso para dentro da luz de material aterosclerótico através dos coils. Foi implantado outro stent (Palmaz-Schatz biliar dentro do stent GRII com sucesso e ótimo resultado angiográfico. Um 2º stent Palmaz-Schatz biliar foi implantado em lesão distal no corpo da ponte, ultrapassando os dois stents, anteriormente implantados, com sucesso. Em algumas situações, implante de stent dentro de outro stent é recurso útil para otimização de resultado angiográfico do implante de um stent.A 60 year-old woman with progressive angina who had been submitted to saphenous bypass-graft to right coronary artery and a left mammary artery graft to anterior descending artery eight years previously, underwent implantation of a Gianturco Roubin II stent in the proximal third of the saphenous vein graft. The result was suboptimal by persistence of a residual stenosis probably due to prolapse of atherosclerotic material through the coil spaces. Another stent (Palmaz-Schatz biliar stent was implanted at the previously stented site with no residual stenosis. Another Palmaz-Schatz biliar stent was successfully implanted in the distal body of the graft to treat another lesion (passing through the previously stents without difficulty. Stenting a stent, in selected situations, is a useful tool to optimize the angiographic result of stent implantation.

Vena cava superior syndrome associated with sarcoidosis

International Nuclear Information System (INIS)

Wurm, K.; Walz, M.; Reidemeister, J.C.; Donhuijsen, K.

1988-01-01

We report the first observation of clinical manifestations of vena cava superior syndrome (VCSS) associated with sarcoidosis. Twenty-four years after the first signs of the disease had been noted, mediastinal lymphomas penetrating the wall of the vena cava superior caused complete obstruction. It is most unusual for the vessel wall to be destroyed in this way, which explains why VCSS is often missed in sarcoidosis. The obstructed vessel was resected and successfully replaced by a Gore-Tex prosthesis. The importance of VCSS for the differential diagnosis is pointed out. Two further peculiarities are the simultaneous occurrence of elevated intraocular pressure and VCSS, and the familial incidence. (orig.) [de

Inferior vena cava filter penetration following Whipple surgical procedure causing ureteral injury.

Science.gov (United States)

Abdel-Aal, Ahmed Kamel; Ezzeldin, Islam B; Moustafa, Amr Soliman; Ertel, Nathan; Oser, Rachel

2015-12-01

We report a case of an indwelling inferior vena cava filter that penetrated the IVC wall after Whipple's pancreatico-duodenectomy procedure performed in a patient with ampullary carcinoma, resulting in right ureteral injury and obstruction with subsequent hydroureter and hydronephrosis. This was incidentally discovered on a computed tomography scan performed as routine follow up to evaluate the results of the surgery. We retrieved the inferior vena cava filter and placed a nephrostomy catheter to relieve the ureteral obstruction. Our case highlights the importance of careful inferior vena cava manipulation during abdominal surgery in the presence of an inferior vena cava filter, and the option of temporary removal of the filter to be placed again after surgery in order to avoid this complication, unless protection is required against clot migration during the surgical procedure.

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

International Nuclear Information System (INIS)

Masuda, Fujio; Chen, Zuicho; Oishi, Yukihiko; Machida, Toyohei

1980-01-01

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

O conduto valvulado bovino contegra, um biomaterial para o tratamento cirúrgico de cardiopatias congênitas

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Shi-Min Yuan

Full Text Available O Contegra, um enxerto de veia jugular bovina, tem sido amplamente utilizado como biomaterial de preferência no tratamento cirúrgico das cardiopatias congênitas, especialmente como um conduto para a reconstrução da via de saída ventricular direita. Este artigo tem como objetivo fazer uma revisão abrangente sobre os desfechos clínicos do Contegra. Foram recuperados, coletados e analisados, relatos de Contegra publicados desde 2002. Havia 1.718 Contegra, aplicados em 1.705 pacientes. Os tamanhos dos condutos foram de 8-22 mm. As idades dos pacientes foram de recém-nascidos até 74,5 anos, com prevalência de pacientes pediátricos. O diagnóstico primário foi cardiopatia congênita em todos os casos, sendo os três diagnósticos principais: tetralogia de Fallot, tronco arterioso e atresia pulmonar, que representaram 25,6%, 16,7% e 13,1%, respectivamente. O Contegra foi utilizado como enxerto tubular na posição pulmonar em 1635 (95,9% pacientes, como remendo monocúspide em 12 (0,7%, como enxerto na posição da valva pulmonar ou monocúspide em 40 (2,3%, e, como conduto artéria pulmonar-veia cava inferior na operação de Fontan, em 18 (1,1% pacientes, respectivamente. O reimplante de conduto foi realizado em 141 (8,3% pacientes, 33,8 ± 37 (8,6-106,8 meses após a inserção do conduto inicial. A plástica do conduto foi necessária em seis (0,4% e a reintervenção em 83 (4,9% dos pacientes. As indicações do reimplante do conduto incluíram estenose importante da anastomose distal, pseudoaneurisma da anastomose proximal e regurgitação importante do conduto. Quanto ao bom desempenho, disponibilidade e longevidade, o Contegra é um biomaterial adequado para a reconstrução da via de saída ventricular direita e como remendo para reparo de comunicação interventricular, mas não é apto para a operação de Fontan.

Retrocaval ureter and anomalies of inferior vena cava

International Nuclear Information System (INIS)

Tsubogo, Yoshitaka; Hiraoka, Hisaki; Tonariya, Yoshito; Miyamae, Tatsuya; Fujioka, Mutsumi

1980-01-01

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

Drenagem anômala total das veias pulmonares, em sua forma infracardíaca: desafio diagnóstico Infracardiac total anomalous pulmonary venous drainage: a diagnostic challenge

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Célia M. C. Silva

2007-04-01

Full Text Available No período neonatal, a drenagem anômala total das veias pulmonares, em sua forma infracardíaca, pode ser erroneamente diagnosticada como desconforto respiratório decorrente de diferentes etiologias. No pré-operatório, a ecocardiografia bidimensional com Doppler orientado pelo mapeamento de fluxo em cores pode definir o local exato da drenagem e o padrão de retorno venoso pulmonar, permitindo, dessa forma, que a cirurgia cardíaca seja realizada imediatamente antes que ocorra qualquer dano clínico.Infracardiac total anomalous pulmonary venous drainage can be erroneously diagnosed as respiratory distress of several different etiologies during the neonatal period. A cross-sectional echocardiography study with Doppler color flow mapping can preoperatively determine the precise drainage site and pulmonary venous return pattern, thereby allowing cardiac surgery to be performed promptly, prior to any clinical deterioration.

Safety of a training program for ultrasound-guided internal jugular vein catheterization in critically ill patients Segurança de um programa de treinamento para punção de veia jugular interna guiada por ultrassom em pacientes críticos

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Felippe Leopoldo Dexheimer Neto

2011-08-01

Full Text Available OBJECTIVES: Evaluate the safety and effectiveness of a training program for performing ultrasound-guided internal jugular vein cannulation in critically ill patients. METHODS: Cohort prospective study, evaluating adult patients admitted in a teaching intensive care unit (ICU. Catheter placement was performed by an ICU medical resident. The patient's baseline characteristics, vessel's position and operator experience were the evaluated variables. The main outcomes were cannulation success rate and incidence of major complications. RESULTS: A total of 118 consecutive patients were enrolled between May 2008 and November 2009. The success rate of ultrasound guided catheter placement was 90% (106/118, 77% in the first attempt. Major complications occurred in 4% of the cases (n = 5 and were not associated with the analyzed variables. Inability to place the guide wire was the reason for 58% (7/12 of the failures. Operators with more than 15 previous ultrasound guided cannulations had an increased success rate (95% vs. 79%, p = 0.01 and increased failure was related to previous catheterization (26% vs. 7%, p = 0.02. CONCLUSION: Learning ultrasound guidance for IJV vein cannulation was safe and feasible in ICU patients. This process was not associated to complications and better results were achieved across the spectrum of operator experienceOBJETIVO: Avaliar a segurança e efetividade de um programa de treinamento para cateterização da veia jugular interna guiada por ultrassom em pacientes críticos. MÉTODOS: Estudo de coorte prospectivo, avaliando pacientes adultos internados em uma unidade de terapia intensiva com programa de ensino. Os médicos residentes do serviço realizaram as punções de veia jugular interna guiadas por ultrassom. Foram avaliadas as características de base dos pacientes, sintopia dos vasos e experiência dos operadores. Os desfechos primários foram a taxa de sucesso da cateterização e a incidência de complica

Blunt injury of the infrarenal inferior vena cava — imaging and ...

African Journals Online (AJOL)

Blunt injury of the infrarenal inferior vena cava — imaging and conservative management. Ian C Duncan, Basil J Sher, Leslie M Fingleson. Abstract. Isolated rupture of the infrarenal segment of the inferior vena cava due to blunt trauma is relatively rare. It may be missed clinically and even diagnostic peritoneal lavage may ...

Creation of the permanent inferior vena cava filter for prevention of pulmonary artery embolism

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Yа.O. Povar

2016-05-01

Full Text Available The aim of the study was to create a new permanent cava filter to improve functional capacities of the construction and achieve high clinical parameters. A new geometry of the permanent inferior vena cava filter was presented which has high blood clot-capturing ability, does not cause thrombus fragmentation, makes migration impossible. The inferior vena cava filter does not injure the vessel wall and preserves integrity under long-term use. The inferior vena cava filter installation is safe and controllable, the filter self-positioning and reposition are possible, the delivery system size is 6F, the blood flow changing is minimal.

Ultrasound and magnetic resonance imaging findings in Schistosomiasis mansoni: expanded gallbladder fossa and fatty hilum signs Achados da ultrassonografia e da ressonância magnética na esquistossomose mansônica: sinais da expansão da fossa da vesícula e do hilo gorduroso

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Luciana Cristina dos Santos Silva

2012-08-01

esquistossomose mansônica. Todos apresentavam US indicativa de fibrose hepática esquistossomótica, e foram avaliados com imagens por RM, realizadas com uma unidade magnética supercondutora de 1,5-T(Sigma. RESULTADOS: Quarenta e sete (87% entre 54 pacientes com sinais ultrassonográficosde fibrose periportal esquistossomótica tiveram este diagnóstico confirmado pela RM. Nos sete(13% casos discordantes, a RM revelou tecido adiposo preenchendo o espaço periportal hilaronde a US indicava espessamento isolado da parede da veia porta em seu ponto de entrada no fígado. Este achado foi nomeado sinal do hilo gorduroso. Um dos 47 pacientes com evidência de fibrose periportal RM era colecistectomizado. Trinta e quatro (76,1% dos 46 pacientes restantes apresentavam expansão da fossa da vesícula, que se encontrava preenchida portecido adiposo. Nos outros sete, a RM revelou sinais de fibrose pericolecística. CONCLUSÕES: Os espessamentos ecogênicos central da parede da veia porta, e da parede da vesícula biliar, até o momento, atribuídos à fibrose, foram frequentemente identificados como tecido adiposopela RM. Entretanto, o espessamento da parede da vesícula identificado pela US (expansão da fossa da vesícula na RM é provavelmente secundário a alterações morfológicas hepáticas na esquistossomose, e representa comprometimento grave do fígado.

Tromboflebite séptica da veia porta secundária à apendicite Septic thrombophlebitis of the portal vein as a complication of appendicitis

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Olival Cirilo Lucena da Fonseca-Neto

2007-06-01

Full Text Available INTRODUÇÃO: A tromboflebite séptica da veia porta ou pileflebite é evento raro e associado com alta mortalidade e seu diagnóstico requer a demonstração de trombo portal. RELATO DO CASO: Mulher de 19 anos com história de dor abdominal há 40 dias com piora há 10 foi admitida no hospital. Referia dor de forte intensidade em hipocôndrio direito, vômitos, febre, e calafrios. No exame físico de entrada tinha sinais e sintomas de sepse abdominal. Submetida à laparotomia exploradora foi encontrado abscesso hepático e apêndice ileiocecal rôto e bloqueado. Realizada apendicectomia e drenagem de abscesso, que evoluiu com necessidade de re-laparotomia no 6º dia e drenagem de novos abscessos hepáticos. Após longa internação, recebeu alta e no seguimento de 6 meses estava bem. CONCLUSÃO: A pileflebite é complicação rara, porém grave, devendo ser rapidamente diagnosticada e o seu manejo multidisciplinar instituído prontamente.BACKGROUND:Portal vein septic thrombophlebitis or pylephlebitis is a rare event associated with high mortality rates and its' diagnosis requires portal thrombosis demonstration. CASE REPORT: Nineteen year-old female was admitted to the hospital with a history of abdominal pain for the last 40 days, worsening for the last 10. The patient complained of intense and strong pain in the right hypochondrium, vomit, fever and cold chills. During physical examination the patient showed signs and symptoms of abdominal sepsis. She was then submitted to exploratory laparotomy, during which a hepatic abscess and blocked and ruptured ileocecal appendix was found. Appendicectomy and drainage of the abcess was performed, having the necessity of a second laparotomy in the sixth day and further drainage of new formatted hepatic abscesses. After a long period of admission, the patient was discharged and was well following the next six months. CONCLUSION: Pylephlebitis is a rare and severe complication, which has the urgency of

Análise morfológica da placenta da paca (Agouti paca, Linnaeus, 1766: Estudo ao microscópio de luz e à microscopia eletrônica de transmissão

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Marina Bonatelli

2001-01-01

Full Text Available Foram estudados os aspectos morfológicos de nove placentas de paca (Agouti paca, L., 1766 mediante análises em microscopia de luz e eletrônica de transmissão dos fragmentos teciduais correspondentes à porção de maior conexão placentária em diferentes fêmeas gestantes, nos estágios intermediário e final da prenhez. Realizamos este estudo, pois, aliada à necessidade da procura de novas espécies que atuem como modelos experimentais adequados, havia a disponibilidade deste roedor em nosso meio; por outro lado, o melhor conhecimento dos aspectos reprodutivos destes animais oferece subsídios ao estabelecimento de criatórios racionais desta espécie, uma vez que a preservação deste vertebrado é necessária, além do grande interesse comercial em torno de sua carne. Os resultados mostraram que este roedor possui uma placenta do tipo vitelina e outra do tipo corioalantoidiana, sendo este órgão do tipo hemocorial, labiríntico, que se apresenta histologicamente composto por lóbulos divididos em três regiões distintas: o centro do lóbulo, o labirinto e o interlóbulo. Na região do centro do lóbulo, verificou-se a presença de artérias e veias; e em sua região periférica estavam presentes dois sistemas tubulares arranjados de forma paralela, onde as lacunas sangüíneas e os capilares estavam em íntimo contato, formando a região do labirinto. O interlóbulo era composto de artérias e veias. O trofoblasto era o principal componente da placenta, que, independentemente da região onde se encontrava, mostrava-se de natureza sincicial. Ultra-estruturalmente a barreira placentária da paca foi classificada como hemomonocorial.

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

International Nuclear Information System (INIS)

Mendelson, D.S.; Mitty, H.; Janus, C.; Gendal, E.; Berson, B.

1987-01-01

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

Vena cava filter behavior and endovascular response : An experimental in vivo study

NARCIS (Netherlands)

Hoekstra, A; Hoogeveen, Y; Elstrodt, JM; Tiebosch, ATMG

2003-01-01

Purpose: To evaluate the behavior and endovascular response of a new nitinol permanent vena cava filter, the TrapEase. Methods: Percutaneous implantation of the filter was performed in six goats, with inferior vena cava (IVC) diameter close to that of man. Radiologic data concerning the IVC, filter

Prosthetic replacement of the infrahepatic inferior vena cava for leiomyosarcoma.

Science.gov (United States)

Illuminati, Giulio; Calio', Francesco G; D'Urso, Antonio; Giacobbi, Daniela; Papaspyropoulos, Vassilios; Ceccanei, Gianluca

2006-09-01

Resection of the infrahepatic inferior vena cava associated with prosthetic graft replacement for caval leiomyosarcoma is an acceptable procedure to obtain prolonged and good-quality survival. A consecutive sample clinical study with a mean follow-up of 40 months. The surgical department of an academic tertiary center and an affiliated secondary care center. Eleven patients, with a mean age of 51 years, who have primary leiomyosarcoma of the infrahepatic inferior vena cava. All of the patients underwent radical resection of the tumor en bloc with the affected segment of the vena cava. Reconstruction consisted of 10 cavocaval polytetrafluoroethylene grafts and 1 cavobiliac graft. An associated right nephrectomy was performed in 2 cases. The left renal vein was reimplanted in the graft in 3 cases. Cumulative disease-specific survival, disease-free survival, and graft patency rates expressed by standard life-table analysis. No patients died in the postoperative period. The cumulative (SE) disease-specific survival rate was 53% (21%) at 5 years. The cumulative (SE) disease-free survival rate was 44% (19%) at 5 years. The cumulative (SE) graft patency rate was 67% (22%) at 5 years. Radical resection followed by prosthetic graft reconstruction is a valuable method for treating primary leiomyosarcoma of the infrahepatic inferior vena cava.

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

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

2014-01-01

Caudal vena cava duplication has been rarely reported in small animals. The purpose of this retrospective study was to describe characteristics of duplicated caudal vena cava in a large group of dogs. Computed tomography (CT) and ultrasound databases from two hospitals were searched for canine reports having the diagnosis "double caudal vena cava." One observer reviewed CT images for 71 dogs and two observers reviewed ultrasound images for 21 dogs. In all CT cases, the duplication comprised two vessels that were bilaterally symmetrical and approximately the same calibre (similar to Type I complete duplication in humans). In all ultrasound cases, the duplicated caudal vena cava appeared as a distinct vessel running on the left side of the abdominal segment of the descending aorta and extending from the left common iliac vein to the left renal vein. The prevalence of caudal vena cava duplication was 0.46% for canine ultrasound studies and 2.08% for canine CT studies performed at these hospitals. Median body weight for affected dogs was significantly lower than that of unaffected dogs (P dogs, caudal vena cava duplication should be differentiated from other vascular anomalies when planning surgeries and for avoiding misdiagnoses. © 2014 American College of Veterinary Radiology.

Modeling Flow Past a Tilted Vena Cava Filter

Energy Technology Data Exchange (ETDEWEB)

Singer, M A; Wang, S L

2009-06-29

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

Pulmonary artery catheter complications: report on a case of a knot accident and literature review Complicações do cateter de artéria pulmonar: relato de caso de formação de nó verdadeiro revisão da literatura

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Marcelo Cruz Lopes

2004-01-01

Full Text Available A particular event concerning a Swan-Ganz catheter complication is reported. A 41-year-old woman was admitted at the emergency room of our hospital with massive gastrointestinal bleeding. A total gastrectomy was performed. During the postoperative period in the intensive care unit , the patient maintained hemodynamic instability. Invasive hemodynamic monitoring with a pulmonary artery catheter was then indicated. During the maneuvers to insert the catheter, a true knot formation was identified at the level of the superior vena cava. Several maneuvers by radiological endovascular invasive techniques allowed removal of the catheter. The authors describe the details of this procedure and provide comments regarding the various techniques that were employed in overcoming this event. A comprehensive review of evidence regarding the benefits and risks of pulmonary artery catheterization was performed. The consensus statement regarding the indications, utilization, and management of the pulmonary artery catheterization that were issued by a consensus conference held in 1996 are also discussed in detail.É relatada uma complicação infreqüente , associada ao uso do Cateter de Artéria Pulmonar. Uma paciente de 41 anos foi admitida no Pronto Socorro do nosso hospital com hemorragia digestiva alta grave. A doente foi submetida à gastrectomia total. Na Unidade de Terapia Intensiva, evoluiu com instabilidade hemodinâmica, sendo indicada a monitorização hemodinâmica invasiva com cateter de artéria pulmonar. Durante as manobras para o correto posicionamento do cateter na artéria pulmonar, foi diagnosticado formação de nó verdadeiro, ao nível da veia cava superior. Os autores discutem as várias opções técnicas empregadas para a resolução desta complicação, através do emprego da radiologia intervencionista endovascular. Extensa revisão da literatura procurando discutir os benefícios e riscos envolvidos na monitorização hemodin

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

DEFF Research Database (Denmark)

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

2005-01-01

Sarcoma of the inferior vena cava (IVC) is a rare clinical entity. Surgical treatment of IVC is associated with improved survival. This case report describes a 42-year-old woman with biopsy-proven leiomyosarcoma of the inferior vena cava with intracardial tumour growth. The primary tumour was only...

Evaluation of gradual occlusion of the caudal vena cava in clinically normal dogs.

Science.gov (United States)

Peacock, John T; Fossum, Theresa W; Bahr, Anne M; Miller, Matthew W; Edwards, John F

2003-11-01

To devise a technique for gradual occlusion of the caudal vena cava in dogs and determine effects of complete occlusion of the caudal vena cava. 8 mixed-breed hounds that weighed between 25 and 30 kg. Baseline evaluation of dogs included serum biochemical analyses and determination of glomerular filtration rate (GFR) with dynamic renal scintigraphy and plasma clearance analysis. An occluder was placed around the vena cava in the region cranial to the renal veins. The occluder was attached to a vascular access port. The vena cava was gradually occluded over 2 weeks. The GFR was measured every 2 weeks after surgery, and venograms were performed every 3 weeks after surgery. Blood samples were collected every 48 hours for the first week and then weekly thereafter to measure BUN and creatinine concentrations and activities of alanine transaminase, alkaline phosphatase, and creatinine kinase. Dogs were euthanatized 6 weeks after surgery, and tissues were submitted for histologic examination. The GFR and biochemical data were compared with baseline values. Gradual occlusion of the caudal vena cava was easily and consistently performed with this method, and adverse clinical signs were not detected. Formation of collateral vessels allowed overall GFR to remain constant despite a decrease in function of the left kidney. Measured biochemical values did not deviate from reference ranges. Gradual occlusion of the caudal vena cava may allow removal of adrenal gland tumors with vascular invasion that would otherwise be difficult or impossible to resect.

Widening of mediastinum with persistent left superior Vena cava - CT diagnosis

International Nuclear Information System (INIS)

Neuwirth, J.; Kolar, J.

1992-01-01

Described in this paper are radiographic findings recorded from a case of persistent left superior vena cava which grew manifest by widening of the left contour of the upper mediastinal region. Contrast-enhanced computed tomography (CT) was undertaken to clear up suspicion of mediastinal tumour and revealed double superior vena cava. The diagnosis was then confirmed by digital subtraction venography. (orig.) [de

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

Energy Technology Data Exchange (ETDEWEB)

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

2009-12-03

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

Liver trauma and transection of the inferior vena cava

International Nuclear Information System (INIS)

Radin, D.R.

1992-01-01

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

Injuries of the retrohepatic inferior vena cava and the liver

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Koprivica Radenko

2008-01-01

Full Text Available Beckground. Injuries of the retrohepatic inferior vena cava, and the liver have mortality rate up to 71-78%. We presented a patient with combined injury of the retrohepatic inferior vena cava, liver, craniocerebral and thoracic traumas, inflicted in a traffic accident. Case report. Man, 20 years old has been injured in a traffic accident. At admission, 20 minutes after the injury, the patient was comatose and hypotensive. Bloody content was obtained by abdominal tracer. The patient underwent emergent laparotomy, utilizing trifurcated incision and cell saver device. Abdominal exploration revealed two liters of free blood and massive retroperitoneal hematoma. Manual compression of the liver was done, as well as perihepatic packing, complete hepatic vascular exclusion and mobilization of the right liver lobe. Due to impressive chemodynamic instability supraceliac aortic clamping was performed. Upon exposure of the retrohepatic inferior vena cava and right liver lobe, multiple lacerations of retrohepatic inferior vena cava and right hepatic vein, and right hepatic vein avulsion were found. We also identified an injury of VII and VIII segments of the liver (grade V according to the Moore's classification. Nonexpansive hepatoduodenal ligament hematoma and the injury of II and III segments of the liver group II/III according to Moore were found. Venorrhaphy of the inferior vena cava was done in the area of circumference of the right hepatic vein, a portion of which served as autologous vein patch. Continuous prolene 3/0 venorrhaphy of the distal caval laceration was done. Total caval and aorta clamping time of the inferior vena cava was 41 minutes. Atypical resection, debridment, of hepatic segments was done by using a harmonic scalpel. Hepatoduodenal ligament was declamped after 65 minutes. Fibrin glue was applied on the resectioned area of liver. The patient received 3.2 l of autologuos blood transfusion with 5 units of packed red blood cells, 6

Deep Venous Thrombosis Associated With Inferior Vena Cava Abnormalities And Hypoplastic Kidney In Siblings

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Duicu Carmen

2016-06-01

Full Text Available Congenital inferior vena cava anomalies have a reduced frequency in general population, many times being an asymptomatic finding. Patients caring such anomalies are at risk to develop deep vein thrombosis. In this paper, we present 2 siblings with deep venous thrombosis and inferior vena cava abnormalities, with a symptomatic onset at similar age. The inferior vena cava abnormality was documented by an angio-CT in each case. The thrombophilic workup was negative. Patients were treated with conservative therapy: low molecular weight heparin anticoagulants converted later to oral anticoagulant with resolution of symptoms and disappearance of the thrombus. Finally, in the absence of any risk factor in a young patient admitted with deep vein thrombosis investigations to exclude inferior vena cava anomalies are mandatory.

Fibrose idiopática do mediastino: A propósito de um caso clínico

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Maria João Canotilho

2005-03-01

Full Text Available Resumo: Descreve-se o caso clínico de um doente do sexo masculino com uma massa mediastínica de crescimento lento. Após terem-se efectuado vários exames complementares, foi através de cirurgia que se confirmou o diagnóstico de fibrose idiopática do mediastino. A remoção parcial da massa permitiu uma estabilização transitória das suas dimensões. Cerca de quatro anos depois, verificou-se um crescimento marcado com repercurssões importantes, através da inevitável compressão de estruturas vitais, que conduziram a hipertensão pulmonar grave. A fibrose idiopática do mediastino é uma entidade extremamente rara, estando descritas associações a outras patologias, mais frequentemente às auto-imunes, mas apresenta sempre um curso fatal quando não é possível a cirurgia.Rev Port Pneumol 2005; XI (2: 155-163 Abstract: We herein report a case of a male patient, who presented a mediastinal mass that had a slow growth over the years. After surgery, that made the diagnosis of idiopathic mediastinal fibrosis, the growth stabilized. Four years latter it was observed a substantial increase which lead to the inevitable compression of vital structures which, in turn, led to pulmonary hypertension. Idiopathic mediastinal fibrosis is an extremely rare pathology. There are same cases in which it is associated with other pathologies but has always a fatal prognosis when surgery is not an option.Rev Port Pneumol 2005; XI (2: 155-163 Palavras-chave: Fibrose do mediastino, síndroma da veia cava superior, hipertensão pulmonar, mediastinite fibrosante, Key words: Mediastinal fibrosis, superior vena cava syndrome, pulmonary hypertension, fibrosis mediastinites

Heart block and cardiac embolization of fractured inferior vena cava filter.

Science.gov (United States)

Abudayyeh, Islam; Takruri, Yessar; Weiner, Justin B

2016-01-01

A 66-year-old man underwent a placement of an inferior vena cava filter before a gastric surgery 9 years prior, presented to the emergency room with a complete atrioventricular block. Chest x-ray and transthoracic echocardiogram showed struts migrating to right ventricle with tricuspid regurgitation. Cardiothoracic surgery was consulted and declined an open surgical intervention due to the location of the embolized fragments and the patient's overall condition. It was also felt that the fragments had migrated chronically and were adhered to the cardiac structures. The patient underwent a dual-chamber permanent pacemaker implantation. Post-implant fluoroscopy showed no displacement of the inferior vena cava filter struts due to the pacemaker leads indicating that the filter fracture had likely been a chronic process. This case highlights a rare combination of complications related to inferior vena cava filter fractures and the importance of assessing for such fractures in chronic placements. Inferior vena cava filter placement for a duration greater than 1 month can be associated with filter fractures and strut migration which may lead to, although rare, serious or fatal complications such as complete atrioventricular conduction system disruption and valvular damage including significant tricuspid regurgitation. Assessing for inferior vena cava filter fractures in chronic filter placement is important to avoid such complications. When possible, retrieval of the filter should be considered in all patients outside the acute setting in order to avoid filter-related complications. Filter retrieval rates remain low even when a retrievable filter is in place and the patient no longer has a contraindication to anticoagulation.

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

International Nuclear Information System (INIS)

Qin Dingwen; Shi Haibin; Liu Sheng; Li Linsun

2008-01-01

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

In vivo evaluation of a new vena cava filter

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Gilberto do Nascimento Galego

2016-01-01

Full Text Available Abstract Background Pulmonary embolism is an important cause of cardiovascular death. Inferior vena cava filters have been shown to be effective for prevention of this condition. Objectives To determine the safety, performance and efficacy of a new inferior vena cava filter in an ovine model. Methods BKone1 filters are self-centering with over-the-wire deployment, have three filtering regions and are made from nickel-titanium alloy. Eight of these filters were implanted in 8 sheep. The sheep were divided into 4 groups of two animals (A and B and the number of clots injected differed by group. Two clots were injected in group 2, four in group 3, eight in group 4 and zero clots in group 1. A animals underwent euthanasia soon after the procedure and B animals were observed for 30 days and then euthanized after a control cavography. All inferior vena cavas were processed for histological examination. Clots were prepared in a metal mold, sectioned and then radiopaque markers were inserted. Clot capture was analyzed by identifying the radiopaque marker on fluoroscopy. Results No clot migration was observed during follow-up. Control cavographies showed patent inferior vena cavas. Pathological examination indicated little inflammatory tissue response. All clots were captured in the condition with 2 clots, only one clot was missed in the group injected with 4 clots and in the condition of 8 clots, they were partly captured. Conclusions The filters were deployed safely. There was a reduction in efficacy as the number of blood clots increased.

Diagnosis of tricuspid insufficiency by Doppler flowmetry in the inferior vena cava

International Nuclear Information System (INIS)

Smith, H.J.

1986-01-01

Eighty-five patients subjected to routine heart catheterization were examined with duplex scanning of the inferior vena cava. Adequate Doppler recordings and a right ventricular angiography were obtained in 79 of them. Tricuspid insufficiency was found to be present in 34 patients at angiography and in 24 at duplex examination. No false positive Doppler diagnoses of tricuspid insufficiency occurred. The possibility of false positive angiographic diagnoses is discussed. A high correlation was found between percentage reversed flow in the inferior vena cava during ventricular systole and degree of angiographic tricuspid insufficiency. It is concluded that duplex scanning of the inferior vena cava seems to be a good alternative to angiography in the diagnosis and quantification of tricuspid insufficiency. (orig.)

Modelo experimental estável de aneurisma sacular em artéria carótida de suínos utilizando veia jugular interna Stable experimental model of carotid artery saccular aneurysm in swine using the internal jugular vein

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Severino Lourenço da Silva Júnior

2013-04-01

Full Text Available OBJETIVO: Desenvolver um modelo experimental estável de aneurisma sacular em carótida de suínos utilizando veia jugular interna. MÉTODOS: Em 12 suínos sadios, com peso variando entre 25 e 50kg, cinco machos e sete fêmeas, foi confeccionado aneurisma na artéria carótida comum direita. Após arteriotomia elíptica, foi realizada anastomose terminolateral com coto distal de veia jugular interna. O volume do aneurisma era calculado de maneira que o valor não excedesse em 27 vezes o valor da área da arteriotomia. Após seis dias, era realizada angiografia e análise microscópica do aneurisma para avaliar perviedade e trombose parcial ou total. RESULTADOS: Houve ganho de peso significante dos suínos no intervalo de tempo entre a confecção do aneurisma e a angiografia (p = 0,04. Foi observada perviedade aneurismática em dez suínos (83%. Ocorreram infecções de feridas operatórias em dois animais (16,6%, ambas com início de aparecimento em três dias após a confecção do aneurisma. Análise histológica dos aneurismas mostrou trombos ocluindo parcialmente a luz em nove suínos (75%. Nesses animais, observou-se que, em média, 9% da luz aneurismática estava preenchida por trombos. CONCLUSÃO: Pôde ser desenvolvido um modelo experimental estável de aneurisma sacular em carótida de suínos utilizando veia jugular interna.OBJECTIVE: To develop an experimental model of stable saccular aneurysm in carotid of pigs using the internal jugular vein. METHODS: In 12 healthy pigs, weighing between 25 and 50kg, five males and seven females, we made a right common carotid artery aneurysm. After elliptical arteriotomy, we carried out a terminolateral anastomosis with the distal stump of the internal jugular vein. Aneurysm volume was calculated so that the value did not exceed 27 times the area of the arteriotomy. After six days angiography and microscopic examination were performed to assess patency of the aneurysm and the presence of total or

Cardiac influence on mechanical ventilation time and mortality in exacerbated chronic respiratory failure patients. The role of echocardiographic parameters

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Paulo Marcelino

2006-03-01

étodos: Estudados 59 doentes com idade média de 74,7 +/- 9,7 anos, tempo médio de ventilação de 10,8 +/- 12,6 dias, APACHE II médio de 23 +/- 8,3. Avaliaram-se parâmetros ecocardiográficos (dimensões das cavidades, débito cardíaco, estudo Doppler do fluxo transvalvular mitral, estudo da veia cava inferior e electrocardiográficos (presença de ritmo sinusal ou fibrilhação auricular nas primeiras 24 horas de internamento na Unidade e parâmetros gasimétricos à saída. Resultados: Um tempo de ventilação mais prolongado associou-se à presença de fibrilhação auricular (p = 0,027, à presença conjunta de fibrilhação auricular e uma veia cava inferior dilatada (> 20 mm p = 0,004 e com níveis séricos de bicarbonato > 35mEq/l na gasimetria obtida à saída (p = 0,04. Verificaram-se 12 óbitos. A mortalidade associou-se à presença de dilatação do ventrículo direito (p = 0,03 e a uma relação entre o ventrículo direito e o esquerdo > 0,6 (p = 0,04. Conclusão: Nos doentes submetidos a ventilação mecânica por exacerbação de insuficiência respiratória crónica, a presença de fibrilhação auricular indica a possibilidade de um período de ventilação mais prolongado, em especial se houver concomitantemente uma veia cava inferior com diâmetro > 20mm. Nestes doentes, a presença de dilatação das cavidades direitas pode indicar uma probabilidade mais elevada de mortalidade. Key-words: Mechanical ventilation, chronic respiratory failure, echocardiography, Palavras-chave: Insuficiência respiratória crónica, ventilação mecânica, ecocardiografia

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

International Nuclear Information System (INIS)

Karmazyn, Boaz; Horev, Gadi; Kornreich, Liora; Dagan, Ovdi; Vidne, Bernado A.

2002-01-01

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

Tratamento da recidiva hemorrágica por varizes do esôfago em doentes esquistossomóticos operados Treatment of recurrent hemorrhage esophageal varices in schistosomotic patients after surgery

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José Cesar Assef

2003-01-01

Full Text Available OBJETIVO: Padronizar o tratamento da recidiva hemorrágica por varizes do esôfago em esquistossomóticos, após operações não-derivativas. MÉTODOS: Tratamos 45 doentes esquistossomóticos que apresentaram recidiva hemorrágica por varizes do esôfago. Realizamos ultra-sonografia abdominal, e, estudos angiográficos constituindo-se dois grupos: Grupo A - Dezenove doentes (42,2% com ausência do baço, artéria esplênica ocluída e artéria e veia gástricas esquerdas pérvias, caracterizando a esplenectomia na operação anterior. Grupo B - Vinte e seis doentes (57,8% com imagem esplênica ausente, artérias esplênica e gástrica esquerda ocluídas e veia gástrica esquerda não-opacificada, evidenciando esplenectomia e alguma forma de desvascularização gastroesofágica praticadas anteriormente. Os doentes do Grupo A foram reoperados para executar a desvascularização gastroesofágica e os do Grupo B, submetidos a programa de escleroterapia endoscópica. RESULTADOS: No Grupo A, um paciente (5,3% apresentou recidiva hemorrágica no pós-operatório tardio. Na avaliação endoscópica final, as varizes esofágicas diminuíram, em número ou calibre, em 14 doentes (73,7%, desapareceram em três (15,8% e em dois (10,5%, permaneceram inalteradas. No Grupo B, seis pacientes (23,1% apresentaram recidiva do sangramento, controlada em quatro deles e em dois, que persistiram com sangramento praticou-se a derivação mesentérico-cava e ambos morreram. Na última avaliação endoscópica, as varizes esofágicas desapareceram em 17 doentes (65,4%, reduziram o número ou calibre em sete (26,9% e, em dois (7,7%, permaneceram inalteradas. CONCLUSÕES: 1 A desvacularização gastroesofágica é adequada para os doentes esplenectomizados, com a artéria e a veia gástricas esquerdas pérvias. 2 Um programa de longa duração de escleroterapia endoscópica das varizes do esôfago pode ser uma opção para os doentes esplenectomizados, com a artéria g

Síndrome de quebra-nozes (nutcracker em uma mulher jovem em investigação por quadro de hematúria recorrente: um relato de caso

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Gustavo Lenci Marques

2012-06-01

Full Text Available INTRODUÇÃO: A síndrome de quebra-nozes (SQN é uma condição na qual há compressão da veia renal esquerda pela aorta e a artéria mesentérica superior, associada a uma sintomatologia característica, porém pouco específica. RELATO DO CASO: Trata-se de uma paciente de 37 anos, apresentando hematúria macroscópica intermitente sem etiologia estabelecida até então. Durante a investigação, uma angiotomografia evidenciou compressão da veia renal esquerda no seu trajeto entre a artéria mesentérica superior e aorta abdominal, associada a importante dilatação de veia ovariana esquerda. DISCUSSÃO: A síndrome desencadeada pela compressão da veia renal esquerda pela aorta e artéria mesentérica superior apresenta prevalência provavelmente aumentada no sexo feminino e postula-se que seja associada a situações particulares, como a nefroptose e a escassez de gordura retroperitoneal. Hematúria, sinal típico, teria como causa a ruptura do fino septo que separa as veias do sistema coletor urinário. Vários exames de imagem podem auxiliar no diagnóstico. O tipo de tratamento que deve ser adotado ainda é controverso, existindo diversas opções cirúrgicas, como o uso de stent intravascular e a conduta conservadora. De diagnóstico costumeiramente tardio, essa síndrome deve ser incluída na investigação de pacientes com quadro de hematúria a esclarecer.

Portable Electronic Tongue Based on Microsensors for the Analysis of Cava Wines.

Science.gov (United States)

Giménez-Gómez, Pablo; Escudé-Pujol, Roger; Capdevila, Fina; Puig-Pujol, Anna; Jiménez-Jorquera, Cecilia; Gutiérrez-Capitán, Manuel

2016-10-27

Cava is a quality sparkling wine produced in Spain. As a product with a designation of origin, Cava wine has to meet certain quality requirements throughout its production process; therefore, the analysis of several parameters is of great interest. In this work, a portable electronic tongue for the analysis of Cava wine is described. The system is comprised of compact and low-power-consumption electronic equipment and an array of microsensors formed by six ion-selective field effect transistors sensitive to pH, Na⁺, K⁺, Ca 2+ , Cl - , and CO₃ 2- , one conductivity sensor, one redox potential sensor, and two amperometric gold microelectrodes. This system, combined with chemometric tools, has been applied to the analysis of 78 Cava wine samples. Results demonstrate that the electronic tongue is able to classify the samples according to the aging time, with a percentage of correct prediction between 80% and 96%, by using linear discriminant analysis, as well as to quantify the total acidity, pH, volumetric alcoholic degree, potassium, conductivity, glycerol, and methanol parameters, with mean relative errors between 2.3% and 6.0%, by using partial least squares regressions.

Portable Electronic Tongue Based on Microsensors for the Analysis of Cava Wines

Directory of Open Access Journals (Sweden)

Pablo Giménez-Gómez

2016-10-01

Full Text Available Cava is a quality sparkling wine produced in Spain. As a product with a designation of origin, Cava wine has to meet certain quality requirements throughout its production process; therefore, the analysis of several parameters is of great interest. In this work, a portable electronic tongue for the analysis of Cava wine is described. The system is comprised of compact and low-power-consumption electronic equipment and an array of microsensors formed by six ion-selective field effect transistors sensitive to pH, Na+, K+, Ca2+, Cl−, and CO32−, one conductivity sensor, one redox potential sensor, and two amperometric gold microelectrodes. This system, combined with chemometric tools, has been applied to the analysis of 78 Cava wine samples. Results demonstrate that the electronic tongue is able to classify the samples according to the aging time, with a percentage of correct prediction between 80% and 96%, by using linear discriminant analysis, as well as to quantify the total acidity, pH, volumetric alcoholic degree, potassium, conductivity, glycerol, and methanol parameters, with mean relative errors between 2.3% and 6.0%, by using partial least squares regressions.

Aspectos morfológicos da placenta da preguiça, Bradypus variegatus Shinz, 1825

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Marleyne José Afonso Accyoli Lins Amorin

2003-01-01

Full Text Available Estudaram-se os aspectos morfológicos da placenta e das membranas fetais de 03 placentas de bichos-preguiça (Bradypus variegatus, adultas e prenhes, originárias da Zona da Mata do Estado de Pernambuco. Essas estruturas foram obtidas de 03 fêmeas doadas pela Universidade Federal de Pernambuco, das quais duas encontravam-se congeladas e a terceira foi colhida mediante realização de cirurgia cesariana, onde mãe e feto foram preservados. Depois de descongeladas, as placentas foram fixadas em solução aquosa de formol 10,00%. Da placenta obtida da cesariana colheram-se pequenos fragmentos da região placentária e do funículo umbilical, os quais foram fixados em paraformoldeido 4,00%, tampão fosfato pH 7,4. Os fragmentos passaram pela rotina histológica, onde foram coradas em Hematoxilina e Eosina e Tricrômio de Masson. A placenta da preguiça é corioamniótica, com o cório viloso constituindo os lobos placentários, que se localizam na região fúndica do útero, e o cório liso relacionando-se com a face interna do útero. Nas placentas de final de prenhez os lobos aglomeram-se e fundem-se aumentando de tamanho, formando uma massa principal discóide, caracterizando uma placenta zonária discoidal, que se une ao feto pelo funículo umbilical, constituído por duas artérias e uma veia umbilical. Os resultados histológicos demonstraram que a placenta desses animais é labiríntica e endoteliocorial. Assim, a placenta da preguiça pode ser classificada como labiríntica, endoteliocorial, múltipla, discóide (a termo e corioamniótica.

Segmental variants of the inferior vena cava - typical findings correlated with embryological development for differential diagnosis; Segmentale Varianten der Vena cava inferior - Erscheinungsbild mit embryologischer Korrelation in Abgrenzung zum sekundaeren Vena-cava-Verschluss

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Meyer, D.R. [Abt. fuer Radiologie, Guestrower Krankenhaus, Akademisches Lehrkrankenhaus der Univ. Rostock (Germany); Inst. fuer Radiologie und Nuklearmedizin, Krankenhaus am Urban, Akademisches Lehrkrankenhaus der Freien Univ. Berlin (Germany); Huggle, H.; Hueppe, T.; Friedrich, M. [Inst. fuer Radiologie und Nuklearmedizin, Krankenhaus am Urban, Akademisches Lehrkrankenhaus der Freien Univ. Berlin (Germany); Andresen, R. [Abt. fuer Radiologie, Guestrower Krankenhaus, Akademisches Lehrkrankenhaus der Univ. Rostock (Germany)

2001-07-01

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.) [German] Die grosse Variabilitaet der als insgesamt selten anzusehenden angeborenen Venenanomalien der Vena cava inferior werden meist zufaellig durch verschiedene bildgebende Untersuchungsverfahren entdeckt. Diese koennen nicht als Pathologien des venoesen Systems klassifiziert werden und sollten nicht mit Lymphomen oder sekundaeren venoesen Kollateralen verwechselt werden. Basierend auf 656 CT-Untersuchungen fanden sich insgesamt 10,5% an bekannten Vena cava inferior (VCI) Anomalien. Unter Beruecksichtigung der embryologischen Entwicklung konnten drei Hauptgruppen an VCI-Varianten nosologisch differenziert werden: Agenesie der suprarenalen VCI, Anomalien der Pars renalis und Anomalien der infrarenalen VCI. Zusaetzlich fanden sich drei ungewoehnliche Anomaliekomplexe. Fuer das Verstaendnis der VCI-Varianten wird eine schematisierte Embryologie praesentiert. (orig.)

Perfil hematimétrico e identificação da hemoglobina do bicho preguiça Bradypus variegatus

OpenAIRE

Ferrari Ramos, Francimar

2006-01-01

O objetivo deste estudo foi, em preguiças Bradypus variegatus, estabelecer o perfil hematimétrico e identificar os tipos de hemoglobina (Hb), além de avaliar se existe influência do sexo sobre estes parâmetros. Estudou-se 10 preguiças (6 machos e 4 fêmeas), não anestesiadas, mantidas em cativeiro, pesando (X±DP) 3,6±0,79kg e com temperatura retal média de 30±1oC. Coleta de sangue, através de punção da veia cefálica medial do membro anterior, foi obtida para realização da hematimetria, do esfr...

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

Science.gov (United States)

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

2012-03-01

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

Ecklonia cava Extract and Dieckol Attenuate Cellular Lipid Peroxidation in Keratinocytes Exposed to PM10.

Science.gov (United States)

Lee, Jeong-Won; Seok, Jin Kyung; Boo, Yong Chool

2018-01-01

Airborne particulate matter can cause oxidative stress, inflammation, and premature skin aging. Marine plants such as Ecklonia cava Kjellman contain high amounts of polyphenolic antioxidants. The purpose of this study was to examine the antioxidative effects of E. cava extract in cultured keratinocytes exposed to airborne particulate matter with a diameter of <10  μ m (PM10). After the exposure of cultured HaCaT keratinocytes to PM10 in the absence and presence of E. cava extract and its constituents, cell viability and cellular lipid peroxidation were assessed. The effects of eckol and dieckol on cellular lipid peroxidation and cytokine expression were examined in human epidermal keratinocytes exposed to PM10. The total phenolic content of E. cava extract was the highest among the 50 marine plant extracts examined. The exposure of HaCaT cells to PM10 decreased cell viability and increased lipid peroxidation. The PM10-induced cellular lipid peroxidation was attenuated by E. cava extract and its ethyl acetate fraction. Dieckol more effectively attenuated cellular lipid peroxidation than eckol in both HaCaT cells and human epidermal keratinocytes. Dieckol and eckol attenuated the expression of inflammatory cytokines such as tumor necrosis factor- (TNF-) α , interleukin- (IL-) 1 β , IL-6, and IL-8 in human epidermal keratinocytes stimulated with PM10. This study suggested that the polyphenolic constituents of E. cava , such as dieckol, attenuated the oxidative and inflammatory reactions in skin cells exposed to airborne particulate matter.

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

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Catherine Yang

2013-07-01

Full Text Available 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.

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

International Nuclear Information System (INIS)

Yang, Catherine; Trad, Clovis Simao; Trad, Henrique Simao

2013-01-01

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)

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

Energy Technology Data Exchange (ETDEWEB)

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

2013-06-15

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

Interrupted inferior vena cava with hemiazygos continuation in an adult with a persistent left superior vena cava and left single coronary artery: A case report

Energy Technology Data Exchange (ETDEWEB)

Kim, Yeo Jin; Kwon, Se Hwan; Ahn, Sung Eun; Kim, Soo Joong; Oh, Joo Hyeong [College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Shin, Jong Soo [Dept. of Radiology, Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of)

2016-06-15

A 50-year-old woman was referred to our institution for medical screening due to an incidental finding on abdominal ultrasonography. She underwent chest, abdomen and cardiac multi-detector computed tomography (MDCT). Her MDCT revealed absence of the hepatic segment of the inferior vena cava (IVC), with hemiazygos continuation and a left single coronary artery. The dilated hemiazygos vein drained directly into the persistent left superior vena cava (SVC). Herein, we reported a very rare case combining an incidentally found interrupted IVC with hemiazygos vein continuation, persistent left SVC and a left single coronary artery diagnosed by MDCT.

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

International Nuclear Information System (INIS)

Nevruz, O.; Ural, U.; Kirici, Y.; Kilic, C.; Bozlar, U.

2007-01-01

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

Tratamento cirúrgico da hipertensão portal esquistossomótica no hc/ufpe: análise de 131 casos

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Álvaro Antônio Bandeira Ferraz

Full Text Available OBJETIVO: A hipertensão portal esquistossomótica com antecedente de hemorragia digestiva foi tratada com esplenectomia + ligadura da veia gástrica esquerda (LVGE + desvascularização da grande curvatura do estômago + esclerose endoscópica pós-operatória. Quando da existência de varizes de fundo gástrico, realizamos a abertura do fundo gástrico e sutura obliterante destas varizes. O objetivo deste trabalho foi avaliar a recidiva de hemorragia digestiva, repercussões laboratoriais e mortalidade do tratamento cirúrgico/endoscópico. MÉTODOS: Entre 1992 e 1998, foram operados no HC-UFPE 131 pacientes. O seguimento médio foi de 30 meses, em 111 pacientes, que foram solicitados a retornar ao ambulatório do HC-UFPE para a realização de controle clínico e laboratorial. RESULTADOS: A recidiva hemorrágica foi de 14,4% (16/111 e uma mortalidade de 5,4% (6/111. A recidiva de hemorragia digestiva alta foi exteriorizada através de hematemese em oito pacientes e oito por melena. Dos seis pacientes que foram a óbito, três apresentavam diagnóstico de linfoma, hepatocarcinoma e infarto agudo do miocárdio, respectivamente. Dois pacientes foram a óbito no pós-operatório imediato (sepse e coagulação intravascular disseminada. O sexto paciente foi a óbito por recidiva da hemorragia digestiva alta. Em nove pacientes, 13,2%, foi diagnosticada trombose da veia porta. Os dados laboratoriais, hematológicos e de função hepática também foram analisados. CONCLUSÕES: Os autores concluíram que o tratamento cirúrgico da hipertensão portal esquistossomótica, através da esplenectomia + LVGE + desvascularização da grande curvatura do estômago + esclerose endoscópica pós-operatória determina resultados compatíveis com a literatura em relação à recidiva de sangramento, mas preserva a funcionalidade hepática.

Computed tomographic diagnosis of calcified inferior vena cava thrombus in a child with Wilm's tumor

Energy Technology Data Exchange (ETDEWEB)

Kirks, D R; Ponzi, J W; Korobkin, M

1980-01-01

A calcified thrombus in the inferior vena cava of infants and children may be imaged by computed tomography. The precise location of the calcification within the inferior vena cava may be confirmed by computed tomographic scanning during injection of intravenous contrast material.

Detection by means of CT of inferior vena cava filters

International Nuclear Information System (INIS)

Zurera Tendero, L.J.; Canis Lopez, M.; Oteros Fernandez, R.; Ramos Gomez, M.; Garcia Revillo, J.; Roman Rios, G.

1995-01-01

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

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

International Nuclear Information System (INIS)

Wu Dayong; Zhang Wenyan; Bian Yanzhu; Hu Yujing

2013-01-01

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

Regeneração do fígado de ratos após oclusão parcial da drenagem venosa hepática Hepatic regeneration after parcial oclusion of hepatic vein drainage in rats

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Luiz Roberto Farion de Aguiar

2009-06-01

Full Text Available INTRODUÇÃO: A regeneração hepática é um mecanismo para superar a perda de tecido funcional do fígado. Este processo é estudado através de diferentes métodos. OBJETIVO: Avaliar o efeito da oclusão parcial da drenagem venosa hepática sobre a regeneração do fígado remanescente de ratos submetidos à hepatectomia parcial. MÉTODO: Foram colhidas biópsias de fígado em 30 ratos Wistar machos, e a seguir realizada hepatectomia a dois terços. Os animais foram divididos em três grupos: um grupo controle e dois grupos de estudo, submetidos a diferentes graus de estenose da veia hepática direita. Após 96 horas do estímulo para regeneração hepática, todos submeteram-se à outra biópsia hepática. Analisaram-se os fragmentos por imunoistoquímica para os marcadores Ki-67 e fator de von Willebrand. Para a leitura das amostras utilizou-se o sistema SAMBA 4000. A deposição de colágeno foi avaliada pela coloração tricrômico de Masson. RESULTADOS: A proliferação celular dos animais submetidos à hepatectomia parcial e estenose moderada ou severa da veia hepática direita persistiu mais elevada quando comparada ao grupo controle. O Índice de Marcação para o Ki-67 foi significativamente mais elevado após a hepatectomia nos grupos submetidos à oclusão parcial da veia hepática, tanto moderada quanto severa. A expressão de fator de von Willebrand estava diminuída após a hepatectomia parcial nos três grupos. Houve pouco depósito de colágeno no tecido hepático nos animais dos dois grupos com estenose da veia hepática direita. CONCLUSÃO: A oclusão parcial da drenagem venosa hepática em ratos submetidos à hepatectomia parcial prolonga o tempo de proliferação de células hepáticas quando comparado aos animais com veias de calibre normal. Como consequência, também houve atraso na restauração da matriz extracelular e na formação de novos vasos sinusoidais.BACKGROUND: Hepatic regeneration is a mechanism to overcome

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

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Jae Goo Kim

2014-06-01

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

Vena cava filters and thrombolytic therapeutic monitoring based on functional near-infrared spectroscopy for deep vein thrombosis

Science.gov (United States)

Pan, Boan; Liu, Weichao; Fang, Xiang; Zhao, Ke; Li, Ting

2018-02-01

Deep vein thrombosis (DVT), happening in inpatients usually and especially with the postoperative population, is a serious disease characterized by an increased incidence. The venography is the golden standard to diagnose DVT. However, it involves invasive contrast agent injection and give patients physical and mental pressure. Functional nearinfrared spectroscopy (fNIRS) has been reported recently to diagnose DVT. Thrombolytic therapy activates the dissolution system with an exogenous activator that dissolves coronary thrombosis. The vena cava filter is a medical filter used for the treatment of thrombosis and the prevention of pulmonary embolism. Here we attempt to use portable NIRS for the DVT monitoring in the whole process of vena cava filter implantation and thrombolytic treatment, and contrast the patients of untreated, vena cava filter implantation and thrombolytic treatment. 19 DVT patients and 12 normal subjects were recruited. Thereinto, 7 patients have taken vena cava filter implantation, and 6 patients have taken the thrombolytic treatment. It was found that deoxyhemoglobins (Δ[Hb]) fluctuates and even increases in DVT. After vena cava filter implantation, Δ[Hb] increases first, then decreases. However, it emerges the rising trend and converge to the curves of normal subjects in thrombolytic treatment. The oxyhemoglobins (Δ[HbO2]) emerges opposite trend in most paradigms. The findings reveal the potential of fNIRS for monitoring DVT and therapeutic effect evaluation of thrombolysis and vena cava filters.

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

International Nuclear Information System (INIS)

Tian Yulong; Zhang Xitong; Hong Duo

2011-01-01

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

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

International Nuclear Information System (INIS)

Hu Baoshan; Li Yong; Luo Pengfei

2005-01-01

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)

Alterações morfológicas da glândula supra-renal na síndrome da imunodeficiência adquirida

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Duch Francisco Moretti

1998-01-01

Full Text Available Na síndrome da imunodeficiência adquirida (AIDS pode-se verificar o acometimento da supra-renal por efeito citopático direto pelo HIV, por infecções oportunistas ou neoplasias. Estes achados poderiam variar de acordo com a procedência do paciente, devido às doenças peculiares à região. Neste trabalho avaliou-se o comprometimento da supra-renal em quatorze pacientes que morreram de AIDS no Hospital Escola, em Uberaba. Treze eram do sexo masculino e treze brancos. A idade foi de 29,9 ± 7,8 anos e o índice de massa corporal foi de 19 ± 4,1kg/m2. Os fragmentos de supra-renal obtidos nas necropsias foram analisados em microscópio de luz. Encontramos inflamação em 100% dos casos, identificando-se o agente etiológico em oito (58,1% casos. O Citomegalovírus foi identificado em sete casos, o Cryptococcus sp e o Herpes simplex em dois e o Histoplasma sp em um caso, estes achados são semelhantes aos da literatura. Em um caso, encontramos calcificação do parênquima e em outro, flebite da veia central. Em alguns casos que apresentavam lesão não foi possível identificar o agente etiológico, talvez em decorrência do efeito citopático direto pelo HIV ou devido a toxicidade das drogas utilizadas no tratamento da AIDS e das infecções oportunistas.

Investigação da trombose venosa na gravidez Deep vein thrombosis during pregnancy work up

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Jorge Agle Kalil

2008-03-01

Full Text Available CONTEXTO: A trombose venosa profunda (TVP na gravidez é fator determinante no aumento da morbidade e da mortalidade maternofetal. Pode ocorrer na presença de trombofilias, por compressão da veia cava inferior, estase venosa ou alterações hormonais. OBJETIVOS: Analisar pacientes grávidas e no pós-parto imediato portadoras de TVP em membros inferiores, pesquisar as possíveis causas de trombofilia e realizar revisão de literatura. MÉTODOS: Foram analisadas gestantes e puérperas encaminhadas por ginecologistas e obstetras com quadro clínico suspeito de TVP, de janeiro de 2004 a novembro de 2006, período em que foram realizados 24.437 partos no Hospital e Maternidade São Luiz (HMSL, sendo 89% cesarianas, 7,5% partos normais e 3,5% fórceps. Do total de pacientes encaminhadas com quadro clínico sugestivo, foram realizados 42 diagnósticos clínicos de TVP em gestantes com idade entre 21 e 39 anos, confirmados por duplex scan venoso. Imediatamente antes da introdução da terapia anticoagulante, foram colhidos exames para pesquisa de trombofilia, os quais foram repetidos após o período de tratamento. RESULTADOS: Das 42 pacientes portadoras de TVP, 32 eram primigestas (três gemelares sem alterações trombofílicas, duas por fecundação in vitro, oito secundigestas e duas tercigestas. Em quatro pacientes, a TVP ocorreu no primeiro trimestre da gestação (9,5%; em 11, no segundo trimestre (26,2%; em 27, no terceiro trimestre (64,3%. Dos 42 casos de diagnóstico de TVP, 18 (42,8% ocorreram nas veias infrapatelares. Houve um caso de tromboembolismo pulmonar (TEP em paciente de 37 anos que havia realizado fecundação in vitro, com gestação gemelar, e TVP (ausência de trombofilia diagnosticada após a cesariana. Das 42 pacientes, 16 (38,1% tiveram a causa da TVP estabelecida, com prevalência de mutação heterozigótica do fator V de Leiden (FVL em seis pacientes (14,2%, seguida pela síndrome antifosfolípide e outras. A maioria das

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

Science.gov (United States)

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

2014-01-01

Collateral venous pathways develop in dogs with obstruction or increased blood flow resistance at any level of the caudal vena cava in order to maintain venous drainage to the right atrium. The purpose of this retrospective study was to describe the sites, causes of obstruction, and configurations of venous collateral pathways for a group of dogs with caudal vena cava obstruction. Computed tomography databases from two veterinary hospitals were searched for dogs with a diagnosis of caudal vena cava obstruction and multidetector row computed tomographic angiographic (CTA) scans that included the entire caudal vena cava. Images for each included dog were retrieved and collateral venous pathways were characterized using image postprocessing and a classification system previously reported for humans. A total of nine dogs met inclusion criteria and four major collateral venous pathways were identified: deep (n = 2), portal (n = 2), intermediate (n = 7), and superficial (n = 5). More than one collateral venous pathway was present in 5 dogs. An alternative pathway consisting of renal subcapsular collateral veins, arising mainly from the caudal pole of both kidneys, was found in three dogs. In conclusion, findings indicated that collateral venous pathway patterns similar to those described in humans are also present in dogs with caudal vena cava obstruction. These collateral pathways need to be distinguished from other vascular anomalies in dogs. Postprocessing of multidetector-row CTA images allowed delineation of the course of these complicated venous pathways and may be a helpful adjunct for treatment planning in future cases. © 2014 American College of Veterinary Radiology.

Vessel wall reaction after vena cava filter placement

NARCIS (Netherlands)

Hoekstra, A; Elstrodt, JM; Nikkels, PGJ; Tiebosch, ATMG

2002-01-01

Purpose: To evaluate the interaction between the Cordis Keeper vena caval filter and vessel wall in a porcine model. Methods: Implantation of the filter was performed in five pigs. Radiologic data concerning inferior vena cava (IVC) diameter and filter patency, filter leg span, and stability were

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

International Nuclear Information System (INIS)

Garcia Egea, Jorge; Lara Guerrero, Isabel; Fustero Aznar, Jose Miguel; Hermoso Cuenca, Vicente; Velez Lomana, Abel

2011-01-01

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

TrapEase inferior vena cava filter placement: use of the subclavian vein.

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Stone, Patrick A; Aburahma, Ali F; Hass, Stephen M; Hofeldt, Matthew J; Zimmerman, William B; Deel, John T; Deluca, John A

2004-01-01

The purpose of this paper was to evaluate the safety and technical success of TrapEase inferior vena cava filter placement via the subclavian vein. As of yet, no reports in the literature have specifically investigated the use of the subclavian vein as a route for deploying TrapEase vena cava filters. Retrospective chart review was conducted of 135 patients with attempted TrapEase inferior vena cava filter placement over a 2-year period. In a majority of cases, the choice of subclavian vein approach was based primarily on surgeon preference. Other circumstances for subclavian vein deployment included cervical immobilization secondary to trauma, desire for concomitant placement of a subclavian long-term central venous access catheter, and patient body habitus limiting exposure to the internal jugular vein. One hundred and thirty-five filters were placed over this 2-year period. The internal jugular vein approach was used in 56 patients, the femoral vein approach in 39 patients, and the subclavian vein approach in 40 patients. Thirty-nine of the 40 TrapEase filter placements using the subclavian vein were successful. Twenty-six were deployed through the right subclavian vein and 14 through the left subclavian vein. The single failed subclavian deployment was due to the inability to pass the guidewire adequately into the inferior vena cava after successful cannulation of the right subclavian vein. The average deployment time for subclavian vein placement was 26 minutes when TrapEase filter placement was the only procedure performed. No insertional complications were encountered, specifically no pneumothoraces confirmed by chest radiography or fluoroscopy. The subclavian vein provides an alternative site of access for the TrapEase inferior vena cava filter. This route is comparable to other alternative methods evaluated both in average deployment time and complication occurrence. Furthermore, the subclavian vein route is valuable in patients with limited central access

Reconstruction of a total avulsion of the hepatic veins and the suprahepatic inferior vena cava secondary to blunt thoracoabdominal trauma.

Science.gov (United States)

Kaemmerer, Daniel; Daffner, Wolfgang; Niwa, Martin; Kuntze, Thomas; Hommann, Merten

2011-02-01

Blunt injury to the inferior vena cava is a rare but dramatic event having a high mortality up to 80%. The mortality increases after total avulsion especially in combination with secondary intra-abdominal injuries. We report on a 15-year-old boy who sustained a blunt trauma with a total, partially covered avulsion of the hepatic veins and the suprahepatic inferior vena cava. We treated the patient under internal bypassing of the retrohepatic vena cava by using the heart-lung machine and reconstructed the hepatic veins and suprahepatic vena cava with a conduit made of pericard.

Hepatic vena cava syndrome: New concept of pathogenesis.

Science.gov (United States)

Shrestha, Santosh Man; Kage, Masayoshi; Lee, Byung Boong

2017-06-01

Hepatic vena cava syndrome, also known as membranous obstruction of inferior vena cava (IVC), was considered a rare congenital disease and classified under Budd-Chiari syndrome. It is now recognized as a bacterial infection-induced disease related to poor hygiene. Localized thrombophlebitis of the IVC at the site close to hepatic vein outlets is the initial lesion which converts on resolution into stenosis or complete obstruction, the circulatory equilibrium being maintained by development of cavo-caval collateral anastomosis. These changes persist for the rest of the patient's life. The patient remains asymptomatic for a variable period until acute exacerbations occur, precipitated by bacterial infection, resulting in deposition of thrombi at the site of the lesion and endophlebitis in intrahepatic veins. Large thrombus close to hepatic vein outlets results in ascites from hepatic venous outflow obstruction, which is followed by development of venocentric cirrhosis. Endophlebitis of intrahepatic veins results in ischemic liver damage and development of segmental stenosis or membrane. Acute exacerbations are recognized clinically as intermittent jaundice and/or elevation of aminotransferase or ascites associated with neutrophil leukocytosis and elevation of C-reactive protein; sonologically, they are recognized as the presence of thrombi of different ages in IVC and thrombosis of intrahepatic veins. Development of liver cirrhosis and hepatocellular carcinoma is related to severity or frequency of acute exacerbations and not to duration or type of caval obstruction. Hepatic vena cava syndrome is a common co-morbid condition with other liver diseases in developing countries and it should be considered in differential diagnosis in patient with intermittent elevation serum bilirubin and or aminotransferase or development of ascites and cirrhosis. © 2017 The Japan Society of Hepatology.

Right to left shunt as a collateral circulation in a patient with superior vena cava syndrome: a case report

International Nuclear Information System (INIS)

Kim, Young Sun; Jeon, Seok Chol; Moon, Won Jin; Choi, Yo Won; Seo, Heung Suk; Hahm, Chang Kok; Park, Choong Ki

1999-01-01

In patients with superior vena cava syndrome, the form of the collateral circulatory system which communicates with the inferior vena cava via various systemic veins usually varics. We found an instance of unusual collateral circulation : direct communication between the systemic and pulmonary vein in a woman with superior vena cava syndrome caused by metastatic lymph node enlargement. In this report, we describe the CT and radionuclide venographic findings

Partial anomalous pulmonary venous connection to the superior vena cava.

Science.gov (United States)

Aramendi, José I; Rey, Estibaliz; Hamzeh, Gadah; Crespo, Alejandro; Luis, Maite; Voces, Roberto

2011-04-01

We describe the surgical technique of reimplantation of the right superior pulmonary vein into the left atrium in 2 patients with partial anomalous pulmonary venous connection to the superior vena cava without atrial septal defect. A right axillary minithoracotomy is done through the fourth intercostal space. The pulmonary vein is detached from its origin in the superior vena cava. This is sutured with 6-0 reabsorbable polydioxanone suture (Ethicon, Somerville, NJ). A lateral clamp is applied to the left atrium, and the pulmonary vein is reimplanted. The patient is extubated in the operating room. Neither cardiopulmonary bypass nor blood transfusion was required. It is simple, safe, and reproducible. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Successful Percutaneous Retrieval of an Inferior Vena Cava Filter Migrating to the Right Ventricle in a Bariatric Patient

International Nuclear Information System (INIS)

Veerapong, Jula; Wahlgren, Carl Magnus; Jolly, Neeraj; Bassiouny, Hisham

2008-01-01

The use of an inferior vena cava filter has an important role in the management of patients who are at high risk for development of pulmonary embolism. Migration is a rare but known complication of inferior vena cava filter placement. We herein describe a case of a prophylactic retrievable vena cava filter migrating to the right ventricle in a bariatric patient. The filter was retrieved percutaneously by transjugular approach and the patient did well postoperatively. A review of the current literature is given.

Acetylcholinesterase and Butyrylcholinesterase Inhibitory Compounds from Corydalis cava (Fumariaceae)

Czech Academy of Sciences Publication Activity Database

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

2011-01-01

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

Prevalência do refluxo na veia safena parva em varizes primárias não complicadas dos membros inferiores pelo eco-Doppler colorido Prevalence of short saphenous vein reflux in primary uncomplicated varicose veins by Doppler ultrasonography

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Fabio Secchi

2006-03-01

Full Text Available OBJETIVO: Determinar a prevalência de refluxo venoso na veia safena parva em membros inferiores com varizes primárias não complicadas pelo eco-Doppler colorido. MÉTODO: No período de 18 meses, 1.953 pacientes foram submetidos ao eco-Doppler colorido de membros inferiores por doença venosa. Destes, 1.631 com varizes primárias não complicadas foram selecionados para esta análise, sendo que 1.383 eram do sexo feminino (84,79% e 248 (15,21% do sexo masculino. A média de idade dos pacientes foi de 42,89 (± 0,48 anos, variando de 13 a 85 anos. Dos 1.631 pacientes, 1.323 foram submetidos a exame bilateral e 308 a exame unilateral, totalizando 2.954 membros inferiores com varizes primárias não complicadas avaliados. Desse total, 1.461 eram membros inferiores direitos e 1.493, esquerdos. Todos os exames foram realizados seguindo o mesmo protocolo. RESULTADO: Dos 2.954 membros inferiores avaliados, 372 (12,59% apresentaram refluxo em veia safena parva. A prevalência nos homens foi de 14,08% e, nas mulheres, de 12,35%. O refluxo da safena parva foi maior no membro inferior esquerdo (13.13% do que no direito (12,05%. A prevalência do refluxo foi significativamente maior nos pacientes acima de 60 anos. CONCLUSÃO: O refluxo da veia safena parva é relativamente comum, e sua pesquisa deve ser sempre realizada em pacientes com varizes primárias de membros inferiores.OBJECTIVE: To determine the prevalence of small saphenous vein reflux (SSVR in patients with uncomplicated varicose veins, using color-flow Doppler ultrasonography. METHOD: Over an 18-month period, a total of 1,953 patients underwent color-flow Doppler ultrasonography for evaluation of venous disease. Out of the total, 1,631 patients with primary uncomplicated varicose veins were selected for this study: 1,383 (84.79% patients were female and 248 (15.21% were male. Mean age was 42.9 (± 0.48 years, ranging from 13 to 85 years. Of the 1,631 patients, 1,323 underwent bilateral

Perfil evolutivo das varizes esofágicas pós esplenectomia associada à ligadura da veia gástrica esquerda e escleroterapia na hipertensão portal esquistossomótica Evolutional profile of the esophageal varices after splenectomy associated with ligation of the left gastric vein and sclerotherapy in schistosomal portal hypertension

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João Batista-Neto

2013-03-01

Full Text Available RACIONAL: A esquistossomose mansônica afeta 200 milhões de pessoas em 70 países do mundo. Estima-se que 10% dos infectados evoluirão para a forma hepatoesplênica e, destes, 30% progredirão para hipertensão portal e varizes esofagogástricas, cuja expressão será através de hemorragia digestiva com mortalidade relevante no primeiro episódio hemorrágico. Múltiplas técnicas cirúrgicas foram desenvolvidas para prevenir o ressangramento. OBJETIVO: Avaliar o perfil evolutivo das varizes esofágicas após esplenectomia + ligadura da veia gástrica esquerda associada à escleroterapia endoscópica na hipertensão portal esquistossomótica. MÉTODO: Estudo prospectivo, observacional, de pacientes esquistossomóticos com antecedentes de hemorragia digestiva alta, submetidos à esplenectomia + ligadura da veia gástrica esquerda e escleroterapia. As variáveis estudadas foram perfil evolutivo das varizes esofágicas antes e após a operação e índice de recidiva hemorrágica. RESULTADOS: Amostra foi constituída por 30 pacientes distribuídos, quanto ao gênero, em 15 doentes para cada sexo. A idade variou de 19 a 74 anos (mediana=43 anos. Houve redução do grau, calibre e red spots em todos os pacientes (pBACKGROUND: The schistosomiasis affects 200 million people in 70 countries worldwide. It is estimated that 10% of those infected will develop hepatosplenic status and of these, 30% will progress to portal hypertension and esophagogastric varices, whose expression is through gastrointestinal bleeding with significant mortality in the first bleeding episode. Multiple surgical techniques have been developed to prevent re-bleeding. AIM: To evaluate the evolutional profile of esophageal varices after splenectomy + ligation of the left gastric vein associated with endoscopic sclerotherapy in schistosomal portal hypertension. METHODS: Prospective and observational study including schistosomiasis patients with previous history of upper digestive

Inferior vena cava leiomyosarcoma: vascular reconstruction is not ...

African Journals Online (AJOL)

... vena cava is a rare and aggressive tumor, arising from the smooth muscle cells in the vessel wall. A large complete surgical resection is the essential treatment. The need of vascular reconstruction is not always mandatory. It's above all to understand the place of the reconstruction with artificial vascular patch prosthetics of ...

Bilateral Deep Vein Thrombosis Associated with Inferior Vena Cava Agenesis in a Young Patient Manifesting as Low Back Pain

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Felipe Langer

2017-04-01

Full Text Available Congenital absence of the inferior vena cava is a rare vascular anomaly, and most cases are asymptomatic. Nevertheless, patients with inferior vena cava malformations may have increased risk of deep venous thrombosis. Particularly, cases of bilateral deep venous thrombosis may arise owing to an insufficient collateral venous drainage from the lower limbs. We hereby describe a case of a previously healthy young male patient presenting with bilateral lower limb deep venous thrombosis as the initial clinical manifestation of congenital inferior vena cava agenesis. We conclude that in young patients presenting with deep venous thrombosis, especially when thrombosis occurs spontaneously, bilaterally, or recurrently, inferior vena cava anomalies should be thoroughly investigated and ruled out as appropriate.

Características das células parasitadas pelo Trypanosoma cruzi na parede da veia central das supra-renais de Chagásicos crônicos

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Hipolito de Oliveira Almeida

1986-12-01

Full Text Available Foram analisados os aspectos das células musculares parasitadas pelo Trypanosoma cruzi, na veia da supra-renal de chagásicos crônicos, através de exame ao microscópio óptico de lâminas coradas pela hematoxilina-eosina (HE, PAS, Feulgen e peroxidase-antiperoxidase (PAP para antigenos do T. cruzi. Além das modificações nucleares descritas anteriormente, os leiomiócitos parasitados exibem alterações citoplasmáticas que podem ser vistas mesmo em células que albergam poucos parasitas. As formas amastigotas geralmente estão envoltas por halo claro e o citoplasma restante adquire aspecto granuloso ou reticular, basófilopelo HE, sendo sempre PAS e Feulgen negativos. Estes dados sugerem que o material basófilo no citoplasma deve ser RNA ribossômico. A periferia dos ninhos que mostram uma "membrana" com reação do PAP para antigenos do T. cruzi fortemente positiva, poderia ser devida a reação cruzada de material celular rechaçado para a periferia ou a difusão de antigenos do T. cruzi e sua adsorção à periferia celular. O material citoplasmático PAP positivo poderia resultar de artefato, de reação imunocitoquimica cruzada, de antigenos tripanossomóticos difundidos ou de antigenos tripanossoma-simile resultantes de interações entre o leiomiócito e o parasita.Some morphologic aspects of the smooth muscle cells, parasitised by T. cruzi in the adrenal vein of chronic chagasic patients were studied. The staining techniques used were the following: Hematoxylin and Eosin (HE, PAS, Feulgen and the peroxidase antiperoxidase (PAP immunocyto chemical method for identification of T. cruzi antigen. The intracellular amastigotes were often surrounded by a clear halo and the cytoplasm of the parasitised smooth muscle cells were granular or reticular in appearance being basophil and, PAS and Feulgen negative. These data suggest that the cytoplasmatic basophil material could be ribosomic RNA. The intracellular nests of amastigotes were

Endobronchial Forceps-Assisted and Excimer Laser-Assisted Inferior Vena Cava Filter Removal: The Data, Where We Are, and How It Is Done.

Science.gov (United States)

Chen, James X; Montgomery, Jennifer; McLennan, Gordon; Stavropoulos, S William

2018-06-01

The recognition of inferior vena cava filter related complications has motivated increased attentiveness in clinical follow-up of patients with inferior vena cava filters and has led to development of multiple approaches for retrieving filters that are challenging or impossible to remove using conventional techniques. Endobronchial forceps and excimer lasers are tools for designed to aid in complex inferior vena cava filter removals. This article discusses endobronchial forceps-assisted and excimer laser-assisted inferior vena cava filter retrievals. Copyright © 2018 Elsevier Inc. All rights reserved.

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

International Nuclear Information System (INIS)

Onat, Levent; Ganiyusufoglu, Ali Kursat; Mutlu, Ayhan; Sirvanci, Mustafa; Duran, Cihan; Ulusoy, Onur Levent; Hamzaoglu, Azmi

2009-01-01

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

Ultrasound evaluation of techniques for internal jugular vein puncture in children Avaliação ultra-sonográfica das técnicas de punção da veia jugular interna em crianças

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Sérgio Tomaz Schettini

2008-10-01

Full Text Available PURPOSE: To determine by ultrasound which access and position the child must stay to obtain the best transversal section of the right Internal Jugular Vein (RIJV allowing a safer puncture. METHODS: Three possible accesses to the RIJV, anterior, lateral and posterior, from 57 healthy children, were analyzed through ultrasound images in a sequence of positions of the head, in supine position, with or without a roll under the scapula: head centered in neutral position with and without a roll (NPP and NP; contra lateral rotation with and without a roll (CLRP and CLR, neutral position and the patient raised in 30° in Trendelenburg position (TDG. To analyze the results it was applied one statistic method, with variation analysis to the same individuals. Basic Procedures: Ultrasound evaluation in each one of the proposed positions. RESULTS: The statistical analysis of the results observed that the lateral puncture with the patient in the neutral position, in Trendelemburg without a roll, offers a bigger area in comparison to all the other options of puncture and positioning of the patient (pOBJETIVO: Determinar pelo ultra-som qual o melhor acesso e posicionamento da criança com o intuito de se obter a melhor secção transversal da veia jugular interna direita (VJID, permitindo uma punção com maior segurança. MÉTODOS: Três possíveis acessos a VJID, anterior, lateral e posterior foram analisados pela ultrassonografia em uma sequência de diferentes posições da cabeça, estando o paciente em posição supina com ou sem um coxim sob a escápula; cabeça na posição neutra; (NPP E NP; rotação lateral da cabeça (CLRP e CLR, posição neutra com o paciente em posição de Trendlemburg a 30(0 (TDG. Para analisar os resultados foi aplicado um método estatístico com análise variada sobre os mesmos indivíduos. Procedimentos básicos: Avaliação ultrassonográfica em cada uma das posições propostas. RESULTADOS: Pela análise estatística dos

Padrões de refluxo nas veias safenas em homens com insuficiência venosa crônica

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Carlos Alberto Engelhorn

Full Text Available Resumo Contexto A insuficiência venosa crônica (IVCr é frequente e predomina nas mulheres, mas ainda há poucas informações sobre o refluxo nas veias safenas na população masculina. Objetivos Identificar os diferentes padrões de refluxo nas veias safenas magnas (VSMs e parvas (VSPs em homens, correlacionando esses dados com a apresentação clínica conforme a classificação Clínica, Etiológica, Anatômica e Fisiopatológica (CEAP. Métodos Foram avaliados 369 membros inferiores de 207 homens pela ultrassonografia vascular (UV com diagnóstico clínico de IVCr primária. As variáveis analisadas foram a classificação CEAP, o padrão de refluxo nas VSMs e VSPs e a correlação entre os dois. Resultados Nos 369 membros avaliados, 72,9% das VSMs apresentaram refluxo com predominância do padrão segmentar (33,8%. Nas VSPs, 16% dos membros inferiores analisados apresentaram refluxo, sendo o mais frequente o padrão distal (33,9%. Dos membros classificados como C4, C5 e C6, 100% apresentaram refluxo na VSM com predominância do refluxo proximal (25,64%, e 38,46% apresentaram refluxo na VSP com equivalência entre os padrões distal e proximal (33,3%. Refluxo na junção safeno-femoral (JSF foi detectado em 7,1% dos membros nas classes C0 e C1, 35,6% nas classes C2 e C3, e 64,1% nas classes C4 a C6. Conclusões O padrão de refluxo segmentar é predominante na VSM, e o padrão de refluxo distal é predominante na VSP. A ocorrência de refluxo na JSF é maior em pacientes com IVCr mais avançada.

Intracranial hemorrhage due to intracranial hypertension caused by the superior vena cava syndrome

DEFF Research Database (Denmark)

Bartek, Jiri; Abedi-Valugerdi, Golbarg; Liska, Jan

2013-01-01

We report a patient with intracranial hemorrhage secondary to venous hypertension as a result of a giant aortic pseudoaneurysm that compressed the superior vena cava and caused obstruction of the venous return from the brain. To our knowledge, this is the first patient reported to have...... an intracranial hemorrhage secondary to a superior vena cava syndrome. The condition appears to be caused by a reversible transient rise in intracranial pressure, as a result of compression of the venous return from the brain. Treatment consisted of surgery for the aortic pseudoaneurysm, which led...

Renal Angiomyolipoma Associated with Inferior Vena Cava Thrombus

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Xavier Durand

2009-01-01

Full Text Available 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.

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

International Nuclear Information System (INIS)

Yu Bo; Shi Weihao; He Qing; Wang Tieping; Wang Wei

2008-01-01

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

Roentgenologic diagnosis of pulmonary veins pathologically inflowing into vena cava inferior

International Nuclear Information System (INIS)

Shumskij, V.I.; Konstantinova, N.V.; Fedorovich, Yu.N.

1986-01-01

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

Unusual caudal vena cava thrombosis in a cow, secondary to Trueperella (Arcanobacterium pyogenes infection

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Rodrigo Garcia Motta

Full Text Available Abstract: The caudal vena cava thrombosis, or pulmonary thromboembolism, in cattle is correlated with lactic acidosis, caused by diets rich in grains and highly fermentable, associated or not to septic situations, used in feedlots of beef or high-producing dairy cattle. This paper reports an unusual caudal vena cava thrombosis in a cow, secondary to Trueperella (Arcanobacterium pyogenes infection, resulting in reduced milk production, anorexia, pale mucous membranes, ruminal atony, sternal decubitus and autoauscultation position. The heart was enlarged at necropsy, presence of clots distributed along the thoracic cavity, adherence between lung and pleura, abscesses, emphysema, petechiae, suffusions and ecchymosis in lungs, thickening of the caudal vena cava wall, hepatomegaly with chronic passive congestion ("nutmeg" aspect, and rumenitis. In lab, the actinomycete Trueperella (Arcanobacterium pyogenes was isolated from liver and lung samples, probably resulting through dissemination of the bacteria of the rumen content, what reaffirms the opportunistic behavior of this actinomycete.

Morfofisiologia da inervação do diafragma de ovinos Morphophysiology of diaphragm innervation in sheep

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Ana E.F. de Almeida

2008-09-01

Full Text Available Foram estudados em 30 diafragmas de ovinos da raça Santa Inês, a origem, a divisão e a distribuição dos nervos frênicos direito e esquerdo (Fde e a participação de outros nervos na inervação do diafragma. Mediante fixação e dissecação das peças foi observado que os nervos frênicos (F originam-se a partir dos ramos ventrais do 5º (C5 e 6º (C6 nervos espinhais cervicais (Ec tanto à direita (46,67% como à esquerda (43,33%. Os F finalizam em tronco lombocostal e ramo esternal à direita (40,00% e em ramo lombar, costal e esternal à esquerda (36,68%. Os ramos lombares dos F inervam à esquerda (96,67% o pilar homolateral do diafragma e, à direita (50,00% fornecem filetes à veia caudal. Os ramos costais dos F ramificam à esquerda (90,00% e à direita (76,67% as regiões dorsal e ventral da pars costalis. Os ramos esternais dos F inervam à direita (100,00% e à esquerda (83,33% a pars sternalis e a região ventral da pars costalis do mesmo lado. Os nervos intercostais (VIII ao XII pares, 63,33% contribuem na inervação do diafragma de ovinos da raça Santa Inês.Thirty diaphragms of sheep of Santa Inês breed were studied regarding their origin, division and arrangement of the right and left phrenic nerves (Fde, and the participation of other nerves in the innervation of the diaphragm. By fixing and dissecting pieces, it was found that phrenic nerves (F frequently come from the ventral branches of the 5th (C5 and 6th (C6 cervical spinal nerves (Ec, at right (46.67% and at left (43.33%. The F often form a lumbocostal trunk, sternal branches at right (40.00% and lumbar, costal and esternal branches at left (36.68%. The lumbar branches of F innervate frequently at left (96.67% the homolateral pillar of the diaphragma, and at right (50.00% they give fillets to Vena cava caudalis. The costal branches of the F innervate at left (90.00% and at right (76.66% the dorsal and ventral regions of the pars costalis. The sternal branches of

Estudo da atividade inibitória enzimática da quercetina sobre a resposta vasodepressora induzida pela bradicinina

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Luciane Pereira Nascimento Häckl

Full Text Available Em estudos recentes tem sido sugerido que os flavonóides, compostos de origem vegetal sendo encontrados em vários produtos alimentares, possuem uma ação inibitória de vários sistemas enzimáticos. A inibição da enzima conversora da angiotensina (ECA tem sido utilizada no tratamento da hipertensão. O mecanismo de ação dos inibidores da ECA implica na formação da Angiotensina II e na degradação da bradicinina. O propósito do presente estudo foi de analisar a ação da quercetina na atividade da ECA através da avaliação do efeito da angiotensina I (AI e da bradicinina (BK na pressão arterial de ratos anestesiados. Foram utilizados neste estudo ratos Wistar machos adultos. Estes animais foram anestesiados com uretana e foi introduzida na traquéia uma cânula de polietileno (PE 240 para facilitar a respiração. Também foi isolada e canulada (PE 50 a veia jugular para administração das substâncias em estudo. Para registro da pressão arterial foi introduzida na artéria carótida comum esquerda uma cânula de polietileno (PE 50 acoplada a um transdutor de pressão. A administração de BK (10 nmol/kg, i.v. induziu um efeito hipotensor, enquanto que a administração de AI (0,1 nmol/kg induziu uma resposta hipertensora. Pré-tratamento com captopril v.o. (100 nmol/kg 45 min antes e i.v. (10 nmol/kg 5 min antes aumentou significativamente a resposta à BK; embora captopril reduziu, também significativamente, o efeito da AI. O tratamento com quercetina via oral (30 mg/kg 45 min antes e via intravenosa (5 mg/kg 5 min antes aumentou significativamente o efeito da BK. O efeito da AI foi significativamente reduzido por ambos os tratamentos. Estes resultados sugerem que a quercetina potenciou o efeito hipotensor da bradicinina e reduziu o efeito hipertensor da angiotensina I através de ação inibitória sobre a enzima conversora da angiotensina, portanto apresentando um mecanismo de ação semelhante ao captopril.

Vascular Reconstruction Technique Using a Tubular Graft for Leiomyosarcoma of the Inferior Vena Cava: A Case Report

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C. Higutchi

Full Text Available Objective/background: This study is a case report that addresses the key aspects of vascular reconstruction, as well as the intraoperative complications, postoperative morbidity, and possibility of adjunctive therapy. Methods: This article reports the case of a 46 year old female patient with a leiomyosarcoma located in the middle segment of the inferior vena cava (between the renal and hepatic veins who underwent surgical resection with vena cava reconstruction and insertion of a tubular graft made of a synthetic material. Results: This case report reveals that surgical resection of the tumor with the insertion of a smaller-caliber tubular graft provide better patency of the vena cava reconstruction, which was maintained for a year after surgery. In addition, the patient was asymptomatic for lower limb edema, despite having a local recurrence after one year. Surgical resection is the treatment of choice for leiomyosarcoma of the inferior vena cava (LIVC and is the only therapy that offers a chance of cure. Several surgical techniques are used for this condition, especially, reconstruction with a vascular graft using natural or synthetic materials. Conclusion: Due to the aggressiveness of the disease, this study suggests that surgical intervention used may have no influence on a patient's survival outcome. However, vascular reconstruction with a smaller-caliber tubular graft may yield a better prognosis for patients in terms of postoperative symptoms, such as edema and thrombosis. Keywords: Inferior vena cava, Leiomyosarcoma, Synthetic vascular grafting

Comparação da perviedade entre artéria radial e veia safena em pacientes em pós-operatório de cirurgia de revascularização miocárdica com retorno dos sintomas Comparison of patency between radial artery and saphenous vein in a coronary artery bypass grafting post operative with return of the symptoms

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Herbert Coelho Hortmann

2010-06-01

Full Text Available OBJETIVO: Comparar a perviedade da artéria radial e veia safena em pacientes com retorno dos sintomas após cirurgia de revascularização do miocárdio (CRVM. MÉTODOS: Estudo retrospectivo. No período de janeiro de 1998 a dezembro de 2005, foram realizadas 469 CRVMs com o uso da artéria radial dentre os enxertos, no Hospital Vera Cruz, em Belo Horizonte/MG. Destes, 94 pacientes apresentaram alterações isquêmicas no pós-operatório recente ou tardio e foram reestudados com cineangiocoronariografia. Os enxertos foram divididos em três grupos: artéria torácica interna (ATI, artéria radial (AR e veia safena (VS, e foram estratificados segundo a gravidade das lesões: sem lesão grave (OBJECTIVE: To compare the radial artery and saphenous vein's patency in patients with recurrence of symptoms in a coronary artery bypass grafting (CABG. METHODS: Retrospective study. From January 1998 to December 2005, 469 CABGs were performed using the radial artery as a graft, in Vera Cruz Hospital in Belo Horizonte/ MG. Among the patients who underwent those surgeries, 94 presented ischemic changes in early or late postoperative period, which led them to be re-evaluated by coronary angiography. The grafts were divided in three groups: internal thoracic artery (ITA, radial artery (RA and saphenous vein (SV, and they were stratified according to the severity of injury: uninjured or patent (< 70%, severe obstruction (70 to 99% and occlusion. RESULTS: For the 94 patients in the study, 86 grafts of ITA, 94 of RA and 111 of SV were used. For the 86 ITA grafts, 73 (84.88% were found patent. For the 94 RA grafts, 55 (58.51% were found patent, and for the 111 SV grafts, 73 (65.76% were uninjured. A statistically significant difference (P= 0.001 was found between RA and SV grafts, with a higher patency found for VS graft. For the RA grafts, women presented a worse result concerning the RA patency (65.7% and 40.7%, with P = 0.006. Concerning coronary

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

NARCIS (Netherlands)

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

2013-01-01

Pre-existing occlusion of the inferior vena cava may complicate renal transplantation. Suppurative abdominal wall phlebitis following renal transplantation was diagnosed in a patient with pre-existing thrombosis of the inferior vena cava of unknown cause. The phlebitis developed in the subcutaneous

Efeitos renais e cardiovasculares da infusão de dopamina e da solução de cloreto de sódio a 7,5%: estudo experimental em cães com restrição hídrica

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Marisa Aparecida Lima Verderese

2003-09-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: É controvertido o uso da infusão de dopamina na proteção renal. O objetivo desta pesquisa foi estudar o efeito da dopamina, da solução hipertônica e da associação de ambas em cães com restrição hídrica, simulando o jejum pré-operatório. MÉTODO: Foram estudados, em 32 cães anestesiados com tiopental sódico e fentanil, os seguintes parâmetros da função renal: fluxo plasmático efetivo renal (depuração de para-aminohipurato de sódio, ritmo de filtração glomerular (depuração de creatinina e as depurações de sódio, de potássio e osmolar, excreção fracionária de sódio e potássio, excreção de sódio e potássio e a resistência vascular renal. Os parâmetros cardiovasculares foram: pressão arterial média, freqüência cardíaca, pressão da veia cava inferior, índice cardíaco, hematócrito e índice de resistência vascular periférica. Os animais foram subdivididos, através de sorteio, em 4 grupos experimentais: Grupo 1 - G1 (n = 8 - grupo controle; Grupo 2 - G2 (n = 8 infusão de dopamina (2 µg.kg-1.min-1, Grupo 3 - G3 (n = 8 solução de cloreto de sódio a 7,5% (2 ml.kg-1 e Grupo 4 - G4 (n = 8 - associação de dopamina (2 µg.kg-1.min-1 e cloreto de sódio a 7,5% (2 ml.kg-1. Os grupos tiveram quatro fases experimentais e cada momento com duração de 30 minutos, compreendendo os momentos M1, M2, M3 e M4. RESULTADOS: O grupo da dopamina (G2 apresentou diminuição da pressão arterial média, da resistência vascular renal e da excreção de potássio. O grupo da solução hipertônica de cloreto de sódio (G3 apresentou aumento do índice cardíaco, do volume urinário, da depuração de sódio e de potássio, da excreção urinária de sódio e potássio e da excreção fracionária de sódio. No grupo da solução hipertônica de cloreto de sódio associada à dopamina (G4, ocorreu elevação da freqüência cardíaca, do índice cardíaco, do fluxo plasmático efetivo renal

Efeitos renais e cardiovasculares da infusão de dopamina e da solução de cloreto de sódio a 7,5%: estudo experimental em cães com restrição hídrica

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Verderese Marisa Aparecida Lima

2003-01-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: É controvertido o uso da infusão de dopamina na proteção renal. O objetivo desta pesquisa foi estudar o efeito da dopamina, da solução hipertônica e da associação de ambas em cães com restrição hídrica, simulando o jejum pré-operatório. MÉTODO: Foram estudados, em 32 cães anestesiados com tiopental sódico e fentanil, os seguintes parâmetros da função renal: fluxo plasmático efetivo renal (depuração de para-aminohipurato de sódio, ritmo de filtração glomerular (depuração de creatinina e as depurações de sódio, de potássio e osmolar, excreção fracionária de sódio e potássio, excreção de sódio e potássio e a resistência vascular renal. Os parâmetros cardiovasculares foram: pressão arterial média, freqüência cardíaca, pressão da veia cava inferior, índice cardíaco, hematócrito e índice de resistência vascular periférica. Os animais foram subdivididos, através de sorteio, em 4 grupos experimentais: Grupo 1 - G1 (n = 8 - grupo controle; Grupo 2 - G2 (n = 8 infusão de dopamina (2 µg.kg-1.min-1, Grupo 3 - G3 (n = 8 solução de cloreto de sódio a 7,5% (2 ml.kg-1 e Grupo 4 - G4 (n = 8 - associação de dopamina (2 µg.kg-1.min-1 e cloreto de sódio a 7,5% (2 ml.kg-1. Os grupos tiveram quatro fases experimentais e cada momento com duração de 30 minutos, compreendendo os momentos M1, M2, M3 e M4. RESULTADOS: O grupo da dopamina (G2 apresentou diminuição da pressão arterial média, da resistência vascular renal e da excreção de potássio. O grupo da solução hipertônica de cloreto de sódio (G3 apresentou aumento do índice cardíaco, do volume urinário, da depuração de sódio e de potássio, da excreção urinária de sódio e potássio e da excreção fracionária de sódio. No grupo da solução hipertônica de cloreto de sódio associada à dopamina (G4, ocorreu elevação da freqüência cardíaca, do índice cardíaco, do fluxo plasmático efetivo renal

Filtros de vena cava en pacientes con cáncer

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Fernando A. Díaz Couselo

2012-08-01

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

Estudo morfológico do funículo espermático em ovinos da raça Corriedale (Ovis aries, L. 1758

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Roberto Carvalhal

2000-01-01

Full Text Available Estudamos em 40 ovinos adultos da raça Corriedale os aspectos histológicos do funículo espermático. Observamos que este se acha envolvido por uma cápsula de tecido conjuntivo fibroelástico denso, de espessura variável, pregueada em alguns pontos, e revestida por mesotélio que circunda todo o conjunto vásculo-nervoso, e projeta-se para formar o mesoducto deferente. Em posição subcapsular, verifica-se uma camada de tecido conjuntivo fibroelástico frouxo, de espessura variável, que circunda parcialmente o funículo espermático, isolando nas regiões deferencial e abdeferencial conjuntos vásculo-nervosos, responsáveis pela nutrição do epidídimo. Na região do mesoducto deferente, o tecido subcapsular acompanhado de tecido adiposo constitui a camada interna deste meso, formando a sua adventícia e abrigando vasos e nervos deferenciais. Na região abdeferencial, pequenos acúmulos de tecido adiposo são vistos de permeio aos vasos e nervos desta região. Entre as artérias, veias e nervos testiculares, bem como entre os vasos das regiões deferencial e abdeferencial, observa-se o tecido conjuntivo denso, intervascular, rico em fibras elásticas, que constitui as adventícias contínuas destes vasos. O arranjo vascular mostra que o segmento da artéria testicular, contido no funículo espermático, apresenta trajeto sinuoso. Estando envolvido pelo plexo venoso pampiniforme, formado por veias testiculares desprovidas de válvulas de calibres variados, apresentando amplas comunicações entre si. As veias responsáveis pela drenagem do epidídimo e ducto deferente estão localizadas em posição subcapsular deferencial e abdeferencial e mostram-se providas de válvulas. O trato das artérias testiculares no funículo espermático apresenta como comprimento médio, máximo e mínimo, respectivamente, 150,4 cm, 198,0 cm e 73,3 cm, à direita, e 149,6 cm, 189,2 cm e 90,0 cm, à esquerda, não existindo diferenças estatisticamente

Myofibroblastic tumor associated to superior vena cava syndrome

International Nuclear Information System (INIS)

Ortega Jaramillo, Hector; Durango Gutierrez, Luisa Fernanda; Perez Figueroa, Maria del Pilar

2005-01-01

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

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

International Nuclear Information System (INIS)

Xiao Liang; Shen Jing; Tong Jiajie; Li Haiwei; Xu Ke

2011-01-01

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

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

Science.gov (United States)

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

2014-09-01

Various bioactive phlorotannins of Ecklonia cava (e.g., dieckol, eckol, 6,6-bieckol, phloroglucinol, phloroeckol, and phlorofucofuroeckol-A) are reported. However, their isolation and purification are not easy. Centrifugal partition chromatography (CPC) can be used to efficiently purify the various bioactive-compounds efficiently from E. cava. Phlorotannins are successfully isolated from the ethyl acetate (EtOAc) fraction of E. cava by CPC with a two-phase solvent system comprising n-hexane:EtOAc:methanol:water (2:7:3:7, v/v) solution. The dieckol (fraction I, 40.2mg), phlorofucofuroeckol-A (fraction III, 31.1mg), and fraction II (34.1mg) with 2,7-phloroglucinol-6,6-bieckol and pyrogallol-phloroglucinol-6,6-bieckol are isolated from the crude extract (500 mg) by a one-step CPC system. The purities of the isolated dieckol and phlorofucofuroeckol-A are ⩾90% according to high performance liquid chromatography (HPLC) and electrospray ionization multi stage tandem mass spectrometry analyses. The purified 2,7-phloroglucinol-6,6-bieckol and pyrogallol-phloroglucinol-6,6-bieckol are collected from fraction II by recycle-HPLC. Thus, the CPC system is useful for easy and simple isolation of phlorotannins from E. cava. Copyright © 2014 Elsevier Ltd. All rights reserved.

Diagnosis of tricuspid insufficiency by Doppler flowmetry in the inferior vena cava. A comparison with right ventricular angiography

Energy Technology Data Exchange (ETDEWEB)

Smith, H.J.

Eighty-five patients subjected to routine heart catheterization were examined with duplex scanning of the inferior vena cava. Adequate Doppler recordings and a right ventricular angiography were obtained in 79 of them. Tricuspid insufficiency was found to be present in 34 patients at angiography and in 24 at duplex examination. No false positive Doppler diagnoses of tricuspid insufficiency occurred. The possibility of false positive angiographic diagnoses is discussed. A high correlation was found between percentage reversed flow in the inferior vena cava during ventricular systole and degree of angiographic tricuspid insufficiency. It is concluded that duplex scanning of the inferior vena cava seems to be a good alternative to angiography in the diagnosis and quantification of tricuspid insufficiency.

Asymptomatic Lumbar Vertebral Erosion from Inferior Vena Cava Filter Perforation

International Nuclear Information System (INIS)

Fang, Wayne; Hieb, Robert A.; Olson, Eric; Carrera, Guillermo F.

2007-01-01

In 2002, a 24-year-old female trauma patient underwent prophylactic inferior vena cava filter placement. Recurrent bouts of renal stones prompted serial CT imaging in 2004. In this brief report, we describe erosion and ossification of the L3 vertebral body by a Greenfield filter strut

Superior vena cava obstruction caused by radiation induced venous fibrosis

NARCIS (Netherlands)

Van Putten, JWG; Schlosser, NJJ; Vujaskovic, Z; Van der Leest, AHD; Groen, HJM

Superior vena cava syndrome is most often caused by lung carcinoma. Two cases are described in whom venous obstruction in the superior mediastinum was caused by local vascular fibrosis due to radiotherapy five and seven years earlier. The development of radiation injury to greater vessels is

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

Energy Technology Data Exchange (ETDEWEB)

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

2006-05-15

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

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

International Nuclear Information System (INIS)

Mody, Rekha N.; Stokes, LeAnn S.; Bream, Peter R.; Spottswood, Stephanie E.

2006-01-01

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

An urban trauma centre experience with abdominal vena cava injuries

African Journals Online (AJOL)

Background: The aim of the study was to present the surgical management of injuries to the abdominal vena cava (AVC) and to identify clinical and physiological factors and management strategies which affect the outcome. Methods: A retrospective review was conducted of AVC injuries in patients attending the trauma ...

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

International Nuclear Information System (INIS)

Rasuli, P.; Mehran, R.; French, G.; Turek, M.; Lalonde, K.A.; Cardinal, P.

2000-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2000-07-01

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

Estudo microscópico das pontes de miocárdio sobre as veias cardíacas de suínos Microscopic study of the myocardial bridges over cardiac veins of pigs

Directory of Open Access Journals (Sweden)

Nadir Eunice Valverde Barbato de Prates

1999-07-01

Full Text Available Com o objetivo de fazer um estudo, em microscópio de luz, das pontes de miocárdio sobre as veias cardíacas, utilizaram-se 5 corações de suínos de ambos os sexos. Esses corações foram fixados em formol a 10%, por um período de 10 dias, embebidos em parafina e submetidos a cortes histológicos seriados de 15 m de espessura. A seguir, os cortes foram corados pelos métodos de Azan e Weigert-van Gieson. Verificou-se que as pontes de miocárdio eram constituídas por fibras da camada superficial do miocárdio. A parede dos segmentos venosos pré-pontino, pós-pontino e pontino das veias cardíacas magna e média de suínos era delgada e possuía características semelhantes. A túnica média apresentava modificações estruturais de acordo com a localização no plano subepicárdico: fibromuscular, próxima ao ápice cardíaco, e fibroelástica, no restante do trajeto. Sob o ponto de vista morfofuncional, as pontes de miocárdio podem ser consideradas como um fator coadjuvante do retorno venoso.Aiming to study the myocardial bridges over the cadiac veins on the optic microscope we used 5 pig hearts. The hearts were fixed in 10% formaldehyde for 10 days, embebbed in paraffin and were submitted to 15m histological serial sections. The sections were stained by Azan and Weigert-van Gieson methods.The myocardial bridges were composed by superficial layer of the myocadium. The great cardiac vein and middle cardiac vein showed similar features on their pre-pontine, pontine, and post-pontine segments. The vessel wall was thin. The middle layer of the veins showed structural changes during its subepicardial course: it was fibro-muscular near the cardiac apex and fibro-elastic on its remaing course were also observed. From a morphofunctional point of view these myocardial bridges may be considered an additional factor for the venous return.

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

DEFF Research Database (Denmark)

Pelta, A.M.; Jorgensen, M.; Jensen, L.P.

2008-01-01

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

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

DEFF Research Database (Denmark)

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

2008-01-01

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

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

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Pradeepkumar Charlagorla

2016-01-01

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

Is there a relationship between the diameter of the inferior vena cava ...

African Journals Online (AJOL)

2015-04-12

Apr 12, 2015 ... Key words: Central venous pressures, critically ill patients, inferior vena cava. Date of Acceptance: ... Regardless of the cause of the patient's status, the blood/ .... AUC=Area under ROC curve, IAP=Anteroposterior diameter of.

Ressecção de aneurisma venoso em veia jugular externa direita Resection of right external jugular vein aneurysm

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Eduardo Pereira Savi

2010-12-01

Full Text Available O aneurisma venoso é uma anomalia rara, cujo diagnóstico pode ser realizado a partir de exames físicos e complementares. Sua raridade justifica a necessidade de investigação e de publicações de estudos de caso, objetivo maior deste estudo. Relata-se aqui o caso de uma paciente que apresentava um abaulamento cervical anterior assintomático, progressivo e com seis meses de evolução. A paciente foi submetida à cervicotomia anterior, sob anestesia geral, com ressecção do segmento venoso acometido e ligadura da veia jugular externa. Realizado o estudo, verificou-se que aneurismas venosos podem causar tromboflebite, embolia pulmonar ou rotura. Cirurgia profilática, quando oferece baixo risco, é cuidadosamente recomendada para pacientes com aneurismas abdominais e altamente recomendada para aneurismas do sistema venoso profundo dos membros inferiores. Outros aneurismas venosos devem ser tratados cirurgicamente quando sintomáticos, desfigurantes ou se apresentarem aumento progressivo.Venous aneurysms are a rare abnormality, usually found in physical or complementary exams. We report a case of a 43-year old female with an asymptomatic and progressive enlarging mass in the neck. She had no history of trauma or cervical puncture. Vascular ultrasound showed a right jugular veins aneurysm with 1,81 x 1,62 cm of diameter. She was undergone resection and ligation of right external jugular vein, under general anesthesia. Venous aneurysm can cause thrombophlebitis, pulmonary embolism or spontaneous rupture. Prophylactic surgery is cautiously recommended for low-risk patients with venous aneurysms of the abdomen and strongly recommended for most patients with lower extremity deep venous aneurysms. Other venous aneurysms should be excised only if they are symptomatic, enlarging, or disfiguring

Outcome of prolonged acute vena cava occlusion after iatrogenic transection and repair in a dog.

Science.gov (United States)

Halwagi, Marie-Chantal; Crawford, Evan; Hoddinott, Katie; Oblak, Michelle L

2017-08-01

A 12-year-old castrated male Airedale terrier dog was diagnosed with a hepatocellular carcinoma in the right medial liver lobe. During tumor resection, inadvertent stapling and transection of the caudal vena cava occurred. Complete caval occlusion was required for 18 minutes and primary anastomosis was completed. The dog received 2 blood transfusions and developed mild pelvic limb edema after surgery. Computed tomography evaluation 9 months after surgery showed collateral circulation and suspected stricture of the vena cava with an absence of clinical effect. The dog remained alive and asymptomatic more than 1 year after surgery.

An elusive persistent left superior vena cava draining into left atrium

NARCIS (Netherlands)

A. Soward; F.J. ten Cate (Folkert); P.M. Fioretti (Paolo); P.W.J.C. Serruys (Patrick); J.R.T.C. Roelandt (Jos)

1986-01-01

textabstractA case report of a persistent left superior vena cava draining into left atrium with a fibromuscular left ventricular outflow tract obstruction and a small atrial septal defect. The anomalous vessel escaped detection during two right and left heart catheterizations from the right arm and

Effects of the Addition of Ecklonia cava Powder on the Selected Physicochemical and Sensory Quality of White Pan Bread

OpenAIRE

Lee, Jun Ho; Choi, Dong Won

2013-01-01

Physicochemical properties and consumer perception of white pan bread as influenced by the addition of Ecklonia cava powder (ECP) were investigated. Freeze-dried Ecklonia cava were ground, sieved through a laboratory sieve and a fraction with particles less than 250 μm was used. Amount of ECP added (0~3%) to the bread was found to affect the bread quality significantly (P

Right atrium and superior vena cava pressure measurements in a novel animal model to study one and a half ventricle repair as compared to Fontan type procedure

Directory of Open Access Journals (Sweden)

Anil Bhattarai

2017-01-01

Full Text Available Background & Objectives: To evaluate the advantages of the one and a half ventricle repair on maintaining a low pressure in the inferior vena cava district. Also evaluate the competition of flows at the superior vena cava – right pulmonary artery anastomosis site, in order to understand the hemodynamic interaction of a pulsatile flow in combination to a laminar one. Materials & Methods: Adult rabbits (n=30 in terminal anaesthesia with a follow up of 8 h were used, randomly distributed in three experimental groups: Group 1: animals with an anastomosis between superior vena cava and right pulmonary artery, as a model of one and one half ventricle repair; Group 2: animals with the cavopulmonary anastomosis followed by clamping of the right pulmonary artery proximal to the anastomosis; and Group 3: sham animals. Pressures of superior vena cava and pulmonary arteries were afterwards measured, in a resting condition as well as after induced pharmacological stress test.Results: In Group 1, superior vena cava pressure was significantly higher, while venous pressure in the inferior vena cava – right atrium district was constant or lower in comparison with the other groups. After stress test, the pressure in the superior vena cava and the heart rate both increased further, but the right ventricular, right atrial and pulmonary artery pressures remained similar to the values in a resting condition. This proved that the inferior vena cava return was well-preserved, and no venous hypertension was present in the inferior vena cava district even after stress test (good exercise tolerance.Conclusion: One and one half ventricle repair can be considered a good surgical strategy for maintaining a low pressure in the inferior vena cava district with potential for right ventricle growth, restoring the more physiological circulation in borderline or failing right ventricle conditions. The experiment presented a positive finding in favour of one and one half

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

International Nuclear Information System (INIS)

Hoffer, Eric K.; Mueller, Rebecca J.; Luciano, Marcus R.; Lee, Nicole N.; Michaels, Anne T.; Gemery, John M.

2013-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2013-08-01

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

Safety and efficacy of the Gunther Tulip retrievable vena cava filter: midterm outcomes.

Science.gov (United States)

Hoffer, Eric K; Mueller, Rebecca J; Luciano, Marcus R; Lee, Nicole N; Michaels, Anne T; Gemery, John M

2013-08-01

To evaluate of the medium-term integrity, efficacy, and complication rate associated with the Gunther Tulip vena cava filter. A 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. Mean 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. The 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.

Manifestações clínicas da cetose nervosa induzida por isopropanol em ovinos

Directory of Open Access Journals (Sweden)

Carolina Akiko Sato Cabral Araújo

2013-12-01

Full Text Available Doze ovelhas hígidas, não prenhes e não lactentes foram submetidas a um protocolo de indução experimental de cetose nervosa para a avaliação de sintomatologia nos quadros de cetose e Toxemia da Prenhez. Neste protocolo, oito animais foram submetidos a infusão de 150 mL de solução de isopropanol a 35% na veia jugular, constituindo o grupo Tratado (GT, e quatro ovinos foram tratados identicamente com solução salina isotônica (NaCl 0,9%, constituindo o grupo Controle (GC no decorrer de 40 minutos. Os animais do GT apresentaram aumento da frequência cardíaca (FC aos 40 minutos de infusão e redução no movimento ruminal a partir dos 10 minutos de infusão com isopropanol, o qual permaneceu diminuído ate 10 minutos do termino da infusão. A atonia ruminal ocorreu em três animais, que manifestaram em seguida leve meteorismo gasoso. A infusão de isopropanol provocou o surgimento de sintomas nervosos como, depressão e sonolência, cambaleios, adução de membros posteriores, pressão da cabeça em obstáculo, ranger de dentes e cegueira quase sempre acompanhada de diminuição do reflexo pupilar e nistagmo. Todos os animais exalaram forte odor cetótico com poucos minutos do inicio da indução, fato que ajudou a eliminação do isopropanol do organismo. Os presentes resultados sugerem que parte dos sintomas nervosos verificados na Toxemia da Prenhez possa ser oriunda da ação do isopropanol. Estes resultados abrem novas perspectivas para o melhor entendimento da patogenia da Toxemia da Prenhez em ovinos.

O antagonismo com acetamida em experimentos com ovinos, caprinos e coelhos indica monofluoroacetato como princípio tóxico de Pseudocalymma elegans Bignoniaceae

Directory of Open Access Journals (Sweden)

Michel A Helayel

2011-10-01

íam em decúbito lateral, esticavam os membros, faziam movimentos de pedalagem e morriam em poucos minutos. Nos coelhos observaram-se apatia, tremores musculares, decúbito lateral e vocalização minutos antes da morte. A avaliação macroscópica revelou, nos ovinos e caprinos, jugulares ingurgitadas, aurículas, veia cava caudal e cranial dilatadas, além de edema pulmonar, congestão hepática e edema na subserosa da vesícula biliar. Nos coelhos as principais alterações observadas foram aurículas dilatadas, veia cava caudal e cranial ingurgitadas, fígado e vasos do diafragma congestos. O exame histopatológico revelou, em dois ovinos e um caprino, degeneração hidrópico-vacuolar dos túbulos uriníferos contornados distais associada à cariopicnose. Nos coelhos havia congestão hepática acentuada com numerosos corpúsculos de choque. Nossos resultados comprovam, de forma indireta, que MF é responsável pela morte dos animais que ingerem essa planta, uma vez que compostos "doadores de acetato" como a acetamida, são capazes de reduzir a inibição competitiva do MF pelo mesmo sítio ativo (Coenzima A, o que impede a formação do fluorocitrato, seu metabólito ativo, formado no organismo por meio da denominada "síntese letal"

[Clinical analysis of patients with lower extremity deep venous thrombosis complicated with inferior vena cava thrombus].

Science.gov (United States)

Dong, Dian-ning; Wu, Xue-jun; Zhang, Shi-yi; Zhong, Zhen-yue; Jin, Xing

2013-06-04

To explore the clinical profiles of patients with lower extremity deep venous thrombosis (DVT) complicated with inferior vena cava (IVC) thrombus and summarize their clinical diagnostic and therapeutic experiences. The clinical characteristics, diagnosis and treatment of 20 hospitalized patients with DVT complicated with inferior vena cava thrombus were analyzed retrospectively. All of them were of proximal DVT. There were phlegmasia cerulea dolens (n = 3), pulmonary embolism (n = 3) and completely occlusion of IVC (n = 5). Clinical manifestations were severe. Retrievable inferior vena cava filter (IVCF) was implanted for 17 cases. Catheter-directed thrombolysis (CDT) through ipsilateral popliteal vein was applied for 7 cases and systemic thrombolysis therapy for 8 cases. The effective rate of thrombolysis for fresh IVC thrombus was 100%. Among 5 cases with Cockett Syndrome, 3 cases underwent balloon dilatation angioplasty and endovascular stenting of iliac vein. And 17 IVCFs were retrieved successfully within 3 weeks. IVC thrombus disappeared completely in 15 cases. Systemic or local thrombolysis with protective IVCF is a safe and effective therapy for nonocclusive IVC thrombus in DVT. And CDT is recommended for symptomatic occlusive IVC thrombus.

Septic thrombosis of the inferior vena cava treated with percutaneous mechanical thrombectomy

NARCIS (Netherlands)

Burgmans, Mark C.; Rommes, Johannes H.; Spronk, Peter E.; van Nidek, Robert J. P. Brouerius; Bouma, Wim H.; Gratama, Jan Willem C.

2006-01-01

The present report describes a patient with septic thrombosis of the inferior vena cava (IVC) related to a subhepatic abscess adjacent to the IVC. Despite prolonged antimicrobial therapy and systemic anticoagulation, sepsis and septic embolism persisted while the size of the thrombus increased.

Morfologia e vascularização do baço de jacaré (Caiman crocodilus yacare – Daudin, 1802

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Rosangela Felipe Rodrigues

2013-09-01

Full Text Available http://dx.doi.org/10.5007/2175-7925.2013v26n4p185 O Caiman crocodilus yacare é encontrado do norte da Argentina até o sul da bacia Amazônica, ocorrendo principalmente no Pantanal. Sua alimentação consiste de peixes e outros vertebrados aquáticos e invertebrados, como caranguejos, caramujos e insetos. Seu comprimento pode chegar a 3 m e essa espécie é importante porque proporciona controle biológico de outras espécies animais, ao se alimentar de indivíduos fracos, velhos e doentes, incapazes de escapar de seu ataque. Foram utilizados 15 jacarés, machos e fêmeas jovens, empregando técnicas histológicas; técnicas de injeção com Neoprene látex 450 e acetato de vinila; e técnicas radiográficas para observar particularidades do baço nessa espécie. O órgão apresenta forma cônica, sendo mais espesso na sua extremidade cranial e afilando-se em sua extremidade caudal. O baço envolveu a artéria mesentérica cranial, que se dirigiu aos intestinos, desde sua origem na artéria celíaca até o seu terço médio, pelo parênquima lienal em todas as preparações. A irrigação do baço de jacaré foi originada da artéria celíaca, por meio de seu ramo, a artéria mesentérica cranial, a qual se ramificou em artérias lienais, somente no interior desse órgão. As veias lienais apresentaram-se como as veias lienais cranial, craniomedial, medial e caudal que drenam da cápsula lienal à região medular, passando pela região cortical e dirigindo-se à veia porta hepática. O baço de jacaré não apresentou correspondência entre as artérias e as veias responsáveis pela vascularização de um determinado território lienal, mas foram observadas artérias que irrigaram e veias que drenaram áreas particulares do parênquima lienal.

Avaliação não invasiva da pressão venosa central por ecocardiografia em cuidados intensivos – Particularidades nos doentes com dilatação do ventrículo direito e exacerbação de doença pulmonar crónica

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Paulo Marcelino

2006-11-01

Full Text Available Resumo: Objectivos: Determinar a possibilidade de avaliação não invasiva da pressão venosa central (PVC através da análise da veia cava inferior (VCI, obtida por ecocardiografia transtorácica (ETT.Desenho: Estudo prospectivo com 3 anos de duração.Local: Unidade de Cuidados Intensivos Polivalente (UCIP de 16 camas.Métodos: Estudados doentes admitidos numa UCIP nos quais se avaliou a PVC em simultâneo com exame ETT que, para além da visualização da VCI, consistiu na obtenção da dimensão das cavidades cardíacas e função sistólica do ventrículo esquerdo. Para a correlação foram utilizados testes estatísticos paramétricos e não paramétricos.Resultados: Admitidos 560 doentes com registo simultâneo de PVC e ETT e incluídos 477 doentes em que foi possível visualizar a VCI, com idade média de 62,6±±17,3 anos, média de internamento de 11,9±18,7 dias, um índice APACHE II médio de 23,9±8,9 e SAPS II médio de 55,7±20,4. Por análise de regressão linear verificou-se uma relação entre a PVC e a dimensão máxima da VCI (p=0,013, o índice da VCI (p=0,001 e a presença de ventilação mecânica (p=0,002. A correlação linear entre a PVC e a dimensão máxima da VCI e respectivo índice foi de 0,34 e 0,44. Por teste de qui-quadrado, verificou-se uma relação estatisticamente significativa entre os seguintes intervalos de valores: índice da VCI >25% e PVC7 mmHg e a dimensão máxima da VCI >10 mm; nos doentes admitidos por exacerbação de doença pulmonar crónica verificou-se uma correlação fraca entre a PVC >7 mmHg e o índice da VCI25% and a CVP 7 mmHg; an IVC maximum dimension10 mmHg and CVP>7 mmHg. Patients with right ventricle enlargement presented a lack of agreement between IVC maximum dimension and CVP7 mmHg was also observed.Conclusions: IVC

First magnetic resonance imaging-guided aortic stenting and cava filter placement using a polyetheretherketone-based magnetic resonance imaging-compatible guidewire in swine: proof of concept.

Science.gov (United States)

Kos, Sebastian; Huegli, Rolf; Hofmann, Eugen; Quick, Harald H; Kuehl, Hilmar; Aker, Stephanie; Kaiser, Gernot M; Borm, Paul J A; Jacob, Augustinus L; Bilecen, Deniz

2009-05-01

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

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

International Nuclear Information System (INIS)

Kos, Sebastian; Huegli, Rolf; Hofmann, Eugen; Quick, Harald H.; Kuehl, Hilmar; Aker, Stephanie; Kaiser, Gernot M.; Borm, Paul J. A.; Jacob, Augustinus L.; Bilecen, Deniz

2009-01-01

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

Morfologia do figado da paca (Cuniculus Paca, Linnaeus 1766

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Leandro Luis Martins

2011-12-01

Full Text Available http://dx.doi.org/10.5007/2175-7925.2012v25n2p109 Foram observados os elementos referentes à morfologia do fígado da paca (Cuniculus paca, segundo maior roedor da fauna brasileira que apresenta alto potencial zootécnico. Utilizaram-se oito animais provenientes do setor de Animais Silvestres da Faculdade de Ciências Agrárias e Veterinárias - Campus de Jaboticabal - UNESP, devidamente credenciado pelo IBAMA como criatório experimental. Mediante procedimento de dissecação verificou-se que o fígado da paca localiza-se na porção cranial do abdome, imediatamente depois do diafragma, ao qual se prende pelos ligamentos triangulares, coronários e falciforme, com sua maior parte localizada à direita do plano médio. O fígado desse roedor apresenta a seguinte lobação: lobo lateral direito, lobo medial direito, lobo quadrado, lobo medial esquerdo e lobo lateral esquerdo, além do lobo caudado formado pelo processo papilar do lobo caudado e processo caudado do lobo caudado. A vesícula biliar encontra-se entre os lobos quadrado e medial direito. Fragmentos desse órgão foram colhidos, fixados e preparadas histologicamente, sendo as amostras analisadas à microscopia de luz. Microscopicamente observou-se que o tecido conjuntivo intralobular é escasso,sua constituição básica de hepatócitos poliédricos organizados em cordões se interpõem por sinusóides e na periferia do lóbulo encontram-se as tríades portais, constituídas pela veia porta, arteria hepática e ducto biliar.

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

DEFF Research Database (Denmark)

Broholm, Rikke; Jørgensen, Maja; Just, Sven

2011-01-01

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

Isolated persistent left superior vena cava: A case report and its clinical implications

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Samarjit Bisoyi

2017-01-01

Full Text Available The venous anomaly of a persistent left superior vena cava (PLSVC affects 0.3%-0.5% of the general population. PLSVC with absent right superior vena cava, also termed as "isolated PLSVC," is an extremely rare venous anomaly. Almost half of the patients with isolated PLSVC have cardiac anomalies in the form of atrial septal defect, endocardial cushion defects, or tetralogy of Fallot. Isolated PLSVC is usually innocuous. Its discovery, however, has important clinical implications. It can pose clinical difficulties with central venous access, cardiothoracic surgeries, and pacemaker implantation. When it drains to the left atrium, it may create a right to left shunt. In this case report, we present the incidental finding of isolated PLSVC in a patient who underwent aortic valve replacement. Awareness about this condition and its variations is important to avoid complications.

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

Energy Technology Data Exchange (ETDEWEB)

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

2014-06-15

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

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

International Nuclear Information System (INIS)

Quaretti, Pietro; Galli, Franco; Maramarco, Lorenzo Paplo; Corti, Riccardo; Leati, Giovanni; Fiorina, Ilaria; Maestri, Marcello

2014-01-01

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

Efeito da aplicação de hCG ou GnRH sobre a concentração sérica de progesterona e eficiência reprodutiva em porcas Effect of injection of hCG or GnRH on progesterone serum concentration and reproductive efficiency of sows

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L.F.R. Carvalho

2003-12-01

Full Text Available Avaliou-se o efeito da aplicação de diferentes hormônios no quinto dia após a primeira inseminação sobre a concentração sérica de progesterona e sobre as características reprodutivas, em 103 porcas entre o terceirro e sexto parto. As matrizes foram divididas em: grupo-controle (n=35, não tratado, grupo GnRH (n=34, animais submetidos à aplicação intramuscular (IM de 50mcg de um análogo-GnRH no quinto dia após a primeira inseminação, e grupo hCG (n=34, animais submetidos à aplicação IM de 500UI de hCG no quinto dia após a primeira inseminação. A aplicação dos hormônios não influenciou as características reprodutivas taxa de parto, número total de nascidos, número de nascidos vivos e peso da leitegada (P>0,05. Cinco animais de cada grupo foram submetidos a coletas de sangue da veia cava nos dias 3, 5, 8, 12, 21 e 28 após a primeira inseminação para avaliação da concentração sérica de progesterona (ng/ml, utilizando a técnica de radioimunoensaio. Não houve diferença significativa quanto à concentração sérica de progesterona entre os grupos.Two different hormones were administered on the fifth day after the first insemination to evaluate their influence on serum progesterone concentrations and on reproductive efficiency, in multiparous sows between the third and the sixth parturition. The reproductive performance was evaluated in 103 sows distributed into three groups: 1-Control (n=35; 2-GnRH, 50m g of GnRH-analogue, administered IM on the fifth day after the first insemination (n=34; and 3-hCG, 500 IU of hCG administered IM in the fifth day after the first insemination (n=34. No effect (P>0.05 of hormone treatments on farrowing rate, litter size, live born and litter weight was observed. Five sows of each group were blood sampled on days 3, 5, 8, 12, 21, 28, after the first insemination, to evaluate serum progesterone concentrations (ng/ml. Serum progesterone concentrations were not affected (P>0.05 by

Ultrasound Detection of Superior Vena Cava Thrombus

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Aaron Birch

2014-09-01

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

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

DEFF Research Database (Denmark)

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

2008-01-01

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

The Anatomical Correlation between the Internal Venous Vertebral System and the Cranial Venae Cavae in Rabbit.

Science.gov (United States)

Mazensky, David; Petrovova, Eva; Danko, Jan

2013-01-01

The aim of this study was to describe the possible variations in the connection between the internal venous vertebral system and the cranial vena cava in rabbit using corrosion technique. The study was carried out on 40 adult New Zealand white rabbits. The venous system was injected by using Batson's corrosion casting kit number 17. We found the connection between the internal venous vertebral system and the cranial vena cava by means of the vertebral veins and the right azygos vein. The vertebral vein was present as independent tributary in 36 cases (90%). In the rest of the cases, it was found as being double, being triple, or forming a common trunk with other veins. The azygos vein was present as independent tributary of the cranial vena cava in 39 cases (97.5%). We found also a common trunk formed by the junction of the deep cervical vein, the right vertebral vein, and the azygos vein in one case (2.5%). The azygos vein received 6, 7, 8, or 9 pairs of dorsal intercostal veins. Documenting the anatomical variations in the rabbit will aid in the planning of future experimental studies and determining the clinical relevance on such studies.

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

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Wang Quan

2012-06-01

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

O conduto valvulado bovino contegra, um biomaterial para o tratamento cirúrgico de cardiopatias congênitas The contegra valved bovine conduit: a biomaterial for the surgical treatment of congenital heart defects

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Shi-Min Yuan

2012-01-01

Full Text Available O Contegra, um enxerto de veia jugular bovina, tem sido amplamente utilizado como biomaterial de preferência no tratamento cirúrgico das cardiopatias congênitas, especialmente como um conduto para a reconstrução da via de saída ventricular direita. Este artigo tem como objetivo fazer uma revisão abrangente sobre os desfechos clínicos do Contegra. Foram recuperados, coletados e analisados, relatos de Contegra publicados desde 2002. Havia 1.718 Contegra, aplicados em 1.705 pacientes. Os tamanhos dos condutos foram de 8-22 mm. As idades dos pacientes foram de recém-nascidos até 74,5 anos, com prevalência de pacientes pediátricos. O diagnóstico primário foi cardiopatia congênita em todos os casos, sendo os três diagnósticos principais: tetralogia de Fallot, tronco arterioso e atresia pulmonar, que representaram 25,6%, 16,7% e 13,1%, respectivamente. O Contegra foi utilizado como enxerto tubular na posição pulmonar em 1635 (95,9% pacientes, como remendo monocúspide em 12 (0,7%, como enxerto na posição da valva pulmonar ou monocúspide em 40 (2,3%, e, como conduto artéria pulmonar-veia cava inferior na operação de Fontan, em 18 (1,1% pacientes, respectivamente. O reimplante de conduto foi realizado em 141 (8,3% pacientes, 33,8 ± 37 (8,6-106,8 meses após a inserção do conduto inicial. A plástica do conduto foi necessária em seis (0,4% e a reintervenção em 83 (4,9% dos pacientes. As indicações do reimplante do conduto incluíram estenose importante da anastomose distal, pseudoaneurisma da anastomose proximal e regurgitação importante do conduto. Quanto ao bom desempenho, disponibilidade e longevidade, o Contegra é um biomaterial adequado para a reconstrução da via de saída ventricular direita e como remendo para reparo de comunicação interventricular, mas não é apto para a operação de Fontan.Contegra, a bovine jugular vein graft, has been widely used as a preferable biomaterial in the surgical treatment of

O conduto valvulado bovino contegra, um biomaterial para o tratamento cirúrgico de cardiopatias congênitas The contegra valved bovine conduit: a biomaterial for the surgical treatment of congenital heart defects

Directory of Open Access Journals (Sweden)

Shi-Min Yuan

2012-12-01

Full Text Available O Contegra, um enxerto de veia jugular bovina, tem sido amplamente utilizado como biomaterial de preferência no tratamento cirúrgico das cardiopatias congênitas, especialmente como um conduto para a reconstrução da via de saída ventricular direita. Este artigo tem como objetivo fazer uma revisão abrangente sobre os desfechos clínicos do Contegra. Foram recuperados, coletados e analisados, relatos de Contegra publicados desde 2002. Havia 1.718 Contegra, aplicados em 1.705 pacientes. Os tamanhos dos condutos foram de 8-22 mm. As idades dos pacientes foram de recém-nascidos até 74,5 anos, com prevalência de pacientes pediátricos. O diagnóstico primário foi cardiopatia congênita em todos os casos, sendo os três diagnósticos principais: tetralogia de Fallot, tronco arterioso e atresia pulmonar, que representaram 25,6%, 16,7% e 13,1%, respectivamente. O Contegra foi utilizado como enxerto tubular na posição pulmonar em 1635 (95,9% pacientes, como remendo monocúspide em 12 (0,7%, como enxerto na posição da valva pulmonar ou monocúspide em 40 (2,3%, e, como conduto artéria pulmonar-veia cava inferior na operação de Fontan, em 18 (1,1% pacientes, respectivamente. O reimplante de conduto foi realizado em 141 (8,3% pacientes, 33,8 ± 37 (8,6-106,8 meses após a inserção do conduto inicial. A plástica do conduto foi necessária em seis (0,4% e a reintervenção em 83 (4,9% dos pacientes. As indicações do reimplante do conduto incluíram estenose importante da anastomose distal, pseudoaneurisma da anastomose proximal e regurgitação importante do conduto. Quanto ao bom desempenho, disponibilidade e longevidade, o Contegra é um biomaterial adequado para a reconstrução da via de saída ventricular direita e como remendo para reparo de comunicação interventricular, mas não é apto para a operação de Fontan.Contegra, a bovine jugular vein graft, has been widely used as a preferable biomaterial in the surgical treatment of

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

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Ríos Giovanny

2012-06-01

Full Text Available La anomalía total del retorno venoso sistémico tiene gran variedad de presentaciones; sin embargo, la patología de más baja frecuencia es el drenaje de vena cava superior derecha a la aurícula izquierda, hecho de peso para que en el mundo se reporten pocos casos. En la Fundación Clínica Abood Shaio se trató el caso de una paciente de seis años de edad con drenaje venoso total de cava superior derecha a la aurícula izquierda, mediante la técnica de movilización de cava superior y anastomosis cavo-atrial, y se obtuvieron buenos resultados. El caso es mención corresponde al número 21 en la literatura mundial.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 superior 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.

Hepatic Veins and Inferior Vena Cava Thrombosis in a Child Treated by Transjugular Intrahepatic Portosystemic Shunt

International Nuclear Information System (INIS)

Carnevale, Francisco Cesar; Santos, Aline Cristine Barbosa; Tannuri, Uenis; Cerri, Giovanni Guido

2010-01-01

We report the case of a 9-year-old boy with portal hypertension, due to Budd-Chiari syndrome, and retrohepatic inferior vena cava thrombosis, submitted to a transjugular intrahepatic portosystemic shunt (TIPS) by connecting the suprahepatic segment of the inferior vena cava directly to the portal vein. After 3 months, the withdrawal of anticoagulants promoted the thrombosis of the TIPS. At TIPS revision, thrombosis of the TIPS and the main portal vein and clots at the splenic and the superior mesenteric veins were found. Successful angiography treatment was performed by thrombolysis and balloon angioplasty of a severe stenosis at the distal edge of the stent.

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

International Nuclear Information System (INIS)

Abdel-Aal, Ahmed Kamel; Saddekni, Souheil; Hamed, Maysoon Farouk; Fitzpatrick, Farley

2013-01-01

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.

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

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

2009-04-15

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

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)

Koecher, Martin; Krcova, Vera; Cerna, Marie; Prochazka, Martin

2009-01-01

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.

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

International Nuclear Information System (INIS)

Aminololama-Shakeri, Shadi; Wootton-Gorges, Sandra L.; Reyes, Melissa; Moore, Elizabeth H.; Pretzlaff, Robert K.

2007-01-01

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

Avaliações clínico-patológicas e laboratoriais da intoxicação experimental por monofluoroacetato de sódio em ovinos

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Tiago C. Peixoto

2010-12-01

Full Text Available O objetivo deste trabalho foi verificar se a administração de doses únicas e de frações diárias da dose letal de monofluoroacetato de sódio (MF a ovinos induzem a clássica degeneração hidrópico-vacuolar (DHV dos túbulos uriníferos contornados distais observada no rim de bovinos intoxicados por plantas brasileiras que causam "morte súbita" (PBCMS. MF foi administrado, por via oral, em doses únicas de 0,5 e 1,0mg/kg, cada dose para dois ovinos, e em doses subletais repetidas diariamente de 0,1mg/kg/dia, por quatro dias, e 0,2mg/kg/dia por seis dias, cada dose para um ovino. Todos os ovinos que receberam MF morreram, exceto um que recebeu 0,5mg/kg e não mostrou sintomas. A evolução da intoxicação variou de 3min a 33h5min. Clinicamente os animais apresentaram taquicardia, respiração abdominal, tremores musculares, ligeira perda de equilíbrio, por vezes cambaleavam, deitavam e apoiavam a cabeça no flanco. Na fase final, os ovinos caíam em decúbito lateral, esticavam os membros, faziam movimentos de pedalagem, apresentavam opistótono e morriam. O exame ecocardiográfico evidenciou dilatação cardíaca e redução da fração de encurtamento sistólico. A análise dos níveis séricos de uréia e creatinina revelou moderada a acentuada azotemia. MF provocou "morte súbita" em todos os ovinos que mostraram sintomas. À necropsia verificaram-se aurículas e veias jugulares, cavas, ázigos e pulmonares moderadamente ingurgitadas e, em alguns animais, edema pulmonar. O exame histopatológico revelou, em todos os ovinos, leve a acentuada DHV das células epiteliais dos túbulos contornados distais, associada à picnose nuclear. Adicionalmente, verificaram-se discreta vacuolização e, por vezes, necrose de coagulação de hepatócitos. Não encontramos referências a esse tipo peculiar de lesão, exceto das descrições sobre lesões renais associadas à ingestão de PBCMS e de recentes estudos em bovinos intoxicados com MF. Este

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

International Nuclear Information System (INIS)

Nadkarni, Sanjay; Macdonald, Sumaira; Cleveland, Trevor J.; Gaines, Peter A.

2002-01-01

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

Simon nitinol vena cava filters: effectiveness and complications

International Nuclear Information System (INIS)

Wolf, F.; Thurnher, S.; Lammer, J.

2001-01-01

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

Transection of the inferior vena cava from blunt thoracic trauma: case reports.

Science.gov (United States)

Peitzman, A B; Udekwu, A O; Pevec, W; Albrink, M

1989-04-01

Blunt thoracic trauma is a frequent cause of death in multiple trauma victims. Myocardial rupture may occur in up to 65% of patients who die with thoracic injuries. Two cases are presented with intrapericardial transection of the inferior vena cava, pericardial rupture, and myocardial rupture from blunt thoracic trauma. Both patients died.

Derivação com veias de membro superior após trombólise de aneurisma de artéria poplítea: alternativa para salvamento de membro Arm vein bypass after popliteal artery aneurysm thrombolysis: an alternative for limb salvage

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João Antonio Corrêa

2007-06-01

Full Text Available Os autores relatam um caso de aneurisma de artéria poplítea trombosado em que se realizou fibrinólise com sucesso na fase aguda. Foram utilizadas veias de braço para realização do enxerto e exclusão do aneurisma, pois o paciente havia sido previamente submetido à safenectomia bilateral e revascularização do miocárdio com as veias do outro braço. Apesar das dificuldades, o salvamento do membro foi alcançado.The authors report a case of a thrombosed popliteal artery aneurysm successfully treated by fibrinolysis in its acute stage. Arm veins were used to perform a bypass and aneurysm exclusion, since the patient had previously been submitted to bilateral saphenous vein stripping and myocardial revascularization using the veins of the other arm. Despite the difficulties, limb salvage was achieved.

Extreme premature with persistent left superior vena cava.

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Aboitiz-Rivera, Carlos Manuel; Blachman-Braun, Ruben; Parra-Pérez, Mariana Yazmin

2017-10-01

Persistent left superior vena cava (PLSVC) is a congenital anomaly, that results when there is an absence of the normal regression of the left common precardinal vein during embryogenesis. Usually, this anomaly remains asymptomatic, however, when the PLSVC drains into the left atrium this could lead to a right-to-left shunt. Additionally, this can result in inadvertent delivery of air or thrombus into the systemic circulation with potential neurologic, cardiac and renal complications. In this article, we present a case of an extreme premature Mexican newborn in which the diagnosis was made after placement of a percutaneous central venues catheter.

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

Energy Technology Data Exchange (ETDEWEB)

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

2002-07-01

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

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

Science.gov (United States)

Köcher, Martin; Krcova, Vera; Cerna, Marie; Prochazka, Martin

2009-04-01

To evaluate the feasibility and efficacy of the retrievable Günther 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. 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 Günther Tulip Vena Cava Filter implantation. All filters were inserted and removed under local anesthesia from the jugular approach. The Günther 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. Retrievable Günther Tulip Vena Cava Filters can be inserted and removed in patients during the perinatal period without major complications.

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

DEFF Research Database (Denmark)

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

1988-01-01

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

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

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Andrei Catanchin

2008-08-01

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

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

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Terry L. Levin, MD

2015-01-01

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

Radiation-induced leiomyosarcoma of the great vessels presenting as superior vena cava syndrome

International Nuclear Information System (INIS)

Weiss, K.S.; Zidar, B.L.; Wang, S.

1987-01-01

A patient with a pleomorphic intravascular leiomyosarcoma of the great vessels of the neck and mediastinum presented clinically with a superior vena cava syndrome. A latent period of 29 years elapsed between receiving orthovoltage radiation to the neck and right side of chest to treat recurrent ganglioneuroblastoma, and the appearance of a leiomyosarcoma and subsequent recurrences. The patient underwent partial resection of the tumor, received adjunct chemotherapy, and was shown to be free of disease by clinical tests and by magnetic resonance imaging (MRI) 17 months after completion of chemotherapy. The criteria for the diagnosis of radiation-induced sarcomas are reviewed in relation to the present case. The critical role of magnetic resonance imaging in both the diagnosis and continued follow-up of the patient is described. This would appear to be the first reported case of radiation-induced intravascular leiomyosarcoma of the great vessels of the neck and mediastinum presenting as a superior vena cava syndrome

The Anatomical Correlation between the Internal Venous Vertebral System and the Cranial Venae Cavae in Rabbit

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David Mazensky

2013-01-01

Full Text Available The aim of this study was to describe the possible variations in the connection between the internal venous vertebral system and the cranial vena cava in rabbit using corrosion technique. The study was carried out on 40 adult New Zealand white rabbits. The venous system was injected by using Batson's corrosion casting kit number 17. We found the connection between the internal venous vertebral system and the cranial vena cava by means of the vertebral veins and the right azygos vein. The vertebral vein was present as independent tributary in 36 cases (90%. In the rest of the cases, it was found as being double, being triple, or forming a common trunk with other veins. The azygos vein was present as independent tributary of the cranial vena cava in 39 cases (97.5%. We found also a common trunk formed by the junction of the deep cervical vein, the right vertebral vein, and the azygos vein in one case (2.5%. The azygos vein received 6, 7, 8, or 9 pairs of dorsal intercostal veins. Documenting the anatomical variations in the rabbit will aid in the planning of future experimental studies and determining the clinical relevance on such studies.

Efeito do sítio de venopunção nos parâmetros hematológicos em tigre-d'água-americano, Trachemys scripta elegans

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Nina C. Medeiros

2012-12-01

Full Text Available O objetivo do presente estudo foi realizar a comparação entre dois sítios de coleta sanguínea em 24 exemplares de tigre-d'água-americano (Trachemys scripta elegans oriundos de um criadouro comercial, localizado no município de Antonina, litoral do Paraná, Brasil. Os animais foram submetidos a contenção física e as venopunções foram realizadas no seio supraocciptal e na veia coccígea dorsal. As amostras heparinizadas foram identificadas e refrigeradas para posterior análise laboratorial. A contagem total de eritrócitos e leucócitos foi realizada pela técnica de hemocitometria. O hematócrito (Ht e a hemoglobina (Hb foram determinados pelo método de microhematócrito e cianometahemoglobina, respectivamente. A proteína plasmática total (PPT foi determinada por refratometria e a contagem diferencial de leucócitos foi realizada através da técnica de Shilling. Houve diferença significativa no número de leucócitos e no valor da proteína plasmática total, e em ambos os casos os valores encontrados nas amostras provenientes da veia coccígea dorsal foram inferiores. A diferença encontrada no número de leucócitos provavelmente foi devido à contaminação por linfa, que também justifica o menor valor na concentração da proteína plasmática total. Conclui-se que é mais indicada a venopunção no seio supraocciptal quando comparado a veia coccígea dorsal.

The superior vena cava syndrome caused by malignant disease

International Nuclear Information System (INIS)

Eren, Suat; Karaman, Adem; Okur, Adnan

2006-01-01

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

The superior vena cava syndrome caused by malignant disease

Energy Technology Data Exchange (ETDEWEB)

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

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

Adult Wilms tumor with inferior vena cava thrombus and distal deep vein thrombosis - a case report and literature review.

Science.gov (United States)

Ratajczyk, Krzysztof; Czekaj, Adrian; Rogala, Joanna; Kowal, Pawel

2018-02-23

Adult Wilms tumor (WT, nephroblastoma) is a rare, but well-described renal neoplasm. Although inferior vena cava tumor thrombosis is present in up to 10% of Wilms tumors in childhood, only few cases of this clinical manifestation in adults have been reported. To the best of our knowledge, this is the first case of adult WT infiltrating into inferior vena cava (IVC) with concomitant distal deep vein thrombosis. A 28-year-old male patient with gross hematuria and right flank pain was diagnosed with right kidney tumor penetrating to IVC. Preoperatively, acute distal thrombosis in inferior vena cava and lower extremities veins occurred. Right radical nephrectomy with tumor thrombectomy via cavotomy was performed. In order to prevent pulmonary embolism, IVC was ligated below left renal vein level. Histopathological examination revealed a triphasic nephroblastoma without anaplastic features. Postoperatively, patient was diagnosed with metastatic liver disease, which was treated with two lines of chemotherapy followed by radiotherapy with achievement of complete response. Adult WT occurs usually in young patients, under 40 years of age. Neoadjuvant chemotherapy proved to be effective in children, resulting with tumor shrinkage and venous tumor thrombus regression. Therefore, percutaneous biopsy should be always considered in young patients presenting with renal tumor invading venous system. IVC ligation is a safe treatment option in the event of complete inferior vena cava occlusion due to distal thrombosis concomitant to tumor thrombus, provided collateral venous pathways are well-developed.

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

Science.gov (United States)

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

2013-02-01

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

Radiotherapy of superior vena cava syndrome

International Nuclear Information System (INIS)

Kawanami, Shoko; Imada, Hajime; Terashima, Hiromi; Nakata, Hajime

1996-01-01

The records of 38 patients with superior vena cava syndrome (SVC syndrome) due to malignancy and who received radiation therapy were retrospectively reviewed. The majority were lung cancers, constituting 28 of the 38 cases (73.7%). All patients were treated with conventional radiation doses ranging from 20 to 70 Gy and good symptomatic response was observed in 31 cases (81.6% ). The response appeared within 1.7±0.9 weeks on average (3 days-4 weeks;, and performance status also improved in 50% of the patients. The median survival was 6.6 months. Long term survivors were seen mostly in patients with thymoma, and only one patient ever showed a recurrence of SVC syndrome. We conclude that radiotherapy can be an effective therapeutic modality for SVC syndrome and that it improves the quality of life in most patients. (author)

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

LENUS (Irish Health Repository)

Leong, S

2010-06-19

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

Aspectos clínicos, ultra-sonográficos e venográficos da tromboflebite jugular experimental em equinos

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Carlos Alberto Hussni

2012-07-01

Full Text Available A tromboflebite jugular ocorre frequentemente em equinos, decorrendo geralmente de processos mórbidos associados à iatrogenia, podendo levar a perda de função, edema cefálico, diminuição do desempenho atlético e ainda causar o óbito. Esta enfermidade nos equinos apesar de frequente é pouco conhecida quanto à sua evolução e tratamentos. O objetivo deste trabalho foi avaliar a evolução da tromboflebite jugular experimental em equinos, quanto às alterações clínicas e estruturais envolvidas na enfermidade, observando-se os aspectos clínicos, ultra-sonográficos e venográficos no contexto do trombo e do vaso, quanto à possibilidade de recanalização do trombo produzido e da vascularização compensatória. A tromboflebite da veia jugular foi induzida, unilateralmente, em 05 equinos nos quais previamente à indução da tromboflebite e diariamente após foram observadas manifestações clínicas e realizados exames ultra-sonográficos. Venografias foram feitas nos momentos pré-indução, na indução e a cada seis dias após a indução da tromboflebite, verificando-se a recanalização do trombo oclusivo e a presença de vasos na drenagem sanguínea compensatória. Observou-se a ocorrência de edema moderado das regiões parotídea, massetérica e supra-orbitária e discreto edema submandibular que reduziram até o 6º dia, permanecendo apenas discreto aumento parotídeo. O ingurgitamento da jugular cranial a região da indução permaneceu durante todo o período de avaliação. A porção caudal à tromboflebite mostrou ingurgitamento frente ao garrote na entrada do tórax desde o primeiro dia após a indução. Os exames ultra-sonográficos mostraram formação de trombo oclusivo total durante todo o período de observação em 3 animais e o restabelecimento parcial do fluxo na jugular em 2 animais e a presença de vasos colaterais conduzindo o sangue da porção cranial para a porção caudal à obstrução. As venografias

Importance of a persisting left vena cava superior in pacemaker therapy

International Nuclear Information System (INIS)

Marosi, G.; Sagi, J.; Pokorny, L.; Simon, Z.; Orvostudomangi Egyetem, Szeged

1982-01-01

Basing on the description of a specific case and a review of literature, the article discusses the relationship between persisting left vena cava superior and pacemaker therapy. The article covers the technical problems caused by the vascular anomaly, the complications which can be expected, the possibilities in respect of recognising the vascular anomaly, as well as the methods for coping with the special situation prevailing in a particular case. (orig.) [de

Guenther Tulip Filter Retrieval from a Left-sided Inferior Vena Cava

International Nuclear Information System (INIS)

Brountzos, Elias N.; Kaufman, John A.; Lakin, Paul L.

2004-01-01

Optional (retrievable) inferior cava filters (IVC) may have advantages over permanent filters in a certain subset of patients, especially in view of recent concerns about the long-term thrombotic complications of the latter. Retrieval of the Guenther Tulip Filter (GTF), an optional filter, has been reported in a total of 76 patients. We present the first description of GTF retrieval from a left-sided IVC using the right internal jugular approach

Superior vena cava syndrome in hemodialysis patient

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Azeb Molhem

2011-01-01

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

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

International Nuclear Information System (INIS)

Zhou Chungao; Shi Haibing; Liu Sheng; Wang Chenghu; Liu Hairi; Li Linsun

2007-01-01

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)

Left kidney angiomyolipoma, spreading to the renal vein, inferior vena cava and involving the heart. Report of one case

OpenAIRE

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

2008-01-01

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. ...

Right-sided duplication of the inferior vena cava and the common iliac vein: hidden hinds in spiral-computed tomography; Rechtsseitige Dopplung der Vena cava inferior und Vena iliaca communis: Bildgebung mit der Spiral-Computertomographie

Energy Technology Data Exchange (ETDEWEB)

Meyer, D.R.; Friedrich, M. [Krankenhaus am Urban (Germany). Abt. fuer Roentgendiagnostik und Nuklearmedizin; Andresen, R. [Staedtisches Krankenhaus Zehlendorf, Behring (Germany). Abt. fuer Roentgendiagnostik und Nuklearmedizin

1998-05-01

Duplications of the inferior vena cava (IVC) are rare variants of the abdominal vessels and are normally located on both sides of the abdominal aorta. The rare case of a rightsided infrarenal duplication of the IVC with involvement of the common iliac vein is reported. Details of the embryology are presented for the understanding of this IVC variant. The spiral CT with multiplanar reconstructions makes it possible to define the vascular morphology and to differentiate it from lymphoma. (orig.) [Deutsch] Duplikaturen der Vena cava inferior (VCI) sind seltene meist bilateral der Aorta abdominalis gelegene abdominelle Gefaessvarianten. Der ungewoehnliche Fall einer rechtsseitigen infrarenalen Dopplung der VCI mit Beteiligung der Vena iliaca communis wird dargestellt. Auf der Embryologie wird, soweit fuer das Verstaendnis der vorliegenden VCI-Variante notwendig, eingegangen. Die Spiral-CT mit multiplanaren Rekonstruktionen erlaubt die morphologische Beschreibung der Gefaesssituation und die Differenzierung gegenueber Lymphomen. (orig.)

Inferior Vena Cava and Renal Vein Thrombosis Associated with Thymic Carcinoma

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Vlad Teodor Berbecar

2017-01-01

Full Text Available Thymic tumors are rare mediastinal tumors that can present with a wide variety of symptoms. They can cause distant manifestations and are frequently associated with paraneoplastic syndromes. In our case, we describe the evolution of a 68-year-old male whose first manifestation was thrombosis of the inferior vena cava and renal veins. Thrombosis of large abdominal veins is rare, especially without being associated with any other comorbidity or risk factors.

Anomalous inferior vena cava in association with omphalocele: a case report

Energy Technology Data Exchange (ETDEWEB)

Antoniou, E E.H. [Dept. of Pediatrics, School of Medicine, Univ. of Tokushima (Japan); Matsuoka, S [Dept. of Pediatrics, School of Medicine, Univ. of Tokushima (Japan); Mori, K [Dept. of Pediatrics, School of Medicine, Univ. of Tokushima (Japan); Hayabuchi, Y [Dept. of Pediatrics, School of Medicine, Univ. of Tokushima (Japan); Kuroda, Y [Dept. of Pediatrics, School of Medicine, Univ. of Tokushima (Japan)

1995-06-01

We present the case of a 6-year-old boy who had an omphalocele repaired at day 1 of life. He had a secundum atrial septal defect and an anomalous inferior vena cava of a type which has not been previously reported. Cine-MRI was a useful noninvasive tool for diagnosing the anomalous subaortic innominate vein and four immature vessels which make up the venous drainage systems of the lumbar region. (orig.)

Anomalous inferior vena cava in association with omphalocele: a case report

International Nuclear Information System (INIS)

Antoniou, E.E.H.; Matsuoka, S.; Mori, K.; Hayabuchi, Y.; Kuroda, Y.

1995-01-01

We present the case of a 6-year-old boy who had an omphalocele repaired at day 1 of life. He had a secundum atrial septal defect and an anomalous inferior vena cava of a type which has not been previously reported. Cine-MRI was a useful noninvasive tool for diagnosing the anomalous subaortic innominate vein and four immature vessels which make up the venous drainage systems of the lumbar region. (orig.)

Reoperação da valva mitral minimamente invasiva sem pinçamento da aorta

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Rodrigo Milani

2013-09-01

Full Text Available INTRODUÇÃO: Reoperações da valva mitral apresentam maior índice de complicações quando comparadas com a primeira cirurgia. Com o domínio das técnicas videoassistidas para as primeiras cirurgias da valva mitral, os casos de reoperações passaram a despertar interesse para esses procedimentos menos invasivos. OBJETIVO: Analisar os resultados e as dificuldades técnicas da retroca valvar mitral minimamente invasiva em 10 pacientes. MÉTODO: A circulação extracorpórea foi instalada por meio de colocação de cânulas femorais e cânula na veia jugular interna direita, conduzida em 28 graus de temperatura em fibrilação ventricular. Realizada toracotomia lateral direita com 5 a 6 cm no terceiro ou quarto espaço intercostal. Pericárdio foi descolado apenas na região do átrio esquerdo no ponto da atriotomia. A aorta não foi pinçada. RESULTADOS: Foram avaliados 10 pacientes com idade média de 56,9±10,5 anos. Quatro encontravam-se em ritmo de fibrilação atrial e 6 em ritmo sinusal. O tempo médio entre a primeira operação e a reoperações foi de 11 ± 3,43 anos. O EuroSCORE médio do grupo foi de 8,3 ± 1,82. O tempo médio de fibrilação ventricular e de circulação extracorpórea foi respectivamente 70,9 ± 17,66 min e 109,4 ± 25,37 min. O tempo médio de internamento foi de 7,6 ± 1,5 dias. Não houve óbitos nessa série. CONCLUSÃO: A reoperação da valva mitral pode ser feita por meio de técnicas menos invasivas com bons resultados imediatos e baixa morbimortalidade. Entretanto, esse tipo de cirurgia requer maior tempo de circulação extracorpórea, especialmente nos casos em que o paciente já tenha uma prótese. A presença de uma mínima insuficiência aórtica também torna esse procedimento tecnicamente mais desafiador.

Omental flap transposition for inferior vena cava filter penetration

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Junji Yamaguchi, MD

2017-03-01

Full Text Available A 40-year-old woman presented with uterine malignancy, deep vein thrombosis, and nonmassive pulmonary embolism in both lungs. Gunter-tulip filter was inserted, because she had severe genital bleeding, which is one of the contraindications to anticoagulation therapy. Total hysterectomy was conducted and anticoagulation therapy was started afterward. The thrombus worsened perioperatively, and the filter could not be retrieved. Since there was lymph node recurrence, the second time operation was performed. During operation, the struts were found to be penetrating the inferior vena cava. Omental flap was used to cover the struts, and no associated complications occurred after operation.

Gallium SPECT detection of neoplastic intravascular obstruction of the superior vena cava

International Nuclear Information System (INIS)

Swayne, L.C.; Kaplan, I.L.

1989-01-01

A rare case of an intravascular neoplastic obstruction of the superior vena cava is discussed. The lesion was detected with gallium single photon emission computed tomography (SPECT) despite a normal appearance on a concurrent radiographic CT study. A computer-generated composite SPECT-CT image confirmed the intravascular localization of the radioisotope, and a subsequent CT-guided transthoracic needle biopsy revealed a poorly differentiated adenocarcinoma

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

Czech Academy of Sciences Publication Activity Database

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

2012-01-01

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

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

International Nuclear Information System (INIS)

Velasco, J.; Fernandez, M.M.; Manzanares, R.; Hernando, A.

1997-01-01

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

CT findings of superior vena cava syndrome

Energy Technology Data Exchange (ETDEWEB)

Lim, Jun; Lee, Jae Mun; Kim, Choon Yul; Bahk, Yong Whee [Catholic Medical College, Seoul (Korea, Republic of)

1986-10-15

Since early 1980's high resolution CT has been used for detection of intrathoracic pathologic condition such as superior vena cava syndrome. Authors retrospectively analysed CT findings of 18 cases of proven SVC syndrome. The results were as follows: 1. The mean age was 50-year-old, and 14 cases were male. 2. Of 18 cases of SVC syndrome, 8 cases had confirmed to be lung cancers, malignant thymoma and teratoma were respectively each 2 cases, and malignant lymphoma, mediastinal abscess, thyroid adenoma and metastatic tumor were 1 case. 3. CT findings were A. Abnormal SVC consisted of compression with displacement (44.4%), intraluminal thrombus (27.8%), and encasement (27.8%). B. The collateral pathways were the azygos-homozygous (88.8%), vertebral (50%), internal mammary (44.4%), and lateral thoracic route (33.3%)

CT findings of superior vena cava syndrome

International Nuclear Information System (INIS)

Lim, Jun; Lee, Jae Mun; Kim, Choon Yul; Bahk, Yong Whee

1986-01-01

Since early 1980's high resolution CT has been used for detection of intrathoracic pathologic condition such as superior vena cava syndrome. Authors retrospectively analysed CT findings of 18 cases of proven SVC syndrome. The results were as follows: 1. The mean age was 50-year-old, and 14 cases were male. 2. Of 18 cases of SVC syndrome, 8 cases had confirmed to be lung cancers, malignant thymoma and teratoma were respectively each 2 cases, and malignant lymphoma, mediastinal abscess, thyroid adenoma and metastatic tumor were 1 case. 3. CT findings were A. Abnormal SVC consisted of compression with displacement (44.4%), intraluminal thrombus (27.8%), and encasement (27.8%). B. The collateral pathways were the azygos-homozygous (88.8%), vertebral (50%), internal mammary (44.4%), and lateral thoracic route (33.3%).

[The assessment of ultrasonic measurement of superior vena cava blood flow for the volume responsiveness of patients with mechanical ventilation].

Science.gov (United States)

Guo, Zhe; He, Wei; Hou, Jing; Li, Tong; Zhou, Hua; Xu, Yuan; Xi, Xiuming

2014-09-01

To approach the evaluative effect of respiratory variation of superior vena cava peak flow velocity measured using transthoracic echocardiography (TTE) on fluid responsiveness in patients with mechanical ventilation. A prospective cohort study was conducted. All mechanical ventilated critically ill patients whose fluid therapy was planned due to hypovolemia in Department of Critical Care Medicine of Beijing Tongren Hospital of Capital Medical University from April 2011 to April 2013 were enrolled. Volume expansion was performed with 500 mL Linger solution within 30 minutes. Patients were classified as responders if pulse pressure variation (PPV) increased ≥ 13% before volume expansion. The respiratory variation in superior vena cava peak velocity was calculated as the difference between maximum and minimum values of velocity in peak A, peak S and peak D over a single respiratory circle, and their variations (ΔA, ΔS, ΔD) were also calculated. The receiver operating characteristic curve (ROC curve) was plotted to assess the evaluative effect of respiratory variation of superior vena cava peak velocity on fluid responsiveness. Twenty-seven patients were enrolled in this study. Volume expansion increased PPV ≥ 13% happened in 14 patients (responders). The velocity of superior vena cava in peak A, peak S, peak D was significantly increased after volume expansion compared with that before volume expansion in responders [peak A (cm/s): 34.6 ± 2.2 vs. 31.3 ± 2.1, t=-2.493, P=0.027; peak S (cm/s): 39.1 ± 1.3 vs. 35.3 ± 2.1, t=-2.564, P=0.024; peak D (cm/s): 28.1 ± 1.2 vs. 23.3 ± 1.4, t=-4.995, P=0.000], but there was no significant difference in ΔA, ΔS and ΔD between before and after volume expansion. The ΔA, ΔS and ΔD were positively correlated with PPV (r=0.040, P=0.854; r=0.350, P=0.074; r=0.749, P=0.000). The area under ROC curve (AUC) of peak S was 0.36 [95% confidence interval (95%CI): 0.11-0.52], but the AUC of ΔS was 0.68 (95%CI 0.47-0.89), the

Prenatal diagnosis of long QT syndrome with the superior vena cava-aorta Doppler approach.

Science.gov (United States)

Chabaneix, Julie; Andelfinger, Gregor; Fournier, Anne; Fouron, Jean-Claude; Raboisson, Marie-Josée

2012-10-01

We describe a fetus at 36 weeks with long QT syndrome presenting with variable types of atrioventricular blocks, ventricular premature beats, and torsades de pointes. All these diagnoses were made with the superior vena cava-aorta Doppler approach and confirmed with postnatal electrocardiography. Copyright © 2012 Mosby, Inc. All rights reserved.

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

International Nuclear Information System (INIS)

Matherne, G.P.; Atkins, D.L.; Frey, E.E.; Smith, W.L.

1987-01-01

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.)

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

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Christian Hélion

2000-09-01

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

Inferior vena cava obstruction and shock

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Megri Mohammed

2018-01-01

Full Text Available Shock is one of the most challenging life-threatening conditions with high mortality and morbidity; the outcomes are highly dependent on the early detection and management of the condition. Septic shock is the most common type of shock in the Intensive Care Unit. While not as common as other subsets of shock, obstructive shock is a significant subtype due to well defined mechanical and pathological causes, including tension pneumothorax, massive pulmonary embolism, and cardiac tamponade. We are presenting a patient with obstructive shock due to inferior vena cava obstruction secondary to extensive deep venous thrombosis. Chance of survival from obstructive shock in our patient was small; however, there was complete and immediate recovery after treatment of the obstruction on recognizing the affected vessels. This case alerts the practicing intensivist and the emergency medicine physician to consider occlusion of the great vessels other than the pulmonary artery or aorta as causes of obstructive shock.

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

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Eun-Young Park

2015-11-01

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

Primary Leiomyosarcoma in the Inferior Vena Cava Extended to the Right Atrium: A Case Report and Review of the Literature

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Shuichi Fujita

2016-10-01

Full Text Available A 38-year-old woman had developed an abdominal distention, lower extremity edema, and dyspnea. Imaging examination revealed a large mass in the right atrium which was connected to lesions within the inferior vena cava. Although complete resection of the mass was not possible, partial surgical tumor resection was performed to avoid pulmonary embolization and circulatory collapse. Leiomyosarcoma was diagnosed histologically, and chemotherapy (doxorubicin followed by radiotherapy was started. By reviewing papers published in the past 10 years that included 322 patients, we also discuss the clinical presentations and prognosis of leiomyosarcoma in the inferior vena cava.

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

LENUS (Irish Health Repository)

Klop, B

2011-01-01

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

Efeitos do ultra-som de baixa intensidade na veia auricular de coelhos Effects of low intensity ultrasound in the auricular vein of rabbits

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Marcelo Araújo

2003-01-01

Full Text Available OBJETIVO: Estudar a ação do ultra-som na veia auricular de coelhos. MÉTODOS: Vinte coelhos foram divididos em dois grupos de dez animais diferindo com relação ao local da aplicação, do ultra-som, o modo e o intervalo de tempo para a análise histopatológica (3 e 7 dias. Os animais foram submetidos à aplicação de ultra-som contínuo e pulsado em dois segmentos venosos da orelha previamente determinados. Cada animal foi o seu próprio controle. Empregou-se a freqüência de 3MHz, intensidade de 3W/cm² nos ciclos pulsado e contínuo por 10 minutos, de forma estacionária. O grupo I foi submetido a eutanásia após 3 dias e o grupo II em 7 dias contemplando a fase aguda do processo inflamatório. Empregou-se o teste exato de Fisher e o teste de Mc Nemar para análise estatística. RESULTADOS: Obteve-se trombose venosa e aumento de linfócitos de forma significativa (p= 0,032 nos grupos tratados com o modo contínuo. O modo pulsado não provocou efeitos deletérios. Outros achados foram congestão, edema, hemorragia e lesão da parede vascular. CONCLUSÕES: O ultra-som pulsado não provoca qualquer alteração na parede vascular nas condições do experimento.O ultra-som contínuo induz a trombose venosa e aumento dos linfócitos de forma significativa.PURPOSE: The purpose of this experimental work was evaluate the effects of low intensity in the auricular vein of rabbits. METHODS: Twenty rabbits were divided in two groups of ten animals. The groups differed about the place where the continuous and pulsed ultrasound were applied and the period that the material was collected for the morphologic examination (3 and 7 days. Acoustic coupling gel was used on marginal ear vein, each animal underwent continuous and pulsed ultrasound treatment, in segments previously marked with indelible ink. Each animal provided its own control. Ultrasound was used in the frequency of 3MHz, intensity of 3W/cm² in the pulsed and continuous modes during 10min

Concomitant Persistent Left Superior Vena Cava and Horseshoe Kidney

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Faraz Jaffer

2015-01-01

Full Text Available 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.

Indications, complications and outcomes of elderly patients undergoing retrievable inferior vena cava filter placement.

Science.gov (United States)

Rottenstreich, Amihai; Kleinstern, Geffen; Bloom, Allan I; Klimov, Alexander; Kalish, Yosef

2017-10-01

The utilization of inferior vena cava filter placement for pulmonary embolism prevention in elderly patients has not been well characterized. The present study aimed to review indications, complications and follow-up data of elderly patients undergoing inferior vena cava filter placement. A retrospective review was carried out of consecutive admitted patients who underwent inferior vena cava filter insertion at a large university hospital with a level I trauma center. Overall, 455 retrievable filters were inserted between 2009 and 2014. A total of 133 patients (29.2%) were aged ≥70 years. Elderly patients were less likely to have their filter retrieved compared with non-elderly patients (5.3% vs 21.4%, P Filter-related complications occurred in 13% of non-elderly patients and 14.3% of elderly patients (P = 0.72), most of them occurring in the first 3 months after filter placement. Survival among elderly patients with no evidence of active malignancy was similar to the non-elderly patients with a 1-year survival rate of 76.3% versus 82% in non-elderly patients (P = 0.22), and a 2-year survival rate of 73.1% versus 78.6% in non-elderly patients (P = 0.27). Although decreased, survival rates among elderly patients with active cancer were still substantial, with a 1-year survival rate of 45% and 2-year survival rate of 40%. Elderly patients had significantly lower rates of filter retrieval with similar complication rate. Survival rates among elderly patients were substantial, and in elderly patients with no active cancer were even comparable with non-elderly patients. When feasible, filter retrieval should be attempted in all elderly patients in order to prevent filter-related complications. Geriatr Gerontol Int 2017; 17: 1508-1514. © 2016 Japan Geriatrics Society.

Particle radiotherapy, a novel external radiation therapy, versus liver resection for hepatocellular carcinoma accompanied with inferior vena cava tumor thrombus: A matched-pair analysis.

Science.gov (United States)

Komatsu, Shohei; Kido, Masahiro; Asari, Sadaki; Toyama, Hirochika; Ajiki, Tetsuo; Demizu, Yusuke; Terashima, Kazuki; Okimoto, Tomoaki; Sasaki, Ryohei; Fukumoto, Takumi

2017-12-01

Hepatocellular carcinoma accompanied with inferior vena cava tumor thrombus carries a dismal prognosis, and the feasibility of local treatment has remained controversial. The present study aimed to compare the outcomes of particle radiotherapy and liver resection in patients with hepatocellular carcinoma with inferior vena cava tumor thrombus. Thirty-one and 19 patients, respectively, underwent particle radiotherapy and liver resection for hepatocellular carcinoma with inferior vena cava tumor thrombus. A matched-pair analysis was undertaken to compare the short- and long-term outcomes according to tumor stage determined using the tumor-node-metastasis classification. Both stages IIIB and IV (IVA and IVB) patients were well-matched for 12 factors, including treatment policy and patient and tumor characteristics. The median survival time of matched patients with stage IIIB tumors in the particle radiotherapy group was greater than that in the liver resection group (748 vs 272 days, P = .029), whereas no significant difference was observed in the median survival times of patients with stage IV tumors (239 vs 311 days, respectively). There were significantly fewer treatment-related complications of grade 3 or greater in the particle radiotherapy group (0%) than in the liver resection group (26%). Particle radiotherapy is potentially preferable in hepatocellular carcinoma patients with stage IIIB inferior vena cava tumor thrombus and at least equal in efficiency to liver resection in those with stage IV disease, while causing significantly fewer complications. Considering the relatively high survival and low invasiveness of particle radiotherapy when compared to liver resection, this approach may represent a novel treatment modality for hepatocellular carcinoma with inferior vena cava tumor thrombus. Copyright © 2017 Elsevier Inc. All rights reserved.

Alterações na gasometria de fetos aloimunizados após procedimento de transfusão intra-uterina

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Nomura Roseli Mieko Yamamoto

2003-01-01

Full Text Available OBJETIVO: este estudo, realizado em gestações com aloimunização pelo fator Rh, tem como objetivo descrever as alterações gasométricas e do equilíbrio ácido-básico fetal antes e após transfusões intra-uterinas (TIU. MÉTODO: no período de junho de 2001 a outubro de 2001, antes e após a TIU em fetos de gestantes aloimunizadas, foram avaliados prospectivamente a gasometria e o equilíbrio ácido-básico no sangue da veia umbilical. As medidas foram realizadas em 8 amostras de sangue de 5 fetos. O sangue fetal foi obtido por cordocentese da veia umbilical antes e após TIU. Os resultados obtidos foram comparados com a expansão volêmica na TIU, a idade gestacional no procedimento, o peso fetal estimado pela ultra-sonografia e as variações da hemoglobina fetal (g/dL. RESULTADOS: em todos os casos foi observada queda nos valores do pH, com redução média de 0,09 (DP=0,02. A hemoglobina fetal apresentou aumento médio de 8,4 g/dL (DP=2,9 g/dL. Foi constatada também variação negativa da pO2 (média = -1,28 mmHg na concentração de HCO3_ (média = _2,25 mEq/l. Houve aumento da pCO2 (média = 3,2 mmHg e redução nos valores do excesso de bases (média = -3,75. CONCLUSÃO: a análise das gasometrias permite concluir que o procedimento de TIU acompanha-se de queda nos valores do pH de sangue de veia umbilical, demonstrando haver acidemia fetal relativa após o procedimento.

Estrutura morfológica do fígado de tambaqui Colossoma macropomum (Cuvier, 1818

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Gerlane de Medeiros Costa

2012-09-01

Full Text Available Este trabalho teve como objetivo descrever macro e microscopicamente o fígado do Tambaqui Colossoma macropomum, Teleósteo de água doce da Família Characidae, de grande interesse econômico da bacia Amazônica. Foram utilizados seis (6 exemplares jovens com idade entre seis meses e um ano, oriundos da Chácara Esteio, Alta Floresta, MT, que desenvolve principalmente a prática da piscicultura. O órgão foi fotodocumentado in situ e descrito macroscopicamente, em seguida procedeu-se a retirada de fragmentos deste, que foram processados pelas técnicas histológicas rotineiras para inclusão em parafina e coloração de HE. O fígado localizou-se ventral à bexiga natatória e craniodorsalmente ao estômago, apresentou coloração amarronzada a vermelho, constituído por três lobos hepáticos, o lobo lateral direito, o lobo lateral esquerdo e o lobo ventral. Microscopicamente, o parênquima era constituído por hepatócitos com formato que variou do arredondado irregular hexagonal ao redondo com núcleo grande e central, arranjados em cordões lineares limitados por sinusóides que irradiam para veias centrais, e com ausência de lóbulos hepáticos. As veias centrais estavam distribuídas pelo parênquima, enquanto que o espaço porta, na maioria das vezes, era constituído apenas por uma veia hepática e o ducto biliar, em outros locais foi observado, uma artéria e um ducto. Não foi observada a formação de tríades portais. Foram frequentemente observados melano macrófagos centrais dispersos pelo parênquima. O estudo morfofuncional do Aparelho Digestório de peixes da bacia Amazônica, se faz pertinente com vistas ao conhecimento do aproveitamento de ganho de peso e produção em alta escala para consumo humano e preservação da espécie, além da importância de estarem sendo utilizados como bioindicadores atualmente.

Is it worth adding an inferior vena cava filter to anticoagulation in thromboembolic disease?

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Alexandra Yunes

2017-06-01

Full Text Available Resumen A pesar del tratamiento anticoagulante, algunos pacientes que han presentado un episodio de enfermedad tromboembólica persisten con riesgo elevado de recurrencia. Se ha planteado que adicionar un filtro de vena cava inferior podría disminuir este riesgo, pero la real utilidad clínica no está clara. Para responder esta pregunta utilizamos la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en múltiples fuentes de información. Identificamos tres revisiones sistemáticas que en conjunto incluyen cuatro ensayos aleatorizados que responden la pregunta. Extrajimos los datos, realizamos un metanálisis y preparamos tablas de resumen de los resultados utilizando el método GRADE. Concluimos que podría existir poca o nula diferencia en cuanto a la ocurrencia de trombosis venosa profunda al agregar un filtro de vena cava inferior en pacientes anticoagulados, y que no está claro si existen diferencias en cuanto a la ocurrencia de tromboembolismo pulmonar o mortalidad porque la certeza de la evidencia es muy baja.

Efeito da denervação cardíaca ventral na incidência de fibrilação atrial após revascularização cirúrgica do miocárdio Effect of ventral cardiac denervation in the incidence of atrial fibrilation after coronary artery bypass graft surgery

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João Roberto Breda

2008-06-01

Full Text Available OBJETIVO: Verificar o efeito da denervação cardíaca ventral na incidência de fibrilação atrial no pós-operatório de revascularização cirúrgica do miocárdio. MÉTODOS: Entre setembro e novembro de 2005, 50 pacientes consecutivos da mesma instituição foram alocados neste estudo prospectivo e randomizado. Foram selecionados pacientes portadores de insuficiência coronariana com indicação de revascularização cirúrgica do miocárdio, sem história ou diagnóstico prévio de arritmia atrial. Os critérios de exclusão foram: idade acima de 75 anos, história prévia de arritmia atrial e operações cardíacas associadas. A denervação era realizada antes do início da circulação extracorpórea pela remoção do tecido gorduroso ao redor da veia cava superior, aorta e artéria pulmonar. Os grupos foram comparados de acordo com as características clínicas, demográficas e variáveis operatórias. RESULTADOS: Não houve mortalidade hospitalar em ambos os grupos. O tempo médio adicional para realização da denervação foi de 7,64 + 2,33 minutos e não houve complicações associadas ao procedimento. Cinco pacientes apresentaram fibrilação atrial no pós-operatório, sendo dois (8% no grupo controle e três (12% no grupo denervação. O risco dos pacientes do grupo denervação apresentarem fibrilação atrial foi 22% maior do que no grupo controle (intervalo de confiança, 0,56-2,66, porém, este resultado não foi estatisticamente significativo (p=0,64. CONCLUSÕES: A denervação cardíaca ventral, apesar de rápida execução e de baixo risco, não apresentou efeito na redução da incidência de fibrilação atrial no pós-operatório de revascularização cirúrgica do miocárdio.OBJECTIVE: To evaluate the effect of ventral cardiac denervation in the incidence of atrial fibrillation after coronary artery bypass surgery. METHODS: Between September and November, 50 patients without history or previous diagnosis of atrial

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

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

2009-12-01

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

Recidiva en vena cava inferior de carcinoma suprarrenal

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Javier Orrit

2005-01-01

Full Text Available Paciente de 15 meses sometido a resección de masa suprarrenal derecha. Estudio de extensión negativo e histología de tumor adrenocortical. Dos meses después presenta recidiva tumoral en vena cava inferior (VCI a nivel de venas suprahepáticas que se reseca bajo hipotermia profunda y parada circulatoria (19 min (Fig. 1. Se extrae una masa friable de 25 × 20 mm que ocluye la VCI, sin evidencia de resto tumoral, aunque se considera resección incompleta al estar infiltradas las paredes de VCI. La histología confirma carcinoma suprarrenal (Fig. 2. A los 5 meses sigue quimioterapia sin datos de nueva invasión de VCI.

Importância clínica da dosagem de lactato e contagem de eritroblastos no sangue colhido no segmento placentário da veia umbilical para o diagnóstico de hipóxia-isquemia em prematuros Clinical value of lactate measurement and nucleated red blood cell counts in the placental segment of the umbilical vein of premature newborns for diagnosis of hypoxia-ischemia

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Yvi Gea

2007-04-01

Full Text Available OBJETIVO: Determinar a validade clínica das dosagens de lactato e contagem de eritroblastos quando comparados com o excesso de bases (EB em sangue do segmento placentário da veia umbilical de prematuros. MÉTODOS: foram colhidas amostras de 25 prematuros, após ligadura e dequitação. Os prematuros foram seguidos até a alta. Estatística incluiu regressão linear, correlação de Spearman, curvas ROC, Teste de Fisher. RESULTADOS: Lactato mostrou boa correlação com pH e EB (p OBJECTIVE: To evaluate the clinical value of lactate measurement and nucleated red blood cell (NRBC counts when compared to base excess (BE in the blood collected from the placental segment of the umbilical vein. METHODS: 25 umbilical cords from premature babies were sampled after placental delivery and cord clamping. Babies were followed until discharge. Statistics involved linear regression, Spearman's correlation, ROC curves, and Fisher's exact test. RESULTS: The relationship between lactate in the umbilical vein blood and pH and BE was significant (p < 0.0001. A 4.04 mmol/L lactate level showed a sensitivity of 62.5% and a specificity of 94.1% in detecting pH <7.2 and BE < -10 mmol/L. NRBC counts were related to BE (p = 0.0095, but with a sensitivity of 37.5% and specificity of 82.4% in detecting BE < -10 mmol/L. CONCLUSIONS: Lactate is a valuable marker of fetal hypoxia when sampled from placental segment veins. NRBC counts demonstrated low sensitivity for the detection of acidosis.

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

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Nagaraja Moorthy

2013-09-01

Full Text Available 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.

Percutaneous Transluminal Angioplasty for Complete Membranous Obstruction of Suprahepatic Inferior Vena Cava: Long-Term Results

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Kucukay, Fahrettin, E-mail: fkucukay@hotmail.com [Turkiye Yuksek Ihtisas Hospital, Department of Interventional Radiology (Turkey); Akdogan, Meral, E-mail: akdmeral@yahoo.com [Turkiye Yuksek Ihtisas Hospital, Department of Gastroenterology (Turkey); Bostanci, Erdal Birol, E-mail: ebbostanci@yahoo.com [Turkiye Yuksek Ihtisas Hospital, Department of Gastrointestinal Surgery (Turkey); Ulus, Ahmet Tulga, E-mail: uluss@yahoo.com [Hacettepe University, Department of Cardiovascular Surgery (Turkey); Kucukay, Murat Bulent, E-mail: dr-mbk@hotmail.com [Lokman Hekim Hospital, Department of Internal Medicine (Turkey)

2016-10-15

PurposeTo determine the long-term results of percutaneous transluminal angioplasty (PTA) for a complete membranous obstruction of the suprahepatic inferior vena cava.MethodsPatients (n = 65) who were referred to the interventional unit for PTA for a complete membranous obstruction of the suprahepatic inferior vena cava between January 2006 and October 2014 were included in the study. Thirty-two patients (18 males, 14 females, mean age 35 ± 10.7, range 20–42 years) were treated. The patients presented with symptoms of ascites (88 %), pleural effusion (53 %), varicose veins (94 %), hepatomegaly (97 %), abdominal pain (84 %), and splenomegaly (40 %). Transjugular liver access set and re-entry catheter were used to puncture and traverse the obstruction from the jugular side. PTA balloon dilations were performed. The mean follow-up period was 65.6 ± 24.5 months. The objective was to evaluate technical success, complications, primary patency, and clinical improvement in the symptoms of the patients.ResultsThe technical success rate was 94 %. In two patients, obstruction could not be traversed. These patients underwent cavoatrial graft bypass surgery. There were no procedure-related complications. Clinical improvements were achieved in all patients within 3 months. The primary patency rate at 4 years was 90 %. There was no primary assisted patency. There was no need for metallic stent deployment in the cohort. The secondary patency rate at 4 years was 100 %.ConclusionsPercutaneous transluminal angioplasty for a complete membranous obstruction of the suprahepatic inferior vena cava is safe and effective, and the long-term results are excellent.

Efeitos da exposição à fumaça lateral do cigarro sobre o barorreflexo em ratos adultos

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Vitor E. Valenti

2011-02-01

Full Text Available FUNDAMENTO: Tem sido demonstrado na literatura que a exposição à fumaça do cigarro causa hipertensão em ratos; entretanto, ainda não foi demonstrado se a função barorreflexa está prejudicada antes do animal se tornar hipertenso. OBJETIVO: Avaliamos os efeitos de curto prazo da exposição à fumaça lateral do cigarro (FLC sobre a função barorreflexa em ratos Wistar normotensos. MÉTODOS: Os ratos foram expostos à FLC durante três semanas, 180 minutos, cinco dias por semana, a uma concentração de monóxido de carbono entre 100-300 ppm. A pressão arterial média (PAM e a freqüência cardíaca (FC foram avaliadas através de canulação da veia e artéria femoral. RESULTADOS: Não houve diferença significante entre os grupos controle e FLC em relação à MAP e FC, componentes simpáticos e parassimpáticos da função barorreflexa. CONCLUSÃO: Nossos dados sugerem que três semanas de exposição à FLC não são suficientes para causar dano significante aos parâmetros cardiovasculares e sensibilidade barorreflexa em ratos Wistar normotensos.

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

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Stacey, C.S.; Manhire, A.R.; Rose, D.H.; Bishop, M.C.

2004-01-01

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

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

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Pinarli, Faruk Guclu; Danaci, Murat; Diren, Baris; Tander, Burak; Rizalar, Riza; Dagdemir, Ayhan; Acar, Sabri

2004-01-01

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.)

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

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

2008-02-04

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

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

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

1974-10-15

This is a case report of multiple congenital vascular anomalies in which coarctation of the aorta combined with the patent ductus arteriosus and the persistent left superior vena cava. The patient was a 15 year old girl and congenital heart disease was suspected during infancy. However, she heard the disease incurable, so she had been well with herb medicine until admission in our hospital. By physical examination and roentgenological studies including aortography, the diagnosis of the patent ductus arteriosus was detected and the coarctation of the aorta was suspected. The persistent left superior vena cava was found during surgery and it was proved roentgenologically by venography.

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

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Dunlap, H.J.; Udjus, K.

1990-01-01

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

Varizes de fundo gástrico na hipertensão portal esquistossomótica: resultados cirúrgicos

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Álvaro Antônio Bandeira Ferraz

Full Text Available OBJETIVO: Apresentar dados epidemiológicos de pacientes esquistossomóticos na forma hepatoesplênica com varizes do fundo gástrico, assim como avaliar os resultados de uma estratégia cirúrgica no manuseio destas varizes. MÉTODO: No período de janeiro de 1992 à julho de 2001 foram acompanhados no Serviço de Cirurgia Geral do Hospital das Clínicas da Universidade Federal de Pernambuco 125 pacientes submetidos à esplenectomia com ligadura da veia gástrica esquerda (LVGE, desvascularização da grande curvatura do estômago e esclerose endoscópica pós-operatória, para o tratamento da hipertensão portal esquistossomótica com antecedentes de hemorragia digestiva. Quando da presença de varizes de fundo gástrico (44/125 foi associado ao procedimento cirúrgico, a abertura do estômago e sutura das varizes. RESULTADOS: Varizes de fundo gástrico foram identificadas em 35,2% (44/125 dos pacientes com esquistossomose hepatoesplênica e antecedentes de hemorragia digestiva alta. Durante o seguimento de 26 meses o procedimento cirúrgico erradicou 76,5% das varizes de fundo gástrico. A incidência de trombose da veia porta no período pós-operatório foi maior no grupo de pacientes sem varizes de fundo gástrico (16,3% quando comparado com os pacientes portadores de varizes de fundo gástrico (8,8%, sem que, no entanto, esta diferença tivesse respaldo estatístico (p = 0,62. Não se identificou correlação entre a presença de varizes do fundo gástrico e o grau de fibrose periportal e o peso do baço. Na análise bioquímica e hematológica, no período pré-operatório dos grupos estudados, o número de leucócitos foi estatisticamente menor no grupo de pacientes que apresentavam varizes de fundo gástrico. CONCLUSÃO: A esplenectomia associada a desvascularização da grande curvatura do estômago, ligadura da veia gástrica esquerda, gastrotomia e sutura da varizes de fundo gástrico, erradicou 76,5% das varizes de fundo g

ASPECTOS ULTRA-SONOGRÁFICOS DA ESQUISTOSSOMOSE HEPATOESPLÊNICA Ultrasound findings in hepatosplenic schistosomiasis

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Márcio Martins Machado

2002-01-01

Full Text Available A ultra-sonografia representa uma importante contribuição no diagnóstico da forma hepatoesplênica da esquistossomose. A ultra-sonografia permite a identificação das principais alterações, como espessamento periportal, perivesicular, aumento do lobo hepático esquerdo, redução do lobo hepático direito e esplenomegalia. Adicionalmente, os padrões hemodinâmicos podem ser avaliados com o Doppler, sendo possível a análise das veias porta, mesentérica superior e esplênica, além de facilitar o estudo dos vasos venosos colaterais. Em áreas endêmicas, a ultra-sonografia assume papel de destaque, sendo superior à avaliação clínica na identificação da hepatoesplenomegalia e possibilitando o acompanhamento dos pacientes submetidos a tratamento clínico. Neste trabalho, os autores apresentam uma revisão dos principais achados sonográficos e ao Doppler da esquistossomose hepatoesplênica, sendo demonstrada, também, a relação destes achados com os aspectos clínico-patológicos desta doença.Ultrasound represents an important contribution to the diagnosis of hepatosplenic mansonic schistosomiasis. Abnormalities such as hyperechoic fibrotic bands along the portal vessels, volumetric reduction of the right hepatic lobe, enlargement of the left lobe, perivesicular fibrotic thickening and splenomegaly can be recognized. Moreover, the hemodynamic status of the portal venous system may also be evaluated by Doppler analysis, including the identification of collateral veins and portosystemic venous shunts. In endemic areas, ultrasound is of great value in the identification of hepatosplenomegaly, allowing follow-up of patients under clinical treatment. This review presents the ultrasonographic and Doppler features of hepatosplenic schistosomiasis. The relationship between these findings and the clinical and pathological characteristics of this disease are also discussed.

Reverse Trendelenburg position is a safer technique for lowering central venous pressure without decreasing blood pressure than clamping of the inferior vena cava below the liver.

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Yoneda, Godai; Katagiri, Satoshi; Yamamoto, Masakazu

2015-06-01

Bleeding remains an important intraoperative complication in patients who undergo hepatectomy. It is generally believed that a reduction in central venous pressure will decrease bleeding from the hepatic venous system. To our knowledge, however, no study has compared the effectiveness of these techniques for controlling bleeding. So we compared the effectiveness of central venous pressure control techniques, such as infrahepatic inferior vena cava clamping, changes in surgical position of the patient, and hypoventilation anesthesia, for lowering central venous pressure. The study group comprised 50 patients who underwent hepatectomy in our department from 2012 through 2013. A central venous catheter was inserted into the right internal jugular vein, and the tip was placed in the superior vena cava. A transducer was placed along the mid-axillary line of the left side of the chest. After opening the abdomen, changes in central venous pressure were measured during inferior vena cava clamping, the reverse Trendelenburg position, the Trendelenburg position, and hypoventilation anesthesia. The inclination relative to the transducer, as measured with an inclinometer, was -10 degrees for the Trendelenburg position and +10 degrees for the reverse Trendelenburg position. The tidal volume was set at 10 mL/kg during conventional anesthesia and 5 mL/kg during hypoventilation anesthesia. The mean central venous pressure was 8.0 cm H(2)O in the supine position during conventional anesthesia, 5.0 cm H(2)O during inferior vena cava clamping, 5.6 cm H(2)O during reverse Trendelenburg position, 10.6 cm H(2)O during Trendelenburg position, and 7.6 cm H(2)O during hypoventilation anesthesia. The mean central venous pressure during inferior vena cava clamping and reverse Trendelenburg position was significantly lower than that during supine position (P = 0.0017 and P = 0.0231, respectively). The mean central venous pressure during hypoventilation

Edema de membro inferior secundário a exérese de veia safena magna para utilização como enxerto na revascularização do miocárdio Lower limb edema after great saphenous vein harvesting to be used as graft in myocardial revascularization

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Cleusa Ema Quilici Belczak

2009-03-01

Full Text Available CONTEXTO: A revascularização do miocárdio utilizando-se a veia safena magna ainda é procedimento cirúrgico bastante realizado na atualidade. O edema que surge no membro inferior operado causa grande desconforto e necessita ser melhor estudado. OBJETIVOS: Caracterizar o edema de membro inferior secundário a exérese da veia safena magna pela técnica de incisões escalonadas para sua utilização como enxerto venoso na revascularização do miocárdio. MÉTODOS: Foram selecionados aleatoriamente 44 indivíduos submetidos a exérese de veia safena magna para revascularização miocárdica há mais de 3 meses. Excluíram-se fatores que pudessem interferir na formação de edema dos membros inferiores. Foram avaliados por volumetria e perimetria maleolares ambos os membros inferiores. Considerou-se como presença de edema significativo a diferença de volume maior que 50 mL e maior de 2 cm em relação ao membro não-operado. Para a análise estatística foram empregados o teste do qui-quadrado, teste exato de Fisher, teste t de Student e o teste de McNemar. O nível de significância adotado foi de 5% (a = 0,05. RESULTADOS: Encontraram-se diferenças estatisticamente significativas (p BACKGROUND: Myocardial revascularization using the great saphenous vein is still a very common surgical procedure. The edema that occurs in the operated leg causes much discomfort and requires further studies. OBJECTIVES: To describe lower limb edema secondary to great saphenous vein harvesting using the bridge technique for use as venous graft in myocardial revascularization. METHODS: Forty-four individuals previously submitted to great saphenous vein harvesting for myocardial revascularization more than 3 months before were randomly selected. Patients with factors that might interfere with formation of lower limb edema were excluded. Both operated and non-operated legs were evaluated by volumetry and perimetry of the malleolar region. Differences greater than

'Pseudothrombus' of the inferior vena cava

International Nuclear Information System (INIS)

Takebayashi, Shigeo; Odagiri, Kunio; Matsui, Kengo; Hayano, Ikuo.

1983-01-01

Normal Inferior Vena Cava (IVC) of 15 cases were studies on CT with bolus injection in the foot vein.FWell dilated IVC were obtained on scan both at full-inspiration and full-expiration. As the normal findings of IVC, different opacification patterns which may be designate ''homogenous'', ''layered'' and ''pseudothrombus'' were obtained. The ''homogenous'' opacification was noted both at full-inspiration and full-expiration. In homogenous patterns as noted as ''layered'' and ''pseudothrombus'' were suspected to occur in the case of insufficient mixing of contrast agent with blood and/or insufficient amount of contrast agent. And both these patterns were observed in dilated IVC. The ''layered'' opacified IVC was shown on scan at full-inspiration at which respiratory phase the blood flow in IVC may decrease.FThe ''pseudothrombus'' pattern was generally noted at full-expiration at which the blood flow may increase.FAlthough bolus injection of contrast agent into foot vein is useful for evaluation of IVC, one shound be aware of normal opacification of IVC including ''pseudothrombus'' pattern. (author)

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

Directory of Open Access Journals (Sweden)

Lipp Rainer W

2010-07-01

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

Safety of Ecklonia cava phlorotannins as a novel food pursuant to Regulation (EC) No 258/97

DEFF Research Database (Denmark)

Sjödin, Anders Mikael

2017-01-01

/97. The novel food is a phlorotannin-rich alcohol extract of Ecklonia cava, which is an edible marine brown alga species. The information provided on the composition, the specifications, the production process and the batch-to-batch variability of the novel food is sufficient and does not raise safety concerns......Following a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver a scientific opinion on the safety of Ecklonia cava phlorotannins (marketed as SeaPolynolTM) as a novel food submitted pursuant to Regulation (EC) No 258....... The intention is to market the novel food as a food supplement for healthy individuals over the age of 12 years. A subchronic repeated dose oral toxicity study in rodents tested the novel food at daily doses of 0, 375, 750 and 1,500 mg/kg body weight (bw). The Panel considers the middose as the no...

Percutaneous insertion of inferior vean cava filter:clinical results of 8 patients

International Nuclear Information System (INIS)

Bae, Kyung Soo; Shin, Hyun Woong; Park, No Hyuck; Ryeom, Hun Kyu; Kim, Yong Joo

1997-01-01

To evaluate the efficacy and clinical results of percutaneous insertion of inferior vena cava(IVC) filter. Over a two year period, eight IVC filters were placed in eight patients with pulmonary thromboembolism resulting from deep vein thrombosis of the legs. The indications for placement were contraindication to anticoagulation(3), and recurrent pulmonary embolism during anticoagulant therapy(5). Both femoral(7) and jugular(1) routes were used for percutaneous transvenous insertion. To delineate the caval anatomy and to ensure placement just caudal to the renal vein, a cavogram was obtained before filter placement. Bird's Nest (7) and Greenfield (1) filters were inserted. Follow-up information was obtained by means of duplex sonography, CT scan, abdominal radiograph, and perfusion scan of the lungs, followed by clinical evaluation. In all cases, procedures were technically successful. Placement complications occurred in three patients. In one, the filter was inadvertently placed above the iliac bifurcation; in the other two, prolapse of the Bird's Nest filter wire occurred. Occlusion of IVC occurred in two patients, and recurrent pulmonary embolism was suspected in one, who suffered from chest pain and short-ness of breath. In the other patients, there was no clinical evidence of recurrence of the pulmonary embolism. Insertion of an inferior vena cava filter is a safe and effective method for the prevention of pulmonary embolism when anticoagulant therapy is either ineffective or contraindicated

Haematogenous tumour growth in the inferior vena cava in a patient with a nonseminomatous testicular tumour

NARCIS (Netherlands)

Ham, S J; Koops, H Schraffordt; Sleijfer, D T; Freling, N M; Molenaar, W M

1991-01-01

The case history is reported of a patient with an invasion of the inferior vena cava by metastases of a non-seminomatous testicular tumour. He was treated with combination chemotherapy, followed by laparotomy and resection of residual tumour tissue. Fourteen months after this operation he is in good

Trinità di Cava in 1111. Conflict resolution and definition of a border

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Vito Lorè

2006-06-01

Full Text Available At the beginning of the 12th century, in the course of a few years, the dukes of Puglia and the lords of Nocera put an end to a period of contrasts and redrew the map of powers in the area North of Salerno. The Trinità di Cava became the core of this new balance. Confirming its already evident inclination to act as a mediator in the conflicts between secular powers, the Trinità directed the agreements between the parts to its advantage through the payment of large amounts of money. Thus, it came into possession of an important castle and of the whole of the land of the involved parties inside a large area, delimited on in this occasion by neat boundaries. However, such area, lacking military defences in its Northern part, at the time was neither a territory subjected to a lordship nor a free space; it was, rather, a compensation area, avoiding contacts between the two rival powers. Only several decades later, when the Cava area was no more a borderland between different rules, the Trinità got hold of it and built up new fortifications, thus giving its presence in the area a lordship character.

Inferior vena cava filter thrombus: A possible cause of an unanticipated finding of {sup 99m} Tc-labeled red blood cell scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Song, Hee Sung; Choi, Joon Hyouk; Kim, Young Suk [Jeju National University School of Medicine, Jeju (Korea, Republic of)

2016-06-15

{sup 99m}Tc-labeled red blood cell scintigraphy, a sensitive and specific diagnostic test, is useful for patients suspected of suffering from active gastrointestinal bleeding. This study follows a case of a patient who was suspected of gastrointestinal bleeding after an inferior vena cava filter was inserted due to a deep vein thrombosis of the femoral vein. To evaluate an exact focus of bleeding, {sup 99m}Tc-labeled red blood cell scintigraphy was executed. Herein, an unanticipated finding of {sup 99m}Tc-labeled red blood cell scintigraphy probably due to a thrombus on the inferior vena cava filter is reported.

Analysis of the tensile strength on the healing of the abdominal wall of rats treated with infliximab Análise da força tênsil na cicatrização da parede abdominal de ratos tratados com infliximabe

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João Vieira Lopes

2008-10-01

monoclonal quimérico humano-murino, sobre a força tênsil da ferida operatória abdominal. MÉTODOS: Sessenta ratos, linhagem Wistar, machos, sadios, com peso corporal inicial entre 215 e 390 g e 60 e 90 dias de vida foram distribuídos aleatoriamente em dois grupos, E (Experimental e C (Controle com 30 animais cada. Os animais do grupo E receberam por via subcutânea, dose única, de 5mg/Kg de infliximabe, via subcutânea e os animais do grupo C receberam, volume equivalente, de solução de NaCl a 0,9%, via subcutânea. Depois de 48h os animais de ambos os grupos foram submetidos à incisão mediana na parede abdominal com 4 cm de extensão incluindo todos os planos que foram reconstituídos com sutura contínua músculo aponeurótica e pele, separadamente, com fio de nylon 5.0. A seguir os animais grupo E foram separados por sorteio simples em três subgrupos denominados E3, E7 e E14 com dez animais e os do grupo C em C3, C7 e C14 e foram submetidos, respectivamente, à reoperação e eutanásia no terceiro, sétimo e 14º dia pós-operatório. A parede abdominal anterior, ressecada dos animais durante a reoperação, foi cortada, com lamina de bisturi nº 15, perpendicularmente à ferida operatória. Cada espécime, em forma de fita, com 6 cm por 2 cm, foi preso pela extremidade de modo que a linha de sutura ficasse eqüidistante dos pontos de fixação do dinamômetro e realizado o teste de resistência tensil. O dinamômetro, aferido a cada série de medidas, foi calibrado para aplicar velocidade do teste de ruptura de 25 mm/min e o valor de ruptura foi expresso em N (Newtons Antes da eutanásia a veia cava abdominal foi identificada e puncionada para retirada de sangue para dosagem de TNF-α. RESULTADOS: A média da força tensil encontrada para os animais dos subgrupos E3, E7, E14, C3, C7 e C14 foram, respectivamente, 16,03; 18,69; 27,01; 28,40; 27,22; 29,15 e 24,30 N. Nos resultados dos testes de múltiplas comparações foram encontradas diferenças significantes

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

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Ann C Gaffey

2016-03-01

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

Transection of the hepatic parenchyma associated or not with the contralateral portal vein branch ligature and its effect in liver regeneration.

Science.gov (United States)

Wiederkehr, Henrique de Aguiar; Wiederkehr, Julio Cesar; Collaço, Luiz Martins; Sousa, Eros Luiz de; Salvalaggio, Paolo; Carvalho, Caroline Aragão de; Wiederkehr, Barbara de Aguiar; Marques, Camila Aparecida Moraes; Rosa, Francielle França da; Nanni, Felipe de Negreiros; Fuchs, Taíse

2017-01-01

To analyze the influence of portal vein ligation in hepatic regeneration by immunohistochemical criteria. Ten pigs divided into two groups of five animals underwent hepatectomy in two stages, and the groups were differentiated by ligation or not of the left portal vein tributary, which is responsible for vascularization of the left lateral and medial lobes of the pig liver. Five days after the procedure, the animals underwent liver biopsies for further analysis of histological and immunohistochemical with marker Ki67. The group submitted to hepatectomy with vascular ligation showed an increase of approximately 4% of hepatocytes in regeneration status, as well as a greater presence of Kupffer and inflammatory cells as compared to control. As a result of positive cell replication observed through the Ki67 marker, we can suspect that the ligation of a tributary of the portal vein associated with liver resection promoted a greater stimulus of liver regeneration when compared to liver resection alone. Analisar a influência da ligadura da tributária da veia porta no estímulo regenerativo hepático por meio de critérios imuno-histoquímicos. Dez suínos, divididos em dois grupos de cinco animais, foram submetidos à hepatectomia em dois estágios, sendo que os grupos foram diferenciados pela ligadura ou não da tributária da veia porta, responsável pela vascularização dos lobos lateral e medial esquerdos do fígado do suíno. Cinco dias após o procedimento, os animais foram reabordados para retirada de amostras hepáticas para posterior análise de histológica e imunoistoquímica com o marcador Ki67. O grupo submetido à hepatectomia com ligadura vascular apresentou incremento de 4% aproximadamente de hepatócitos em processo de regeneração, bem como grande número de células de Kupffer e células inflamatórias, quando comparado ao controle. Em virtude da análise positiva da replicação celular observada por meio do marcador Ki67, pode-se observar que a

Collateral circulations in inferior vena cava obstruction

International Nuclear Information System (INIS)

Lee, Jong Beum; Park, Jae Hyung; Han, Man Chung; Park, Soo Soung

1985-01-01

Obstruction of the inferior vena cava (IVC) is an uncommon condition, and the collateral pathway varies according to the level, extent, duration and the cause of obstruction. Membranous obstruction of IVC in its hepatic portion might be one of the principle cause among Korean, though not reported till now. Analytical study was performed in 26 cases of IVC obstruction with various cause. 1. The level of the obstruction showed relatively even distribution as follows, upper caval in 11 cases, middle caval in 6 cases and infrarenal in 9 cases. 2. The main cause of upper caval obstruction was membranous obstruction. 3. As a whole, the main collateral pathway was the central route (22 cases: 85%). 4. Characteristic collateral pathway unique to upper caval obstruction was transhepatic venous collateral, developed between the obstructed segment and unobstructed segment of IVC. 5. Scalloping of left cardiac border produced by pericardiophrenic venous collateral was characteristic simple chest x-ray finding in IVC obstruction

Symptomatic caval penetration by a Celect inferior vena cava filter

International Nuclear Information System (INIS)

Bogue, Conor O.; John, Philip R.; Connolly, Bairbre L.; Rea, David J.; Amaral, Joao G.

2009-01-01

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

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

International Nuclear Information System (INIS)

Xiao Liang; Xu Ke; Shen Jing; Li Haiwei; Tong Jiajie; Zhang Xitong

2010-01-01

Objective: To discuss the therapeutic efficacy and manipulation skill of Gunther Tulip retrievable inferior vena cava filter in interventional treatment for acute deep venous thrombosis of lower extremity. Methods: From September 2007 to April 2008, a total of 36 patients with acute deep venous thrombosis of lower extremity were treated in our hospital. The time of the onset of disease ranged from 1 day to 12 days. The precipitation causes included prolonged lying in bed due to surgery or bone fracture (n = 18) and postpartum (n = 5), while no obvious precipitation causes could be found in 13 patients. Pulmonary embolism was coexisted in 12 cases. Clinically, the affected limb was swelling and painful, the skin was cyan-purple or pale in color with higher skin temperature. The circumferential length of the affected thigh was 3-10 cm longer than that of normal side. Patients with coexisted pulmonary embolism had the clinical presentation of dyspnea, chest pain, hemoptysis, etc. Gunther Tulip retrievable inferior vena cava filter was implanted via femoral venous access or via right internal jugular venous access, which was followed by intravenous transcatheter thrombolysis. Vascular ultrasonography and angiography were performed 45-75 days after the treatment to confirm that there was no fresh or free thrombus in the veins of lower limb or in the pulmonary arteries. When it was confirmed, Gunther Tulip retrievable inferior vena cava filter was taken out via right internal jugular venous access, which was followed by inferior venacavography. After the procedure anticoagulation and antibiotic medication were employed for 3-5 days. A follow-up for 4-10 months was made. Results: A total of 36 Gunther Tulip retrievable inferior vena cava filters were successfully implanted by one procedure, the average time cost for the filter delivery was 1.5 minutes (0.5-5 minutes). During the delivery procedure, the amplitude of elastic displacement of filter was less than 2 mm. One

Changes in inferior vena cava blood flow velocity and diameter during breathing movements in the human fetus

NARCIS (Netherlands)

T. Huisman (T.); S. van den Eijnde (Stefan); P.A. Stewart (Patricia); J.W. Wladimiroff (Juriy)

1993-01-01

textabstractBreathing movements in the human fetus cause distinct changes in Doppler flow velocity measurements at arterial, venous and cardiac levels. In adults, breathing movements result in a momentary inspiratory collapse of the inferior vena cava vessel wall. The study objective was to quantify

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

International Nuclear Information System (INIS)

Currarino, G.; Stannard, M.W.; Texas Univ., Dallas, TX; Kolni, H.

1991-01-01

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.)

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

Energy Technology Data Exchange (ETDEWEB)

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

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.).

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

International Nuclear Information System (INIS)

Sybilski, Adam J.; Michalczuk, Małgorzata; Chudoba, Anna; Tolak-Omernik, Katarzyna; Bulski, Tomasz; Walecki, Jerzy

2013-01-01

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

Trombose séptica de seios cavernosos, transverso e sigmóide e de veia jugular, associada à meningite, secundária a furúnculo nasal: Relato de Caso Septic thrombosis of cavernous, transverse, sigmoid sinuses and jugular vein, associated with meningitis, secondary to nasal furuncle: Case report

Directory of Open Access Journals (Sweden)

Hélio Utida

2002-06-01

Full Text Available Os autores descrevem um caso de furúnculo nasal que evoluiu com trombose séptica de seio cavernoso, bilateral e assimétrica, e de seios transverso e sigmóide e de veia jugular interna a esquerda, associada à meningite bacteriana, em um paciente previamente hígido. Apesar da trombose séptica extensa de seios venosos, o paciente apresentou boa evolução, após tratamento clínico agressivo com antibióticos, corticosteróides e anticoagulantes. Porém, manteve como seqüela: paresia de VI nervo à esquerda e lesão parcial de nervo óptico homolateral.The authors report a case of nasal furuncle that progressed to septic bilateral and asymmetric thrombosis of cavernous, transverse, sigmoid sinus and internal jugular vein, associated with bacterial meningitis, in a previously healthy patient. In spite of the extensive thrombosis, the patient presented a good evolution, after an aggressive clinical treatment with antibiotics, corticosteroids and anticoagulants. However, there remained paresis of the VI nerve on the left and partial lesion of the homolateral optic nerve.

Venous Thromboembolism After Removal of Retrievable Inferior Vena Cava Filters

International Nuclear Information System (INIS)

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

2010-01-01

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 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%).

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

International Nuclear Information System (INIS)

Lanciego, Carlos; Rodriguez, Mario; Rodriguez, Adela; Carbonell, Miguel A.; Garcia, Lorenzo Garcia

2003-01-01

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

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

International Nuclear Information System (INIS)

Ma Congfeng; Tan Meifang; Fu Bing; Luo Chunhua; Jiang Fengjiao

2011-01-01

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

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

International Nuclear Information System (INIS)

Mahrer, Arie; Zippel, Douglas; Garniek, Alexander; Golan, Gil; Bensaid, Paul; Simon, Daniel; Rimon, Uri

2008-01-01

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.

Vessel Wall Reaction after Vena Cava Filter Placement

International Nuclear Information System (INIS)

Hoekstra, Arend; Elstrodt, Jan M.; Nikkels, Peter G.J.; Tiebosch, Anton T.M.G.

2002-01-01

Purpose: To evaluate the interaction between the Cordis Keeper vena caval filter and vessel wall in aporcine model.Methods: Implantation of the filter was performed in five pigs. Radiologic data concerning inferior vena cava(IVC) diameter and filter patency, filter leg span, and stability were collected. At 2 or 6 months post-implantation, histopathologic analysis of the IVC wall was performed.Results: All filters remained patent with no evidence of migration. However, at 6 months follow-up, two legs of one filter penetrated the vessel wall and were adherent to the liver. These preliminary results suggest that with the observed gradual increase in the filter span, the risk of caval wall penetration increases with time, especially in a relatively small IVC(average diameter 16 mm).Conclusion: The Cordis Keeper filter was well tolerated, but seems to be prone to caval wall penetration in the long term

Cold-Adapted Viral Attenuation (CAVA): Highly Temperature Sensitive Polioviruses as Novel Vaccine Strains for a Next Generation Inactivated Poliovirus Vaccine.

Science.gov (United States)

Sanders, Barbara P; de Los Rios Oakes, Isabel; van Hoek, Vladimir; Bockstal, Viki; Kamphuis, Tobias; Uil, Taco G; Song, Yutong; Cooper, Gillian; Crawt, Laura E; Martín, Javier; Zahn, Roland; Lewis, John; Wimmer, Eckard; Custers, Jerome H H V; Schuitemaker, Hanneke; Cello, Jeronimo; Edo-Matas, Diana

2016-03-01

The poliovirus vaccine field is moving towards novel vaccination strategies. Withdrawal of the Oral Poliovirus Vaccine and implementation of the conventional Inactivated Poliovirus Vaccine (cIPV) is imminent. Moreover, replacement of the virulent poliovirus strains currently used for cIPV with attenuated strains is preferred. We generated Cold-Adapted Viral Attenuation (CAVA) poliovirus strains by serial passage at low temperature and subsequent genetic engineering, which contain the capsid sequences of cIPV strains combined with a set of mutations identified during cold-adaptation. These viruses displayed a highly temperature sensitive phenotype with no signs of productive infection at 37°C as visualized by electron microscopy. Furthermore, decreases in infectious titers, viral RNA, and protein levels were measured during infection at 37°C, suggesting a block in the viral replication cycle at RNA replication, protein translation, or earlier. However, at 30°C, they could be propagated to high titers (9.4-9.9 Log10TCID50/ml) on the PER.C6 cell culture platform. We identified 14 mutations in the IRES and non-structural regions, which in combination induced the temperature sensitive phenotype, also when transferred to the genomes of other wild-type and attenuated polioviruses. The temperature sensitivity translated to complete absence of neurovirulence in CD155 transgenic mice. Attenuation was also confirmed after extended in vitro passage at small scale using conditions (MOI, cell density, temperature) anticipated for vaccine production. The inability of CAVA strains to replicate at 37°C makes reversion to a neurovirulent phenotype in vivo highly unlikely, therefore, these strains can be considered safe for the manufacture of IPV. The CAVA strains were immunogenic in the Wistar rat potency model for cIPV, inducing high neutralizing antibody titers in a dose-dependent manner in response to D-antigen doses used for cIPV. In combination with the highly productive

Diagnostic importance of the recognition of the inferior Vena cava abnormalities on CT-examinations

Energy Technology Data Exchange (ETDEWEB)

Gouliamos, A.; Striggaris, K.; Haliasos, N.; Vlahos, N.; Pontifex, G.

1981-09-01

Two unusual variations of the Vena cava inferior, as shown by CT examinations, are reported and characteristic X-rays, as well as CT scans, are presented. The first case shows an IVC course to the left of the aorta and the second case absence of the intrahepatic portion of the IVC with azygos continuation. Difficulties in the differential diagnosis are analyzed and discussed, both demonstrated by plain X-rays and CT scans.

Technical Error During Deployment Leads to Vena Cava Filter Migration and Massive Pulmonary Embolism

International Nuclear Information System (INIS)

Fotiadis, Nikolas I.; Sabharwal, Tarun; Dourado, Renato; Fikrat, Shabbo; Adam, Andreas

2008-01-01

The Guenther Tulip vena cava filter is a safe, effective, well-established device for pulmonary embolism prophylaxis. We report a patient in whom there was migration of the filter to the right atrium, 2 weeks after insertion, caused by a technical error during deployment. An attempt to retrieve the filter percutaneously failed, necessitating removal at open-heart surgery. The potential causes of migration are described and the lessons learned from this unusual case are outlined.

Immediate endovascular treatment of an aortoiliac aneurysm ruptured into the inferior vena cava.

Science.gov (United States)

Kopp, Reinhard; Weidenhagen, Rolf; Hoffmann, Ralf; Waggershauser, Tobias; Meimarakis, Georgios; Andrassy, Joachim; Clevert, Dirk; Czerner, Stephan; Jauch, Karl-Walter

2006-07-01

An aortocaval fistula is a severe complication of an aortoiliac aneurysm, usually associated with high perioperative morbidity and mortality during open operative repair. We describe the successful endovascular treatment of a symptomatic infrarenal aortic aneurysm ruptured into the inferior vena cava with secondary interventional coiling of a persistent type II endoleak because of retrograde perfusion of the inferior mesenteric artery. Endovascular exclusion of ruptured abdominal aneurysms seems to be a valuable treatment option for selected patients even with complicated vascular conditions like an aortocaval fistula.

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

International Nuclear Information System (INIS)

Ray, Charles E.; Prochazka, Allan

2008-01-01

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

Marker-Negative Pheochromocytoma Associated with Inferior Vena Cava Thrombosis

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S. Poudyal

2017-01-01

Full Text Available Pheochromocytoma associated with inferior vena cava (IVC thrombosis is very rare. A 27-year-old female presented with right flank pain and hypertensive urgency. Contrast-enhanced CT abdomen and gadolinium-contrast MRI abdomen revealed right adrenal mass suspicious of malignancy with invasion and compression to the right IVC wall along with IVC thrombus extending from the level of renal veins to the level of confluence with hepatic veins. Her routine laboratory investigations including 24-hour urine fractionated metanephrines, vanillylmandelic acid, and cortisol were normal. Right adrenalectomy with IVC thrombectomy was done. Perioperative period was uneventful. Histopathology of the mass turned out to be pheochromocytoma with thrombus revealing fibroadipose tissue with fibrin. Pheochromocytoma may present with IVC thrombus as well as normal serum and urinary markers. Thus, clinical suspicion is imperative in perioperative management of adrenal mass.

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

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S. V. Mukhtarulina

2014-12-01

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

Níveis de lípides plasmáticos em ratos submetidos à esplenectomia total, ligadura simultânea dos vasos esplênicos e à esplenectomia subtotal com preservação do pólo inferior

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Isabel Cristina Andreatta Lemos Paulo

Full Text Available OBJETIVO: Verificar o efeito da esplenectomia total, da ligadura dos vasos esplênicos principais e da esplenectomia subtotal com preservação do pólo inferior, nos lípides plasmáticos de ratos alimentados com dieta-controle ou dieta acrescida com 2,5% de colesterol. MÉTODO: Foram utilizados 111 ratos Wistar, machos, pesando entre 273g e 427g, com idade aproximada de 12 semanas, assim distribuídos: Grupo 1, controle (N = 20, não operado; Grupo 2 (N = 20 submetido à manipulação do baço; Grupo 3 (N = 31 submetido à esplenectomia total; Grupo 4 (N = 20, ligadura simultânea da artéria e veia esplênicas; Grupo 5 (N = 20, esplenectomia subtotal com preservação do pólo inferior. Foram dosados os lípides plasmáticos, e os ratos foram distribuídos em dois subgrupos, de acordo com a dieta (Subgrupo A- dieta-controle; Subgrupo B - dieta acrescida com 2,5% de colesterol. Todos os animais foram submetidos à nova colheita de sangue após 90 dias do início do experimento. RESULTADOS: Os animais submetidos à esplenectomia total, independentemente do tipo de dieta, apresentaram aumento significante (p 0,05. Os animais submetidos à ligadura simultânea da artéria e veia esplênicas e à esplenectomia subtotal com preservação do pólo inferior e alimentados com dieta-controle, não apresentaram alterações nos níveis de lípides plasmáticos, exceto pelo aumento da HDL (p < 0,05 observado no grupo da esplenectomia subtotal. Nos animais desses grupos, alimentados com dieta acrescida com 2,5% de colesterol, houve aumento significante de colesterol total, LDL, e VLDL e triglicérides. CONCLUSÕES: A esplenectomia total produz aumento significante do colesterol total, das frações LDL e VLDL e dos triglicérides, tanto nos ratos alimentados com dieta-controle quanto nos alimentados com dieta acrescida com 2,5% de colesterol. O aumento é mais significante nos animais alimentados com dieta acrescida com 2,5% de colesterol. A ligadura

Anatomia do fígado de fetos de Guinea pig em final de gestação (Cavia porcellus [Linnaeus, 1758

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Mariangela Toledo Barbino

2011-08-01

Full Text Available http://dx.doi.org/10.5007/2175-7925.2011v24n3p97 Desenvolveu-se este trabalho com o objetivo de descrever a anatomia do fígado de fetos de Guinea pig (Cavia porcellus [Linnaeus, 1758] em final de gestação e obter caracterizações anatômicas que possam fundamentar e auxiliar na compreensão da fisiologia da circulação fetal. Coletou-se os fetos de 3 fêmeas em final de gestação, os quais foram dissecados e retirado o fígado. Estes foram analisados, descritos e fotodocumentados macroscopicamente, por microscopia de luz em coloração HE e por microscopia eletrônica de varredura. O fígado dos fetos apresenta coloração castanho avermelhada e sua divisão em lobos é nitidamente observada, assim como a presença da vesícula biliar.  O fígado divide-se em lobo lateral esquerdo, lobo medial esquerdo, lobo lateral direito, lobo medial direito, lobo quadrado e lobo caudado com processos papilar e caudado Através da microscopia de luz, observa-se o tecido intensamente vascularizado sendo que, a porção esquerda do fígado recebe o sangue oriundo da placenta pela veia umbilical, e a porção direita é irrigada pela veia porta. Através desses resultados pode-se concluir que os fetos de Guinea pig possuem estruturas semelhantes anatomicamente aos de outras espécies de mamíferos.

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

OpenAIRE

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

2014-01-01

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 w...

The diagnostic importance of the recognition of the inferior Vena cava abnormalities on CT-examinations

International Nuclear Information System (INIS)

Gouliamos, A.; Striggaris, K.; Haliasos, N.; Vlahos, N.; Pontifex, G.

1981-01-01

Two unusual variations of the Vena cava inferior, as shown by CT examinations, are reported and characteristic X-rays, as well as CT scans, are presented. The first case shows an IVC course to the left of the aorta and the second case absence of the intrahepatic portion of the IVC with azygos continuation. Difficulties in the differential diagnosis are analyzed and discussed, both demonstrated by plain X-rays and CT scans. (orig.) [de

Outcome of prolonged acute vena cava occlusion after iatrogenic transection and repair in a dog

OpenAIRE

Halwagi, Marie-Chantal; Crawford, Evan; Hoddinott, Katie; Oblak, Michelle L.

2017-01-01

A 12-year-old castrated male Airedale terrier dog was diagnosed with a hepatocellular carcinoma in the right medial liver lobe. During tumor resection, inadvertent stapling and transection of the caudal vena cava occurred. Complete caval occlusion was required for 18 minutes and primary anastomosis was completed. The dog received 2 blood transfusions and developed mild pelvic limb edema after surgery. Computed tomography evaluation 9 months after surgery showed collateral circulation and susp...

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

International Nuclear Information System (INIS)

Haider, Ehsan A.; Rosen, J. Choi; Torres, Carlos; Valenti, David A.

2005-01-01

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

Inferior vena cava/aorta diameter index in the assessment of the body fluid status – a comparative study of measurements performed by experienced and inexperienced examiners in a group of young adults

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Kaja Durajska

2014-09-01

Full Text Available The assessment of the body fluid status is one the most challenging tasks in clinical practice. Although there are many methods to assess the body fluid status of patients, none of them is fully satisfactory in contemporary medical sciences. In the article below, we compare the results of measurements performed by experienced and inexperienced examiners based on the inferior vena cava/aorta diameter index in a sonographic hydration assessment. The study enrolled 50 young students at the age of 19–26 (the median age was 22.95 including 27 women and 23 men. The volunteers were examined in the supine position with GE Logiq 7 system and a convex transducer with the frequency of 2–5 MHz. The measurements were performed in the longitudinal and transverse planes by two inexperienced examiners – the authors of this paper, following a four-hour training conducted by an experienced sonographer. The longitudinal values of the inferior vena cava/aorta diameter index obtained in this study were similar to those found in the literature. The reference value for the inferior vena cava/aorta index determined by Kosiak et al., which constituted 1.2 ± 2 SD, for SD = 0.17, was similar to the values obtained by the authors of this paper which equaled 1.2286 ± 2 SD, for SD = 0.2. The article presented below proves that measuring the inferior vena cava/aorta diameter index is not a complex examination and it may be performed by physicians with no sonographic experience. Furthermore, the paper demonstrates that the inferior vena cava/aorta diameter index measured in the transverse plane is similar to the inferior vena cava/aorta diameter index determined in the longitudinal plane. Thus, both measurements may be used interchangeably to assess the hydration status of patients.

Uso do ultra-som para punção venosa central em paciente obeso com adenomegalia cervical

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Jaderson Wollmeister

2008-08-01

Full Text Available JUSTIFICATICA E OBJETIVOS: As técnicas clássicas para punção venosa central são realizadas com base em referências anatômicas de superfície e conhecimento da anatomia vascular da região em que se realizará a punção. O uso do ultra-som permite a realização da punção sob visão direta das estruturas vasculares, peri-vasculares e da agulha de punção. O objetivo deste relato foi descrever o uso do ultra-som no auxílio de acesso venoso central em paciente obeso e com adenomegalias. RELATO DO CASO: Paciente do sexo masculino, branco, 28 anos, 1,70 m, 120 kg, com diagnóstico de linfoma de Hodgkin esclerose nodular. Solicitado ao Serviço de Anestesiologia do Hospital Governador Celso Ramos, punção de veia jugular interna direita guiada por ultra-som devido à presença de gânglio supraclavicular que prejudicava a referência anatômica de punção e à obesidade do paciente. Após a obtenção da melhor imagem a veia jugular interna esquerda foi puncionada e colocado um cateter venoso de triplo lúmen. A punção foi única, com progressão fácil do cateter e realizada sem complicações. CONCLUSÕES: O uso da ultra-sonografia para punção venosa central pode evitar complicações tornando o procedimento mais seguro para o paciente.

Técnica venográfica contrastada in vivo dos dígitos de ovinos e caprinos

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I.F.C. Santos

2015-12-01

Full Text Available Foram utilizados 10 membros torácicos e pélvicos de ovinos e caprinos hígidos, de raça e sexo variados, com idade entre dois e quatro anos e peso corpóreo médio de 53kg. A porção distal dos membros torácicos e pélvicos foi submetida à técnica venográfica contrastada e à contagem vascular venosa da mesma região, em ambas as espécies. Não foram observadas diferenças numéricas em relação às veias entre machos e fêmeas, nem entre os membros direito e esquerdo da mesma espécie. Os ovinos possuem maior número de veias em relação aos caprinos. A técnica venográfica distal anterógrada de ambos os membros em ovinos e caprinos se mostrou aplicável revelando a vasculatura distal e podal, a comunicação entre os vasos venosos e a quantidade dos vasos presentes na região.

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

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Koh Ghee

2009-01-01

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

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

International Nuclear Information System (INIS)

Wei Ning; Zu Maoheng; Xu Hao; Gu Yuming; Li Guojun; Zhang Qingqiao; Xu Wei; Liu Hongtao

2008-01-01

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

Análise do comportamento do hemometabolismo cerebral durante endarterectomia carotídea com pinçamento transitório Análisis del comportamiento del hemometabolismo cerebral durante endarterectomia carotídea con pinzamiento transitorio Analysis of brain hemometabolism behavior during carotid endarterectomy with temporary clamping

OpenAIRE

Gastão Fernandes Duval Neto; Augusto H. Niencheski

2004-01-01

JUSTIFICATIVA E OBJETIVOS: A endarterectomia carotídea com pinçamento transitório altera a relação entre o fluxo sangüíneo cerebral e a demanda metabólica cerebral de oxigênio, com conseqüente geração de uma tendência a hipóxia oliguêmica ou desacoplamento hemometabólico. O objetivo do presente estudo foi identificar as alterações do hemometabolismo cerebral, avaliados através das alterações da saturação da oxihemoglobina no bulbo da veia jugular interna (SjO2), durante endarterectomia carotí...

Análise do comportamento do hemometabolismo cerebral durante endarterectomia carotídea com pinçamento transitório

OpenAIRE

Duval Neto, Gastão Fernandes; Niencheski, Augusto H.

2004-01-01

JUSTIFICATIVA E OBJETIVOS: A endarterectomia carotídea com pinçamento transitório altera a relação entre o fluxo sangüíneo cerebral e a demanda metabólica cerebral de oxigênio, com conseqüente geração de uma tendência a hipóxia oliguêmica ou desacoplamento hemometabólico. O objetivo do presente estudo foi identificar as alterações do hemometabolismo cerebral, avaliados através das alterações da saturação da oxihemoglobina no bulbo da veia jugular interna (SjO2), durante endarterectomia carotí...

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

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Ahmad Parvinian

2014-01-01

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

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

International Nuclear Information System (INIS)

Harman, Mustafa; Sayarlioglu, Mehmet; Arslan, Halil; Ayakta, Hayati; Harman, Ece

2003-01-01

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

Ultrasound-guided catheterization of the left subclavian vein without recognition of persistent left superior vena cava

OpenAIRE

Park, Sun Young; Yoo, Jae Hwa; Kim, Mun Gyu; Kim, Sang Ho; Park, Byoung-Won; Oh, Hong Chul; Kim, Hojoon

2017-01-01

Abstract Rationale: A persistent left superior vena cava (PLSVC) is rare, but the most common thoracic venous anomaly. We report a case of PLSVC unrecognized during left subclavian vein catheterization using real-time ultrasound-guided supraclavicular approach. Patient concerns: A 79-year-old man with history of hypertension presented with traumatic subdural hemorrhage, subarachnoid hemorrhage, and epidural hemorrhage. Before the operation, a central venous catheter (CVC) was placed into the ...

Superior Vena Cava Syndrome in a Patient with Small-Cell Lung Cancer: A Case Report

OpenAIRE

Christina Brzezniak; Bryan Oronsky; Corey A. Carter; Bennett Thilagar; Scott Caroen; Karen Zeman

2017-01-01

Superior vena cava (SVC) syndrome, a potential oncologic emergency, is closely associated with malignancy and right-sided lung cancer in particular. A case of SVC syndrome presenting with facial swelling, neck distension, and enlarged veins of the upper chest, which developed over a period of 5 weeks in a 46-year-old patient on a clinical trial with small-cell lung cancer, is reported. Computed tomography scan of the chest revealed slight enlargement of a superior conglomerate mediastinal lym...

Estudo da circulação hepatomesentérica pela angiografia por ressonância magnética com gadolínio: comparação entre doses simples e dupla no estudo de pacientes esquistossomóticos Gadolinium-enhanced magnetic resonance angiography for hepatomesenteric vascular evaluation: single and double doses comparison in schistosomiasis patients

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Rogério Pedreschi Caldana

2006-08-01

Full Text Available OBJETIVO: Determinar a freqüência de visualização dos segmentos da circulação hepatomesentérica pela angiografia por ressonância magnética (angio-RM com contraste e comparar o valor do método, utilizando-se duas diferentes dosagens de gadolínio (doses simples e dupla. MATERIAIS E MÉTODOS: Estudo prospectivo de 36 pacientes esquistossomóticos submetidos a angio-RM. Os exames foram realizados em equipamento de RM de 1,5 T, usando-se bobina de corpo e bomba injetora para a administração endovenosa do contraste. Foram utilizadas, de maneira randomizada, dose dupla do contraste paramagnético (0,2 mmol/kg de Gd-DTPA em 21 pacientes e dose simples (0,1 mmol/kg em outros 15 pacientes. Os exames foram interpretados por dois observadores em consenso, que classificaram o grau de visualização de 25 segmentos vasculares estabelecidos para análise, sem conhecimento da dose de gadolínio utilizada. RESULTADOS: Os segmentos vasculares proximais e de maior calibre foram as estruturas com melhor grau de visualização na maioria da amostra em estudo. O tronco celíaco, a artéria hepática comum, a artéria esplênica, a croça e terço médio da artéria mesentérica superior, a veia porta, a veia esplênica e a veia mesentérica superior apresentaram grau 2 de visualização em mais de 70% da amostra. Quanto à comparação das diferentes dosagens, não houve diferença significante (p OBJECTIVE: To evaluate the visibility of hepatomesenteric vascular segments by 3D gadolinium-enhanced magnetic resonance (MR angiography and to compare the method effectiveness between two different gadolinium doses (single and double doses. MATERIALS AND METHODS: A prospective study was performed with 36 schistosomiasis patients who were submitted to 3D contrast-enhanced MR angiography. Scans were performed in a high-field equipment (1.5 T, with body coil and power injector for intravenous contrast administration. Contrast double doses (Gd-DTPA 0.2 mmol/kg and

Cerebral Fat Embolism in a Trauma Patient with Captured Imaging of Echogenic Emboli in the Inferior Vena Cava

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Nancy N. Wang

2016-12-01

Full Text Available The authors present a case of fat embolism syndrome after traumatic long-bone fracture in a patient with rapid neurologic deterioration and multiple cerebral embolic events. Diagnostic workup revealed the neuroradiologic findings classically described with cerebral fat emboli. The authors present hallmark ultrasound imaging of echogenic material actively traveling through the inferior vena cava.

Bilateral Breast Enlargement: An Unusual Presentation of Superior Vena Cava Obstruction in a Hemodialysis Patient with Fibrosing Mediastinitis

International Nuclear Information System (INIS)

Goo, Dong Erk; Kim, Yong Jae; Choi, Deuk Lin; Kwon, Kui Hyang; Yang, Seung Boo

2011-01-01

A 67-year-old woman with end-stage renal disease presented with profound edema of both breasts. The presence of a patent hemodialysis basilic transposition fistula and superior vena cava obstruction (SVC), due to fibrosing mediastinitis, was demonstrated by the use of fistulography. Endovascular treatment with a balloon and stent caused immediate resolution of the breast edema.

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

International Nuclear Information System (INIS)

Khalil, A.; Hayat, A.

2015-01-01

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

Inhibitory Effects of Ecklonia cava Extract on High Glucose-Induced Hepatic Stellate Cell Activation

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Akiko Kojima-Yuasa

2011-12-01

Full Text Available Nonalcoholic steatohepatitis (NASH is a disease closely associated with obesity and diabetes. A prevalence of type 2 diabetes and a high body mass index in cryptogenic cirrhosis may imply that obesity leads to cirrhosis. Here, we examined the effects of an extract of Ecklonia cava, a brown algae, on the activation of high glucose-induced hepatic stellate cells (HSCs, key players in hepatic fibrosis. Isolated HSCs were incubated with or without a high glucose concentration. Ecklonia cava extract (ECE was added to the culture simultaneously with the high glucose. Treatment with high glucose stimulated expression of type I collagen and α-smooth muscle actin, which are markers of activation in HSCs, in a dose-dependent manner. The activation of high glucose-treated HSCs was suppressed by the ECE. An increase in the formation of intracellular reactive oxygen species (ROS and a decrease in intracellular glutathione levels were observed soon after treatment with high glucose, and these changes were suppressed by the simultaneous addition of ECE. High glucose levels stimulated the secretion of bioactive transforming growth factor-β (TGF-β from the cells, and the stimulation was also suppressed by treating the HSCs with ECE. These results suggest that the suppression of high glucose-induced HSC activation by ECE is mediated through the inhibition of ROS and/or GSH and the downregulation of TGF-β secretion. ECE is useful for preventing the development of diabetic liver fibrosis.

A fractured inferior vena cava filter strut migrating to the left pulmonary artery

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Tamer Hudali

2015-01-01

Full Text Available Inferior vena cava filters are increasingly used in patients with recurrent venous thromboembolism who are contraindicated to anticoagulation. Migration of a broken strut to the pulmonary artery is a very rare complication of these filters. We report the case of an 83-year-old female who experienced this complication with the migratory strut remaining in the same position for years. This case provides evidence that such filters probably have higher rates of complications than what has been thought that remain asymptomatic. The indications and the management of complications of such devices need to be studied further.

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

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Robinson RA

2013-05-01

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

[Value of x-ray computed tomography in the study of the inferior vena cava in urologic practice].

Science.gov (United States)

Barré, C; Vialle, M; Rieux, D; Caron-Poitreau, C; Soret, J Y; Rognon, M

1985-01-01

The CT scan provides a reliable evaluation of the inferior vena cava, especially since the development of second and third generation scanners. It can readily detect congenital malformations and obstructive anomalies complicating renal cancer and it is also able to determine the tumoral or thrombotic nature of the venous obstruction. This excellent definition of the vessel reduces the indications for caval angiography to a few exceptional cases.

Utilização da safena magna in situ para arterialização do arco venoso do pé The great saphenous vein in situ for the arterialization of the venous arch of the foot

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Cesar Roberto Busato

2010-09-01

Full Text Available CONTEXTO: O tratamento da isquemia crítica de membros inferiores sem leito arterial distal pode ser realizado por meio da inversão do fluxo no arco venoso do pé. OBJETIVO: O objetivo deste trabalho foi apresentar a técnica e os resultados obtidos com a arterialização do arco venoso do pé, mantendo a safena magna in situ. MÉTODOS: Dezoito pacientes, dos quais 11 com aterosclerose (AO, 6 com tromboangeíte obliterante (TO e 1 com trombose de aneurisma de artéria poplítea (TA foram submetidos ao método. A safena magna in situ foi anastomosada à melhor artéria doadora. O fluxo arterial derivado para o sistema venoso progride por meio da veia cujas válvulas são destruídas. As colaterais da veia safena magna são ligadas desde a anastomose até o maléolo medial, a partir do qual são preservadas. RESULTADOS: Dos pacientes, 10 (55,6% mantiveram suas extremidades, 5 com AO e 5 com TO; 7 (38,9% foram amputados, 5 com AO, 1 com TO e 1 com Ta; houve 1 óbito (5,5%. CONCLUSÃO: A inversão do fluxo arterial no sistema venoso do pé deve ser considerada para salvamento de extremidade com isquemia crítica sem leito arterial distal.BACKGROUND: Critical lower limb ischemia in the absence of a distal arterial bed can be treated by arterialization of the venous arch of the foot. OBJETIVE: The objective of this paper was to present the technique and the results of the arterialization of the venous arch of the foot with the in situ great saphenous vein. METHODS: Eighteen patients, 11 with atherosclerosis (AO, 6 with thromboangiitis obliterans (TO and 1 with popliteal artery aneurysm thrombosis were submitted to venous arch arterialization. The in situ great saphenous vein was anastomosed to the best donor artery. Arterial flow derived from the venous system progresses through the vein whose valves were destroyed. The collateral vessels of the great saphenous vein are linked from the anastomosis to the medial malleolus and preserved from this point

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

International Nuclear Information System (INIS)

Sofue, Keitaro; Takeuchi, Yoshito; Arai, Yasuaki; Sugimura, Kazuro

2013-01-01

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.

Variabilidade fenotípica na síndrome do cromossomo supernumerário der(22t(11;22 (síndrome de Emanuel Phenotypical variability in supernumerary chromosome der(22t(11;22 syndrome (Emanuel syndrome

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Rafael Fabiano M. Rosa

2010-09-01

Full Text Available OBJETIVO: Relatar dois pacientes com a síndrome de Emanuel (SE ou cromossomo supernumerário der(22t(11;22, secundária a translocações balanceadas familiares, apresentando fenótipos distintos. DESCRIÇÃO DE CASO: O primeiro paciente é uma menina branca de cinco anos de idade, apresentando hipotonia, atraso no desenvolvimento neuropsicomotor, movimentos estereotipados, microcefalia, ptose palpebral, orelhas proeminentes, fossetas e apêndices pré-auriculares, e imperfuração anal. As avaliações adicionais identificaram hipoplasia cerebral e estenose da válvula pulmonar. Possuía história também de laringotraqueomalácia e fenda palatina. O segundo paciente é um menino branco de seis meses de idade com hipotonia, movimentos coreoatetóticos, déficit de crescimento, microcefalia, microssomia hemifacial, fenda palatina, microtia, apêndices pré-auriculares e polegares proximalmente implantados. A ecocardiografia demonstrou estenose da válvula pulmonar, comunicação interatrial e interventricular, persistência do canal arterial e da veia cava superior esquerda. A radiografia de tórax identificou uma costela cervical. O cariótipo por bandas GTG mostrou a presença, em ambos os pacientes, de um cromossomo adicional der(22t(11;22, secundário a uma translocação balanceada materna no primeiro caso e paterna no segundo caso. COMENTÁRIOS: Apesar de a primeira paciente apresentar achados frequentes da SE, o caso adicional representa a segunda descrição da literatura com um fenótipo de espectro óculo-aurículo-vertebral (EOAV. Assim, ambos salientam a variabilidade clínica observada na SE e a importância da avaliação cariotípica em indivíduos com fenótipo de EOAV.OBEJECTIVE: To report two patients with Emanuel syndrome (ES or supernumerary chromosome der(22t(11;22, secondary to familial balanced translocations, presenting distinct phenotypes. CASES DESCRIPTION: The first patient was a five-year-old white girl presenting

Radiographic evaluation of caudal vena cava size in dogs

International Nuclear Information System (INIS)

Lehmkuhl, L.B.; Bonagura, J.D.; Biller, D.S.; Hartman, W.M.

1997-01-01

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

Impact of evolving strategy on clinical outcomes and central pulmonary artery growth in patients with bilateral superior vena cava undergoing a bilateral bidirectional cavopulmonary shunt.

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Honjo, Osami; Tran, Kim-Chi D; Hua, Zhongdong; Sapra, Priya; Alghamdi, Abdullah A; Russell, Jennifer L; Caldarone, Christopher A; Van Arsdell, Glen S

2010-09-01

We reported a high incidence of thrombosis, central pulmonary artery hypoplasia, and mortality for bilateral bidirectional cavopulmonary shunts. We hypothesized that technical modifications in the cavopulmonary anastomosis and anticoagulation would limit thrombus and central pulmonary artery hypoplasia, and thereby improve outcomes. Sixty-one patients (median age, 8.4 months; weight, 6.6 kg) underwent bilateral bidirectional cavopulmonary shunt from 1990 to 2007. The cohort was divided into 2 groups: 1) the conventional group (1990-1999, n = 37) and 2) the V-shaped group, with a hemi-Fontan or modification in which the cavae were anastomosed to the pulmonary artery adjacent to each other so they formed the appearance of a V (1999-2007, n = 24). Central and branch pulmonary artery growth, survival, and reinterventions were determined. The pre-Fontan study showed equivalent superior venae cavae and Nakata indices. The central pulmonary artery index and central pulmonary artery/Nakata index ratio were significantly higher in the V-shaped group (P analysis showed anastomotic strategy, low saturation, and thrombosis were predictors for death. Anastomotic strategy, lack of anticoagulation, thrombosis, and small superior venae cavae were predictors for reintervention (P strategy affected reintervention. Anastomotic strategy and postoperative thrombus affected mortality. 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Experimental investigation of the effects of inserting a bovine venous valve in the inferior vena cava of Fontan circulation

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Santhanakrishnan, Arvind; Johnson, Jacob; Kotz, Monica; Tang, Elaine; Khiabani, Reza; Yoganathan, Ajit; Maher, Kevin

2012-11-01

The Fontan procedure is a palliative surgery performed on patients with single ventricle (SV) congenital heart defects. The SV is used for systemic circulation and the venous return from the inferior vena cava (IVC) and superior vena cava (SVC) is routed to the pulmonary arteries (PA), resulting in a total cavopulmonary connection (TCPC). Hepatic venous hypertension is commonly manifested in the Fontan circulation, leading to long-term complications including liver congestion and cirrhosis. Respiratory intrathoracic pressure changes affect the venous return from the IVC to the PA. Using a physical model of an idealized TCPC, we examine placement of a unidirectional bovine venous valve within the IVC as a method of alleviating hepatic venous hypertension. A piston pump is used to provide pulsatility in the internal flow through the TCPC, while intrathoracic pressure fluctuations are imposed on the external walls of the model using a pair of linear actuators. When implanted in the extrathoracic position, the hepatic venous pressure is lowered from baseline condition. The effects of changing caval flow distribution and intrathoracic pressure on TCPC hemodynamics will be examined.

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

International Nuclear Information System (INIS)

Sierre, Sergio; Lipsich, Jose; Questa, Horacio

2007-01-01

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

Fracture and embolization of a Celect inferior vena cava filter strut to the liver: A Case Report

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Kim, So Hee; Song, Yun Gyu [Dept. of Radiology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon (Korea, Republic of)

2017-07-15

Inferior vena cava (IVC) filters are typically used for prophylaxis against pulmonary embolism. A new version of the Günther Tulip filter, the Celect IVC filter was introduced in April 2007. To the best of our knowledge, there are no reports commenting on Celect IVC filter fracture and fragment embolization to liver. We report a case in which the strut of the Celect IVC filter embolized to the liver.

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

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Patel Nehal

2009-01-01

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

Fracture and embolization of a Celect inferior vena cava filter strut to the liver: A Case Report

International Nuclear Information System (INIS)

Kim, So Hee; Song, Yun Gyu

2017-01-01

Inferior vena cava (IVC) filters are typically used for prophylaxis against pulmonary embolism. A new version of the Günther Tulip filter, the Celect IVC filter was introduced in April 2007. To the best of our knowledge, there are no reports commenting on Celect IVC filter fracture and fragment embolization to liver. We report a case in which the strut of the Celect IVC filter embolized to the liver

Morfologia da glândula mamária do quati (Nasua nasua

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Juliana B. Casals

2013-11-01

Full Text Available Nasua nasua é um animal onívoro, encontrado em todo Brasil. A reprodução da espécie ocorre somente uma vez ao ano, na primavera. As fêmeas são matriarcas e amamentam suas crias até os 5 meses de idade, vivem com seus filhotes em bandos de até 30 indivíduos. Para descrição morfológica da glândula mamaria do Nasua nasua foram utilizados seis animais provenientes do Criatório Cientifico (Cecrimpas, Unifeob. Autorizado pelo Ibama (Proc.02027.002322/98-99. Para análise macroscópica um animal foi injetado com látex neoprene, sendo a artéria femoral injetada com látex de cor vermelha e a veia jugular de cor azul. Os demais animais foram fixados em solução aquosa a 10% de formaldeído. Para análise microscópica, fragmentos glandulares foram coletados e submetidos ao processo rotineiro, embebido em parafina e corados com Hematoxilina e Eosina, Picrossírius e Azul de Toluidina. Macroscopicamente foram evidenciados três pares de glândulas mamárias, sendo dois pares posicionados na região abdominal e um par na região inguinal. Microscopicamente, notou-se epitélio de revestimento externo das papilas mamárias, epitélio pavimentoso estratificado queratinizado, o qual seguia por toda glândula de forma irregular. Na entrada do óstio, o epitélio da epiderme era modificado ocorrendo uma transição de epitélio pavimentoso estratificado para um epitélio cúbico no ducto papilar. O parênquima glandular era caracteristicamente túbulo alveolar com células secretoras, evidenciado principalmente no animal lactente. Os resultados macroscópicos e microscópicos assemelham-se aos já descritos nas cadelas (Canis familiaris e os do Procyon cancrivorus pertencente à mesma família do quati, Família Procyonidae.

Radiotherapeutic handling in the compression syndrome of the superior vena cava

International Nuclear Information System (INIS)

Ferreira, P.R.F.; Barletta, A.

1989-01-01

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

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

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

2014-08-01

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.

Uma causa rara de hipertensão portal: Caso clínico A rare cause of portal hypertension: Case report

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Joana Moreira

2011-06-01

Full Text Available Apresenta-se caso clínico de doente com quadro de hipertensão portal pela presença de fístula artério-venosa entre a artéria gastroduodenal e a veia porta. Indivíduo do sexo masculino, de 77 anos, previamente saudável, com ascite volumosa de instalação recente. Hemorragia digestiva alta por rotura de varizes esofágicas. TAC abdominal revelando acentuada dilatação da veia porta (30 mm, envolvida em fístula artério-venosa com origem na artéria gastroduodenal; fígado sem estigmas de hepatopatia crónica e sem nódulos; ascite volumosa. Procedeu-se à laparotomia com drenagem de ascite, isolamento e laqueação do trajecto fístuloso entre a artéria gastroduodenal e a veia porta. Sem complicações intra-operatórias. Ao 18º dia, após regressão da ascite, teve alta medicado com diuréticos.A case report of a patient with a framework for portal hypertension due to the presence of arteriovenous fistula between the gastroduodenal artery and portal vein is presented. A 77 years male previously healthy with a recent ascites appeared with a digestive hemorrhage caused by rupture of esophageal varices. Abdominal CT scan revealed marked dilatation of the portal vein (30 mm related with an arteriovenous fistula between this vein and the gastroduodenal artery, liver without chronic liver disease stigmata and without nodules; remarkable ascites. Laparotomy, drainage of ascites, isolation and ligation of the journey fistula between the gastroduodenal artery and portal vein was performed. No intraoperative complications. Discharged the 18th postoperative day after regression of ascites, treated with diuretics.

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

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Giovanny Ríos, MD

2012-05-01

Full Text Available La anomalía total del retorno venoso sistémico tiene gran variedad de presentaciones; sin embargo, la patología de más baja frecuencia es el drenaje de vena cava superior derecha a la aurícula izquierda, hecho de peso para que en el mundo se reporten pocos casos. En la Fundación Clínica Abood Shaio se trató el caso de una paciente de seis años de edad con drenaje venoso total de cava superior derecha a la aurícula izquierda, mediante la técnica de movilización de cava superior y anastomosis cavo-atrial, y se obtuvieron buenos resultados. El caso es mención corresponde al número 21 en la literatura mundial.

Subclavian vein thrombosis following fracture of the clavicle: case report

OpenAIRE

Terra, Bernardo Barcellos; Cocco, Luiz Fernando; Ejnisman, Benno; Fernandes, Hélio Jorge Alvachian; Reis, Fernando Baldy dos

2011-01-01

A trombose venosa profunda no membro superior não é frequente na literatura ortopédica. Relatamos um caso de trombose da veia subclávia durante o tratamento conservador de fratura do terço médio da clavícula. O diagnóstico é difícil e requer um alto grau de suspeição e o tratamento pode prevenir um tromboembolismo fatal. Há raros casos descritos associados à fratura de clavícula.Deep vein thrombosis in the upper limbs is uncommon in the orthopedic literature. We report on a case of subclavian...

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

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

2013-02-15

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

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

International Nuclear Information System (INIS)

Fagedet, Dorothée; Thony, Frederic; Timsit, Jean-François; Rodiere, Mathieu; Monnin-Bares, Valérie; Ferretti, Gilbert R.; Vesin, Aurélien; Moro-Sibilot, Denis

2013-01-01

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

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

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Venkateshwaran Subramanian

2014-01-01

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

Cytotoxic activity of proteins isolated from extracts of Corydalis cava tubers in human cervical carcinoma HeLa cells

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Balcerkiewicz Stanislaw

2010-12-01

Full Text Available Abstract Background Corydalis cava Schweigg. & Koerte, the plant of numerous pharmacological activities, together with the studied earlier by our group Chelidonium majus L. (Greater Celandine, belong to the family Papaveraceae. The plant grows in Central and South Europe and produces the sizeable subterraneous tubers, empty inside, which are extremely resistant to various pathogen attacks. The Corydalis sp. tubers are a rich source of many biologically active substances, with the extensive use in European and Asian folk medicine. They have analgetic, sedating, narcotic, anti-inflammatory, anti-allergic and anti-tumour activities. On the other hand, there is no information about possible biological activities of proteins contained in Corydalis cava tubers. Methods Nucleolytic proteins were isolated from the tubers of C. cava by separation on a heparin column and tested for DNase activity. Protein fractions showing nucleolytic activity were tested for cytotoxic activity in human cervical carcinoma HeLa cells. Cultures of HeLa cells were conducted in the presence of three protein concentrations: 42, 83 and 167 ng/ml during 48 h. Viability of cell cultures was appraised using XTT colorimetric test. Protein fractions were separated and protein bands were excised and sent for identification by mass spectrometry (LC-ESI-MS/MS. Results The studied protein fractions showed an inhibiting effect on mitochondrial activity of HeLa cells, depending on the administered dose of proteins. The most pronounced effect was obtained with the highest concentration of the protein (167 ng/ml - 43.45 ± 3% mitochondrial activity of HeLa cells were inhibited. Mass spectrometry results for the proteins of applied fractions showed that they contained plant defense- and pathogenesis-related (PR proteins. Conclusions The cytotoxic effect of studied proteins toward HeLa cell line cells has been evident and dependent on increasing dose of the protein. The present study, most

Prevalência dos tipos sangüíneos A, B e AB em gatos domésticos mestiços da cidade de Porto Alegre, Rio Grande do Sul, Brasil

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Luciana de Almeida Lacerda

2008-12-01

Full Text Available O presente estudo teve como objetivo determinar a prevalência dos tipos sangüíneos em felinos domésticos, mestiços, da cidade de Porto Alegre, Rio Grande do Sul, Brasil. Foram selecionados aleatoriamente 100 gatos, clinicamente saudáveis, mestiços e sem parentesco entre si. Amostras de sangue foram coletadas da veia jugular e a tipagem sangüínea foi realizada através do teste RapidVet H Feline (DMS Laboratories, Flemington, USA e do teste hemaglutinação em tubo de ensaio. A tipagem reversa foi realizada para confirmar o tipo e a presença de aloanticorpos naturais. No presente estudo encontrou-se prevalência de 97% e 3% de gatos do tipo A e B, respectivamente. Não foram encontrados gatos do tipo AB. Os resultados indicam que no sul do Brasil há uma alta prevalência de gatos domésticos mestiços do tipo A, entretanto a prevalência de gatos do tipo B encontrada no trabalho é mais alta do que aquelas relatadas em alguns países. O conhecimento da prevalência dos tipos sangüíneos da população de gatos de uma região pode auxiliar na determinação dos riscos de reações transfusionais e de ocorrência de isoeritrólise neonatal, e estes podem ser prevenidos através de tipagem sangüínea e teste de compatibilidade sangüínea.

Qualidade da água durante a formação de lagos profundos em cavas de mineração: estudo de caso do lago de Águas Claras - MG Water quality during the filling of deep mining lakes: case study of Aguas Claras pit lake - MG

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Eduardo von Sperling

2004-09-01

Full Text Available O trabalho apresenta os resultados do monitoramento de qualidade da água durante o processo inicial de formação do Lago de Águas Claras, cuja gênese é decorrente do enchimento da cava exaurida de uma mineração de ferro. Em sua configuração final o lago possuirá uma área de 0,7 km² e uma profundidade máxima de 234 m, o que o posicionaria atualmente como o ambiente hídrico mais profundo do país. Constata-se o predomínio de uma boa qualidade de água, com baixo grau de mineralização, excelentes condições de oxigenação e ausência de contaminação orgânica e mineral. No aspecto hidrobiológico destaca-se a frequente alternância no predomínio de grupos algais, indicando a instabilidade de ecossistemas que se encontram em processo de formação.The paper presents the results of a broad monitoring program carried out during the beginning of the filling process of Lake Aguas Claras, Brazil. This lake was created after the exhaustion of an iron ore mining activity. In its final conformation the lake will have a surface area of 0,7 km² and the maximum depth of 234 m, which will make it the deepest lake in the country. The results of a two years monitoring program show the prevalence of good water quality (well oxygenated, low degree of mineralization, absence of organic and mineral contamination, but also a quite interesting shift in the dominance of phytoplanktonic groups, indicating the high instability of lakes that are undergoing a process of formation.

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

International Nuclear Information System (INIS)

Rosch, J.; Bedell, J.; Putnam, J.; Antonovic, R.; Uchida, B.

1986-01-01

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

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

International Nuclear Information System (INIS)

Juan, Yu Hsiang; Saboo, Sachin S.; Anand, Vishal; Chatzizisis, Yiannis S.; Steigner, Michael L.; Lin, Yu Ching

2014-01-01

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

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

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Verma Gita

2008-10-01

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.

Contrast-enhanced fluorodeoxyglucose positron emission tomography/contrast-enhanced computed tomography in mediastinal T-cell lymphoma with superior vena cava syndrome

International Nuclear Information System (INIS)

Santhosh, Sampath; Gorla, Arun Kumar Reddy; Bhattacharya, Anish; Varma, Subhash Chander; Mittal, Bhagwant Rai

2016-01-01

Positron emission tomography-computed tomography (PET/CT) is a routine investigation for the staging of lymphomas. Contrast-enhanced computed tomography is mandatory whenever parenchymal lesions, especially in the liver and spleen are suspected. We report a rare case of primary mediastinal T-cell lymphoma evaluated with contrast-enhanced PET/CT that showed features of superior vena cava syndrome

Retrievable Inferior Vena Cava Filters: Indications, Indwelling Time, Removal, Success and Complication Rates.

Science.gov (United States)

Tashbayev, Alisher; Belenky, Alexander; Litvin, Sergey; Knizhnik, Michael; Bachar, Gil N; Atar, Eli

2016-02-01

Various vena cava filters (VCF) are designed with the ability to be retrieved percutaneously. Yet, despite this option most of them remain in the inferior vena cava (IVC). To report our experience in the placement and retrieval of three different types of VCFs, and to compare the indications for their insertion and retrieval as reported in the literature. During a 5 year period three types of retrievable VCF (ALN, OptEase, and Celect) were inserted in 306 patients at the Rabin Medical Center (Beilinson and Hasharon hospitals). Indications, retrieval rates, median time to retrieval, success and complication rates were viewed and assessed in the three groups of filter types and were compared with the data of similar studies in the literature. Of the 306 VCFs inserted, 31 (10.1%) were retrieved with equal distribution in the three groups. In most patients the reason for filter insertion was venous thromboembolic events (VTE) and contraindications to anticoagulant therapy. Mean age was 68.38 ± 17.5 years (range 18-99) and was noted to be significantly higher compared to similar studies (53-56 years) (P < 0.0001). Multi-trauma patients were significantly older (71.11 ± 14.99 years) than post-pulmonary embolism patients (48.03 ± 20.98 years, P < 0.0001) and patients with preventive indication (26.00 ± 11.31, P < 0.0001). The mean indwelling time was 100.6 ± 103.399 days. Our results are comparable with the results of other studies, and there was no difference in percentage of retrieval or complications between patients in each of the three groups. In 1 of 10 patients filters should be removed after an average of 3.5 months. All three IVC filter types used are safe to insert and retrieve.

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

International Nuclear Information System (INIS)

Kalva, Sanjeeva P.; Marentis, Theodore C.; Yeddula, Kalpana; Somarouthu, Bhanusupriya; Wicky, Stephan; Stecker, Michael S.

2011-01-01

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

Should We Remove the Retrievable Cook Celect Inferior Vena Cava Filter? Eight Years of Experience at a Single Center.

Science.gov (United States)

Son, Joohyung; Bae, Miju; Chung, Sung Woon; Lee, Chung Won; Huh, Up; Song, Seunghwan

2017-12-01

The inferior vena cava filter (IVCF) is very effective for preventing pulmonary embolism in patients who cannot undergo anticoagulation therapy. However, if a filter is placed in the body permanently, it may lead to other complications. A retrospective study was performed of 159 patients who underwent retrievable Cook Celect IVCF implantation between January 2007 and April 2015 at a single center. Baseline characteristics, indications, and complications caused by the filter were investigated. The most common underlying disease of patients receiving the filter was cancer (24.3%). Venous thrombolysis or thrombectomy was the most common indication for IVCF insertion in this study (47.2%). The most common complication was inferior vena cava penetration, the risk of which increased the longer the filter remained in the body (p=0.032, Exp(B)=1.004). If the patient is able to retry anticoagulation therapy and the filter is no longer needed, the filter should be removed, even if a long time has elapsed since implantation. If the filter cannot be removed, it is recommended that follow-up computed tomography be performed regularly to monitor the progress of venous thromboembolisms as well as any filter-related complications.

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

International Nuclear Information System (INIS)

Linsenmaier, Ulrich; Rieger, Johannes; Schenk, Franz; Rock, Clemens; Mangel, Eugen; Pfeifer, Klaus Juergen

1998-01-01

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

Batendo à porta do céu o bóson de Higgs e como a física modern ilumina o universo

CERN Document Server

Randall, Lisa

2013-01-01

Nesta obra a autora conduz seu mais novo trabalho, seduzindo o leitor pelas descobertas e teorias mais recentes da fisica, conforme realiza uma apaixonada - e necessaria - defesa da importancia da ciencia em nossas vidas. Na veia de autores como Stephen Hawking, Michio Kaku, Brian Greene e Carl Sagan, Randall explora seculos de conhecimento cientifico para tracar uma rica e esclarecedora historia do nosso Universo - do seu nascimento ate a inevitavel morte. Explica tambem o funcionamento do LHC, o maior acelerador de particulas do mundo, uma estrutura gigantesca construida na Suica que vem ajudando cientistas de todo o mundo a solucionar os misterios da materia e da origem da vida. Num capitulo feito especialmente apos a descoberta do boson de Higgs, a chamada 'particula de Deus', Randall elucida as consequencias deste que e um dos mais importantes avancos da historia da fisica. Valendo-se de uma prosa agil e explicativa, e travando um dialogo com profissionais de diversas areas, como roteiristas de cinema, c...

Hipertensão pulmonar secundária à fístulas coronarianas para tronco da pulmonar Pulmonary hypertension secondary to coronary-to-pulmonary artery fistula

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José Ramos Filho

2008-08-01

Full Text Available A fístula coronariana é uma anomalia caracterizada por comunicação entre uma artéria coronária e uma câmara cardíaca, artéria pulmonar, seio coronariano e veias pulmonares. Representa 0,2% a 0,4 % das cardiopatias congênitas e 0,1% a 0,2% da população adulta submetida a angiografia coronariana. Relatamos o caso clínico de uma paciente com 64 anos, cuja anomalia foi diagnosticada durante investigação clínica por desconforto torácico, dispnéia e síncope, sendo indicada correção cirúrgica com abertura da artéria pulmonar através de circulação extracorpórea.The coronary fistula is an anomaly characterized by the communication between a coronary artery and a cardiac chamber, pulmonary artery, coronary sinus and pulmonary veins. It represents 0.2 to 0.4% of the congenital cardiopathies and 0.1% to 0.2% of the adult population submitted to coronary angiography. We report the clinical case of a 64-year-old female patient, whose anomaly was diagnosed during a clinical investigation due to chest discomfort, dyspnea and syncope; the surgical correction was indicated, with opening of the pulmonary artery through extracorporeal circulation.

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

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Neema Praveen

2009-01-01

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

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

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Juan F Jaramillo

2010-04-01

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

Successful Venous Angioplasty of Superior Vena Cava Syndrome after Heart Transplantation

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Thomas Strecker

2014-01-01

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

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

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HUANG Long

2015-06-01

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

Tromboembolismo pulmonar asociado al síndrome de la vena cava superior de origen trombótico

OpenAIRE

Barrera-López, Ana Madeleine; Cortés-P., Luis Arcadio; Salazar-C., Erika María

2016-01-01

Se describe el caso de un paciente masculino de 32 años de edad, quien consulta al servicio de urgencias con historia clínica del síndrome de la vena cava superior, en el estudio de la angiotomografía pulmonar, se demuestra embolismo pulmonar izquierdo, trombosis de la vena yugular interna derecha y confluente yugulo subclavio. No hay evidencia de asociación con neoplasia, infecciones o enfermedades del tejido conectivo, siendo el único factor de riesgo asociado para la trombosis, hiperviscoc...

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

International Nuclear Information System (INIS)

Stambo, Glenn W.; Leto, John; George, Christopher; Van Epps, Kelly; Woeste, Troy; Berlet, Mathew

2008-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2008-05-15

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

Should We Remove the Retrievable Cook Celect Inferior Vena Cava Filter? Eight Years of Experience at a Single Center

Directory of Open Access Journals (Sweden)

Joohyung Son

2017-12-01

Full Text Available Background: The inferior vena cava filter (IVCF is very effective for preventing pulmonary embolism in pa-tients who cannot undergo anticoagulation therapy. However, if a filter is placed in the body permanently, it may lead to other complications. Methods: A retrospective study was performed of 159 patients who under-went retrievable Cook Celect IVCF implantation between January 2007 and April 2015 at a single center. Baseline characteristics, indications, and complications caused by the filter were investigated. Results: The most common underlying disease of patients receiving the filter was cancer (24.3%. Venous thrombolysis or thrombectomy was the most common indication for IVCF insertion in this study (47.2%. The most common complication was inferior vena cava penetration, the risk of which increased the longer the filter remained in the body (p=0.032, Exp(B=1.004. Conclusion: If the patient is able to retry anticoagulation therapy and the filter is no longer needed, the filter should be removed, even if a long time has elapsed since implantation. If the filter cannot be removed, it is recommended that follow-up computed tomography be performed regularly to monitor the progress of venous thromboembolisms as well as any filter-related complications.

A prebiotic role of Ecklonia cava improves the mortality of Edwardsiella tarda-infected zebrafish models via regulating the growth of lactic acid bacteria and pathogen bacteria.

Science.gov (United States)

Lee, WonWoo; Oh, Jae Young; Kim, Eun-A; Kang, Nalae; Kim, Kil-Nam; Ahn, Ginnae; Jeon, You-Jin

2016-07-01

In this study, the beneficial prebiotic roles of Ecklonia cava (E. cava, EC) were evaluated on the growth of lactic acid bacteria (LAB) and pathogen bacteria and the mortality of pathogen-bacteria infected zebrafish model. The result showed that the original E. cava (EC) led to the highest growth effects on three LABs (Lactobacillus brevis, L. brevis; Lactobacillus pentosus, L. pentosus; Lactobacillus plantarum; L. plantarum) and it was dose-dependent manners. Also, EC, its Celluclast enzymatic (ECC) and 100% ethanol extracts (ECE) showed the anti-bacterial activities on the fish pathogenic bacteria such as (Edwardsiella tarda; E. tarda, Streptococcus iniae; S. iniae, and Vibrio harveyi; V. harveyi). Interestingly, EC induced the higher production of the secondary metabolites from L. plantarum in MRS medium. The secondary metabolites produced by EC significantly inhibited the growth of pathogen bacteria. In further in vivo study, the co-treatment of EC and L. plantarum improved the growth and mortality of E. tarda-infected zebrafish as regulating the expression of inflammatory molecules such as iNOS and COX2. Taken together, our present study suggests that the EC plays an important role as a potential prebiotic and has a protective effect against the infection caused by E. tarda injection in zebrafish. Also, our conclusion from this evidence is that EC can be used and applied as a useful prebiotic. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

International Nuclear Information System (INIS)

Kokubo, Takashi; Oyama, Kazuyuki; Ohtomo, Kuni; Yashiro, Naobumi; Itai, Yuji; Iio, Masahiro; Masuyama, Shigeyoshi.

1988-01-01

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

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

International Nuclear Information System (INIS)

Yamagami, Takuji; Kato, Takeharu; Iida, Shigeharu; Hirota, Tatsuya; Nishimura, Tsunehiko

2005-01-01

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

The Use of the Peripherally Inserted Central Catheter (Picc in the Hospital Environment La utilización del catéter central de inserción periférica (CCIP en el ambiente hospitalario A utilização do cateter central de inserção periférica (CCIP no ambiente hospitalar

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Graziella Gasparotto Baiocco

2010-12-01

prontuários do Grupo de Cateteres da Associação Hospitalar Moinhos de Vento, em Porto Alegre, RS, totalizando 229 cateteres inseridos. A curva de crescimento na utilização do cateter central de inserção periférica (CCIP foi de 1 cateter inserido em 2000 a 57 inseridos em 2007. A prevalência inerente à patologia foi a oncológica (17,9%, n=41. Em relação às indicações ao uso, prevaleceu a antibioticoterapia (54,1%, n=124. Na confirmação radiológica, a veia cava foi prevalente (68,1%, n=156. Pode-se concluir que a utilização do CCIP no ambiente hospitalar está em expansão e a enfermagem tem papel fundamental na inserção, manutenção e sua remoção.

Cultivo primário de células hepáticas de Metynnis roosevelti (Pisces, Teleostei, Characidae

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Ligia Maria Salvo

2000-01-01

Full Text Available A fim de obter culturas celulares e monocamada de células hepáticas do peixe subtropical Metynnis roosevelti, foram comparadas três metodologias: dissociação celular enzimática com tripsina versene 0,25%; utilização do soro fetal bovino; e soro homólogo, obtido por meio da punção da veia caudal, de exemplares adultos da mesma espécie de peixe. O meio de cultura utilizado foi F10-199 acrescido de L-glutamina 2 mM, insulina 10 µg/mL, fibronectina 50 µg/mL; e antibióticos. A dissociação celular enzimática apresentou maior eficiência na adesão e confluência da monocamada celular em comparação a outras metodologias utilizadas.

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

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

2012-06-15

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

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

International Nuclear Information System (INIS)

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

2012-01-01

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

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)

Stockx, Luc; Raat, Henricus; Donck, Jan; Wilms, Guy; Marchal, Guy

1999-01-01

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

Persistent Left Superior Vena Cava Associated with Hemiazygos Vein Draining in It and Absence of Left Brachiocephalic Vein, in a Patient with Congenital Heart Defect

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Opincariu Diana

2016-09-01

Full Text Available Persistent left superior vena cava is an anomalous vein that derives from a malfunction of obliteration of the left common cardinal vein during intrauterine life. The diagnosis can be suggested by a dilated coronary sinus as seen in echocardiography, or other imagistic methods. Due to the lack of hemodynamic impairment, and consequently with few or no symptoms, this vascular anomaly is frequently discovered incidentally. In this brief report we present the case of a 35-year-old male known with a complex congenital cardiovascular malformation that included atrial septum defect, persistent left superior vena cava and anomalous right pulmonary vein drainage in the PLSVC, diagnosed with sinoatrial block that required pacemaker implantation. Due to the patient’s medical history, investigations to decide the best approach needed for pacemaker implantation were performed, including a thoracic CT that incidentally found additional anomalies — the hemiazygos vein draining in PLSVC and the lack of the left brachiocephalic vein.

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

OpenAIRE

Turker Acar; Mustafa Harman; Serkan Guneyli; Sait Sen; Nevra Elmas

2014-01-01

Epithelioid angiomyolipoma (E-AML), accounting for 8% of renal angiomyolipoma, is usually associated with tuberous sclerosis (TS) and demonstrates aggressive behavior. E-AML is macroscopically seen as a large infiltrative necrotic tumor with occasional extension into renal vein and/or inferior vena cava. However, without history of TS, renal sinus and venous invasion E-AML would be a challenging diagnosis, which may lead radiologists to misinterpret it as a renal cell carcinoma (RCC). In this...

Técnica para obtenção do aparelho geniturinário e dosagem do PSA (Prostate Specific Antigen no hamster sírio, Mesocricetus auratus Technique for collecting blood for PSA (Prostate Specific Antigen dosing and genitourinary system obtaining in syrian hamster, Mesocricetus auratus

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Dimas José Araújo Vidigal

2004-12-01

Full Text Available Objetivo: Expor a técnica utilizada na colheita de sangue para dosagem do PSA ( Prostate Specific Antigen e retirada do aparelho geniturinário no hamster sírio, Mesocricetus auratus, e correlacionar os achados do PSA com as alterações histológicas dos anexos sexuais desse roedor. Métodos: Foram usados no experimento trinta (n= 30 Hamsters: dez (n=10 animais considerados jovens com idade média no momento da morte de 47,5 dias e vinte (n=20 animais considerados adultos com idade superior à um ano. Após serem anestesiados com cloridrato de quetamina e diazepam, foi colhido diretamente da veia cava, em nível de abdome superior, cerca de 1,5mL a 2,0mL de sangue para dosagem do PSA totalpelo método ELISA, com antígeno humano. Morriam após colheita do sangue. Constatado a morte do animal, fazia-se a laparotomia retirando-se em monobloco todo aparelho geniturinário para estudo histológico dos anexos sexuais. Correlacionou-se o PSA com as alterações histológicas encontradas. Resultados: Os animais após serem anestesiados com cloridrato de quetamina e diazepam intraperitonealmente, obteve-se um excelente plano anestésico, que possibilitou colher via trans-dérmica da veia cava inferior em abdome superior sangue para dosagem do PSA. O animal morria após colheita do sangue. Fazia-se a laparotomia, com retirada em monobloco do aparelho geniturinário para estudo histológico e comparação das alterações encontradas nos anexos sexuais com o PSA dosado. Entre os Hamsters Jovens a média do PSA encontrado foi de 0,252ng/mL. Desvio Padrão (DP = 0,36. Entre os Hamsters adultos esta média foi de 0,325 ng/mL, DP= 0,12 . Quando comparou-se as médias do PSA entre os dois grupos de jovens e adultos obteve-se p= 0,0427. Dentre os Hamsters jovens, três apresentaram PSA não detectado. A análise histológica mostrou que, entre os animais jovens, não foi identificada qualquer alteração das estruturas microscópicas da próstata, ves

Esclerose de pequenos vasos venosos com corrente elétrica galvânica ponteada, em orelhas de coelhos Galvanic electric sharp stream and the sclerosis of marginal veins in the ear of rabbits

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Sergio Santiago

2001-12-01

Full Text Available Foi idealizado e construido um aparelho que utiliza a corrente elétrica galvânica em baixa amperagem (100m A ,200m A, 300m A com o propósito de causar esclerose em vasos venosos de pequeno calibre, utilizando a veia marginal da orelha direita do coelho. O presente estudo buscou verificar em modelo experimental, o efeito da corrente elétrica galvânica em baixa amperagem. Foram utilizados 45 coelhos Nova Zelandia, distribuídos em 3 grupos de 15 animais , sendo utilizada a orelha esquerda como controle e a orelha direita como experimento. No grupo experimento os animais do grupo I foram submetidos à corrente elétrica galvânica de 100m A , no grupo II à 200m A, e no grupo III à 300m . No grupo controle, os animais foram submetidos somente ao procedimento mecânico de aplicação da agulha ao longo da veia marginal da orelha esquerda, sendo realizado uma, duas e três aplicações com intervalo de sete dias entre cada aplicação. Todos os animais foram avaliados quatorze dias após a última aplicação, em aspectos macro e microscópicos. Os resultados mostraram que, tanto a corrente elétrica galvânica em baixa amperagem, quanto o simples trauma mecânico da agulha, não são capazes de produzir esclerose na veia marginal da orelha do coelho que seja estatisticamente significante.Telangiectases, in accordance with current concepts, must be treated in a surgical way. The most commons surgicals treatments included the electrosurgery, electocauterization and electrolysis. The injury to the peripherical dermal tissue was a problem as the insatisfactory results in the vessels scleroses. Therefore, the aim of this study was estimated the value of one electrical device planned with care and exactness to provide a galvanic electric sharp stream to be used in a animal model. Thus, 45 white New Zealand adults male rabbits received a electrical galvanic pulse(marginal vein of the right ear or only the mechanical puncture(marginal vein of the left

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

International Nuclear Information System (INIS)

Helzel, M.V.; Mueller, E.

1993-01-01

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

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

International Nuclear Information System (INIS)

Markovic, S.; Odavic, M.; Spaic, R.; Rostovac, M.; Ajdinovic, B.; Matunovic, A.; Raicevic, B.; Prvulov, S.; Kamenica, S.

1991-01-01

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

Tromboembolia pulmonar asociada al síndrome de la vena cava superior de origen trombótico

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Ana Madeleine Barrera-López

2017-07-01

Full Text Available Se describe el caso de un paciente masculino de 32 años de edad, quien consulta al servicio de urgencias con historia clínica del síndrome de la vena cava superior, en el estudio de la angiotomografía pulmonar, se demuestra embolismo pulmonar izquierdo, trombosis de la vena yugular interna derecha y confluente yugulo subclavio. No hay evidencia de asociación con neoplasia, infecciones o enfermedades del tejido conectivo, siendo el único factor de riesgo asociado para la trombosis, hiperviscocidad (tríada de virchow por poliglobulia.

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

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

2013-12-15

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

Vena Cava Filter Retrieval with Aorto-Iliac Arterial Strut Penetration.

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Holly, Brian P; Gaba, Ron C; Lessne, Mark L; Lewandowski, Robert J; Ryu, Robert K; Desai, Kush R; Sing, Ronald F

2018-05-03

To evaluate the safety and technical success of inferior vena cava (IVC) filter retrieval in the setting of aorto-iliac arterial strut penetration. IVC filter registries from six large United States IVC filter retrieval practices were retrospectively reviewed to identify patients who underwent IVC filter retrieval in the setting of filter strut penetration into the adjacent aorta or iliac artery. Patient demographics, implant duration, indication for placement, IVC filter type, retrieval technique and technical success, adverse events, and post procedural clinical outcomes were identified. Arterial penetration was determined based on pre-procedure CT imaging in all cases. The IVC filter retrieval technique used was at the discretion of the operating physician. Seventeen patients from six US centers who underwent retrieval of an IVC filter with at least one strut penetrating either the aorta or iliac artery were identified. Retrieval technical success rate was 100% (17/17), without any major adverse events. Post-retrieval follow-up ranging from 10 days to 2 years (mean 4.6 months) was available in 12/17 (71%) patients; no delayed adverse events were encountered. Findings from this series suggest that chronically indwelling IVC filters with aorto-iliac arterial strut penetration may be safely retrieved.

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

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

2000-09-01

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

Ante situm liver resection with inferior vena cava replacement under hypothermic cardiopolmunary bypass for hepatoblastoma: Report of a case and review of the literature

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Roberta Angelico

2017-01-01

Conclusions: We report for the first time a case of ante situ liver resection and inferior-vena-cava replacement associated with hypothermic cardiopulmonary bypass in a child with hepatoblastoma. Herein, we extensively review the literature for hepatoblastoma with thumoral thrombi and we describe the technical aspects of ante situm approach, which is a realistic option in otherwise unresectable hepatoblastoma.

Operação de Glenn bidirecional Bidirectional Glenn anastomosis

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Paulo Chaccur

1992-09-01

Full Text Available A cirurgia de Gleen bidirecional tem sido empregadacomo uma opção ao tratamento cirúrgico de pacientes considerados candidatos "não ideais" à cirurgia de derivação átrio-pulmonar. A operação consiste na anastomose da veia cava superior com a artéria pulmonar (anastomose término-lateral, permitindo o fluxo sanguíneo também para o pulmão contra-lateral. A partir de janeiro de 1990 até fevereiro de 1992, 20 pacientes foram operados em nosso Serviço, com idade variando de 5 meses a 8 anos (média de 37,7 meses. Oito pacientes eram do sexo feminino e o peso variou de 6,3 a 18,8 Kg (média - 12,4 kg. A indicação cirúrgica foi considerada primária em 10 casos. Sete casos de atresia tricúspide e 3 de ventrículo único, que apresentavam acentuada diminuição do fluxo pulmonar e não eram candidatos a correção total funcional. Os demais pacientes tiveram a indicação considerada secundária, ou seja, já haviam sido submetidos a operação de shunt artério-venoso, cerclagem do tranco pulmonar, ou atriosseptostomia, 8 casos de atresia tricúspide, 3 de ventrículo único com estenose ou cerclagem pulmonar e 1 caso de DVSVD com ventrículo superior-inferior. A operação foi realizada com desvio da veia cava-átrio direito em 12 casos e com o uso de CEC em 8. Durante o procedimento cirúrgico, os pacientes foram monitorizados com oxímetro pulsátil e a saturação de oxigênio média pré-correção foi de 75,5% (71% a 86% e após, de 95% (91% a 98%. Não ocorreu óbito hospitalar e o único óbito tardio foi devido a infecção pulmonar no 2º mês de pós-operatório. Achamos, portanto, que a operação de Glenn bidirecional estará bem indicada como primeira etapa da correção definitiva, pois não aumenta o trabalho cardíaco e a resistência vascular pulmonar não produz distorções em artéria pulmonar como shunt tipo Blalock-Taussig.The bidirectional Glenn anastomosis has bee used as an effective mean of palliating

Atrophic inferior vena cava is a marker of chronicity of intra-filter and inferior vena cava thrombosis: based on CT findings.

Science.gov (United States)

Chen, Liang; Shi, Wanyin; Gu, Jianping; He, Xu; Lou, Wensheng

2018-04-11

A permanently indwelling filter in the inferior vena cava (IVC) may induce caval thrombosis, which could develop and evolve from an acute to a chronic phase. The differential diagnosis of acute and chronic thromboses determines the treatment strategy. The role of computed tomography (CT) in diagnosing acute and chronic intra-filter and IVC thromboses has not been well established. This retrospective study summarizes the CT signs that indicate acute and chronic phases of intra-filter and IVC thromboses. This study included eight patients who developed a lower-extremity deep venous thrombosis (DVT) and were treated with intracaval filter placement as an alternative to anticoagulation and thrombolysis. During the follow-up, all patients developed an intra-filter thrombosis in the IVC confirmed by CT and/or CT venography (CTV). Demographic and CT data of all patients during the follow-up period were collected for analysis. All patients had normal-appearing IVCs prior to filter placement, as shown on trans-femoral venography. Eight filters (five TrapEase, three OptEase) were placed in the eight IVCs, respectively. Subsequently, IVC-CT or CTV revealed acute intra-filter or IVC thrombosis in all eight patients, manifesting as an intracaval filling defect and thickened IVC wall. Filter protrusion and secondary caval atrophy seen on CT indicated a chronically occluded IVC. IVC thrombosis may result from filter placement. The chronicity of caval thrombotic occlusion is likely to be associated with filter protrusion and secondary IVC atrophy revealed on CT scans.

Influência do veículo na eficácia da reposição de potássio em ratos hipocalêmicos Vehicle influence on potassium replacement effectiveness in hypokalemic rats

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Márcio Petenusso

2009-09-01

Full Text Available INTRODUÇÃO: Pacientes após cirurgia cardíaca são comumente tratados com diuréticos para controle de volume plasmático. A preocupação de distúrbios hipocalêmicos em adultos antes, durante ou após a cirurgia já foi ressaltada anteriormente, visto o risco de arritmias cardíacas. Clinicamente, a diluição da solução de potássio (K+ para administração por via intravenosa, em situações que requerem a sua reposição é realizada utilizando-se soro fisiológico (SF ao invés de soro glicosado 5% (SG5%, possivelmente em vista de poder ocorrer estimulação da secreção de insulina, que interferiria sobre a qualidade da reposição de K+. Porém, não está comprovado experimentalmente se o SF e SG5% poderiam realmente interferir na qualidade da reposição de potássio em ratos com hipocalemia. OBJETIVO: Analisar a influência da reposição de K+ diluído em diferentes veículos sobre as concentrações plasmáticas de K+([K+]p em ratos submetidos a hipocalemia induzida por furosemida. MÉTODOS: Ratos Wistar adultos foram divididos em quatro grupos: K++SF, K++SG, SF e SG. Foi realizada a canulação da veia jugular para reposição e da veia femoral para coleta de sangue. O diurético furosemida na dose de 50mg/kg foi usado para induzir hipocalemia, foi analisado nível plasmático de potássio 24 h antes da injeção de furosemida, 24 h pós-indução e 30 minutos pós-reposição. RESULTADOS: Os níveis da [K+] pós-injeção de furosemida sofreram redução, comparado aos valores basais (pré-furosemida em todos os grupos. Entretanto, os níveis [K+] retornaram aos valores basais tanto nos grupos que receberam K++SF ou K++SG, o que não foi observado nos grupos que receberam apenas SF e SG. Quanto ao Na+ plasmático, somente o grupo K+SF apresentou aumento após reposição. CONCLUSÃO: A reposição de K+ diluído tanto em SF quanto SG parece não afetar a qualidade da reposição de K+ plasmático em ratos

Bleeding 'downhill' esophageal varices associated with benign superior vena cava obstruction: case report and literature review.

Science.gov (United States)

Loudin, Michael; Anderson, Sharon; Schlansky, Barry

2016-10-24

Proximal or 'downhill' esophageal varices are a rare cause of upper gastrointestinal hemorrhage. Unlike the much more common distal esophageal varices, which are most commonly a result of portal hypertension, downhill esophageal varices result from vascular obstruction of the superior vena cava (SVC). While SVC obstruction is most commonly secondary to malignant causes, our review of the literature suggests that benign causes of SVC obstruction are the most common cause actual bleeding from downhill varices. Given the alternative pathophysiology of downhill varices, they require a unique approach to management. Variceal band ligation may be used to temporize acute variceal bleeding, and should be applied on the proximal end of the varix. Relief of the underlying SVC obstruction is the cornerstone of definitive treatment of downhill varices. A young woman with a benign superior vena cava stenosis due to a tunneled internal jugular vein dialysis catheter presented with hematemesis and melena. Urgent upper endoscopy revealed multiple 'downhill' esophageal varices with stigmata of recent hemorrhage. As there was no active bleeding, no endoscopic intervention was performed. CT angiography demonstrated stenosis of the SVC surrounding the distal tip of her indwelling hemodialysis catheter. The patient underwent balloon angioplasty of the stenotic SVC segment with resolution of her bleeding and clinical stabilization. Downhill esophageal varices are a distinct entity from the more common distal esophageal varices. Endoscopic therapies have a role in temporizing active variceal bleeding, but relief of the underlying SVC obstruction is the cornerstone of treatment and should be pursued as rapidly as possible. It is unknown why benign, as opposed to malignant, causes of SVC obstruction result in bleeding from downhill varices at such a high rate, despite being a less common etiology of SVC obstruction.

Vascularização arterial e venosa do linfonodo poplíteo em cães

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Karina de Senna Villar

2009-08-01

Full Text Available O linfonodo poplíteo nos cães situa-se, à direita e à esquerda em um espaço designado fossa poplítea, no terço distal dos músculos bíceps femoral, lateralmente e semitendinoso, medialmente, projetando-se na altura da face caudal das articulações femoro tibial e femoro patelar (articulação do joelho. Neste estudo foram utilizados vinte e cinco cães, machos e fêmeas adultos, procedentes do canil municipal de Araçatuba, São Paulo, cujas capturas foram efetuadas pela defesa sanitária animal desta cidade. Os vasos arteriais destinados a esta estrutura derivam sempre, de ambos os lados, da artéria femoral caudal distal e variam de 10 a 1, com maior freqüência de 2 (7 vezes, 28% à direita e de 6 a 2 igualmente com maior freqüência de 2 (8 vezes, 32%. Tão logo tem-se ainda à direita 5 e 6 ramos (3 vezes, 12%, 1, 7 e 10 (1 vez, 4%. Relativamente às veias derivadas deste linfonodo, convergem sempre para a veia safena lateral, estes vasos oscilam entre 9 e 2, com maior freqüência de 3 (9 vezes, 3,6%, à direita e de 12 a 2, com maior freqüência de 3 (10 vezes, 40% à esquerda. Assim, os demais ramos oriundos da linfonodo poplíteo direito e que se inserem na veia supracitada são em número de 2 e 5 (5 vezes, 20%, 4 e 6 (2 vezes, 8% e 8 e 9 (1 vez, 4%. Não obstante, ao lado esquerdo verifica-se em número de 2 ramos (6 vezes, 24%, 4 (4 vezes, 16%, 6 (3 vezes, 12% e finalizando 9 e 12 ramos (1 vez, 4%. O tamanho do linfonodo poplíteo em cães soropositivos para Leishmaniose Visceral pode encontrar-se entre 7,8 x 3,8 x 6,1 a 50,0 x 20,7 x 28,5 , em mm, sendo a média 26,18 x 10,5 x 15,97 mm para o direito e 26,98 x 11,14 x 15,25 mm para o esquerdo (referente as medidas dorso-ventral, latero-lateral e crânio-caudal, respectivamente.

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

International Nuclear Information System (INIS)

Meyer, D.R.; Huggle, H.; Hueppe, T.; Friedrich, M.; Andresen, R.

2001-01-01

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.) [de

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

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

2014-10-15

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

Are too many inferior vena cava filters used? Controversial evidences in different clinical settings: a narrative review.

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Dalla Vestra, Michele; Grolla, Elisabetta; Bonanni, Luca; Pesavento, Raffaele

2018-03-01

The use of inferior vena cava filters to prevent pulmonary embolism is increasing mainly because of indications that appear to be unclearly codified and recommended. The evidence supporting this approach is often heterogeneous, and mainly based on observational studies and consensus opinions, while the insertion of an IVC filter exposes patients to the risk of complications and increases health care costs. Thus, several proposed indications for an IVC filter placement remain controversial. We attempt to review the proof on the efficacy and safety of IVC filters in several "special" clinical settings, and assess the robustness of the available evidence for any specific indication to place an IVC filter.

Vertebral uptake of Tc-99m macroaggregated albumin (MAA) with SPECT/CT occurring in superior vena cava obstruction

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Karls, Shawn; Hassoun, Hani; Derbekyan, Vilma [Dept. of Nuclear Madicine, Royal Victoria Hospital, Montreal (Canada)

2016-09-15

A 67-year-old male presented with dyspnea for which lung scintigraphy was ordered to rule out pulmonary embolus. Planar images demonstrated abnormal midline uptake of Tc-99m macroaggregated albumin, which SPECT/CT localized to several thoracic vertebrae. Thoracic vertebral uptake on perfusion lung scintigraphy was previously described on planar imaging. Radionuclide venography and contrast-enhanced CT subsequently demonstrated superior vena cava (SVC) obstruction with collateralization through the azygous/hemiazygous system and vertebral venous plexus. SPECT/CT differentiated residual esophageal/tracheal ventilation activity, a clinically insignificant finding, from vertebral uptake indicative of SVC obstruction, a potentially life-threatening condition.

Aneurismas múltiplos de pontes aorto-coronárias de veia safena com ruptura fatal Multiple aneurysms of aortocoronary saphenous vein grafts with fatal rupture

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Fábio R. Távora

2007-05-01

Full Text Available Aneurismas de pontes aorto-coronárias de veia safena são eventos raros, usualmente assintomáticos e detectados de forma incidental. Rupturas espontâneas de pontes de safena são raras, havendo poucos dados radiológicos disponíveis na literatura. Relatamos o caso de um senhor de 39 anos internado com hematêmese dez anos depois de ter sido submetido a cirurgia de revascularização miocárdica. Imagens tomográficas mostraram três aneurismas nas pontes de safena, mas o exame não detectou ruptura. O paciente veio a falecer e a necropsia revelou que a causa do óbito havia sido ruptura de aneurisma de pontes de safena. Esse caso ilustra a necessidade de tratamento agressivo de aneurismas sintomáticos de pontes coronarianas.Aortocoronary saphenous vein graft (SVG aneurysms are rare, and are usually asymptomatic and detected incidentally. Spontaneous rupture of SVG is rare and imaging data are few. We report on a 39-year old man who was admitted to the hospital with hematemesis 10 years after aortocoronary bypass surgery. CT images revealed 3 aortocoronary SVG aneurysms, but failed to detect any rupture. His subsequent death due to rupture of SVG aneurysm was documented at autopsy, illustrating the need for aggressive treatment of symptomatic coronary graft aneurysms.

Incidental Finding of Inferior Vena Cava Atresia Presenting with Deep Venous Thrombosis following Physical Exertion

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Shalini Koppisetty

2015-01-01

Full Text Available Inferior vena cava atresia (IVCA is a rare but well described vascular anomaly. It is a rare risk factor for deep venous thrombosis (DVT, found in approximately 5% of cases of unprovoked lower extremity (LE DVT in patients <30 years of age. Affected population is in the early thirties, predominantly male, often with a history of major physical exertion and presents with extensive or bilateral DVTs. Patients with IVC anomalies usually develop compensatory circulation through the collateral veins with enlarged azygous/hemizygous veins. Despite the compensatory circulation, the venous drainage of the lower limbs is often insufficient leading to venous stasis and thrombosis. We describe a case of extensive and bilateral deep venous thrombosis following physical exertion in a thirty-six-year-old male patient with incidental finding of IVCA on imaging.

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

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

2013-01-01

The aim of this study was to evaluate complications experienced during implantation of the Braile Vena Cava filter (VCF) and the efficacy of the centralization mechanism of the filter. This retrospective cohort study evaluated all Braile Biomédica VCFs implanted from 2004 to 2009 in Hospital de Base Medicine School in São José do Rio Preto, Brazil. Of particular concern was the filter's symmetry during implantation and complications experienced during the procedure. All the angiographic examinations performed during the implantation of the filters were analyzed in respect to the following parameters: migration of the filter, non-opening or difficulties in the implantation and centralization of the filter. A total of 112 Braile CVFs were implanted and there were no reports of filter opening difficulties or in respect to migration. Asymmetry was observed in 1/112 (0.9%) cases. A statistically significant difference was seen on comparing historical data on decentralization of the Greenfield filter with the data of this study. The Braile Biomédico filter is an evolution of the Greenfield filter providing improved embolus capture and better implantation symmetry.

Infra-renal angles, entry into inferior vena cava and vertebral levels of renal veins.

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Satyapal, K S

1999-10-01

Current norms for renal vasculature hold true in only half the population. Standard textbooks perpetuate old misconceptions regarding renal venous anatomy. This study is aimed to determine left and right infra-renal angles (L-IRA, R-IRA); entry level of renal veins into the inferior vena cava (IVC), and height of IVC under renal vein influence; and their vertebral level. One hundred morphologically normal en-bloc renal specimens randomly selected from post-mortem examinations were dissected and resin casted. IRA were also measured from venograms of 32 adult and 11 foetal cadavers, as were vertebral entry levels. IRA measurements (degrees) were as follows: left, 55 degrees +/- 16 degrees (20 degrees -102 degrees ); right, 60 degrees +/- 17 degrees (10 degrees -93 degrees ). Left vein entered IVC higher than right 54%, lower 36%, and opposite each other 10%. Vertical distance between lower borders of veins was 1.0 +/- 0.9 cm. Vertical distance of IVC under renal vein influence was 2.3 +/- 1.0 cm. Vertebral level of veins in adults lies between TI2-L2. In foetuses, IRA was as follows: left, 65 degrees +/- 12 degrees (45 degrees -90 degrees ); right, 58 degrees +/- 7 degrees (40 degrees -70 degrees ); vertebral level between T12 and L3. Similar IRA values from literature noted on right, 51 degrees (26 degrees -100 degrees ); differences on left, 77 degrees (43 degrees -94 degrees ), clearly differing from Williams et al. (Gray's Anatomy, 37(th) ed, 1989) statement that renal veins "open into the inferior vena cava almost at right angles." Large variations of IRA are not surprising since kidneys are considered normally "floating viscera," varying position with posture and respiratory movement as well as in live vs. cadaveric subjects. The entry level into the IVC also differs from Williams et al. This study uniquely quantitated actual height difference between lower borders of left and right veins. The data presented appears to be the first documentation of vertebral

Trauma inguinal penetrante com formação de fístula arteriovenosa e pseudoaneurisma: relato de caso

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Frederico Michelino de Oliveira

2015-12-01

Full Text Available Resumo Os autores apresentam um relato de caso de vítima de acidente de trabalho com ferimento penetrante em região inguinal direita com peça metálica em espiral, que evoluiu com fístula arteriovenosa da artéria femoral profunda com a veia femoral profunda associado a pseudoaneurisma envolvendo essas estruturas e a veia femoral comum. As fístulas arteriovenosas ocorrem frequentemente após traumas e a associação com pseudoaneurisma é fato raro, devendo ser tratadas precocemente após seu diagnóstico. O ultrassom duplex é atualmente o exame mais utilizado para a avaliação inicial e a arteriografia, o padrão ouro para diagnóstico. No paciente em questão foi realizado tratamento convencional com abordagem cirúrgica direta, sutura arterial e ligaduras venosas. Entretanto, nos dias atuais a cirurgia endovascular e a compressão guiada por ultrassom são métodos terapêuticos que têm sido utilizados com sucesso. O paciente evoluiu sem intercorrência, recebendo alta para acompanhamento ambulatorial com preservação do membro.

Different commercial yeast strains affecting the volatile and sensory profile of cava base wine.

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Torrens, Jordi; Urpí, Pilar; Riu-Aumatell, Montserrat; Vichi, Stefania; López-Tamames, Elvira; Buxaderas, Susana

2008-05-10

36 semi-industrial fermentations were carried out with 6 different yeast strains in order to assess differences in the wines' chemical and volatile profile. Two of the tested strains (Y3 and Y6) showed the fastest fermentation rates throughout 3 harvests and on 2 grape varieties. The wines fermented by three of the tested strains (Y5, Y3 and Y4) stand out for their high amounts of esters and possessed the highest fruity character. Wines from strains producing low amounts of esters and high concentrations of medium chain fatty acids, higher alcohols and six-carbon alcohols were the least appreciated at the sensory analysis. The data obtained in the present study show how the yeast strain quantitatively affects the final chemical and volatile composition of cava base wines and have repercussions on their sensory profile, independently of must variety and harvest year.

An experimental and computational study of the inferior vena cava hemodynamics under respiratory-induced collapse of the infrarenal IVC.

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Tedaldi, Elisabetta; Montanari, Chiara; Aycock, Kenneth I; Sturla, Francesco; Redaelli, Alberto; Manning, Keefe B

2018-04-01

Inferior vena cava (IVC) filters have been used for over five decades as an alternative to anticoagulation therapy in the treatment of venous thromboembolic disease. However, complications associated with IVC filters remain common. Though many studies have investigated blood flow in the IVC, the effects of respiration-induced IVC collapse have not been evaluated. Our hypothesis is that IVC collapse may have an influence on IVC filter performance. Therefore, we herein investigate the hemodynamics in uncollapsed and collapsed IVC configurations using in vitro flow experiments and computational simulations. Particle image velocimetry (PIV) is used to measure the hemodynamics in an idealized, compliant model of the human IVC made of silicone rubber. Flow is studied under uncollapsed and collapsed scenarios, with the minor diameter of the IVC reduced by 30% in the collapsed state. Both rest and exercise flow conditions are investigated, corresponding to suprarenal flow rates of 2 lpm and 5.5 lpm, respectively. Finite element analysis simulations are carried out in a computational model of the undeformed, idealized IVC to reproduce the 30% collapse configuration and an additional 50% collapse configuration. Computational fluid dynamics (CFD) simulations are then performed to predict the flow in the uncollapsed and collapsed scenarios, and CFD results are compared to the experimental data. The results show that the collapsed states generate a higher velocity jet at the iliac junction that propagates farther into the lumen of the vena cava in comparison to the jet generated in the uncollapsed state. Moreover, 50% collapse of the IVC causes a shift of the jet away from the IVC wall and towards the center of the vena cava lumen. The area of maximum wall shear stress occurs where the jet impacts the wall and is larger in the collapsed scenarios. Secondary flow is also more complex in the collapsed scenarios. Interestingly, this study demonstrates that a small variation in

Hipertensão portal por esquistossomose mansônica hepatoesplênica: efeito da desconexão ázigo-portal com esplenectomia no diâmetro e na velocidade média de fluxo do sistema portal (estudo ultra-sonográfico com Doppler Hepatosplenic schistosomotic portal hypertension: effect of esophagogastric devascularization with splenectomy on the diameter and mean flow velocity in the portal system (ultra-sonographic Doppler study

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Azzo WIDMAN

2001-01-01

Full Text Available Racional - A esplenectomia com desconexão ázigo-portal tem sido indicada para o tratamento da hemorragia digestiva pelas varizes esofágicas na hipertensão portal da esquistossomose mansônica hepatoesplênica. Todavia, esta técnica terapêutica apresenta índices variáveis de complicações trombóticas precoces do sistema portal (13,3% a 53,2%. Supondo que as alterações circulatórias devidas ao tratamento cirúrgico tenham papel preponderante neste acontecimento, procurou-se identificar elementos hemodinâmicos que, dentre os múltiplos fatores causais, tenham facilitado a ocorrência desta complicação. Com este intuito estudou-se comparativamente, mediante ultra-sonografia com Doppler, o sistema portal de dois grupos de pacientes em condições clínicas semelhantes: não-operados e com desconexão ázigo-portal em fase pós-operatória tardia (período superior a 6 meses. Casuística/Método - Foram estudados 58 pacientes com esquistossomose mansônica hepatoesplênica e com antecedentes de hemorragia digestiva alta, divididos em dois grupos: A (29 sob controle ambulatorial: clínico e endoscópico; B (29 submetidos previamente a desconexão ázigo-portal. Em todos foi feita a medida do diâmetro e da velocidade média de fluxo do sangue na veia porta e seus ramos direito e esquerdo, mediante ultra-sonografia com Doppler. Os resultados foram submetidos a análise univariada inter e intragrupo. Resultados - No grupo A (não-operados: a veia porta apresentou diâmetro maior do que o dos ramos direito e esquerdo e nestes esta medida foi semelhante (10,6 ± 2,9, 8,0 ± 1,8, 9,1 ± 2,6 cm; a velocidade média de fluxo na veia porta e nos ramos portais foi semelhante (15,62 ± 6,17, 14,92 ± 5,33, 16,12 ± 4,18 cm/seg. No grupo B (operados: houve diminuição de ambos os parâmetros na veia porta e seus ramos (8,8 ± 1,7, 5,2 ± 1,2, 7,5 ± 2,2 cm/12,53 ± 2,60, 8,86 ± 1,75, 9,60 ± 3,75 cm/seg. Conclusões - Houve redu

Parâmetros dopplervelocimétricos na avaliação da perviedade da anastomose portossistêmica intra-hepática transjugular (TIPS Dopplerflowmetric patterns for evaluation of transjugular intrahepatic portosystemic shunt patency

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Antonio Sergio Zafred Marcelino

2005-02-01

Full Text Available A anastomose portossistêmica intra-hepática transjugular (TIPS é um procedimento intervencionista minimamente invasivo realizado pela introdução de prótese metálica auto-expansível no parênquima hepático, via transjugular. Tem por objetivo tratar as complicações da hipertensão portal, principalmente a hemorragia digestiva alta e a ascite refratária. A estenose é complicação freqüente, embora o procedimento seja eficaz e com baixo índice de insucesso. O diagnóstico precoce da estenose é de fundamental importância, pois interfere no tipo de tratamento a ser realizado e o reaparecimento dos sintomas pode ser grave. O ultra-som Doppler é então utilizado para o seguimento dos pacientes portadores do TIPS, e vários parâmetros são descritos na literatura para o diagnóstico de estenose, como: as velocidades mínima e máxima no interior da prótese, a velocidade na veia porta, o gradiente de velocidade entre dois pontos da prótese, e outros. Infelizmente não há consenso sobre qual parâmetro ou conjunto de parâmetros é mais eficaz no diagnóstico, porque os protocolos de avaliação variam de instituição para instituição. Os autores realizaram uma revisão dos parâmetros de estenose descritos na literatura e de outros aspectos de fundamental importância na compreensão do procedimento, como as indicações, as contra-indicações e a fisiopatologia da estenose.Transjugular intrahepatic portosystemic shunt (TIPS is a minimally invasive interventional procedure that consists of placement of an auto expandable metallic stent in the hepatic parenchyma via transjugular. It is used to treat the complications of portal hypertension, particularly digestive bleeding of gullet varices and refractory ascites. Although TIPS is an efficient procedure with low rate of failure some complications such as stenosis are frequent. Early diagnosis of stenosis is mandatory since it interferes with the type of treatment and the

Mensuração de pressão venosa central por meio de cateteres venosos central e periférico: comparação entre os valores obtidos em cães e elaboração de índice de correção Measurement of central venous Pressure by mean of central and peripheric catheters: comparison among the obtained vallues in dogs and elaboration of a correction index

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Eduardo Santiago Ventura de Aguiar

2004-12-01

Full Text Available A Pressão Venosa Central (PVC é a pressão de retorno do sangue ao lado direito do coração e é um importante parâmetro a ser aferido em numerosas situações clínicas, cirúrgicas e experimentais. Para sua realização, utiliza-se um Cateter Venoso Central (CVC aplicado na veia jugular. Em virtude de este ser um aparato intravenoso de alto custo, optou-se por testar a validade de se aferir a PVC com um Cateter Venoso Periférico (CVP aplicado à mesma veia, o qual apresenta custo reduzido. Como resultado, a medida da PVC, tomada com o CVC, deve sofrer um índice de redução, chegando-se, assim, ao valor da PVC que seria obtido com o uso do CVC. Os resultados deste estudo permitem concluir que o CVP é apropriado para a aferição da PVC em cães.The Central Venous Pressure (CVP is a very important pattern for monitorization in many clinical, surgical and experimental procedures, and it reflects the blood pressure that returns to the right heart side. For its measurement a Central Venous Catheter (CVC must be used inside the jugular vein. Because of the high cost of the CVC, an option was taken to measure the CVP with a Peripheric Venous Catheter (PVC inside the jugular vein, with low cost. The CVP measure obtained with the PVC must be subtracted to a reduction index, in this way the measure would correspond to the ones done with the CVC. This study alouds to conclude that the PVC is adequate for CVP measurement in dogs.

Avaliação da influência de alterações cardíacas na ultrassonografia vascular periférica de idosos

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Alcides José Araújo Ribeiro

Full Text Available Resumo Contexto As cardiopatias podem causar alterações no formato das ondas da ultrassonografia vascular (UV em vasos periféricos. Essas alterações, tipicamente bilaterais e sistêmicas, são pouco conhecidas e estudadas. Objetivo Avaliar as ondas periféricas da UV de pacientes idosos para identificar alterações decorrentes de cardiopatias. Métodos Foram estudados 183 pacientes idosos submetidos a UV periférica no ano de 2014. Resultados Foram avaliados 102 mulheres (55,7% e 81 homens (44,3% com idade entre 60 e 91 anos (média de 70,4±7,2 anos. Encontraram-se alterações pela UV em 84 pacientes (45,9%. Foram identificadas 138 alterações de oito dos 13 tipos descritos na literatura: arritmia, onda bisferiens de pico sistólico, baixa velocidade de pico sistólico, pulsatilidade em veias femorais, bradicardia, taquicardia, onda de pulso parvus tardus e onda de pulso alternans. Houve baixa concordância entre a presença e a não presença de alterações na UV e na avaliação cardiológica. Na análise específica das alterações, os exames tiveram uma concordância variável, que foi boa para o achado de taquicardia, moderada para arritmia e baixa para bradicardia. Não houve concordância entre a UV e os exames cardiológicos para as demais alterações. Conclusões É possível identificar determinadas alterações cardíacas em idosos por meio da análise do formato das ondas periféricas da UV. É importante reconhecer e relatar a presença dessas alterações, pela possibilidade de alertar para um diagnóstico ainda não identificado nesses pacientes. Entretanto, mais estudos são necessários para que seja definida a importância das alterações no formato das ondas Doppler periféricas no reconhecimento de cardiopatias.

AVALIAÇÃO DAS COMPLICAÇÕES E DA PERFORMANCE REPRODUTIVA SUBSEQÜENTE À OPERAÇÃO CESARIANA REALIZADA A CAMPO EM BOVINOS

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Duvaldo Eurides

2006-10-01

Full Text Available O objetivo deste trabalho foi avaliar as principais complicações decorrentes da cesariana e alguns parâmetros reprodutivos, em fêmeas bovinas. Após o exame clínico geral e o exame específico das vias fetais, 50 animais foram submetidos à operação cesariana, realizada em decúbito lateral direito. Foi utilizado anestésico local e, após a retirada do feto, cloridrato de xilazina. A incisão foi realizada entre o úbere, a prega do joelho e a veia superficial abdominal; a sutura do útero foi feita com categute e a da pele com fio de algodão 000. O período pós-operatório constou de antibioticoterapia e curativo local. As distocias foram decorrentes de estática fetal incorreta, partos gemelares, fetos absolutos ou relativamente grandes, monstros fetais e torção parcial de útero. Quanto aos fetos, 24 nasceram vivos e 26 mortos, dentre esses últimos 14 estavam enfisematosos; duas vacas morreram e nove foram descartadas. Pode-se concluir que as principais complicações pós-operatórias observadas nesse estudo foram a retenção dos envoltórios fetais (44%, metrite clínica (48%, retenção associada à metrite (26%, deiscência de ferida (6%, peritonite (2% e edema (6%. A cesariana acarretou aumento do período de serviço e do número médio de serviços por concepção das fêmeas operadas. PALAVRAS-CHAVE: Bovino, cesariana, fertilidade, complicações.

Preditores de injúria renal aguda em pacientes submetidos ao transplante ortotópico de fígado convencional sem desvio venovenoso Predictors of acute kidney injury in patients undergoing a conventional orthotopic liver transplant without veno-venous bypass

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Olival Cirilo L. da Fonseca-Neto

2011-06-01

Full Text Available RADICAL: Injúria renal aguda é uma das complicações mais comuns do transplante ortotópico de fígado. A ausência de critério universal para sua definição nestas condições dificulta as comparações entre os estudos. A técnica convencional para o transplante consiste na excisão total da veia cava inferior retro-hepática durante a hepatectomia nativa. Controvérsias sobre o efeito da técnica convencional sem desvio venovenoso na função renal continuam. OBJETIVO: Estimar a incidência e os fatores de risco de injúria renal aguda entre os receptores de transplante ortotópico de fígado convencional sem desvio venovenoso. MÉTODOS: Foram avaliados 375 pacientes submetidos a transplante ortotópico de fígado. Foram analisadas as variáveis pré, intra e pós-operatórias em 153 pacientes submetidos a transplante ortotópico de fígado convencional sem desvio venovenoso. O critério para a injúria renal aguda foi valor da creatinina sérica > 1,5 mg/dl ou débito urinário BACKGROUND: Acute kidney injury is one of the most common complications of orthotopic liver transplantation. The absence of universal criteria for definition of these conditions make comparisons difficult between studies. The conventional technique for transplantation is the total excision of the inferior vena cava during liver retro-native hepatectomy. Controversies about the effect of the conventional technique without venovenous bypass on renal function remain. AIM: To estimate the incidence and risk of acute kidney injury factors among recipients of orthotopic liver transplantation without conventional venovenous bypass. METHODS: Was studied 375 patients undergoing orthotopic liver transplantation. Variables were analyzed in preoperative, intraoperative and postoperative complications in 153 patients undergoing orthotopic liver transplantation without conventional venovenous bypass. The criterion for acute kidney injury was serum creatinine > 1.5 mg/dl or

[Extracorporeal circulation and hypothermy surgery in tumors with vena cava extension: 20 years experience at the University Clinic of Navarra].

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

2008-04-01

We present our 20 years experience treating patients with vena cava extension in whom an extracorporeal circulation, hypothermia, cardio circulatory arrest (ECC-H-CCA) in order to perform, together with a tumoral resection, a thrombus resection. From 1985 to 2005 a total of 28 retroperitoneal tumor were treated: 25 renal cancers, a Wilms tumor, a paratesticular rabdomiosarcoma, and a pheocromocitoma. All of them had an extension by means of thrombus above the suprahepatics veins. All of them were treated by means of ECC-H-CCA for thrombus extraction. A descriptive study of the serie is performed as well as a Kaplan Meyer survival study. Surgical complications were present within 10 patients (35%), with a surgical mortality of two patients (7%): one intra-operatively because a massive embolism of the lungs and the other because of a lung embolism on the 4th post-operative day. Global actuarial survival was 29.1+/-10% at three years and 17.5+/-8% at five years. Analyzing only who do not have metastatic lesions, nor lymph nodes at diagnosis their three year survival was 50.9+/-16.3% and 32.2+/-16% at five years. Mean while those who have any metastatic lesion at diagnosis their three and five years survival was 20.8+/-12% and 10.4+/-9% respectively. The employ of surgical techniques with ECC-H-CCA with in oncological pathology associated with vena cava thrombus is justified and its employment does not worsen the survival; it is indicated because its results, allowing a complete tumoral resection in a safe and reproducible fashion.

Multi-slice spiral CT multiplanar reconstruction findings of localized fat collection adjection to the subdiaphragmatic inferior vena cava

International Nuclear Information System (INIS)

Cao Hetao; Lu Jian; Zhao Jinli; Liu Tingting; Qin Jufeng; Xu Wen; Qin Jiangchun; Jiang Junkang

2012-01-01

Objective: To discusses the MSCT multiplanar reconstruction manifestation (MPR) of localized fat collection adjection to subdiaphragmatic inferior vena cava (IVC fat ). Methods: The thoracic and abdominal MSCT scan data of 8246 patients were browsed,45 patients with presumed IVC fat on axial CT scans were further studied prospectively with MSCT MPR. The predisposing position of IVC fat and its relationship with IVC were observed. It was divided into two kinds of intraluminal type and extraluminal type according to the angle of IVC fat with respect of the wall of IVC.The other 50 patients without IVC fat were randomly selected as the control group. The sagittal inclination angle (SIA) and diameter ratio (DR) between supra- and sub-diaphragmatic IVC between the two groups were compared by using t test. Results: The detection rate was 0.55% (45/8246). Of which hepatic vein lacuna 8 patients, subdiaphragmatic gap medial to IVC 28 patients and IVC groove 9 patients. The shape of IVC fat showed mainly for the round, oval and crescents on axial CT scans, of 15 patients intraluminal type, 4 showed 'target signs'. The shape of IVC fat showed mainly for 'half-moon' at MPR.The SIA and DR at IVC fat group were 21.62° ± 8.42° and 2.01 ±0.84 respectively, at control group were 16.75° ±7.82° (t=1.594, P>0.05) and 1.31 ±0.28 (t=2.341, P<0.05) respectively. Conclusion: The round, oval or half of limited fat density shadow adjection to subdiaphragmatic inferior vena cava which similar to in the lumen is the characteristic performance of IVC fat , it may be an anatomical variation. (authors)

Transfemoral Filter Eversion Technique following Unsuccessful Retrieval of Option Inferior Vena Cava Filters: A Single Center Experience.

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Posham, Raghuram; Fischman, Aaron M; Nowakowski, Francis S; Bishay, Vivian L; Biederman, Derek M; Virk, Jaskirat S; Kim, Edward; Patel, Rahul S; Lookstein, Robert A

2017-06-01

This report describes the technical feasibility of using the filter eversion technique after unsuccessful retrieval attempts of Option and Option ELITE (Argon Medical Devices, Inc, Athens, Texas) inferior vena cava (IVC) filters. This technique entails the use of endoscopic forceps to evert this specific brand of IVC filter into a sheath inserted into the common femoral vein, in the opposite direction in which the filter is designed to be removed. Filter eversion was attempted in 25 cases with a median dwell time of 134 days (range, 44-2,124 d). Retrieval success was 100% (25/25 cases), with an overall complication rate of 8%. This technique warrants further study. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

Interventional therapy and complications after liver transplantation: the obstruction of the hepatic vein and inferior vena cava

International Nuclear Information System (INIS)

Li Linsun; Shi Haibing; Zhao Linbo

2009-01-01

The occurrence rate of the obstruction of the hepatic vein or the inferior vena cava is very low. Obstruction can develop acutely as a result of technical problems or can present itself much later after the transplantation due to intimal hyperplasia or perianastomotic fibrosis. Clinically, the common presentations include hepatic dysfunction, liver engorgement, ascites, abdominal pain, etc. Percutaneous endovascular treatment with balloon dilation or stent placement is a safe and effective alternative treatment, which can keep the vessels open for a long period of time. Angioplasty can achieve technical success in restoring anastomotic patency almost to 100% of cases, but, unfortunately, restenosis occurs frequently. For, adult patients or pediatric patients with adult-sized hepatic veins, stenting seems to be the optimal choice. (authors)

Renal sinus fat invasion and tumoral thrombosis of the inferior vena cava-renal vein: only confined to renal cell carcinoma.

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

2014-01-01

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

Left-sided and duplicate inferior vena cava: a case series and review.

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Ang, Wee Choen; Doyle, Terry; Stringer, Mark D

2013-11-01

Left-sided and duplicate inferior vena cava (IVC) are two major anatomical variants within the spectrum of IVC malformations, both of which are developmental abnormalities of the supracardinal veins. Four clinical cases are described to highlight the computed tomographic appearances of these vascular malformations and provide novel data on venous dimensions. A systematic review of the recent literature (2000-2011) was conducted focusing on the anatomy, demographics, and associated pathology (congenital and acquired) of isolated left-sided and duplicate IVC. A total of 73 relevant articles were retrieved, consisting of case reports and small case series. The prevalence of left-sided IVC is about 0.1-0.4% and that for duplicate IVC about 0.3-0.4%; both anomalies show a slight male preponderance. In each condition, there are documented variations in the course and tributaries of the IVC. The clinical importance of these anomalies lies in three principal areas: the potential for misdiagnosis on imaging; technical difficulties during retroperitoneal surgery (particularly abdominal aortic aneurysm repair and live donor nephrectomy); and their significance in relation to the etiology and management of venous thromboembolism. Copyright © 2012 Wiley Periodicals, Inc.

Cirurgia de Glenn bidirecional: importância da manutenção de fluxo "pulsátil" na artéria pulmonar Bidirectional Glenn procedure: the importance of "pulsatile" flow in the pulmonary artery

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Fernando Antônio Fantini

1995-03-01

Full Text Available Com o objetivo de avaliar a importância clínica da presença de fluxo pulsátil na artéria pulmonar de pacientes submetidos à cirurgia de Glenn bidirecional, 36 casos consecutivos operados no período de outubro de 1990 a julho de 1994 foram revistos. As crianças, com idade variando de 11 meses a 14 anos (média, 4,4 ± 3,4 anos, eram portadoras das seguintes lesões: atresia tricúspide (18, ventrículo único (16, atresia mitral (1 e atresia pulmonar sem comunicação interventricular (1. Dezenove (52,8% pacientes haviam sido submetidos a 22 procedimentos cirúrgicos prévios, sendo que 2 fizeram duas e outro, três anastomoses sistêmico-pulmonar. Circulação extracorpórea foi utilizada em todos os casos, sendo com hipotermia leve em 11 e com hipotermia profunda e parada cardiocirculatória total nos demais. A técnica cirúrgica básica foi a anastomose término-lateral da veia cava superior à artéria pulmonar ipsilateral. Nos casos com fluxo anterógrado, o tronco pulmonar foi ligado somente quando a pressão média ao nível da anastomose era superior a 15 mmHg, sendo que em 2 casos recentes com pressão acima de 20 mmHg, optouse por cerclar o tronco pulmonar, ajustando-se, assim, os níveis pressóricos. Ocorreram 3 óbitos imediatos; a sobrevida hospitalar foi de 91,7%. Uma criança, que evoluiu no pós-operatório com baixa saturação arterial sistêmica, foi submetida após 7 dias à anastomose sistêmico-pulmonar com prótese vascular de 3 mm. Vinte e oito pacientes foram acompanhados por um período de tempo que variou de 3,1 meses a 4,1 anos (média 1,8 ± 1,2 anos e foram divididos em 2 grupos: A-18 crianças com fluxo pulmonar dependente exclusivamente do Glenn; B -10 crianças com outra fonte de circulação pulmonar promovendo fluxo "pulsátil" ao nível da anastomose. No Grupo A a saturação arterial sistêmica tem variado de 68% a 85% (média, 77,6 ± 5,5% e no Grupo B de 80% a 90% com média de 86,0 ± 3,8% (p

Vena Cava Responsiveness to Controlled Isovolumetric Respiratory Efforts.

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Folino, Anna; Benzo, Marco; Pasquero, Paolo; Laguzzi, Andrea; Mesin, Luca; Messere, Alessandro; Porta, Massimo; Roatta, Silvestro

2017-10-01

Respirophasic variation of inferior vena cava (IVC) size is affected by large variability with spontaneous breathing. This study aims at characterizing the dependence of IVC size on controlled changes in intrathoracic pressure. Ten healthy subjects, in supine position, performed controlled isovolumetric respiratory efforts at functional residual capacity, attaining positive (5, 10, and 15 mmHg) and negative (-5, -10, and -15 mmHg) alveolar pressure levels. The isovolumetric constraint implies that equivalent changes are exhibited by alveolar and intrathoracic pressures during respiratory tasks. The IVC cross-sectional area equal to 2.88 ± 0.43 cm 2 at baseline (alveolar pressure = 0 mmHg) was progressively decreased by both expiratory and inspiratory efforts of increasing strength, with diaphragmatic efforts producing larger effects than thoracic ones: -55 ± 15% decrease, at +15 mmHg of alveolar pressure (P < .01), -80 ± 33 ± 12% at -15 mmHg diaphragmatic (P < .01), -33 ± 12% at -15 mmHg thoracic. Significant IVC changes in size (P < .01) and pulsatility (P < .05), along with non significant reduction in the response to respiratory efforts, were also observed during the first 30 minutes of supine rest, detecting an increase in vascular filling, and taking place after switching from the standing to the supine position. This study quantified the dependence of the IVC cross-sectional area on controlled intrathoracic pressure changes and evidenced the stronger influence of diaphragmatic over thoracic activity. Individual variability in thoracic/diaphragmatic respiratory pattern should be considered in the interpretation of the respirophasic modulations of IVC size. © 2017 by the American Institute of Ultrasound in Medicine.

Fluxômetro hidrodinámico em cirurgia de revascularização do miocárdio Hidro-dynamic flowmeter in myocardial revascularization surgery

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Fábio Biscegli Jatene

1986-08-01

Full Text Available A avaliação do fluxo pelas pontes de veia safena na cirurgia de revascularização do miocárdio fornece uma informação segura do aporte sangüíneo ao miocárdio, bem como da perspectiva de perviabilidade destas anastomoses a longo prazo. Contudo, em nosso meio, a disponibilidade de fluxômetros eletrônicos, habitualmente utilizados, é, por vezes, difícil, sobretudo em função de seu custo e manutenção. O sistema desenvolvido consta de um conector para a linha arterial, com saída lateral, ligado a um tubo de Y. Uma das extremidades é conectada a um manómetro e a outra, à veia safena, ao término da anastomose distal. Como a saída lateral tem diâmetro conhecido, a queda da pressão, quando se liga o sistema para aveia safena, é proporcional ao fluxo. Uma tabela obtida por calibração prévia, permite conhecer, instantaneamente, o fluxo para a artéria tratada. Outra vantagem do sistema é a irrigação seletiva para a área tratada antes da realização da anastomose proximal, situação favorável quando existem áreas severamente isquémicas. Este sistema, em uso corrente em nosso Serviço, vem provando a sua eficiência, aliada à sua praticidade e ao custo irrelevante.Evaluation of blood flow in saphenous vein grafts during coronary surgery gives valuable information about myocardial perfusion and long-term by- pass patency as well. However, electronic flowmeter availability is a limiting factor because of costs and maintenance. A system was developed consisting of a connection to the arterial line, with a Y tube; one branch of the Y tube is connected to a manometer and the other one to the vein graft. Since the connection to the arterial line has a know diameter, pressure drop in the system is proportional to the flow in the graft. With previous calibration, a chart was constructed that allows instantaneous evaluation of the flow. Another advantage of the system is the selective perfusion of the area to be treated before

The clinical application of inferior vena cava filters: the essential point is to use it appropriately

International Nuclear Information System (INIS)

Yang Zhengqiang; Li Linsun

2011-01-01

This paper aims to describe the history and current situation of the clinical application of inferior venal cava (IVC) filters. As there is a possible tendency for physicians to abuse the IVC filters in clinical practice, the authors think that it is necessary now to judge the advantages and disadvantages of the use of IVC filters again and to conscientiously reconsider what kind of patients are suitable for IVC filter implantation. In this article, the proper characteristics that an ideal IVC filter should possess are introduced, the indications for IVC filter implantation are discussed and the complications occurred after IVC filter implantation are analyzed. The authors believe that the retrievable filters will gradually substitute for permanent filters, for this reason, studies concerning IVC retrievable filters will become the hot spots of research in the near future. (authors)

SU-G-IeP4-15: Ultrasound Imaging of Absorbable Inferior Vena Cava Filters for Proper Placement

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Mitcham, T; Bouchard, R; Melancon, A; Melancon, M [University of Texas MD Anderson Cancer Center, Houston, TX (United States); Eggers, M [Adient Medical Technologies, Pearland, TX (United States)

2016-06-15

Purpose: Inferior vena cava filters (IVCFs) are used in patients with a high risk of pulmonary embolism in situations when the use of blood thinning drugs would be inappropriate. These filters are implanted under x-ray guidance; however, this provides a dose of ionizing radiation to both patient and physician. B-mode ultrasound (US) imaging allows for localization of certain implanted devices without radiation dose concerns. The goal of this study was to investigate the feasibility of imaging the placement of absorbable IVCFs using US imaging to alleviate the dosage concern inherent to fluoroscopy. Methods: A phantom was constructed to mimic a human IVC using tissue-mimicking material with 0.5 dB/cm/MHz acoustic attenuation, while agar inclusions were used to model acoustic mismatch at the venous interface. Absorbable IVCF’s were imaged at 15 cm depth using B-mode US at 2, 3, 5, and 7 MHz transmit frequencies. Then, to determine temporal stability, the IVCF was left in the phantom for 10 weeks; during this time, the IVCF was imaged using the same techniques as above, while the integrity of the filter was analyzed by inspecting for fiber discontinuities. Results: Visualization of the inferior vena cava filter was possible at 5, 7.5, and 15 cm depth at US central frequencies of 2, 3, 5, and 7 MHz. Imaging the IVCF at 5 MHz yielded the clearest images while maintaining acceptable spatial resolution for identifying the IVCF’s, while lower frequencies provided noticeably worse image quality. No obvious degradation was observed over the course of the 10 weeks in a static phantom environment. Conclusion: Biodegradable IVCF localization was possible up to 15 cm in depth using conventional B-mode US in a tissue-mimicking phantom. This leads to the potential for using B-mode US to guide the placement of the IVCF upon deployment by the interventional radiologist. Mitch Eggers is an owner of Adient Medical Technologies. There are no other conflicts of interest to disclose.

Impact of an inferior vena cava filter retrieval algorithm on filter retrieval rates in a cancer population.

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Litwin, Robert J; Huang, Steven Y; Sabir, Sharjeel H; Hoang, Quoc B; Ahrar, Kamran; Ahrar, Judy; Tam, Alda L; Mahvash, Armeen; Ensor, Joe E; Kroll, Michael; Gupta, Sanjay

2017-09-01

Our primary purpose was to assess the impact of an inferior vena cava filter retrieval algorithm in a cancer population. Because cancer patients are at persistently elevated risk for development of venous thromboembolism (VTE), our secondary purpose was to assess the incidence of recurrent VTE in patients who underwent filter retrieval. Patients with malignant disease who had retrievable filters placed at a tertiary care cancer hospital from August 2010 to July 2014 were retrospectively studied. A filter retrieval algorithm was established in August 2012. Patients and referring physicians were contacted in the postintervention period when review of the medical record indicated that filter retrieval was clinically appropriate. Patients were classified into preintervention (August 2010-July 2012) and postintervention (August 2012-July 2014) study cohorts. Retrieval rates and clinical pathologic records were reviewed. Filter retrieval was attempted in 34 (17.4%) of 195 patients in the preintervention cohort and 66 (32.8%) of 201 patients in the postintervention cohort (P filter retrieval in the preintervention and postintervention cohorts was 60 days (range, 20-428 days) and 107 days (range, 9-600 days), respectively (P = .16). In the preintervention cohort, 49 of 195 (25.1%) patients were lost to follow-up compared with 24 of 201 (11.9%) patients in the postintervention cohort (P filter placement to death, when available. The overall survival for patients whose filters were retrieved was longer compared with the overall survival for patients whose filters were not retrieved (P filter retrieval, two patients (2.5%) suffered from recurrent VTE (n = 1 nonfatal pulmonary embolism; n = 1 deep venous thrombosis). Both patients were treated with anticoagulation without filter replacement. Inferior vena cava filter retrieval rates can be significantly increased in patients with malignant disease with a low rate (2.5%) of recurrent VTE after filter retrieval

Evaluation of Retrievability of the Gunther Tulip Vena Cava Filter

International Nuclear Information System (INIS)

Yamagami, Takuji; Kato, Takeharu; Hirota, Tatsuya; Yoshimatsu, Rika; Matsumoto, Tomohiro; Nishimura, Tsunehiko

2007-01-01

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

Outcome and management of pacemaker-induced superior vena cava syndrome.

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Fu, Hai-Xia; Huang, Xin-Miao; Zhong, Li; Osborn, Michael J; Bjarnason, Haraldur; Mulpuru, Siva; Zhao, Xian-Xian; Friedman, Paul A; Cha, Yong-Mei

2014-11-01

We aimed to determine the long-term outcomes of percutaneous lead extraction and stent placement in patients with pacemaker-induced superior vena cava (SVC) syndrome. The study retrospectively screened patients who underwent lead extraction followed by central vein stent implantation at Mayo Clinic (Rochester, MN, USA), from January 2005 to December 2012, to identify the patients with pacemaker-induced SVC syndrome. Demographic, clinical, and follow-up characteristics of those patients were collected from electronic medical records. Six cases were identified. The mean (standard deviation) age was 56 (15) years (male, 67%). All patients had permanent dual-chamber pacemakers, with a mean 11-year history of pacemaker placement. The entire device system was explanted in five patients; one patient had a 21-year-old pacemaker lead that could not be removed. Eight stents were implanted in six patients: five patients had one stent, one patient had three. A new pacemaker system was reimplanted through the stented vein in five patients. Technical success was achieved in all patients, without any complication. Symptoms rapidly resolved in all patients after stent deployment. The mean follow-up duration was 48 months (range, 10-100 months). Three patients remained symptom free. Reintervention with percutaneous balloon venoplasty was successful in three patients with symptom recurrence. Percutaneous stent implantation after lead removal followed by reimplantation of leads is a feasible alternative therapy for pacemaker-induced SVC syndrome, although some cases may require repeat intervention. ©2014 Wiley Periodicals, Inc.

Utilização da veia glicerolada na regeneração neural: Estudo experimental em ratos The use of glycerol-treated venous graft in damaged nerves repair: an experimental study in rats

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Armando dos Santos Cunha

2007-01-01

Full Text Available A auto-enxertia de nervo é o tratamento de escolha para grandes perdas de tecido neural que não podem ser reparadas por meio de rafia primária. A utilização do enxerto venoso previamente conservado em glicerol seria uma alternativa para diminuir o tempo operatório e a morbidade cirúrgica nesses casos. Os vasos preservados em glicerol não apresentam destruição de sua estrutura, o que permite seu uso na microcirurgia vascular, tendo a vantagem de diminuir a imunogenicidade do enxerto. O objetivo deste trabalho experimental foi comparar o grau de reparação nervosa, utilizando análise histológica, contagem do número de axônios mielinizados regenerados e análise funcional, obtida com a interposição de enxerto autógeno (grupo A e de tubo de veia glicerolada (grupo B em defeitos de 5 mm no nervo fibular de ratos Wistar. Somente no grupo A foi observado a formação de neuroma. O grupo B apresentou padrões histológicos compatíveis com diminuição quantitativa do número de axônios mielinizados regenerados em menor número em relação ao grupo A (controle. Na recuperação funcional, não houve diferença estatisticamente significativa entre os dois grupos.Autografting is the treatment of choice for cases of major nervous tissue loss where the ruptured nerve ends cannot be reduced. The use of a venous autograft previously treated with glycerol may be an alternative treatment, as it reduces surgery time duration and level of morbidity. Blood vessel explants, used in vascular microsurgery, kept in glycerol maintain their original biological structure, and when used in autografting, present reduced levels of patient's immune response. The aim of this study was to compare the level of nervous tissue regeneration by using histological analysis, regenerated myelinized axons counts, and functional analysis, obtained with the interposition of autologous graft (group A and glycerol-treated vein tube (group B in 5-mm defects on Wistar

Implantation of a cardiac resynchronization therapy-defibrillator device in a patient with persistent left superior vena cava.

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Atar, İlyas; Karaçağlar, Emir; Özçalık, Emre; Özin, Bülent; Müderrisoğlu, Haldun

2015-06-01

Presence of a persistent left superior vena cava (PLSVC) is generally clinically asymptomatic and discovered incidentally during central venous catheterization. However, PLSVC may cause technical difficulties during cardiac device implantation. An 82-year-old man with heart failure symptoms and an ejection fraction (EF) of 20% was scheduled for resynchronization therapy-defibrillator device (CRT-D) implantation. A PLSVC draining via a dilated coronary sinus into an enlarged right atrium was diagnosed. First, an active-fixation right ventricular lead was inserted into the right atrium through the PLSVC. The stylet was preshaped to facilitate its passage to the right ventricular apex. An atrial lead was positioned on the right atrium free wall, and an over-the-wire coronary sinus lead deployed to a stable position. CRT-D implantation procedure was successfully completed.

Inverted Nutcracker Syndrome: A Case of Persistent Hematuria and Pain in the Presence of a Left-Sided Inferior Vena Cava

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Obi Ekwenna

2011-01-01

Full Text Available Nutcracker syndrome is described as the symptomatic compression of left renal vein between the aorta and the superior mesenteric artery, resulting in outflow congestion of the left kidney. We present the case of a 51-year-old male with a left-sided inferior vena cava, resulting in compression of the right renal vein by the superior mesenteric artery. Secondary to this anatomic anomaly, the patient experienced a many-year history of flank pain and intermittent gross hematuria. We have termed this unusual anatomic finding and its associated symptoms as the “inverted nutcracker syndrome”, and describe its successful management with nephrectomy and autotransplantation.

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

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Turker Acar

2014-01-01

Full Text Available 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.

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

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Anupam Patra

2015-01-01

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

Angiografia como método de diagnóstico da síndrome do desfiladeiro torácico neurovascular: a propósito de um caso

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Margarida Cruz

2003-08-01

Full Text Available O termo síndrome do desfiladeiro torácico (SDT é usado para descrever o quadro clínico atribuível à compressão do plexo braquial, artéria e veia subclávias na região designada por desfiladeiro torácico. Até hoje, nenhum exame foi considerado gold standard para o diagnóstico. Os autores descrevem o caso de uma adolescente de 16 anos observada na consulta de Reumatologia por omalgia direita com 3 meses de evolução, acompanhada de disestesias do antebraço e mão homolaterais, desencadeadas por movimentos de abdução do ombro. Na observação, a manobra de hiperabdução do membro superior direito desencadeava os sintomas e um enfraquecimento significativo do pulso radial e da pressão arterial, que não sucediam no membro superior contralateral, tendo sido diagnosticada síndrome do desfiladeiro torácico à direita. Foi realizada tomografia axial computorizada (TAC da região torácica, que não revelou massas infra-claviculares nem axilares à direita. O ecodoppler do membro superior mostrou uma onda trifásica na artéria subclávia, realizou-se também angiografia das artérias subclávia e axilar do membro superior direito. Esta apresentou-se normal em posição neutra, mas, com o braço em abdução máxima, observou-se uma redução do contraste no interior da artéria axilar. Os autores propõem que, quando a clínica for sugestiva de SDT e existir uma suspeita de compressão vascular, deve ser realizada angiografia das artérias subclávia e axilar, para localizar e caracterizar a compressão. A SDT dessa paciente foi atribuída a uma hipotonia muscular do ombro, que foi ultrapassada após fisioterapia com exercícios de reforço dos músculos elevadores do ombro.

Dopplervelocimetria da artéria cerebral média fetal e outros parâmetros de vitalidade fetal na sobrevida neonatal em gestações com insuficiência placentária

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Roseli Mieko Yamamoto Nomura

2013-08-01

Full Text Available OBJETIVO: Estudar a dopplervelocimetria da artéria cerebral média fetal em gestações complicadas pela insuficiência placentária e verificar o seu papel no prognóstico de sobrevida neonatal. MÉTODOS: Trata-se de estudo prospectivo de 93 gestantes com diagnóstico de insuficiência placentária estabelecida antes da 34ª semana. A insuficiência placentária foi caracterizada pelo Doppler de artéria umbilical (AU alterado (> p95. Foram analisados os seguintes parâmetros: índice de pulsatilidade (IP da artéria umbilical (AU, IP da artéria cerebral média (ACM, relação cerebroplacentária -RCP(IP-ACM/IP-AU, pico de velocidade sistólicada ACM (PVS-ACM e IP para veias (IPV do ducto venoso (DV. Os parâmetros foram analisados pelos valores absolutos, em escores zeta (desvios padrão a partir da média ou múltiplos da mediana (MoM. O desfecho investigado foi o óbito neonatal no período de internação após o nascimento. RESULTADOS: Nas 93 gestações analisadas, ocorreram 25 (26,9% óbitos neonatais. No grupo que evoluiu com óbito neonatal, quando comparado com o grupo com sobrevida, houve associação significativa com o diagnóstico de diástole zero ou reversa (88% vs. 23,6%, p < 0,001, com maior mediana do IP da AU (2,9 vs. 1,7, p < 0,001 e seu escore zeta (10,4 vs. 4,9, p < 0,001; maior valor do PVS-ACM MoM (1,4 vs. 1,1, p = 0,012; menor valor da RCP (0,4 vs. 0,7, p < 0,001; maior valor do IPV-DV (1,2 vs. 0,8, p < 0,001 e no escore zeta do DV (3,6 vs.0,6, p<0,001. Na regressão logística, as variáveis independentes para a prediçãodoóbito neonatal foram a idade gestacional no parto (OR = 0,45; IC95% 0,3 a 0,7, p < 0,001 e o escore zeta do IP-AU (OR 1,14, IC95% 1,0 a 1,3, p = 0,046. CONCLUSÃO: Apesar da associação verificada pela análise univariada entre a morte neonatal e os parâmetros da dopplervelocimetria cerebral fetal, a análise multivariada identificou a prematuridadeeograude insuficiência da circula

Distribution of the Entodiniomorphid ciliate Troglocorys cava Tokiwa, Modrý, Ito, Pomajbíková, Petrželková, & Imai, 2010, (Entodiniomorphida: Blepharocorythidae) in wild and captive chimpanzees

Czech Academy of Sciences Publication Activity Database

Pomajbíková, K.; Petrželková, Klára Judita; Petrášová, J.; Profousová, Ilona; Kalousová, Barbora; Jirků, Miloslav; Sá, R. M.; Modrý, David

2012-01-01

Roč. 59, č. 1 (2012), s. 97-99 ISSN 1066-5234 R&D Projects: GA ČR GA524/06/0264; GA ČR GA206/09/0927; GA AV ČR KJB600930615 Institutional research plan: CEZ:AV0Z60930519; CEZ:AV0Z60220518 Keywords : chimpanzees * Entodiniomorphida * intestinal ciliates * prevalence * Troglocorys cava Subject RIV: EG - Zoology Impact factor: 2.162, year: 2012

Tratamiento endovascular con estent de síndrome de vena cava superior asociado a cables de marcapasos. Revisión de la literatura

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Andrés Reyes Valdivia

2017-09-01

Full Text Available La aparición de trombosis venosa asociada a cables de marcapasos no es una entidad infrecuente, cursando habitualmente de forma asintomática o con síntomas leves debido a la dificultad del retorno venoso. Esto debido a la colateralidad secundaria y progresiva que compensa dicho componente mecánico obstructivo. La presentación sintomática como síndrome de vena cava superior no es habitual y su aparición por tanto, poco frecuente; dada la extensa colateralidad venosa que asocian estos pacientes.

Is the inferior vena cava diameter measured by bedside ultrasonography valuable in estimating the intravascular volume in patients with septic shock?

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Mortaza Talebi Doluie

2016-07-01

Full Text Available Introduction:Resuscitation should be initiated immediately in shock. Early goal-directed therapy is an established algorithm for the resuscitation in septic shock. The first step is to maintain cardiac preload. Central venous pressure (CVP plays an important role in goal-directed therapy. Central venous catheterization is invasive and time-consuming in emergency conditions. There are some alternative and noninvasive methods for estimating the intravascular volume such as measuring the inferior vena cava (IVC diameter by ultrasonography. Methods: We searched PubMed, Google scholar, and Scopus databases with keywords (central venous pressure OR venous pressure OR CVP AND (ultrasonography OR sonography AND (sepsis OR septic shock AND (inferior vena cava OR IVC.Result: The search resulted in 2550 articles. The articles were appraised regarding the relevance, type of article, and statistical methods. Finally, 12 articles were selected. The number of patients was between 30 and 83 cases (mean age=57-67 years, intubated and non-intubated in each study. The IVC diameter was measured in respiratory cycle by bedside ultrasonography in longitudinal subxiphoid view and caval index was calculated, then they were compared with the CVP measured by central venous catheter.Discussion: CVP is an indicator of intravascular fluid status and right heart function. CVP measurement is an invasive method and of course with some complications. The IVC is the biggest vein of venous system with low-pressure; expansion of the vein reflects intravascular volume.Conclusion: It seems that IVC diameter measured by ultrasonography could be used as an alternative method for the determination of CVP in the emergency or critical patients.

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

International Nuclear Information System (INIS)

Kos, Sebastian; Bilecen, Deniz; Baumhoer, Daniel; Guillaume, Nicolas; Jacob, Augustinus L.

2010-01-01

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.

Design of a new biodegradable vena cava filter%新型生物可降解腔静脉滤器的设计研究

Institute of Scientific and Technical Information of China (English)

赵辉; 张福先; 李海磊; 张欢

2015-01-01

目的：为了弥补目前临床应用中腔静脉滤器的缺陷，本研究设计了一款新型生物可降解型腔静脉滤器，在肺栓塞危险期度过后，滤器可缓慢的降解、吸收，避免了二次取出手术。方法该款滤器由手工制作，分为上下2部分：上方是由6条聚糖乳酸缝线组成的圆锥形过滤结构；下方是聚己内酯支架，支架展开后实现滤器在腔静脉的中央型固定。在超声引导下，将滤器植入到10只犬体内。术后6周手术取出滤器，下腔静脉和肺组织行病理学检查，观察滤器的降解情况、下腔静脉壁的改变以及滤器的降解产物是否导致医源性肺栓塞。结果本研究手工制作了生物可降解滤器，并成功的植入到10只杂交犬的下腔静脉。术后所有犬均正常存活，未发生异常生命体征及伤口感染，有1例犬出现双下肢肿胀。①滤器移位：所有滤器不同程度的向头端移位。有1例犬的植入滤器移位至右房室孔，剩余的9例，滤器移位小于2 cm，仍位于肾静脉以下。②标本肉眼所见：所有的可降解支架被下腔静脉内皮细胞覆盖，肉眼未见明显的变化。滤器植入处下腔静脉壁增厚，但未出现明显狭窄。8例犬可见可吸收缝线完全降解，1例犬出现可吸收缝线被下腔静脉壁包裹，管腔内可见增生的纤维结缔组织和少量炎性细胞浸润，导致约70％的管腔阻塞。③标本HE 染色：9例犬下腔静脉均存在炎性反应，中膜和内膜增厚，肺组织切片未见到降解产物所致的肺动脉栓塞和肺动脉壁的炎性反应。结论本研究成功设计了一款生物可降解腔静脉滤器，并通过动物体内实验证实这款滤器具有良好的生物相容性和可降解性。%Objective To design a new biodegradable vena cava filter which could degrade and be absorbed slowly when the risk of pulmonary embolism (PE)has passed.Methods The filters were

Ligation of the abdominal esophagus decreases scorpion toxin-induced gastric secretion in rats Ligadura do esôfago abdominal diminui a secreção gástrica induzida por toxina de escorpião em ratos

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Claudia S. Vidal

2004-06-01

Full Text Available PURPOSE: Scorpion toxin purified from Tityus serrulatus venom (Tx induces an increase in volume, acidity and pepsin secretion in the gastric juice of rats. Ligation of oesophagus has been shown to reduce the acid gastric secretion in rats. The aim of this paper was to determine the influence of the esophageal ligation on gastric secretion induced by Tx in rats METHODS: Forty-four male albino rats were given water ad libitum, but no food for 20 to 24 hours, anesthetized with urethane and the trachea and jugular vein cannulated. Cervical or abdominal esophageal ligation or sham-operations were performed before and after the injection of 0.25 mg/kg of scorpion toxin (fraction T1 into the jugular vein. One hour later, the volume, acidity, pH and peptic activity of gastric juice were determined. RESULTS: The scorpion toxin induced an increase in gastric juice volume, acidity and pepsin output and a decrease in pH when injected into the vein of intact animals or in sham-operated animals. Cervical esophagus ligation did not interfere with the effects of toxin, however, ligation of the abdominal esophageal decreased the toxin effect on the rat stomach. CONCLUSION: Ligation of the abdominal esophagus decreases the gastric secretion induced by scorpion toxin.OBJETIVO: A toxina de escorpião purificada do veneno do escorpião Tityus serrulatus (Tx induz um aumento no volume, acidez e secreção de pepsina no suco gástrico de ratos. A ligadura do esôfago diminui a secreção ácida do estômago em ratos. O objetivo deste trabalho foi determinar a influência da ligadura do esôfago sobre a secreção gástrica induzida pela Tx em ratos. MÉTODOS: 44 ratos machos, brancos foram administrados água ad libitum, mas não alimentados por 20 a 24 horas, anestesiados com uretana e canulados a traquéia e a veia jugular. Foram realizadas as ligaduras do esôfago cervical ou abdominal ou operações simuladas antes e após a administração na veia jugular de 0

Hemiazygos continuation of v.cava inferior: a case report

International Nuclear Information System (INIS)

Incedayi, M.; Aribal, S.; Sivrioglu, A.; Kara, K.

2012-01-01

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

Percutaneous placement of bird's nest inferior vena cava filter

International Nuclear Information System (INIS)

Lee, Seung Hoon; Sung, Kyu Bo; Yoon, Hyun Ki

1999-01-01

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

Efeito do sítio de venopunção nos parâmetros hematológicos em tigre-d'água-americano, Trachemys scripta elegans Effect of the blood collection site on the hematological parameters in red-eared slider, Trachemys scripta elegans

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Nina C. Medeiros

2012-12-01

Full Text Available O objetivo do presente estudo foi realizar a comparação entre dois sítios de coleta sanguínea em 24 exemplares de tigre-d'água-americano (Trachemys scripta elegans oriundos de um criadouro comercial, localizado no município de Antonina, litoral do Paraná, Brasil. Os animais foram submetidos a contenção física e as venopunções foram realizadas no seio supraocciptal e na veia coccígea dorsal. As amostras heparinizadas foram identificadas e refrigeradas para posterior análise laboratorial. A contagem total de eritrócitos e leucócitos foi realizada pela técnica de hemocitometria. O hematócrito (Ht e a hemoglobina (Hb foram determinados pelo método de microhematócrito e cianometahemoglobina, respectivamente. A proteína plasmática total (PPT foi determinada por refratometria e a contagem diferencial de leucócitos foi realizada através da técnica de Shilling. Houve diferença significativa no número de leucócitos e no valor da proteína plasmática total, e em ambos os casos os valores encontrados nas amostras provenientes da veia coccígea dorsal foram inferiores. A diferença encontrada no número de leucócitos provavelmente foi devido à contaminação por linfa, que também justifica o menor valor na concentração da proteína plasmática total. Conclui-se que é mais indicada a venopunção no seio supraocciptal quando comparado a veia coccígea dorsal.The aim of the present study was to compare two different blood collection sites of 24 red-eared sliders (Trachemys scripta elegans from a commercial breeder, situated in Antonina, Paraná, Brasil. The animals were physically restrained and paired blood samples were collected from the dorsal coccygeal vein and the occipital sinus. The samples were collected in syringes containing heparin. After collection the samples were identified and refrigerated to posterior hematological analysis. Red blood cell and white blood count were performed using a hemocytometer. The packed