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

Energy Technology Data Exchange (ETDEWEB)

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.)

Fiebre amarilla en Africa: su impacto en salud pública y perspectivas para su control en el siglo XXI

OpenAIRE

Oyewale Tomori

2002-01-01

Durante las últimos dos décadas, la fiebre amarilla ha vuelto a emerger con fuerza hasta constituirse en un grave problema de salud pública en Africa, trayendo indecibles sufrimientos a mucha de su población y convirtiéndose en un obstáculo más para su desarrollo social y económico. A pesar de los destacados logros alcanzados en el conocimiento de la epidemiología de esta enfermedad y de la disponibilidad de una vacuna segura y eficaz, la fiebre amarilla continúa siendo un serio problema de s...

Resultados del examen de las primeras 5.000 muestras de higado humano obtenidas en Colombia para el estudio de fiebre amarilla

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Augusto Gast Galvis

1941-08-01

Full Text Available Entre septiembre de 1934 y febrero de 1940 se obtuvieron en diferentes partes del país 5.000 muestras de hígado gracias al Servicio de Viscerotomía de la Sección de Estudios Especiales del Ministerio de Traabajo, Higiene y Previsión Social. Su examen reveló 196 casos de fiebre amarilla, siendo el sexo massulino el más fuertemente atacado, (186 hombres y 10 mujeres, y hallándose el mayor número de casos entre los 20 y los 29 años de edad; 555 de paludismo, 51 de atrofia amarilla, aguda, y además muchas otras lesiones de interés anatomo-patológico. Resalta la importancia de dicho servicio en el descubrimiento de brotes insospechados de fiebre amarilla que de otra manera escaparían el diagnóstico correcto, y su utilidad en el estudio de otras enfermedades que producen lesiones hepáticas características es innegables.

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.

Vigilancia comercial de la cadena productiva de la Pitaya Amarilla

OpenAIRE

Henry A. Mosquera; Benjamín Betancourt; Julio César Castellanos; Luis Enrique Perdomo

2011-01-01

El objetivo de este artículo es mostrar la interacción de los distintos eslabones y sus respectivos segmentos que conforman el encadenamiento productivo de la pitaya amarilla; el uso de la vigilancia comercial permitió estudiar los aspectos referentes a clientes, proveedores y empresas, los mercados, la evolución de necesidades, los proveedores, entre otros. Por otra parte, se empleó el instrumento conocido como agenda prospectiva, el cual es un proceso de gestión estratégica que permite evid...

Detección molecular del virus de la fiebre amarilla en muestras de suero de casos fatales humanos y en cerebros de ratón.

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Jairo A. Méndez

2003-06-01

Full Text Available Hemos adaptado un método molecular basado en la técnica de transcripción reversa seguida de la reacción en cadena de la polimerasa (RT-PCR para diagnóstico alternativo de la infección por el virus de la fiebre amarilla. Se tomaron tres sueros liofilizados de casos fatales de fiebre amarilla y cuatro sueros frescos, de los cuales tres pertenecían a casos fatales de la enfermedad y el cuarto a un paciente sintomático con serología IgM positiva para fiebre amarilla; los sueros fueron tratados con Trizol-LS® para extraer el ARN viral que fue sometido a reacción de RT y posteriormente a PCR, para la cual se diseñaron dos parejas de iniciadores específicos de fiebre amarilla: iniciadores directos (sentido JM2104 (5´-CGTTGGGAGAGGAGATTC-3´ y JM2249 (5´-TTCTTCACTTCGGTTGGG-3´, e iniciadores inversos (antisentido JM2673 (5´- TCATCTGCCCTGCTTCTC-3´ y JM2751 (5´-CCTCTCTGGTAAACATTCT-3´. La aplicación de la técnica en tejidos se hizo en cerebros de ratón infectados con el virus amarílico, tratados con una solución de lisis antes de purificar el ARN. En geles de agarosa se observaron bandas únicas de amplificación del tamaño esperado (569 pb y 502 pb; todas las muestras fueron corroboradas con las dos parejas de iniciadores y en dos de las muestras de suero fresco los resultados positivos para fiebre amarilla fueron comprobados con estudio histopatológico. Este método de detección molecular permitió demostrar de manera rápida y eficiente la presencia del virus de la fiebre amarilla, hecho que tiene importantes implicaciones diagnósticas para este problema de salud pública.

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

Empleo de la Tarjeta Amarilla y el Formato NOM220 para las notificaciones de sospechas de reacciones adversas a medicamentos

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Lourdes Cristina Carrillo-Alarcón

Full Text Available Introducción: la notificación de reacciones adversas a medicamentos es una obligación a nivel mundial. Aunque se han establecido muchas metodologías para esta acción, en la actualidad existen problemas. Objetivo: determinar la frecuencia de sospecha de reacciones adversas a la administración de medicamentos en pacientes y comparar la accesibilidad del llenado del formato de la NOM220 de la Secretaría de Salud y la Tarjeta Amarilla propuesta por la Organización Mundial de la Salud. Métodos: estudio transversal y observacional. Participaron 50 médicos responsables de las clínicas de diabetes del Estado de Hidalgo. Inicialmente, los médicos fueron capacitados para identificar las sospechas de reacciones adversas a la administración de medicamentos en los pacientes atendidos. Se realizó un diseño cruzado, en el que el 50 % de los médicos utilizaron por tres meses el formato de la NOM220 y 50 % la Tarjeta Amarilla. Después intercambiaron formatos y los utilizaron durante los tres meses siguientes. Al cabo de este periodo, respondieron un cuestionario para determinar la utilidad, claridad, tiempo de llenado y practicidad de ambos formatos. Se realizó estadística descriptiva y análisis bivariado para determinar los factores asociados a las sospecha de reacciones adversas a medicamentos, con el software SPSS (versión 17. Resultados: se registraron 46 sospechas de reacciones adversas a medicamentos en 46 pacientes con el formato de la NOM220 y 78 sospechas de reacciones adversas a medicamentos con la Tarjeta Amarilla en 78 pacientes. Todas las sospechas de reacciones adversas a la administración de medicamentos fueron tipo A. Los médicos recomiendan la utilización de la Tarjeta Amarilla, consideran claro el formato, sencillo, legible, fácil de llenar, entendible y accesible (p< 0,05. Conclusiones: los resultados permiten proponer la Tarjeta Amarilla como una alternativa más accesible para la notificación de sospechas de

An unusual cause of an inferior vena cava syndrome

NARCIS (Netherlands)

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

Endovascular management of inferior vena cava filter thrombotic occlusion.

Science.gov (United States)

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.

Fiebre amarilla en Africa: su impacto en salud pública y perspectivas para su control en el siglo XXI

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Oyewale Tomori

2002-06-01

Full Text Available Durante las últimos dos décadas, la fiebre amarilla ha vuelto a emerger con fuerza hasta constituirse en un grave problema de salud pública en Africa, trayendo indecibles sufrimientos a mucha de su población y convirtiéndose en un obstáculo más para su desarrollo social y económico. A pesar de los destacados logros alcanzados en el conocimiento de la epidemiología de esta enfermedad y de la disponibilidad de una vacuna segura y eficaz, la fiebre amarilla continúa siendo un serio problema de salud pública tanto en Africa como en América en donde anualmente afecta a 200.000 personas, aproximadamente, y causa alrededor de 30.000 muertes. Africa contribuye con más del 90% de la morbilidad y mortalidad por fiebre amarilla en el planeta. Además de la severidad de la morbilidad y la mortalidad, que muestran un acusado subregistro, los sucesivos brotes y las medidas de control han traumatizado la prestación de los servicios de salud disponibles, sobrecargando los ya exiguos recursos internos, abusando de las donaciones y llevando a un lamentable desperdicio de vacunas. Las epidemias recientes en Africa han afectado predominantemente a los niños menores de 15 años. La fiebre amarilla es una enfermedad de fácil control, lo cual puede ilustrarse con dos situaciones ocurridas en Africa. Entre 1939 y 1952, la enfermedad virtualmente desapareció en varias zonas del continente en las que se adelantaron programas de vacunación masiva de manera regular. Más recientemente, después de la epidemia de 1978-1979 en Gambia, se llevó a cabo una campaña masiva de vacunación contra la fiebre amarilla, logrando un cubrimiento de 97% de la población mayor de seis meses de edad, a partir de la cual la vacuna se incorporó permanentemente al programa de inmunización. Desde entonces, Gambia ha mantenido cubrimientos de más del 80%, sin notificación de nuevos casos, a pesar de tener frontera con Senegal que padeció brotes en 1995 y 1996. La

Los vecinos de Buenos Aires ante las epidemias de cólera y fiebre amarilla (1856-1886

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Maximiliano Ricardo Fiquepron

2017-01-01

Full Text Available El artículo analiza un tipo particular de institución surgida para combatir en las epidemias de cólera de 1867, 1868 y 1873, y en las de fiebre amarilla, ocurridas en 1871 y 1886. Las comisiones de vecinos han sido interpretadas mayormente por la historiografía como una respuesta de la sociedad frente a la parálisis del Estado, sobre todo en su dimensión municipal. Este artículo revisa esta afirmación y argumenta que las epidemias generaron la posibilidad de crear, reformar y convertiráreas específicas del Estado municipal, sobre todo aquellas vinculadas con la salud e higiene. Hemos denominado a este proceso vector de institucionalización, dado que con las epidemias de cólera y de fiebre amarilla aparecieron –en principio, transitoriamente– una serie de medidas y formas de organización que luego fueron institucionalizadas. Además, sostenemos que la indudable relevancia de la fiebre amarilla de 1871 no debe obstruir el estudio de otras epidemias, en la medida en que estas fueron también muy significativas en el proceso de gestación de las comisiones de vecinos y, más importante, contribuyeron al fortalecimiento institucional de la municipalidad. Esta mirada permite mostrar espacios de interacción, subordinación, independencia y/o enfrentamiento producidos entre las comisiones de vecinos y el Estado municipal y provincial de la provincia de Buenos Aires.

The clinical application of inferior vena caval CO2-DSA

International Nuclear Information System (INIS)

Guo Jinhe; Teng Gaojun; Zhu Guangyu; Li Guozhao; Fang Wen; He Shicheng; Deng Tang

2007-01-01

Objective: To explore the feasibility and safety of inferior vena caval CO 2 -DSA and evaluate the results of inferior vena cavography using CO 2 -DSA or iodinated contrast media. Methods: 25 patients diagnosed as deep venous thrombosis of lower limb were prepared to conceive the implantation of inferior vena caval filter. The inferior vena cava and right renal vein CO 2 -DSA and iodinated contrast media DSA were carried out through jugular or femoral vein approach in all patients. Results: The inferior vena caval angiography with CO 2 -DSA or iodinated contrast media were carried out successfully in all patients. The quality of the inferior vena caval angiogram showed: with CO 2 as contrast media, 14 cases obtained excellent images and 11 cases had good images; with iodinated contrast media the images of 18 cases were excellent and 7 cases were good. No thrombus and variation of inferior vena cava were found by the two kinds of angiography. The diameter of inferior vena cava showed: (20.01 ± 0.83) mm with CO 2 contrast media and (20.15 ± 0.92) mm with iodinated contrast media, (P=0.006); having statistical significance between them. The safety of angiography with CO 2 presented only 1 case with transient slight decrease of O 2 saturation. No abnormal changes were found in blood pressure, heart rate and so on. Conclusions: Inferior vena caval CO 2 -DSA is feasible and safe, with statistical significance in the measurement of inferior vena caval diameter comparing with iodinated contrast material but with no influence on the implantation of filter. (authors)

Evaluación serológica de una proteína recombinante a partir de una cepa aislada del virus de la fiebre amarilla en el Perú: un estudio piloto

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Carlos Yábar V

2003-10-01

Full Text Available Objetivo: Evaluar serológicamente una proteína recombinante de 66 kDa (Er66 de una cepa del virus de la fiebre amarilla aislada en el Perú usando anticuerpos inmunoreactivos. Material y métodos: La proteína Er66 fue expresada in vitro en la bacteria Escherichia coli y enfrentada a títulos de 1/100, 1/50 y 1/25 de anticuerpos monoclonales, y a sueros con anticuerpos IgM e IgG inmunoreactivos contra el virus de la fiebre amarilla mediante ensayos de Western blot (WB. Asimismo, se evaluaron proteínas totales de las cepas de referencia del virus dengue (DEN y fiebre amarilla como controles de antigenicidad. Resultados: La proteína recombinante Er66 presentó antigenicidad contra títulos de 1/50 y 1/25 de anticuerpo monoclonal (MAB8701; sin embargo, no se observó inmunoreactividad en sueros positivos para fiebre amarilla y dengue. Los ensayos con extractos crudos de la cepa de fiebre amarilla Asibi 17D (PTFA revelaron que la antigenicidad de las proteínas virales comprendidas entre 60 y 80 kDa fue afectada negativamente a temperaturas desnaturalizantes de 100°C. En cambio, tratamientos con ß-mercaptoetanol sin calor generó un aumento de la antigenicidad de dichas proteínas. Siguiendo este mismo principio, la proteína Er66 fue sometida a tratamientos desnaturalizantes con ß-mercaptoetanol sin incluir calor y fue enfrentada nuevamente a los sueros reactivos. El resultado final reveló que la proteína Er66 generó inmunoreactividad frente a sueros con altos títulos de anticuerpos IgM e IgG para fiebre amarilla mientras que en otras muestras se observó una débil señal. Conclusiones: Los datos obtenidos en este trabajo demuestran que la Er66 pudo ser reconocida por anticuerpos IgM e IgG específicos para fiebre amarilla presentes en sueros de pacientes infectados. Los datos presentados en este artículo sugieren el uso de proteínas recombinantes como posibles candidatas de valor diagnóstico para la FA.

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...

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

Late Cretaceous paleosols as paleoclimate proxies of high-latitude Southern Hemisphere: Mata Amarilla Formation, Patagonia, Argentina

Science.gov (United States)

Varela, Augusto N.; Raigemborn, M. Sol; Richiano, Sebastián; White, Tim; Poiré, Daniel G.; Lizzoli, Sabrina

2018-01-01

Although there is general consensus that a global greenhouse climate characterized the mid-Cretaceous, details of the climate state of the mid-Cretaceous Southern Hemisphere are less clearly understood. In particular, continental paleoclimate reconstructions are scarce and exclusively derived from paleontological records. Using paleosol-derived climofunction studies of the mid- to Upper Cretaceous Mata Amarilla Formation, southern Patagonia, Argentina, we present a reconstruction of the mid-Cretaceous climate of southern South America. Our results indicate that at 60° south paleolatitude during the Cenomanian-Santonian stages, the climate was subtropical temperate-warm (12 °C ± 2.1 °C) and humid (1404 ± 108 mm/yr) with marked rainfall seasonality. These results are consistent with both previous estimations from the fossil floras of the Mata Amarilla Formation and other units of the Southern Hemisphere, and with the previous observations of the displacement of tropical and subtropical floras towards the poles in both hemispheres. The data presented here show a more marked seasonality and slightly lower mean annual precipitation and mean annual temperature values than those recorded at the same paleolatitudes in the Northern Hemisphere.

Fatal pericardial tamponade after superior vena cava stenting.

NARCIS (Netherlands)

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

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

Directory of Open Access Journals (Sweden)

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.

Topography and distribution of ostia venae hepatica in the ...

African Journals Online (AJOL)

BACKGROUND: Openings of hepatic veins into the retrohepatic surface of the inferior vena cava. (ostia venae hepatica) play a part in controlling hepatic circulation by acting as collateral channels in obstruction. Their topography and distribution must be taken into account during catheterization and liver transplantation.

Right superior vena cava draining into the left atrium

Energy Technology Data Exchange (ETDEWEB)

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.)

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

U-Pb zircon constraints on the age of the Cretaceous Mata Amarilla Formation, Southern Patagonia, Argentina: Its relationship with the evolution of the Austral Basin

International Nuclear Information System (INIS)

Varela, Augusto N; Poire, Daniel G; Martin, Thomas; Gerdes, Axel; Goin, Francisco J; Gelfo, Javier N; Hoffmann, Simone

2012-01-01

Despite the abundant fossil content of the Mata Amarilla Formation (Southern Patagonia, Santa Cruz Province, Argentina), its age has always generated a considerable number of questions and debates. The chronological data provided by invertebrates, dinosaurs, fish, turtles, plesiosaurs and fossil flora are contradictory. In this work, twenty U-Pb spot analyses by laser ablation were carried out on the outer parts of the zoned zircon crystals from a tuff layer of the middle section of the Mata Amarilla Formation, yielding a U-Pb concordia age of 96.23±0.71 Ma, which corresponds to the middle Cenomanian. The deposition of the lower section of the Mata Amarilla Formation marks the onset of the foreland stage of the Austral Basin (also known as Magallanes Basin); this transition is characterized by the west-east shift of the depositional systems, which is consistent with the progradation of the Cretaceous fold-and-thrust belt. Thus, the onset of the foreland stage could have occurred between the upper Albian and lower Cenomanian, as the underlying Piedra Clavada Formation is lower Albian in age. On comparing the data obtained with information from the Ultima Esperanza Province in Chile, it can be suggested that the initiation of the closure of the Rocas Verdes Marginal Basin occurred simultaneously

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)

Vena caval impalement: an unusual lawn mower injury in a child.

Science.gov (United States)

Muńoz-Juárez, M; Drugas, G T; Hallett, J W; Zietlow, S P

1998-06-01

Penetrating injury to the vena cava is a potentially life threatening condition that necessitates prompt recognition and immediate treatment. Herein we describe a unique lawn mower-related injury in a 4-year-old boy, resulting in the impalement of the inferior vena cava by a foreign body projectile. Relevant concepts in the management of children with lawn mower injuries are discussed, with emphasis on penetrating injury to the inferior vena cava.

Informe sobre la fiebre amarilla silvestre en la región del Meta, desde julio 1934 hasta diciembre de 1936

Directory of Open Access Journals (Sweden)

Jorge Boshell Manrique

1938-02-01

Full Text Available En agosto de 1934 el Padre Francisco Savary, misionero de la Compañía Montfort, da la voz de alarma acerca de unos casos de fiebres que se han presentado en unas veredas del vecindario de Restrepo y cuyo cuadro clínico corresponde al descrito en el capítulo de fiebre amarilla de su Manual de Misionero. Se practica una primera investigación encontrando, en efecto, manifestaciones mórbidas que sugieren fiebre amarilla. El brote presenta una característica extraña que confunde a primera vista la investigación, en un momento en que la noción de la fiebre silvestre, o sea sin Aedes aegypti, no está aún generalizada. No se encuentra tal zancudo en la región. A consecuencia de un informe de la Dirección Nacional de Higiene, el Dr. E. R. Rickard, médico de la Fundación Rockefeller, baja a Villavicencio y me deja instrucciones precisas, con elementos de investigación. En esta época el autor era Director Intendencial de Higiene. Se toman 30 muestras de sangre distribuídas entre personas convalecientes de ataques de la enfermedad, entre personas que moraban en las casas en que habían ocurrido casos y entre compañeros de trabajo de personas atacadas. De las muestras sometidas a la prueba de inmunidad para fiebre amarilla, 20 resultaron positivas, 2 inconclusivas y 8 negativas. Estos resultados traen por consecuencia el establecimiento de una comisión de investigación epidemiológica en la región de Restrepo.

Resumen de notas históricas sobre la fiebre amarilla en Colombia

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Hernando Groot

2004-03-01

Full Text Available

Dos formas epidemiológicas, la urbana y la selvática, de hecho íntimamente ligadas. En cuanto a la primera, transmitida de hombre a hombre por Aedes aegypti, debe recordarse que se observaba frecuentemente en los poblados de la costa del Caribe desde el siglo XVII, produciendo a veces epidemias como la que sufrieron las tropas de Vernon en 1741 cuando al intentar tomar a Cartagena se vieron atacadas por la enfermedad; de los 23.000 invasores, 9.000 perecieron en la empresa, la mayoría de ellos por causa de la fiebre amarilla. En épocas más recientes durante el siglo XIX y a principios del XX, el mal siguió siendo azote común del litoral Atlántico y causó también diversas epidemias a lo largo del Río Magdalena y en algunas poblaciones aisladas, como El Carmen y Ocaña. Igualmente se registraron casos de la enfermedad en Buenaventura. Las dos últimas epidemias urbanas que sufrió Colombia, fueron las de Bucaramanga en 1923 y la del Socorro en 1928. Es de notar que la desaparición de la fiebre amarilla de las ciudades se debió sin duda a las vigorosas campañas para eliminar el mosquito transmisor que culminaron en 1960 con su erradicación, exceptuada Cúcuta. Sin embargo, años más tarde el país se reinfestó con el Aedes y, por consiguiente, quedó nuevamente expuesto a las epidemias de fiebre amarilla urbana, pero con riesgo mayor por cuanto el mosquito se había dispersado por todo el país y se había establecido en lugares donde nunca había existido antes. Afortunadamente hasta el momento actual no se ha presentado brote alguno del famoso vómito negro urbano.

En cambio se han observado gigantescas epidemias de dengue (1.

En lo referente a la fiebre amarilla selvática lo primero por indicar es que

U-Pb zircon constraints on the age of the Cretaceous Mata Amarilla Formation, Southern Patagonia, Argentina: its relationship with the evolution of the Austral Basin Edades U-Pb en circones de la Formación Mata Amarilla (Cretácico, Patagonia Austral, Argentina: su relación con la evoluci��n de la Cuenca Austral

Directory of Open Access Journals (Sweden)

Augusto N Varela

2012-09-01

Full Text Available Despite the abundant fossil content of the Mata Amarilla Formation (Southern Patagonia, Santa Cruz Province, Argentina, its age has always generated a considerable number of questions and debates. The chronological data provided by invertebrates, dinosaurs, fish, turtles, plesiosaurs and fossil flora are contradictory. In this work, twenty U-Pb spot analyses by laser ablation were carried out on the outer parts of the zoned zircon crystals from a tuff layer of the middle section of the Mata Amarilla Formation, yielding a U-Pb concordia age of 96.23±0.71 Ma, which corresponds to the middle Cenomanian. The deposition of the lower section of the Mata Amarilla Formation marks the onset of the foreland stage of the Austral Basin (also known as Magallanes Basin; this transition is characterized by the west-east shift of the depositional systems, which is consistent with the progradation of the Cretaceous fold-and-thrust belt. Thus, the onset of the foreland stage could have occurred between the upper Albian and lower Cenomanian, as the underlying Piedra Clavada Formation is lower Albian in age. On comparing the data obtained with information from the Última Esperanza Province in Chile, it can be suggested that the initiation of the closure of the Rocas Verdes Marginal Basin occurred simultaneously.A pesar del abundante contenido fosilífero de la Formación Mata Amarilla (Patagonia Austral, Provincia de Santa Cruz, Argentina, siempre se generaron abundantes dudas y debates acerca de cuál es la edad de esta formación. Los datos cronológicos aportados por los invertebrados, los dinosaurios, peces, tortugas, plesiosaurios y flora fósil son dispares. En el presente trabajo se obtuvo una edad U-Pb concordia por la metodología de ablación láser aplicada a 20 puntos de la parte externa de circones zonados provenientes de un nivel tobáceo hallado en la sección media de la Formación Mata Amarilla, lo cual arrojó una edad de 96,23±0,71 Ma, que

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

Symptomatic duodenal perforation by inferior vena cava filter.

Science.gov (United States)

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.

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)

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

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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.)

Desarrollo de un método de transcripción inversa seguida de reacción en cadena de la polimerasa para la detección del virus de la fiebre amarilla

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María C. Méndez

2013-08-01

Full Text Available Introducción. La fiebre amarilla se considera una enfermedad reemergente y endémica en regiones tropicales de África y Suramérica. Actualmente, no existen estuches estandarizados o comerciales disponibles para la detección del virus de la fiebre amarilla y, por lo tanto, el diagnóstico debe hacerse mediante técnicas de rutina que consumen mucho tiempo y algunas veces no garantizan la detección del virus o de sus proteínas. Además, la cocirculación con otros flavivirus, incluyendo el del dengue, hacen el diagnóstico más complicado. Objetivo. Desarrollar un ensayo específico de amplificación basado en transcripción inversa seguida de reacción en cadena de la polimerasa, con el fin de mejorar la detección y el diagnóstico de la fiebre amarilla, tanto a partir de suero como de tejido fresco. Materiales y métodos. Se diseñaron iniciadores específicos para amplificar un fragmento conservado del virus de la fiebre amarilla. Un segundo par de iniciadores se usó en una reacción de amplificación anidada para incrementar la sensibilidad. Se probaron 33 muestras clínicas con la técnica estandarizada. Resultados. El amplímero esperado se obtuvo en 25 de las 33 muestras analizadas usando este método y 2 más resultaron positivas después de la reacción anidada. Conclusión. Esta técnica mejorada garantiza la detección de todos los genotipos virales de fiebre amarilla y puede incrementar la sensibilidad del ensayo introduciendo una segunda etapa de amplificación, lo cual permite el diagnóstico diferencial con infección por dengue y otros flavivirus, lo cual es de gran importancia para la vigilancia y la toma de medidas epidemiológicas oportunas. doi: http://dx.doi.org/10.7705/biomedica.v33i0.1452

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.

Establecimiento y micropropagación de selenicereus megalanthus (pitahaya amarilla) e hylocereus polyrhizus (pitahaya roja)

OpenAIRE

Suarez Román, Rocío Stella; Caetano, Creuci María; Ramírez, Hernando

2014-01-01

Pitahaya amarilla y roja se establecieron y micropropagaron en condiciones in vitro vía organogénesis somática, a partir de hojas cotiledonares y fragmentos de cladodio  provenientes de plántulas con 20 días de desarrollo expuestos a medio Murashige & Skoog (MS), suplementado con auxinas (ANA) y citocininas (Kinetina y BAP). En el medio de cultivo M3 (BAP + Kinetina 2 mg/l) se obtuvieron entre cuatro y 11 brotes enraizados de 4 cm de longitud, en un periodo de 30 días. En  pitahaya roja s...

Evaluación de la actividad fungistática in vitro de bacterias ácido lácticas contra especies de Fusarium causantes de pudrición basal en pitahaya amarilla (Selenicereus megalanthus Haw)

OpenAIRE

Valencia Hernández, Leidy J

2015-01-01

Fusarium sp. Es uno de los principales hongos fitopatógenos causantes de enfermedades en pitahaya amarilla. Estudios previos han demostrado la capacidad antimicrobiana de bacterias ácido lácticas (BAL) contra patógenos; sin embargo no se ha reportado en la literatura científica actividad fungistática de BAL contra especies de Fusarium causantes de pudrición basal en pitahaya amarilla. En este trabajo se evaluó in vitro la actividad fungistática de una BAL aislada de cultivos de pitahaya amari...

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

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 ...

Memoria triste de la España menguante: La lluvia amarilla, de Julio Llamazares

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José Belmonte Serrano

2012-08-01

Full Text Available En 1988, l’écrivain de León, Julio Llamazares, publie son deuxième roman, La lluvia amarilla [La pluie jaune]. Un texte bien travaillé, de prose poétique, dans lequel il met en avant, dans une sorte de dénonciation, l’abandon dans lequel se trouvent de nombreux villages de l’Espagne rurale. L’œuvre a pour cadre le village d’Ainielle, un hameau situé dans les montagnes de la communauté d’Aragón, dont le dernier habitant refuse de quitter les lieux. Le protagoniste, qui raconte l’histoire à la première personne, nous expose la décadence inexorable d’Ainielle a travers quelques passages évocateurs, où il est question d’un village abandonné à son sort par les autorités, dont la seule préoccupation est le progrès, sans jamais tenir compte du destin de ces gens.En 1988, el escritor leonés Julio Llamazares publica su segunda novela, La lluvia amarilla. Un texto bien cuidado, de prosa poética, en el que pone de manifiesto, a modo de denuncia, el abandono que sufren muchos de los pueblos de la España rural. Su obra está ambientada en Ainielle, una pequeña población anclada en las montañas de la comunidad aragonesa, donde su último habitante se resiste a abandonar su tierra. El protagonista, que narra la historia en primera persona, nos proporciona evocadores pasajes retrospectivos en los que se aprecia el progresivo deterioro de Ainielle, abandonado a su suerte por las autoridades que han puesto sus ojos en el progreso sin importarles en absoluto el destino de estas gentes.

Estimación de la huella hídrica para un cultivo de pitahaya amarilla (Selenicereus megalanthus

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Eliana Alexandra Sánchez Bautista

2015-10-01

Full Text Available El presente proyecto evaluó el impacto de la huella hídrica dentro del proceso productivo de pitahaya amarilla (Selenicereus megalanthus. La huella hídrica es un indicador multidimensional que cuantifica el volumen de agua utilizado para la producción de un bien. El objetivo del presente estudio es cuantificar el consumo del recurso hídrico, para concientizar a los habitantes del municipio de Palestina, Huila sobre la importancia de la administración adecuada y eficiente del mismo. Adicional a esto, se diseñó un sistema de captación de agua para suplir las necesidades de la población en época de sequía y, de esta manera, no parar las actividades económicas por falta del recurso. Cada tipo de huella hídrica se determinó a partir de valores teóricos e información secundaria suministrada por un cultivador del municipio de Palestina. Estos valores se utilizaron como base para determinar las huellas azul, verde y gris del cultivo de pitahaya amarilla en su fase productiva. El estudio se realizó por medio del manejo del software CropWat 8.0 (propuesto por la FAO en el año 2010, el cual es un programa informático que permite calcular las necesidades hídricas de los cultivos, con base en la tierra, el clima y los datos del mismo cultivo.

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.

Science.gov (United States)

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.

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...

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)

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

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.

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.

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.)

La eficacia de la vacunación en la prevención de la fiebre amarilla en Colombia

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John C. Bugher

1944-11-01

Full Text Available La introducción de la vacuna contra la fiebre amarilla trajo como consecuencia la eliminación de las infecciones con el mismo virus, ocurridas en el laboratorio entre el personal de la División Sanitaria Internacional de la Fundación Rockefeller. Además, en Colombia no ha ocurrido ningún caso de infección entre los empleados de la Sección de Estudios Especiales, a pesar del contacto íntimo que mantienen con el virus, tanto en el laboratorio como en el campo.

La eficacia de la vacunación en la prevención de la fiebre amarilla en colombia

OpenAIRE

Bugher, John C.; Gast-Galvis, Augusto

2011-01-01

La introducción de la vacuna contra la fiebre amarilla trajo como consecuencia la eliminación de las infecciones con el mismo virus, ocurridas en el laboratorio entre el personal de la División Sanitaria Internacional de la Fundación Rockefeller. Además, en Colombia no ha ocurrido ningún caso de infección entre los empleados de la Sección de Estudios Especiales, a pesar del contacto íntimo que mantienen con el virus, tanto en el laboratorio como en el campo.

Veia cava superior esquerda anômala com ausência de veia cava superior direita: achados de imagem Persistent left superior vena cava with absent right superior vena cava: image findings

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Cyrillo Rodrigues de Araújo Júnior

2003-10-01

Full Text Available A persistência da veia cava superior esquerda com ausência da veia cava superior direita é uma anomalia rara, com menos de 150 casos descritos na literatura. A não-obliteração e regressão da veia cardinal anterior esquerda durante o desenvolvimento embriológico promove uma variação sistêmica de retorno venoso ao coração, com persistência da veia cava superior esquerda. Sua incidência varia de 0,3% em pacientes sem alterações cardíacas congênitas concomitantes a 4,3% naqueles com cardiopatias. Na maioria das vezes coexiste a veia cava superior direita, porém se houver regressão e degeneração da veia cardinal anterior direita, implicará a sua ausência e a drenagem venosa para o coração será feita pela veia cava superior esquerda ao átrio direito, através do seio coronariano. Mostramos um caso de um paciente submetido a radiografia de tórax e tomografia computadorizada para avaliação de doença pulmonar obstrutiva crônica, tendo como achado a persistência da veia cava superior esquerda com ausência da direita, sem qualquer cardiopatia associada e com a drenagem cardíaca sendo feita, através do seio coronariano, para o átrio direito.Persistent left superior vena cava with absent right superior vena cava is a rare anomaly, with less than 150 cases reported in the literature. Congenitally persistent left superior vena cava is the most common variant of systemic venous return to the heart, resulting embryologically from failure of the left anterior cardinal vein to become obliterated. Its incidence varies from 0.3% in patients with otherwise normal heart to 4.3% in patients with congenital heart disease. In the majority of the patients, a right superior vena cava is present as well, but rarely the right anterior cardinal vein degenerates resulting in the absence of the normal right superior vena cava. The blood from the right side is carried by the persistent left superior vena cava to the right atrium through the

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.)

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.

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

Energy Technology Data Exchange (ETDEWEB)

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.)

La distribución estacional de fiebre amarilla humana y del mosquito haemagogus en la Intendencia del Meta (Colombia

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Augusto Gast Galvis

1945-08-01

Full Text Available Las zonas de las estribaciones de la cordillera en la Intendencia del Meta han sido por muchos años de gran interés desde el punto de vista de fiebre amarilla selvática. Las condiciones generales de estas zonas en relación con la endemicidad de esta enfermedad han sido descritas por Boshell (1938 y el pormenorizado trabajo de campo llevado a cabo por Bugher y sus colaboradores (1944 incriminó al Haemagogus capricornii como el principal vector en esa región.

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

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

International Nuclear Information System (INIS)

Dalsey, W.C.; Barsan, W.G.; Joyce, S.M.; Hedges, J.R.; Lukes, S.J.; Doan, L.A.

1984-01-01

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

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

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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)

Superior vena caval obstruction - decompression with chemotherapy and subsequent irradiation

International Nuclear Information System (INIS)

Kolaric, K.; Maricic, Z.; Dujmovic, I.; Mrsic, Z.

1975-01-01

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

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.

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

Directory of Open Access Journals (Sweden)

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.

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.)

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)

Complications after the placement of domestic ZQL filter and imported inferior vena caval filter: a mid-and long-term comparative study

International Nuclear Information System (INIS)

Huang Kun; Zhao Yi; Xu Ke; Feng Bo; Liang Songnian

2009-01-01

Objective: To investigate the clinical value of domestic ZQL-type inferior vena caval filter through comparing its complications with that of imported inferior vena caval filter. Methods: Domestic ZQL-type inferior vena caval filter was placed in 62 patients (study group) and imported inferior vena caval filter in 58 patients (control group) for the treatment of deep venous thrombosis of the lower limb. Abdominal plain film, lower limb phlebography and/or pulmonary arteriography, color Doppler ultrasonography were performed after the procedure. 3D-CT scanning was carried out when pulmonary embolism was suspected. The complications were documented and analyzed. Results In all patients the inferior vena caval filter was successfully implanted in planned site. In study group, the complications included filter migration over 10 cm (n = 1), thrombus in the filter (n = 1), inferior vena cava obstruction (n = 2) and pulmonary embolism (n = 1). In control group, the complications included thrombus in the filter (n = 2), deep venous thrombus of the lower extremities (n = 2), inferior vena cava obstruction (n = 9), venous perforation by filter (n = 1) and pulmonary embolism (n = 1). The data were compared between two groups and statistic analysis showed no significant difference between two groups (P > 0.05). Conclusion: No significant difference in the occurrence of complications exists between domestic ZQL-type inferior vena caval filter and imported inferior vena caval filter, therefore, domestic ZQL-type inferior vena caval filter can safely substitute for the imported filter. (authors)

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)

Hepatic Scintigraphic Findings of Budd-Chiari Syndrome due to Inferior Vena Caval Obstruction

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Kim, Sung Hoon; Chung, Soo Kyo; Byun, Jae Young; Lee, Sung Yong; Shinn, Kyung Sub; Kim, Choon Yul; Bahk, Yong Whee [Catholic University College of Medicine, Seoul (Korea, Republic of)

1988-03-15

Budd-Chiari syndrome (BCS) is a rare clinical entity characterized by post-sinusoidal portal hypertension caused by the obstruction to the hepatic vein outflow. The diagnosis is suggested by hepatic scintigraphy and is usually confirmed by hepatic venography, inferior vena cavography and biopsy. The scintigraphic finding of BCS caused by the obstruction of main hepatic vein has been reported to consist typically of hypertrophy of the caudate lobe with increased radionuclide accumulation. Such a typical finding has been accounted for by the fact that the venous outflow from the caudate lobe is preserved when the main hepatic vein is obstructed. But usually, the hepatic venous outflow from the caudate lobe is also obstructed in BCS due to inferior vena caval obstruction. So hepatic scintigraphic findings of BCS due to inferior vena caval obstruction show different findings as compared with the BCS due to hepatic vein obstruction. We evaluate the hepatic scintigrams of the 13 cases of BCS due to inferior vena caval obstruction and review the literatures. The results are as follows: 1) We cannot observe the caudate lobe hypertrophy with increased uptake, which is known as a classic finding in BCS due to hepatic vein obstruction. 2) The most prominent hepatic scintigraphic findings of BCS are nonhomogenous uptake in the liver with extrahepatic uptake in the all cases. 3) We can see cold areas at the superior aspect of right hepatic lobe in 7 cases (54%). This is a useful finding suggesting BCS due to inferior vena caval obstruction.

Hepatic Scintigraphic Findings of Budd-Chiari Syndrome due to Inferior Vena Caval Obstruction

International Nuclear Information System (INIS)

Kim, Sung Hoon; Chung, Soo Kyo; Byun, Jae Young; Lee, Sung Yong; Shinn, Kyung Sub; Kim, Choon Yul; Bahk, Yong Whee

1988-01-01

Budd-Chiari syndrome (BCS) is a rare clinical entity characterized by post-sinusoidal portal hypertension caused by the obstruction to the hepatic vein outflow. The diagnosis is suggested by hepatic scintigraphy and is usually confirmed by hepatic venography, inferior vena cavography and biopsy. The scintigraphic finding of BCS caused by the obstruction of main hepatic vein has been reported to consist typically of hypertrophy of the caudate lobe with increased radionuclide accumulation. Such a typical finding has been accounted for by the fact that the venous outflow from the caudate lobe is preserved when the main hepatic vein is obstructed. But usually, the hepatic venous outflow from the caudate lobe is also obstructed in BCS due to inferior vena caval obstruction. So hepatic scintigraphic findings of BCS due to inferior vena caval obstruction show different findings as compared with the BCS due to hepatic vein obstruction. We evaluate the hepatic scintigrams of the 13 cases of BCS due to inferior vena caval obstruction and review the literatures. The results are as follows: 1) We cannot observe the caudate lobe hypertrophy with increased uptake, which is known as a classic finding in BCS due to hepatic vein obstruction. 2) The most prominent hepatic scintigraphic findings of BCS are nonhomogenous uptake in the liver with extrahepatic uptake in the all cases. 3) We can see cold areas at the superior aspect of right hepatic lobe in 7 cases (54%). This is a useful finding suggesting BCS due to inferior vena caval obstruction.

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

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

International Nuclear Information System (INIS)

Le Blanche, Alain F.; Ricco, Jean-Baptiste; Bonneau, Michel; Reynaud, Philippe

2012-01-01

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

De miasmas a mosquitos: el pensamiento médico sobre la fiebre amarilla en Yucatán, 1890-1920

OpenAIRE

Alcalá Ferráez,Carlos

2012-01-01

La fiebre amarilla fue un problema de salud pública desde la época colonial debido a la frecuencia con que se presentaba en forma epidémica y a su alta letalidad. El objetivo de este trabajo es analizar el pensamiento médico y su evolución con respecto al vómito prieto entre 1890 y 1921 en Yucatán. Dos aspectos serán abordados: algunos antecedentes con respecto a la enfermedad y las ideas predominantes hasta 1881; y la propuesta de Carlos Finlay para vencer el escepticismo ante su teoría por ...

Dieta y hábitos alimenticios de la corvina amarilla Cynoscion albus en el Pacífico ecuatoriano

OpenAIRE

Calle Morán, Marcos; Galván Magaña, Felipe

2017-01-01

El objetivo de este estudio fue determinar los hábitos alimenticios de la corvina amarilla Cynoscion albus y su relación con el sexo y la época del año. Se colectaron muestras de contenido estomacal de C. albus en el mercado municipal de Bahía de Caráquez para poder analizar las presas que conformaban parte de su dieta, la categorización de dichas especies, así como también la diversidad de las mismas, la amplitud de su nicho trófico, el traslapamiento trófico y el nicho trófico. Se registrar...

Aneurisma de la vena de Galeno Galen's vein aneurysm

Directory of Open Access Journals (Sweden)

Sergio Piloña Ruiz

2010-09-01

Full Text Available La malformación arteriovenosa de la vena de Galeno es una enfermedad congénita poco frecuente que se produce a partir de un defecto en la fusión de las venas cerebrales internas y que, debido a la baja resistencia, produce un cuadro de falla cardíaca de alto gasto. Las manifestaciones clínicas son muy variables y dependen de la edad de presentación. El pronóstico depende del tamaño del aneurisma. Se presenta el caso de un recién nacido del sexo masculino, con diagnóstico prenatal de aneurisma de la vena de Galeno y, desde el nacimiento, graves signos de insuficiencia cardíaca congestiva de difícil tratamiento. Se realiza una revisión sobre el tema.Arteriovenous malformation of Galen's vein is an uncommon congenital disease present from a defect in internal cerebral veins fusion and that due to the low resistance, produces a high output heart failure. Clinical manifestations are very variables depending on age of presentation. Prognosis depends on the size of aneurysm. This is the case of a male newborn diagnosed prenatally with Galen's vein aneurysm and from his birth severe signs of congestive heart failure of difficult treatment. A literature review on this subject is made.

El veneno y el mosquito: aspectos epistemológicos de la etiología y la profilaxis de la fiebre amarilla

OpenAIRE

Caponi,Sandra

2000-01-01

En el II Congreso Médico Latinoamericano (Buenos Aires, 1904) se discutieron las estrategias que Argentina y Brasil delinearon para combatir la fiebre amarilla. El análisis de la controversia entre sanitaristas brasileños y argentinos en torno a los modelos explicativos y a las estrategias de profilaxis internacional de esa enfermedad, nos permite una comprensión epistemológica de la ruptura operada por la emergencia de la medicina de los vectores. Este capítulo de la historia de la medicina ...

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

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)

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.

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.

Science.gov (United States)

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

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.

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.

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.

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

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.

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

Directory of Open Access Journals (Sweden)

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.

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.

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.)

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

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

LENUS (Irish Health Repository)

Power, C K

2012-02-03

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

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.

Spontaneous tilting after placement of the gunther-tulip inferior vena caval filter: a case report

International Nuclear Information System (INIS)

Seo, Tae Seok; Cha, In Ho; Seol, Hae Young; Park, Cheol Min

2006-01-01

Tilting of a deployed filter in the inferior vena cava (IVC) is a particular kind of periprocedural complication and this can reduce the filter's clot-trapping ability and increase the occlusion of the IVC at a later period. The authors report here on a case of spontaneous tilting of an inferior vena caval filter that was associated with thrombosis in the IVC within 2 weeks of the initially successful placement of the filter without tilting

Vena porta thrombosis in patient with inherited factor VII deficiency

DEFF Research Database (Denmark)

Klovaite, Jolanta; Friis-Hansen, Lennart Jan; Larsen, Fin S

2010-01-01

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

Revista de tesis

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Facultad de Medicina Revista

1945-08-01

Full Text Available Efectos del curare colombiano sobre el electrocardiograma y la tensión arterial. Tesis de grado "Meritoria". 1945. - Presentada por Rafael Peña Peña / La fiebre amarilla selvática y el género haemagogus (Diptera, Culicidae en Colombia. Tesis de grado "Meritoria". 1945. - Presentada por Pedro Nel Saavedra / Tratamiento de las fracturas abiertas por el yeso oclusivo. Tesis de grado "Meritoria". 1945. Presentada por Julio Durán Tavera / Tratamiento del varicocele por la ligadura alta de las venas espermáticas. Tesis de grado. 1945. - Presentada por Rodrigo Durán Cordovez.

Spontaneous tilting after placement of the gunther-tulip inferior vena caval filter: a case report

Energy Technology Data Exchange (ETDEWEB)

Seo, Tae Seok; Cha, In Ho; Seol, Hae Young; Park, Cheol Min [Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

2006-10-15

Tilting of a deployed filter in the inferior vena cava (IVC) is a particular kind of periprocedural complication and this can reduce the filter's clot-trapping ability and increase the occlusion of the IVC at a later period. The authors report here on a case of spontaneous tilting of an inferior vena caval filter that was associated with thrombosis in the IVC within 2 weeks of the initially successful placement of the filter without tilting.

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

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

Detección por reacción en cadena de la polimerasa de transcriptasa inversa del virus de la fiebre amarilla en monos silvestres: una herramienta sensible para la vigilancia epidemiológica

Directory of Open Access Journals (Sweden)

Jairo A. Méndez

2007-09-01

Conclusión. El hallazgo del virus de la fiebre amarilla en monos silvestres representa una evidencia de su actividad enzoótica en nuestro territorio, que incrementa el riesgo de transmisión a humanos y de urbanización por procesos de migración de la población.

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.

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

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

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.

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.)

ABLANDAMIENTO DE FRUTOS DE PITAYA AMARILLA (Acanthocereus pitajaya A TEMPERATURA AMBIENTE Y EN REFRIGERACIÓN: ACTIVIDAD DE POLIGALACTURONASA, CELULASA Y XILANASA

Directory of Open Access Journals (Sweden)

Yenny Maritza Dueñas

2012-05-01

Full Text Available Una de las mayores causas de pérdidas poscosecha de frutos de pitaya amarilla es su ablandamiento excesivo, el cual ha sido documentado previamente cuando la fruta es almacenada a temperaturas de cosecha o después de refrigeración. Además, tratamientos de choque térmico antes del almacenamiento refrigerado ofrecen control en el ablandamiento de estos frutos. Diferentes experimentos fueron llevados a cabo para evaluar el papel de algunas enzimas degradadoras de pared celular en el ablandamiento de frutos de pitaya amarilla: almacenamiento a 18 °C (TA y refrigeración con choque térmico previo (ChT-R. Se incluyó también un tratamiento refrigerado control, sin choque térmico (control-R. Si midió el color de la corteza, la firmeza y las actividades de poligalacturonasa (PG, celulasa (CEL y xilanasa (XIL. La evaluación del color indicó que los frutos almacenados a TA alcanzaron su madurez comercial luego de seis días. Luego de 12 días de almacenamiento a TA el pardeamiento y ablandamiento excesivo afectaron negativamente la calidad de los frutos. El pardeamiento y ablandamiento excesivo fueron detectados también en los frutos control-R cuando se movieron de 2 a 18°C. Un ligero pardeamieno fue observado en los frutos ChT-R. Estos frutos alcanzaron su madurez comercial luego de 24 días de almacenamiento (9 días luego de terminado el almacenamiento refrigerado. La actividad de XIL se asoció al ablandamiento en los frutos almacenados a TA y ChT-R. No se observó una clara correlación entre las actividades de PG y el ablandamiento, como tampoco entre CEL y el ablandamiento.

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 ...

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

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)

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...

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.

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.

Leonardo da Vinci and Kethem-Kiveris vena.

Science.gov (United States)

Dolezal, Antonín; Skorepova-Honzlova, Zita; Jelen, Karel

2012-01-01

In the drawing of coitus by Leonardo da Vinci are pictured the contemporary hypotheses regarding this act. The authors analyze the mamillaruteral connection depicted by the artist and grow up to believe that this is a hypothetical kiveris vena, female vein described by Anatomist Master Nicolai Physicus from the Salerno School. The Hebrew roots were found in the name. The connection is described also by Mondino in The Anathomia. The same connection can be found in the picture of the pregnant woman in Fasciculus Medicinæ by Johannes De Ketham.

Epidemiología molecular de la fiebre amarilla en Colombia: análisis filogenético

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Jorge Boshell

2004-03-01

Full Text Available

El virus de la fiebre amarilla pertenece a la familia Flaviviridae, género Flavivirus, y es el responsable de una enfermedad hemorrágica aguda que aún hoy en día afecta a más de 200.000 personas al año en regiones tropicales de África y Suramérica. El virus puede ser transmitido de un humano infectado a un humano susceptible por el mosquito doméstico Aedes aegypti o de primates no humanos a primates humanos por vectores selváticos, principalmente del género Haemagogus spp. (1-5. La infección con el virus puede ser asintomática o cursar con fiebre moderada en 40% a 65% de los pacientes, hasta convertirse en una infección fatal fulminante caracterizada por postración, daño hepático, renal, cardíaco y choque en 35-60% de los casos; la letalidad en casos graves varía entre 20% y 50%.(1-2.

Aunque el virus puede ser detectado mediante técnicas serológicas (MAC-ELISA o virológicas (aislamiento viral en células o en ratón (1,6, estos sistemas no ofrecen ninguna información acerca del origen epidemiológico de las cepas analizadas, ni ponen en evidencia relaciones genéticas inter-cepa; por esta razón y para mejorar la sensibilidad de la clasificación viral, hemos realizado un análisis filogenético de las cepas del virus fiebre amarilla que han circulado en nuestro país y que han generado brotes epidémicos durante el último año.

Se procesaron 20 muestras de pacientes (incluyendo suero y tejido hepático con diagnóstico previo de fiebre amarilla, obtenidas entre el 1º de junio de 2003 y el 20 de enero de 2004 y 4 muestras obtenidas entre 1954 y 1973, las cuales fueron tratadas con Trizol LS para la extracción del ARN; mediante RT-PCR utilizando iniciadores previamente reportados (6, se amplificaron

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

Cavernoma de la vena porta: Descripción de casos clínicos pediátricos

OpenAIRE

Maurente, Lucía; García, Ma Lucila; Machado, Karina; López, Carola; Montano, Alicia

2012-01-01

Resumen La cavernomatosis portal es una patología poco frecuente causada por la trombosis de la vena porta. Es la principal causa de hipertensión portal en niños. La causa muchas veces no se identifica, pudiendo reconocerse factores predisponentes, entre los cuales los más frecuentes son el cateterismo de la vena umbilical y la onfalitis. Se manifiesta a través de sus complicaciones: hemorragia digestiva alta por várices esofágicas y esplenomegalia. El diagnóstico se confirma con ecografía ab...

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.

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

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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

Optional inferior vena caval filters: where are we now?

LENUS (Irish Health Repository)

Keeling, A N

2008-08-01

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

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.

Primitive neuroectodermal tumour of the kidney with vena caval and atrial tumour thrombus: a case report

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Ong Poh

2008-08-01

Full Text Available Abstract Introduction Renal primitive neuroectodermal tumour is an extremely rare malignancy. Case presentation A 21-year-old woman presented with microscopic haematuria, a palpable right loin mass, dyspnoea, dizziness and fatigue. Initial ultrasound scan of the kidneys revealed an 11 cm right renal mass with venous extension into the inferior vena cava. Computed tomography of the thorax and abdomen revealed an extension of the large renal mass into the right renal vein, inferior vena cava and up to the right atrium. A small paracaval lymph node was noted and three small metastatic nodules were identified within the lung parenchyma. The patient underwent a radical nephrectomy and inferior vena caval tumour (level IV thrombectomy with cardiopulmonary bypass and deep hypothermic circulatory arrest. Immunohistochemical staining of the specimen showed a highly specific cluster of differentiation (CD 99, thus confirming the diagnosis of a primitive neuroectodermal tumour. Conclusion It is important that a renal primitive neuroectodermal tumour be considered, particularly in young patients with a renal mass and extensive thrombus.

[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.

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...

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.

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

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Luís Marcelo Inaco Cirino

2005-12-01

Full Text Available A veia cava superior é formada pela união das duas veias inominadas, direita e esquerda, e localiza-se no mediastino médio, à direita da artéria aorta e anteriormente à traquéia. A síndrome da veia cava superior representa um conjunto de sinais (dilatação das veias do pescoço, pletora facial, edema de membros superiores, cianose e sintomas (cefaléia, dispnéia, tosse, edema de membro superior, ortopnéia e disfagia decorrentes da obstrução do fluxo sanguíneo através da veia cava superior em direção ao átrio direito. A obstrução pode ser causada por compressão extrínseca, invasão tumoral, trombose ou por dificuldade do retorno venoso ao coração secundária a doenças intra-atriais ou intraluminais. Aproximadamente 73% a 97% dos casos de síndrome da veia cava superior ocorrem durante a evolução de processos malignos intratorácicos. A maioria dos pacientes com a síndrome secundária a neoplasias malignas é tratada sem necessidade de cirurgia, através de radioterapia ou quimioterapia, ou através da colocação de stents endoluminais. Quando a síndrome é de etiologia benigna, o tratamento é feito através de medidas clínicas (anticoagulação, elevação da cabeça, etc. ou, em casos refratários, através de angioplastia, colocação de stents endoluminais e cirurgia.The superior vena cava is formed by the union of the right and left brachiocephalic veins. It is located in the middle mediastinum, to the right of the aorta and anterior to the trachea. Superior vena cava syndrome consists of a group of signs (dilation of the veins in the neck, facial swelling, edema of the upper limbs, and cyanosis and symptoms (headache, dyspnea, cough, orthopnea and dysphagia caused by the obstruction of blood flow through the superior vena cava to the right atrium. This obstruction can be caused by extrinsic compression, tumor invasion or thrombosis. Such obstruction may also occur as a result of insufficient venous return

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.

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.

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

Energy Technology Data Exchange (ETDEWEB)

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.)

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.

Epidemiologia de la fiebre amarilla selvática en Colombia durante los últimos años

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Jorge Boshell Manrique

1944-08-01

Full Text Available La primera manifestación de Fiebre Amarilla Selvática en los Llanos Orientales de Colombia se registro en agosto de 1934 en forma de un brote epidémico en la vecindad de la población de Restrepo, y se prolongó hasta febrero de 1935 (1. En la segunda mitad del mismo año la enfermedad apareció en los alrededores de Villavicencio y Acacías; en los últimos meses de 1936 se registraron casos en las tres regiones. Nuevas manifestaciones se presentaron en 1937 en el curso inferior de los ríos correspondientes a tales regiones, seguidas por un silencio que se prolongó hasta 1940, año en que principió el brote actual. No hubo explicación satisfactoria respecto al origen del brote de 1934. Era evidente que la infección atacaba de preferencia a los peones que trabajaban en el bosque. En ningún sitio de toda esa región, a pesar de larga y cuidadosa búsqueda, fue posible encontrar larvas o adultos de Aedes aegypti.

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

A mortality study of the last outbreak of yellow fever in Barcelona City (Spain in 1870 Estudio de la mortalidad del último brote de fiebre amarilla en la ciudad de Barcelona (España en 1870

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Jaume Canela Soler

2009-08-01

Full Text Available Background: The last outbreak of yellow fever in the city of Barcelona, Spain, was caused by a ship arriving from Cuba. The objective of this study was to describe and analyze the epidemic of 1870 by using the available mortality data. Methods: The information on 1,235 deaths identified in the parochial registries was analyzed, using statistical and epidemiological procedures for epidemic outbreaks. Results: Mortality due to yellow fever was 549.7 per 100,000 inhabitants. The temporal distribution of the deaths showed two peaks at the end of September and October with the last fatalities occurring in December 1870. The distribution of the fatalities in the city's neighborhoods was unequal. In La Barceloneta, in particular, more fatalities were found in the streets adjacent to the port than in the most remote streets (r=0.83; pObjetivo: El último brote de fiebre amarilla en la ciudad de Barcelona, España, se originó a partir de un barco que venía de Cuba. El objetivo de este estudio es describir y analizar esa epidemia ocurrida en 1870, utilizando los datos disponibles de mortalidad. Métodos: La información de las 1235 defunciones identificadas en los registros parroquiales se ha analizado utilizando los procedimientos estadísticos y epidemiológicos para brotes epidémicos. Resultados: La tasa de mortalidad por fiebre amarilla fue de 549.7 por 100,000 habitantes. La distribución temporal de las muertes tenía dos modas en el final de septiembre y octubre, y los últimos muertos ocurrieron en diciembre de 1870. La distribución de las defunciones según los barrios de la ciudad fue desigual. En La Barceloneta, en particular, hubo mas muertos en las calles adyacentes al puerto que en las más lejanas (r=0,83; p<0,0001. Conclusiones: Este estudio muestra una distribución bimodal de la mortalidad por fiebre amarilla durante el brote, con un impacto alto en hombres adultos, y en el barrio de La Barceloneta.

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.

Extreme premature with persistent left superior vena cava.

Science.gov (United States)

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.

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...

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.

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

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.

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

Energy Technology Data Exchange (ETDEWEB)

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)

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.

La arteria radial puede ser una alternativa a la vena safena

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Oscar Gil-Albarova

2011-10-01

Full Text Available La arteria radial se ha propuesto como alternativa a la vena safena en cirugía de revascularización miocárdica con el objetivo de mejorar la permeabilidad a largo plazo de los injertos. Se analizan los datos provenientes de los estudios prospectivos aleatorizados y los de trabajos retrospectivos con gran número de pacientes y seguimiento a largo plazo.

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.

Ablación por radiofrecuencia de vía anómala en paciente con agenesia de la vena cava inferior

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Carlos A. Gómez

2015-05-01

Full Text Available Describimos un caso de una paciente de sexo femenino de 55 años de edad a quien se le diagnosticó síndrome de Wolff-Parkinson-White, y al ser llevada al procedimiento de ablación se le encuentra agenesia de la vena cava inferior, con continuidad hacia las cavidades cardiacas derechas a través de la vena ácigos. La realización posterior del procedimiento a través de dicha vena se consideró exitosa, pero ante la recurrencia de las alteraciones electrocardiográficas y nuevos episodios de taquicardia se le realizó nuevo estudio electrofisiológico y ablación por vía yugular interna derecha con éxito. Presentamos además una revisión de la literatura sobre este tópico.

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

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)

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.

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.

Estudio de un brote epidémico de fiebre amarilla selvática en el pie de monte de La Sierra Nevada de Santa Marta, 1979

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Hernando Vidales

1981-12-01

Full Text Available En 1979 se observó en Colombia una epidemia de fiebre amarilla selvática, en las estribaciones más bajas de la Sierra Nevada de Santa Marta, donde nunca antes se había registrado la enfermedad. Los casos ocurrieron en las cercanías de las ciudades de Valledupar y Santa Marta, por entonces infestadas con Aedes aegypti .Veinte de ellos fueron confirmados por examen histopatológico de hígado o por aislamiento de virus y en otros 36 se hizo un diagnóstico de presunción, con base en estudios clínicos, epidemiológicos y serológicos. Entre los primeros hubo 14 defunciones y entre los segundos 13. En las localidades urbanas del Brea se llevaron a cabo intensas campañas de lucha contra el A. aegyptiy de vacunación. No se registraron casos urbanos de la enfermedad. Los enfermos se infectaron en bosques estrechos de galería y en cafetales. donde previa y paralelamente se observó mortalidad en monos í Alouatta seniculus. El reconocimiento entomológico mostró en la región la presencia de 3 especies de Haemagogus, entre ellas H. janthinomys Con 745 mosquitos se hicieron 192 mezclas para intentar aislamiento de virus, habiéndose obtenido sólo uno positivo para fiebre amarilla, a partir de H. janthinomys. La epidemia descrita es un ejemplo mBs de la invasión del virus amarílico a nuevos "habitats" rurales,  con la consiguiente amenaza para las ciudades vecinas infestadas con A. aegypti, el riesgo de la urbanización del virus, lo cual exige la adopción inmediata de medidas para abatir el mosquito y para vacunar a la población expuesta.

Breast varices: imaging findings of an unusual presentation of collateral pathways in superior vena caval syndrome

International Nuclear Information System (INIS)

Oezdemir, Ayseguel; Ilgit, Erhan T.; Konus, Oeznur L.; Cetin, Meltem; Oezsunar, Yelda

2000-01-01

Imaging findings are presented of an unusual pathway of collateral circulation consisting of bilateral and diffuse dilated breast veins from a patient with long standing superior vena caval syndrome. The main importance of this case is the extent of the collateral development through the breast veins, serving as the major pathway of collateral circulation. Identification of this unusual collateral development, which resembles breast varices, was performed with contrast-enhanced chest CT scans, digital subtraction venography, color Doppler ultrasonography, and mammographic studies. Collateral development was secondary to a long segment idiopathic venous occlusion involving bilateral subclavian and brachiocephalic veins as well as vena cava superior. We conclude that dilated breast veins when detected on any imaging modality should raise the suspicion of central venous obstruction

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

Monorail system for percutaneous repositioning of the Greenfield vena caval filter.

Science.gov (United States)

Guthaner, D F; Wyatt, J O; Mehigan, J T; Wright, A M; Breen, J F; Wexler, L

1990-09-01

The authors describe a technique for removing or repositioning a malpositioned Greenfield inferior vena caval filter. A "monorail" system was used, in which a wire was passed from the femoral vein through the apical hole in the filter and out the internal jugular vein; the wire was held taut from above and below and thus facilitated repositioning or removal of the filter. The technique was used successfully in two cases.

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.

Caracterización genética del virus de la fiebre amarilla proveniente de un brote icterohemorrágico en una comunidad nativa del distrito de Imaza, Amazonas, 2005

OpenAIRE

Yábar, Carlos; Mamani, Enrique

2006-01-01

La fiebre amarilla (FA) sigue siendo una enfermedad de importancia en salud pública en el mundo a pesar de la existencia de una vacuna eficaz (WHO, 2005). En Sudamérica, el Perú fue uno de los países que registró el mayor número de casos de FA durante el 2004 (WHO, 2005), contando con zonas endémicas que se extienden desde la selva norte hacia la selva central. Recientemente, en diciembre de 2005 la Dirección de Salud (DISA) de Bagua tomó conocimiento de un brote icterohemorrágico en la co...

Análisis genético del virus peruano de la fiebre amarilla

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Carlos Yábar V

2002-01-01

Full Text Available Objetivo: Determinar las variantes genéticas de aislamientos del virus peruano de la Fiebre Amarilla (FA. Materiales y métodos: la región carboxiterminal del gen de la envoltura (E de cinco aislamientos de FA obtenidas de pacientes provenientes de Ayacucho 1978 (PER1, Junín 1995 (PER2, Cerro de Pasco (PER3, Cusco (1998 y San Martín (1999 fue amplificada por PCR, secuenciada y analizada con programas software de ADN. Resultados: el índice de similaridad de la secuencia de nucleótidos entre los cinco aislamientos reveló valores oscilantes entre 94,3% y 99,3%, mientras que la secuencia de aminoácidos presentó valores entre 97,6% y 99,7% de similaridad. El análisis filogenético demostró una distancia genética entre 0,40 y 6,50 mediante la secuencia de nucleótidos y a través de la secuencia de aminoácidos se observó un rango de 0,30 y 4,29. Sin embargo, las secuencias correspondientes a los sitios de glicosilación y a los epítopes de reconocimiento humoral fueron conservadas entre los cinco aislamientos, con excepción de algunos aislamientos de referencia reportados por otros autores. Conclusiones: los virus de FA peruanos forman un grupo filogenético distinto a otros virus de FA sudamericanos, basados en el análisis genéticos del gen E.

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)

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

International Nuclear Information System (INIS)

Pellerin, O.; Barral, F. G.; Lions, C.; Novelli, L.; Beregi, J. P.; Sapoval, M.

2008-01-01

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

Lugares, actitudes y momentos durante la peste: representaciones sobre la fiebre amarilla y el cólera en la ciudad de Buenos Aires, 1867-1871

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Maximiliano Ricardo Fiquepron

Full Text Available Resumen El objetivo de este trabajo es analizar las distintas representaciones que sobre la salud y la enfermedad se asociaron con las epidemias de fiebre amarilla y cólera durante el período 1867-1871 en la ciudad de Buenos Aires. El argumento es que existió un repertorio muy amplio y heterogéneo de representaciones que se condensó en variadas actitudes individuales con la cual se enfrentó la crisis, así como una transformación del espacio y del tiempo social. Para poder sobrellevar esta experiencia traumática se buscó de maneras muy diversas mantener un vínculo social que era también al mismo tiempo una forma de mantener la salud.

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. ...

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.)

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

CT findings of superior vena cava syndrome

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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%).

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

Multiplicación de Selenicereus megalanthus (pitahaya amarilla e Hylocereus polyrhizus (pitahaya roja vía organogénesis somática

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Rocío Stella Suárez Román

2014-09-01

Full Text Available Pitahaya amarilla (Selenicereus megalanthus y roja (Hylocereus polyrhizus se multiplicaron vía organogénesis somática, a partir de hojas cotiledonares y fragmentos de cladodio provenientes de plántulas con 20 días de desarrollo, en medio Murashige & Skoog (MS suplementado con auxinas (ANA y citocininas (Kinetina y BAP. En el medio de cultivo M3 (BAP + Kinetina 2 mg/l se obtuvieron entre cuatro y nueve brotes enraizados de 4 cm de longitud, en un periodo de 30 días. En pitahaya roja se desarrolló mayor número de brotes. En todos los medios estudiados se observó formación de callo, siendo más alto el número en el medio con altas concentraciones de ANA. Las vitroplantas en fase de climatización alcanzaron 100% de sobrevivencia y presentaron respuestas diferenciales al sustrato empleado.

[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.

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.

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.

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.

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.

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.

El veneno y el mosquito: aspectos epistemológicos de la etiología y la profilaxis de la fiebre amarilla Poison and the mosquito: epistemological aspects of the etiology and prophylactics of yellow fever

OpenAIRE

Sandra Caponi

2000-01-01

En el II Congreso Médico Latinoamericano (Buenos Aires, 1904) se discutieron las estrategias que Argentina y Brasil delinearon para combatir la fiebre amarilla. El análisis de la controversia entre sanitaristas brasileños y argentinos en torno a los modelos explicativos y a las estrategias de profilaxis internacional de esa enfermedad, nos permite una comprensión epistemológica de la ruptura operada por la emergencia de la medicina de los vectores. Este capítulo de la historia de la medicina ...

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.

De miasmas a mosquitos: el pensamiento médico sobre la fiebre amarilla en Yucatán, 1890-1920 From miasmas to mosquitoes: medical thought on yellow fever in Yucatan, 1890-1920

OpenAIRE

Carlos Alcalá Ferráez

2012-01-01

La fiebre amarilla fue un problema de salud pública desde la época colonial debido a la frecuencia con que se presentaba en forma epidémica y a su alta letalidad. El objetivo de este trabajo es analizar el pensamiento médico y su evolución con respecto al vómito prieto entre 1890 y 1921 en Yucatán. Dos aspectos serán abordados: algunos antecedentes con respecto a la enfermedad y las ideas predominantes hasta 1881; y la propuesta de Carlos Finlay para vencer el escepticismo ante su teoría por ...

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.

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

International Nuclear Information System (INIS)

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

International Nuclear Information System (INIS)

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.)

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.

Un análisis retrospectivo de cavernomatosis de la vena porta en Chile.: I. Perfil clínico y de laboratorio

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Harris D., Paul; Brinck M., Patricio

1999-01-01

Resumen Objetivo: evaluar el perfil clínico de la cavernomatosis de la vena porta en la población chilena, en especial los factores clínicos y de laboratorio útiles para el diagnóstico precoz. Pacientes y métodos: se analizaron los antecedentes demográficos, clínicos, perinatales y exámenes de laboratorio de 34 pacientes con cavernomatosis de la vena porta. Resultados: la edad al momento del diagnóstico fue de 3,4 ± 2,8 años (x ± 1 DE). La hemorragia digestiva y la esplenomegalia fueron las p...

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

Directory of Open Access Journals (Sweden)

Rafael Demarchi Malgor

2008-06-01

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

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

International Nuclear Information System (INIS)

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.)

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

Superior vena thrombosis with peripartum dilated cardiomyopathy

International Nuclear Information System (INIS)

Munir, R.; Hussain, S.; Kayani, A.M.

2014-01-01

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

Endovascular Repair of a Perforation of the Vena Caval Wall Caused by the Retrieval of a Gunther Tulip Filter After Long-Term Implantation

International Nuclear Information System (INIS)

Morishita, Hiroyuki; Yamagami, Takuji; Matsumoto, Tomohiro; Takeuchi, Yoshito; Sato, Osamu; Nishimura, Tsunehiko

2011-01-01

Symptomatic penetration of the inferior vena cava (IVC) wall reportedly occurs in 0.3% of patients in whom a filter has been implanted, and it causes injury to the adjacent structures (Bogue et al. in Pediatr Radiol 39(10):1110–1113, 1; Brzezinski et al. in Burns 32(5):640–643, 2). We succeeded in the endovascular repair of perforation of the IVC wall occurring during the retrieval of a penetrated Gunther tulip vena cava filter (Cook, Bjaeverskov, Denmark) after long-term implantation.

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.

Science.gov (United States)

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

'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)

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

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Gustavo J. Ventura Couto

2008-03-01

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

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

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

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

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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.

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.)

Incidencia del modelo de otorgamiento de cartera en la gestión del riesgo de crédito de la cooperativa de ahorro y crédito Bola Amarilla de la ciudad de Ibarra

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Ayala Pupiales, Sandra Maribel

2017-01-01

Evaluar la incidencia del modelo de otorgamiento de cartera en la gestión del riesgo de crédito de la cooperativa de ahorro y crédito Bola Amarilla de la ciudad de Ibarra. El presente trabajo proporciona estrategias, políticas y procedimientos con el fin de dar cumplimiento a las resoluciones emitidas por el órgano de supervisión y control para las cooperativas de ahorro y crédito Superintendencia de Economía Popular y Solidaria del Ecuador y la Junta Política de Regulación Financiera y Mo...

Reversal of flow in the inferior vena cava and hepatic veins on dynamic CT

International Nuclear Information System (INIS)

Lelij, H. van der; Mallens, W.M.C.

1988-01-01

A tricuspid insufficiency may not be clinically evident and may remain unknown to the clinician. The phenomenon of a reversal of inferior vena caval blood flow and hepatic veins is known to occur in tricuspid regurgitation from right ventricular angiography and duplex scanning. Demonstration of such a reversal flow on a dynamic CT scan, as in our case, has, to our knowledge, not as yet been reported

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

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.

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)

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.

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

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

2001-07-01

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

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

Evaluación de un método inmunohistoquímico para el diagnóstico de la fiebre amarilla

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Orlando Ricaurte

1993-03-01

Full Text Available La confirmación diagnóstica de casos fatales de fiebre amarilla (FA es esencial en los programas de vigilancia epidemiológica de la entidad, en regiones endémicas. Se evaluó un método inmunohistoquímico para la detección de antígeno viral de FA en cortes de tejido fijados en formo1 e incluidos en parafina. Aplicamos el procedimiento a 59 casos, con criterios clínico-patológicos y epidemiológicos de FA, dos de ellos con aislamiento viral, ocurridos en Colombia entre 1934 y 1992, incluyendo casos típicos y tardíos. La sensibilidad del método fue del 98,30% : 58 casos fueron positivos mientras que un caso con importantes cambios de autólisis fue negativo. Por Otra parte, se seleccionaron 10 hígados con patologías diferentes, incluyendo 4 con hepatitis fulminante por coinfección de virus de la hepatitis B y delta, ninguno de los cuales mostró inmunorreactividad (especificidad: 100%. Estos resultados indican que este método es un recurso útil para la confirmación del diagnóstico histopatológico de la FA.

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)

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.

Síntesis in vitro de la proteína de la envoltura del virus peruano de la fiebre amarilla

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Carlos Yábar V

2001-01-01

Full Text Available Objetivo: Sintetizar la proteína recombinante de la envoltura (Er del virus peruano de la Fiebre Amarilla (FA utilizando técnicas moleculares. Materiales y métodos: El gen de la proteína de interés fue amplificado por transcripción reversa - reacción en cadena de la polimerasa (RT-PCR y clonado en un vector plasmídico para ser analizado mediante secuenciamiento de ADN. El inserto de ADN fue subdonado en un vector de expresión para ser traducido a proteína. Se purificó la proteína mediante cromatografía de afinidad bajo condiciones denaturantes, siendo visualizada por electroforesis en SDS-PAGE. Resultados: Se sintetizó y purificó la pr E del virus de la FA. Presentó un peso de 66 kDa, y luego de tres horas de inducción a partir de 1x108 células (OD=0.5 se obtuvo 10 mg/mL de la proteína a miniescala. Conclusión: El análisis de la secuencia de aminoácidos demostró que Er podría ser un buen candidato a ser evaluado serológicamente y luego ser usado como herramienta de diagnóstico específico para la FA.

Renal angiomyolipoma with inferior vena caval thrombus in a 32-year-old male

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Matthew W Christian

2009-01-01

Full Text Available Renal angiomyolipoma (AML rarely presents with evidence of extension into the renal vein, inferior vena cava (IVC or atrium. We report a case of a renal AML with a tumor thrombus to the IVC in a 32-year-old male. The patient subsequently underwent a right radical nephrectomy with IVC tumor thrombectomy. To our knowledge, there are four published cases of renal AML presenting with tumor thrombus in males. This case report describes the management of the youngest male ever to develop a renal AML with IVC tumor thrombus.

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.)

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

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Radeleff Boris

2008-10-01

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

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.

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.

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 ...

Aspectos críticos do controle da febre amarela no Brasil Aspectos críticos del control de la fiebre amarilla en Brasil Critical aspects of yellow fever control in Brazil

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Pedro Luiz Tauil

2010-06-01

Full Text Available São apresentados aspectos epidemiológicos e do controle da febre amarela no Brasil, considerando os ciclos de transmissão silvestre e urbano. Sem registros de transmissão no Brasil desde 1942, houve casos de febre amarela urbana em 2008 no Paraguai, depois de mais de 50 anos sem essa ocorrência nas Américas. A redução do número dos casos silvestres e a manutenção da eliminação dos casos urbanos são os dois principais objetivos do controle da febre amarela no Brasil. Embora haja consenso quanto às medidas que devem ser tomadas nas áreas endêmicas para a forma silvestre, isso não ocorre em relação às áreas infestadas pelo Aedes aegypti. São discutidos argumentos favoráveis e contrários à expansão da área de vacinação. Há necessidade de estudos ambientais e entomológicos para o reconhecimento de áreas receptivas para transmissão silvestre, mesmo que estejam silentes há muitos anos.Se presentan aspectos epidemiológicos y del control de la fiebre amarilla en Brasil, considerando los ciclos de transmisión silvestre y urbana. Sin registros de transmisión en Brasil desde 1942, hubo casos de fiebre amarilla urbana en 2008 en Paraguay, después de más de 50 años sin ocurrir en las Américas. La reducción del número de casos silvestre y el mantenimiento de la eliminación de los casos urbanos son los dos principales objetivos del control de la fiebre amarilla en Brasil. A pesar de que exista consenso con respecto a las medidas que deben ser tomadas en las áreas endémicas para la forma silvestre, esto no ocurre con relación a las áreas infestadas por el Aedes aegypti. Son discutidos argumentos favorables y contrarios a la expansión del área de vacunación. Hay necesidad de estudios ambientales y entomológicos para el reconocimiento de áreas receptivas para transmisión silvestre, aunque se encuentren silentes desde hace muchos años.This paper presents epidemiological and control characteristics of yellow

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...

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)

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)

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.

[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.

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

Agenesia de veia cava inferior associada à trombose venosa profunda Agenesis of inferior vena cava associated with deep venous thrombosis

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Clovis Luis Konopka

2010-09-01

Full Text Available A agenesia da veia cava inferior é uma anomalia congênita rara, que foi recentemente identificada como um importante fator de risco para o desenvolvimento e a recorrência de trombose venosa profunda de membros inferiores em jovens. O objetivo deste trabalho foi relatar o caso de uma paciente que apresentou trombose venosa profunda dois meses após a realização de cirurgia de varizes. A angiotomografia computadorizada demonstrou a presença de anomalia venosa complexa com ausência da veia cava inferior.The agenesis of the inferior vena cava is a rare congenital anomaly, which was recently identified as an important risk factor for the development and recurrence of deep venous thrombosis especially in young people. The goal of this work was to report the case of a patient who presented deep venous thrombosis approximately two months after varicose vein surgery. The computerized angiotomography demonstrated the presence of a complex venous anomaly with absence of the inferior vena cava.

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

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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.

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

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

Análisis de los compuestos volátiles de la ciruela amarilla (Prunus domestica L. ssp. domestica

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Yineth Ruiz

2011-01-01

Full Text Available El aroma de las frutas se debe a los constituyentes volátiles presentes que, aunque se encuentran en muy bajas concentraciones, contribuyen al aroma global en grados muy diversos. Se hace necesario usar técnicas de aislamiento y concentración que garanticen el análisis de una composición química semejante a la de la fruta. Este trabajo tuvo como objetivo el análisis de los compuestos volátiles de la ciruela amarilla (Prunus domestica L. ssp. domestica por el método de evaporación del aroma asistida por solvente (SAFE. Este método utiliza un equipo de destilación conectado a una bomba de alto vacío que ofrece la posibilidad de aislar rápidamente compuestos volátiles sin daño térmico en diferentes matrices alimentarias. La separación e identificación de los compuestos volátiles se realizó por cromatografía de gases-espectrometría de masas (GC-MS. Se identificaron 47 compuestos (6,55 mg/kg de pulpa de fruta, entre ellos 14 alcoholes, 8 aldehídos, 7 ésteres, 5 cetonas, 4 ácidos carboxílicos, 4 hidrocarburos aromáticos, 3 lactonas, un compuesto azufrado y una hidroxicetona; 16 de ellos se informan por primera vez. El acetato de etilo (2,88 mg/kg, etanol (1 mg/kg y ácido octanoico (0,78 mg/kg fueron los constituyentes volátiles mayoritarios de esta variedad de ciruela.

Análisis de los compuestos volátiles de la ciruela amarilla (Prunus domestica L. ssp. domestica

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Yineth Ruiz

2011-06-01

Full Text Available El aroma de las frutas se debe a los constituyentes volátiles presentes que, aunque se encuentran en muy bajas concentraciones, contribuyen al aroma global en grados muy diversos. Se hace necesario usar técnicas de aislamiento y concentración que garanticen el análisis de una composición química semejante a la de la fruta. Este trabajo tuvo como objetivo el análisis de los compuestos volátiles de la ciruela amarilla (Prunus domestica L. ssp.domestica por el método de evaporación del aroma asistida por solvente (SAFE. Este método utiliza un equipo de destilación conectado a una bomba de alto vacío que ofrece la posibilidad de aislar rápidamente compuestos volátiles sin daño térmico en diferentes matrices alimentarias. La separación e identificación de los compuestos volátiles se realizó por cromatografía de gases-espectrometría de masas (GC-MS. Se identificaron 47 compuestos (6,55 mg/kg de pulpa de fruta, entre ellos 14 alcoholes, 8 aldehídos, 7 ésteres, 5 cetonas, 4 ácidos carboxílicos, 4 hidrocarburos aromáticos, 3 lactonas, un compuesto azufrado y una hidroxicetona; 16 de ellos se informan por primera vez. El acetato de etilo (2,88 mg/kg, etanol (1 mg/kg y ácido octanoico (0,78 mg/kg fueron los constituyentes volátiles mayoritarios de esta variedad de ciruela.

Dinámica de mesoescala y capturas de atún aleta amarilla en el Pacífico mexicano

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2005-01-01

Full Text Available Se usaron datos de captura de la pesquería de atún aleta amarilla (AAA para estudiar la relación entre la variación estacional y espacial del AAA con la presencia/ausencia de estructuras de mesoescala en la entrada al Golfo de California (19º–24ºN y 104º–112ºW. Las capturas de AAA están distribuidas sobre el talud continental, alrededor de islas y montes submarinos la mayor parte del año. Altas concentraciones de lances ocurren alrededor de las islas Marías y Cabo Corrientes a lo largo del año, particularmente en marzo y junio. En febrero y abril se encontró un flujo de agua caliente (>28ºC con un ancho de 1.5 radios de Rossby (~20.6 km que cubre toda la plataforma continental fuera de Cabo Corrientes. Su velocidad media es 0.31 m s–1 y se extiende al norte del bajo Roca Corbetera. La interacción con el agua fría genera una zona frontal alrededor de la cual se concentran las capturas de AAA. En contraste, durante marzo se observó una región de surgencia costera con temperatura superficial del mar de 18ºC, con un ancho de 3.7 radios de Rossby hacia fuera de la costa y cubriendo 2600 km2. Las capturas de AAA ocurren en agua caliente, hacia el norte de la zona de surgencia.

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

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

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

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Valary T. Raup

2015-01-01

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

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.

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.

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.

Estandarización de un protocolo de regeneración en pitahaya amarilla (Selenicereus megalanthus (K. Schum. ex Vaupel Moran

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Diego Geraldo Caetano Nunez

2014-01-01

Full Text Available A partir de meristemos axilares (aréolas cultivados en medio MS (Murashige y Skoog se estandarizó un protocolo de regeneración in vitro vía organogénesis indirecta en pitahaya amarilla (Selenicereus megalanthus. Se ensayaron tres concentraciones de 2,4-D (2.26, 3.26 y 4.26 µM y 2,4-D suplementado con 6-BAP al 2.21 µM; y tres concentraciones de TDZ (200, 300 y 400 µM o TDZ con 6-BAP, para un total de 12 tratamientos. Las condiciones de crecimiento evaluadas incluyeron el uso de luz (fotoperiodo de 16/8 y oscuridad (0/24. El 2,4-D indujo callo, pero la eficiencia en regeneración para la especie fue nula. A su vez, el TDZ o TDZ suplementado con BAP se mostró más eficiente en la inducción de callos compactos, de color verde-morado, con capacidad de regeneración vía organogénesis indirecta. Con el TDZ a 300 µM se observó mayor eficiencia de respuesta, ya que el número de brotes formados por punto de regeneración fue el más alto. Un análisis histológico confirmó la vía de regeneración en S. megalanthus, evidenciando estructuras primordiales características de la formación de brotes a partir de callos.

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.

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

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.

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

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.

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.

Angiographic and hemodynamic evaluation of the mesoatrial shunt in patients with Budd-Chiari syndrome and inferior vena caval obstruction

International Nuclear Information System (INIS)

Redmond, P.L.; Kadir, S.; Cameron, J.L.; Kaufman, S.L.; White, R.I. Jr.

1986-01-01

Obstruction of the inferior vena cava (IVC) is not uncommon in patients with the Budd-Chiari syndrome. The caval obstruction may be due to thrombus or compression by an enlarged caudate lobe. Conventional portosystemic shunts are not possible in the presence of an obstructed IVC; the mesoatrial shunt is indicated in these patients. Between 1973 and 1986, the authors studied 13 patients (ten female, three male) with Budd-Chiari syndrome and IVC obstruction in whom mesoatrial shunts were subsequently constructed. Polycythemia rubra vera was the most common predisposing condition. Preoperative evaluation included US, scintigraphy, CT, and angiography (hepatic arteriography, hepatic venography and pressure measurements, inferior vena cavography, arterial portography). Postoperatively shunts were assessed angiographically and hemodynamically, and several patients underwent CT. The shunts were catheterized via a brachial or femoral venous approach, which allowed pressures along the shunt from the superior mesenteric vein to the right atrium to be measured. The mesoatrial shunt is a relatively new procedure which is indicated in patients with the Budd-Chiari syndrome complicated by IVC obstruction. Shunt patency may be demonstrated arteriographically or with CT, but hemodynamic evaluation with measurement of pressure gradients is required to assess shunt function

Aneurisma de la vena de Galeno como causa de falla cardíaca Galen's vein aneurysm as cause of heart failure

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Claudia Echeverría

2005-04-01

Full Text Available Se presenta el caso de un recién nacido que ingresa a cuidado intensivo con un cuadro de falla cardiaca de difícil manejo con ductus arterioso de gran tamaño, a quien se le realizó cierre quirúrgico del mismo y pese a ello persistía con clínica de falla cardiaca que no mejoraba con tratamiento médico. Se hizo un hallazgo incidental de un aneurisma de la vena de Galeno de gran tamaño. El aneurisma de la vena de Galeno es una patología congénita poco frecuente que se origina de un defecto en la fusión de las venas cerebrales internas, debido a la baja resistencia produce un cuadro de falla cardiaca de alto gasto. Los defectos de gran tamaño pueden contener entre 50% a 60% del gasto cardiaco. Se debe sospechar aneurisma en todo recién nacido o lactante menor con cuadro de falla cardíaca y dilatación de cavidades derechas sin evidencia de anomalía cardíaca estructural.We present the case of a newborn admitted to the intensive care unit with a heart failure of difficult medical management. A large ductus arteriosus was found. It was surgically corrected, but the heart failure persisted and did not improve with medical treatment. Incidentally, a big Galen's vein aneurysm was found. Galen's vein aneurysm is a rare congenital pathology, originated by a fusion defect of the internal cerebral veins. Due to its low resistance, it produces a picture of high-output heart failure. Large defects may contain 50% to 60% of cardiac output. An aneurysm may be suspected in each newborn or infant with clinical picture of heart failure and right cardiac chamber dilation without any evidence of structural cardiac anomaly.

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.

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.

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.

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.

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

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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

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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.

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

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.

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

International Nuclear Information System (INIS)

Kale, A.; Akdeniz, N.A.; Akyildiz, L.; Kale, E.

2006-01-01

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

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

Una rareza bibliográfica escrita en Cuba sobre fiebre amarilla A bibliography rarity on yelow fever written in Cuba

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José Antonio López Espinosa

2004-12-01

Full Text Available Se brinda una síntesis biográfica del cirujano de origen escosés John Holliday Heragod (Juan Tomás José Agustín Domínguez, quien fue el autor de una de las primeras obras escritas en Cuba sobre la fiebre amarilla, y se ofrecen algunas observaciones en relación con el proceso de convalidación de su título ante el Real Tribunal del Protomedicato de La Habana. Se emiten varias consideraciones referentes a las circunstancias que rodearon la redacción en español del citado documento en 1794, su presentación en la Real Sociedad Patriótica de Amigos del País en 1796 y su publicación en inglés fuera de Cuba el mismo año, como elementos para ubicarlo en el lugar adecuado en el contexto de la historia de la bibliografía médica cubanaA brief bibliography on the Scoth surgeon John Holliday Heragod (Juan Tomás José Agustín Domínguez is given. Dr. Heragod was one of the first authors who wrote about the yellow fever in Cuba. Some observations are made concerning the process for validating his diploma at the Real Tribunal del Protomedicato de la Habana. Some considerations are made referring the Spanish equivalent of the document in 1794, its presentation at the Real Sociedad Patriótica Amigos del País in 1794, and its publication in the English languaje outside Cuba in the same year, as well as its palce in the history of the Cuban bibliography on Medicine

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.

Inventario de la entomofauna asociada al cultivo de pitahaya amarilla (Selenicereus megalanthus Haw. en Briceño (Boyacá

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Héctor Iván Patiño-Tiria

2015-04-01

Full Text Available Boyacá es uno de los departamentos con mayor producción de pitahaya amarilla en el país. Los estudios realizados sobre este cultivo son muy pocos, y el conocimiento de la entomofauna asociada a él es un punto de partida para realizar nuevas investigaciones que permitan identificar la entomofauna asociada a este cultivo en el municipio de Briceño (Boyacá. El desarrollo de esta investigación se llevó a cabo en plantaciones de pitahaya en tres fincas del municipio de Briceño (Boyacá. Se realizaron muestreos empleando métodos activos, como captura manual directa, uso de red y aspirador entomológico, y métodos pasivos, como trampas con atrayentes y trampas  de caída. Los insectos colectados se sometieron a cámara letal y luego se montaron en alfileres para su posterior identificación con ayuda del estereoscopio y claves taxonómicas. En las tres fincas se identificaron un total de 9 órdenes y 58 familias, y los órdenes Hymenóptera y Díptera se reportaron con la mayor cantidad de individuos benéficos. En la finca San Pablo se observó la mayor cantidad de insectos; también fue la única en donde se evidenció la presencia de la plaga más limitante para este cultivo, que es Dasiops saltans (mosca del botón floral. La cantidad de familias presentes en los muestreos se ve influenciada más por el manejo agronómico implementado en cada finca que por las variables climatológicas, como temperatura, humedad relativa y precipitación.

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...

Caval penetration by retrievable inferior vena cava filters: a retrospective comparison of Option and Günther Tulip filters.

Science.gov (United States)

Olorunsola, Olufoladare G; Kohi, Maureen P; Fidelman, Nicholas; Westphalen, Antonio C; Kolli, Pallav K; Taylor, Andrew G; Gordon, Roy L; LaBerge, Jeanne M; Kerlan, Robert K

2013-04-01

To compare the frequency of vena caval penetration by the struts of the Option and Günther Tulip cone filters on postplacement computed tomography (CT) imaging. All patients who had an Option or Günther Tulip inferior vena cava (IVC) filter placed between January 2010 and May 2012 were identified retrospectively from medical records. Of the 208 IVC filters placed, the positions of 58 devices (21 Option filters, 37 Günther Tulip filters [GTFs]) were documented on follow-up CT examinations obtained for reasons unrelated to filter placement. In cases when multiple CT studies were obtained after placement, each study was reviewed, for a total of 80 examinations. Images were assessed for evidence of caval wall penetration by filter components, noting the number of penetrating struts and any effect on pericaval tissues. Penetration of at least one strut was observed in 17% of all filters imaged by CT between 1 and 447 days following placement. Although there was no significant difference in the overall prevalence of penetration when comparing the Option filter and GTF (Option, 10%; GTF, 22%), only GTFs showed time-dependent penetration, with penetration becoming more likely after prolonged indwelling times. No patient had damage to pericaval tissues or documented symptoms attributed to penetration. Although the Günther Tulip and Option filters exhibit caval penetration at CT imaging, only the GTF exhibits progressive penetration over time. Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.

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.

Science.gov (United States)

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.

OCTOGESIMO ANIVERSARIO DEL DESCUBRIMIENTO DE LA FIEBRE AMARILLA SELVÁTICA POR EL DOCTOR ROBERTO FRANCO

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Carlos Sanmartín Barberi

1989-09-01

Full Text Available

La reunión que hoy nos congrega en esta sesión conjunta tiene por objeto conmemorar una importante efemérides de la medicina universal y tributar homenaje a la memoria de un excepcional galeno de nuestra patria.

Me permitiré leer una breve comunicación que el 8 de octubre del año pasado dirigí al Presidente de nuestra Academia, pues resume el motivo central de esta ceremonia:
“El año próximo venidero se cumplen ochenta de la trascendental comunicación del Dr. Roberto Franco sobre una epidemia febril que estudió en las Minas de Muzo.
Tal investigación constituye uno de los hitos más importantes de la medicina tropical. Las novedosas conclusiones del Dr. Franco, basadas en un juicioso estudio de campo y en una sagaz observación clínica y epidemiológica, fueron puestas en duda y aún negadas en su época. Sólo el tiempo y las investigaciones posteriores dieron razón a su notable afirmación de la existencia de la fiebre amarilla de los bosques.

Me parece que sería justo y oportuno que la Academia celebre tal aniversario de manera apropiada y que se aproveche la ocasión para exaltar la memoria del que fue, sin duda, una de las figuras cimeras de la medicina nacional”.
Tanto la Academia como nuestra Sociedad histórica, a las que me honro en pertenecer, acogieron favorablemente la sugerencia. Me enaltece sobremanera ser yo quien esta noche las representa.

En el número 331 de Noviembre de 1907 de la Revista Médica de Bogotá, órgano de la Academia Nacional de Medicina, se publicó el informe presentado al Presidente del Sindicato de las Minas de Muzo, por la misión encargada de estudiar la epidemia de fiebres observada en la mina en los meses de Marzo y Abril de 1907. Tal documento tiene fecha del 14 de Mayo del mismo año y está suscrito por el Dr. Roberto Franco, quien deja constancia de la invaluable colaboración de dos de sus estudiantes que le acompañaron a Muzo y que fueron los

Brote de fiebre amarilla selvática en Colombia 2004

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Pilar Bernal M.

2004-03-01

Full Text Available

Antecedentes: el 9 de enero se confirma un caso de fiebre amarilla en la sierra nevada de Santa Marta cuya circulación viral es la continuación de la presentada en el 2003 en la región del Catatumbo. En la región no se confirmaban casos desde el año 1979 y el comportamiento del brote es similar al presentado en dicho año.

Metodología: estudio descriptivo longitudinal de casos captados mediante vigilancia activa comunitaria, estudio de casos y vigilancia pasiva. Los casos son confirmados por IgM, inmunohistoquímica y patología. Se realizaron acciones del fortalecimiento de la vigilancia de febriles icterohemorrágicos, entomológica, vectorial y de epizootias. Igualmente acciones de intensificación de la inmunización de susceptibles y educación a la comunidad.

Resultados: se confirmó la circulación del virus en epizootias ocurridas en tres zonas de la región (Municipios de Valledupar, La Paz y Santa Marta. Por fecha de inicio de síntomas los casos comenzaron en la semana 51 de 2003 y el pico epidémico fue en la semana 1 de 2004; el último caso se confirmó el 22 de enero de 2004. Se confirmaron 29 casos de 787 notificados (15 del distrito de Santa Marta, 8 del departamento del Cesar y 6 de La Guajira; 20% de los casos fueron captados por vigilancia activa. El 28% fue confirmado por patología e inmunohistoquímica y el restante por IgM. El grupo de edad con mayor incidencia fue 15 a 44 años (75%, hombres (72% y agricultores (45%. La letalidad fue 28%.

La vigilancia entomológica reportó la presencia de Sabethes s.p en Valledupar y los índice médicos, excepto en esta última ciudad, fueron mayores del 10%. Las coberturas de

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.

Atrophic inferior vena cava is a marker of chronicity of intra-filter and inferior vena cava thrombosis: based on CT findings.

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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.

Malformação de veia cava inferior e trombose venosa profunda: fator de risco de trombose venosa em jovens Inferior vena cava malformation and deep venous thrombosis: a risk factor of venous thrombosis in the young

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Renan Roque Onzi

2007-06-01

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

Bleeding 'downhill' esophageal varices associated with benign superior vena cava obstruction: case report and literature review.

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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.

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

International Nuclear Information System (INIS)

Lee, Dong Ho; Lim, Jae Hoon; Ko, Young Tae; Yoon, Yup; Lim, Joo Won

1992-01-01

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

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

International Nuclear Information System (INIS)

Morita, Yutaka; Yamada, Masataka; Miyata, Mutsuhiko; Kubo, Kohzo.

1994-01-01

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

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

International Nuclear Information System (INIS)

Zhang Xiao; Xiao Yueyong; Yang Jie; Ma Xuyang; Liu Shirong; Ren Chao; Wang Xiaoping

2012-01-01

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

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.

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.

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

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Luntz S

2006-06-01

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

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

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

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Eduardo González-Bosquet

2009-06-01

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

Tratamento endovascular da síndrome da veia cava superior: relato de caso e revisão da literatura Endovascular treatment of superior vena cava syndrome: case report and review of the literature

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Marco Aurélio Cardozo

2006-12-01

Full Text Available Relatamos o caso de uma paciente portadora de síndrome da veia cava superior sintomática de origem benigna tratada pela técnica endovascular. A angiorressonância magnética pré-angioplastia evidenciou extensa trombose do tronco braquiocefálico esquerdo, da veia subclávia esquerda e obstrução da veia cava superior junto ao tronco braquiocefálico direito. A paciente realizou mastectomia radical 2 anos antes, associada à quimioterapia e radioterapia do tórax. Foram realizados angioplastia venosa e implante de stent expansível por balão. O resultado foi satisfatório, com alívio imediato dos sintomas devido à recanalização da veia cava superior e do tronco braquiocefálico direito. Foi instituída anticoagulação oral. A paciente permanece sem recidiva dos sintomas após 8 meses de acompanhamento. O tratamento endovascular é uma alternativa terapêutica com baixa morbidade e resultado satisfatório a médio prazo que pode ser oferecida aos pacientes portadores de síndrome da veia cava superior.We report a case of a patient with symptomatic benign superior vena cava syndrome treated by the endovascular technique. The angiographic resonance before angioplasty showed extensive thrombosis of the left brachiocephalic trunk, left subclavian vein and superior vena cava obstruction close to the right brachiocephalic trunk. The patient underwent radical mastectomy 2 years ago with adjuvant chemotherapy and chest radiotherapy. Venous angioplasty and balloon-expandable stenting were performed. Satisfactory result was obtained with immediate relief of symptoms due to recanalization of the right brachiocephalic trunk and superior vena cava. Oral anticoagulation was initiated. The patient is still asymptomatic after 8 months of follow-up. The endovascular treatment is a therapeutic alternative with low morbidity and satisfactory mid-term results that can be offered to patients with superior vena cava syndrome.

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

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Jian FU

2015-10-01

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

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

Can the Right Kidney be Salvaged in the Surgical Management of Leiomyosarcoma of the Inferior Vena Cava—a Rare Case Report

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Chakrabarti, Suvadip; Agarwal, Deepak; Desai, Sanjay M.; Mehta, Dharmendra Y.

2015-01-01

Primary leiomyosarcoma is rare malignant tumour arising from the smooth muscles and can appear at any site where smooth muscle is present. It is more common in the peripheral vessels and has predilection for the female sex. We here report a rare case of leiomyosarcoma involving the segment I & II of inferior vena cava with extension into the renal veins in a 70 year old male patient. Midline transperitoneal approach was taken to excise the tumour along with the vessel wall with anastomosis be...

The centennial of the Yellow Fever Commission and the use of informed consent in medical research El centenario de la Comisión de la Fiebre Amarilla y el uso del consentimiento informado en la investigación médica

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Fernando Güereña-Burgueño

2002-04-01

Full Text Available The year 2000 marked the centennial of the discovery of the mode of transmission of yellow fever. Informed consent was systematically used for the first time in research. This process was the result of a complex social phenomenon involving the American Public Health Association, the US and Spanish Governments, American and Cuban scientists, the media, and civilian and military volunteers. The public health and medical communities face the AIDS pandemic at the beginning of the 21st Century, as they faced the yellow fever epidemic at the beginning of the 20th Century. Current medical research dilemmas have fueled the debate about the ethical conduct of research in human subjects. The AIDS pandemic is imposing enormous new ethical challenges on the conduct of medical research, especially in the developing world. Reflecting on the yellow fever experiments of 1900, lessons can be learned and applied to the current ethical challenges faced by the international public health research community.En el año 2000 se cumplió el primer centenario del descubrimiento del modo de transmisión de la fiebre amarilla. El consentimiento informado fue utilizado por primera vez de manera sistemática en una investigación médica. Este proceso fue el resultado de un fenómeno social complejo que involucró a la Asociación Americana de Salud Pública, a los gobiernos de los Estados Unidos de América y España, a científicos norteamericanos y cubanos, a la prensa y a voluntarios civiles y militares. Al inicio del siglo XXI las comunidades de salud pública y médicas en el ámbito internacional enfrentan la pandemia de SIDA al igual que enfrentaron a la fiebre amarilla al iniciarse el siglo XX. A la vez, también debaten los retos éticos que la investigación médica contemporánea les ofrece, especialmente en los países en desarrollo. La reflexión sobre los experimentos de 1900 podría ofrecer enseñanzas aplicables a los retos éticos enfrentados por las

EFECTO DEL EMPAQUE Y DEL 1-MCP SOBRE CARACTERÍSTICAS FÍSICAS, QUÍMICAS Y FISIOLÓGICAS DE PITAHAYA AMARILLA EFEITO DA EMBALAGEM E DO 1-MCP SOB AS PROPRIEDADES QUÍMICAS, FÍSICAS E FISIOLÓGICAS DA PITAHAYA AMARELA EFFECT OF PACKAGING AND 1-MCP ON PHYSICAL, CHEMICAL AND PHYSIOLOGICAL CHARACTERISTICS OF PITAHAYA YELLOW

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LILIANA SERNA C

2011-12-01

Full Text Available En pitahaya amarilla entera con grado de madurez 3, se evaluó el efecto del empaque (canastillas plásticas y cajas de cartón tipo exportación y la aplicación de soluciones acuosas de 1-Metilciclopropeno (200 y 400 µgL-1, sobre la pérdida de peso, firmeza, color, sólidos solubles, acidez titulable, tasa respiratoria y tiempo de vida comercial. Se encontró que en los dos empaques, la aplicación de soluciones acuosas de 200 y 400 µgL-1 de 1-Metilciclopropeno (1-MCP disminuyó los cambios en acidez, tasa respiratoria y color, sin embargo, aumentó la pérdida de peso durante el almacenamiento. El tipo de empaque afectó significativamente la pérdida de peso, los sólidos solubles y el color. La aplicación de 200 µgL-1 de 1-MCP generó menor variación en la luminosidad y en la coloración verde-amarilla en la fruta. Concentraciones de 200 y 400 µgL-1 de 1-MCP y el empaque en canastillas plásticas para mercado local permitieron prolongar el tiempo de vida comercial de la pitahaya amarilla 3 días. Los resultados de este estudio confirman además que la pitahaya amarilla es una fruta climatérica.Na pitahaya amarela inteira com grau tres de madures, foi avallado os efeitos da embalagem (cestos de plástico e caixas de papelão tipo exportação e a aplicação de soluções aquosas de 1-metilciclopropeno (200 e 400 µgL-1 sobre a perda de peso, firmeza, cor, teor de sólidos solúveis totais, acidez, taxa de respiração e tempo de vida comercial. Foi observado que nas duas embalagens, a aplicação de soluções aquosas de 200 e 400 µgL-1 de 1-Metilciclopropeno (1-MCP reduziu as variações na acidez, taxa de respiração e cor, no entanto, aumentou a perda de peso durante o armazenamento. 0 tipo da embalagem afetou significativamente a perda de peso, o teor de sólidos solúveis totais, e acor. A aplicação de 200 µgL-1 de 1-MCP gerou menor variação na luminosidade e na cor verde-amarela no fruto. Concentrações de 200 e 400

[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

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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.

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

OpenAIRE

Harris D., Paul; Brinck M., Patricio

1999-01-01

Objetivo: El tratamiento de la hipertensión portal de origen prehepático en niños es motivo de controversia. El objetivo de este estudio retrospectivo fue analizar la evolución, tratamiento y morbimortalidad de 34 niños con cavermomatosis de la vena porta. Pacientes y método: Se analizó la evolución antropométrica y hematológica, las características del sangramiento digestivo, el tratamiento médico, endoscópico y quirúrgico, y la morbimortalidad. Resultados: El 74% de los niños presentó uno o...

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.

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.

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

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Antonio Eduardo Zerati

2005-10-01

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

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.

Molecular indicators for palaeoenvironmental change in a Messinian evaporitic sequence Vena del Gesso, Italy III. Stratigraphic changes in the molecular structure of kerogen in a single marl bed as revealed by flash pyrolysis

NARCIS (Netherlands)

Sinninghe Damsté, J.S.; Gelin, F.; Harrison, W.N.; Maxwell, J.R.

1995-01-01

Kerogens of nine samples from a single marl bed of the Gessoso-solfifera Formation in the Vena del Gesso basin (Messinian, Italy) were qualitatively and quantitatively studied by analytical pyrolysis. Relationships between the nature of the pyrolysis products and the source organisms were

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.

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.

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.

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

Science.gov (United States)

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.

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.

Molecular indicators for palaeoenvironmental change in a Messinian evaporitic sequence (Vena del Gesso, Italy) II. Stratigraphic changes in abundances and (13)C contents of free and sulphur-bound skeletons in a single marl bed

NARCIS (Netherlands)

Sinninghe Damsté, J.S.; Kenig, F.; Frewin, N.L.; Hayes, J.M.

1995-01-01

The extractable organic matter of 10 immature samples from a marl bed of one evaporitic cycle of the Vena del Gesso sediments (Gessoso-solfifera Fm., Messinian, Italy) was analyzed quantitatively for free hydrocarbons and organic sulphur compounds. Nickel boride was used as a desulphurizing agent to

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

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

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

2002-06-01

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

The high-risk polytrauma patient and inferior vena cava filter use.

Science.gov (United States)

Berber, Onur; Vasireddy, Aswin; Nzeako, Obi; Tavakkolizadeh, Adel

2017-07-01

The aim of this study was to assess the impact on practice of vena cava filter insertion guidelines (Eastern Association for the Surgery of Trauma: practice management guidelines). The study was performed at a level 1 trauma centre with data from the 'Trauma Audit and Research Network' cross-referenced to hospital data. A total of 1138 specific 'high-risk' major trauma patients were identified over a 6-year period. The mean age was 46 years (18-102) and the male to female ratio was 3.3:1. The average Injury Severity Score was 23.6 (4-75). The overall DVT rate was 2.6% and the PE rate was 1.8%. A retrievable IVC filter was inserted in 42 cases (3.8%). The filter retrieval rate was 23.8% at a mean of 68.5days (4-107). Only one complication was reported of a breakthrough PE despite filter. Applying the EAST guidelines to this cohort would have suggested filter insertion in 279 (24.6%) cases. The kappa concordance value between observed practice and the 'EAST filter group' was 0.103 (poor). The PE rate in the 'EAST filter group' was 2.2% vs 1.6% in the 'no filter group' (p=0.601, no statistical difference) and the observed odds ratio was 0.814 (95% CI 0.413, 1.602). The EAST guidelines are useful but may be overestimating the need for filter insertion. Copyright © 2017 Elsevier Ltd. All rights reserved.

INTRASPECIFIC VARIATION OF THE GREEN TURTLE, Chelonia mydas (CHELONIIDAE, IN THE FORAGING AREA OF GORGONA NATURAL NATIONAL PARK (COLOMBIAN PACIFIC

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Laura Sampson

2014-09-01

Full Text Available Se comparó la distribución de tallas y condición corporal de los dos morfotipos conocidos de tortuga verde (Chelonia mydas en el área de forrajeo del Parque Nacional Natural Gorgona (PNNG en el Pacífico colombiano entre 2003 y 2012. Se tomaron medidas de largo recto de caparazón (LRC, largo curvo de caparazón (LCC, peso y condición corporal de 1.023 tortugas capturadas en los arrecifes del PNNG. Se capturaron más tortugas negras (n = 747 que amarillas (n = 276, todas juveniles. Las tortugas negras fueron significativamente más grandes y pesadas que las amarillas. El tamaño de reclutamiento a la zona nerítica fue de 40,0–49,9 cm para ambos morfotipos, pero hubo más tortugas amarillas que negras en este intervalo de tamaños, lo cual sugiere una variación en el patrón de reclutamiento. El índice de condición corporal de las tortugas amarillas fue significativamente más alto que el de las tortugas negras, lo cual podría indicar diferencias en la utilización de recursos. Con base en los resultados obtenidos, se sugiere que el PNNG podría funcionar como un área de reclutamiento para las tortugas amarillas, las cuales llegan más pequeñas a esta zona; y como parte de la ruta migratoria costera de las tortugas negras, las cuales llegan más grandes e incluso residen en esta localidad durante un lapso de tiempo desconocido.

A DUPLICATED GREAT SAPHENOUS VEIN AND CLINICAL SIGNIFICANCE FOR VARICOSITY. Duplicación de la vena safena magna y significado clínico de las várices

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Waseem Al Talalwah

2016-03-01

Full Text Available En varios estudios se ha relacionado la vena safena magna doble con dilataciones varicosas. Durante una clase de disección de pre-grado de la extremidad inferior se encontró una doble vena safena magna unilateral en el miembro inferior izquierdo de un cadáver masculino. La incidencia de esta variación fue del 1,3% de todos los especímenes muestra. En este trabajo se reporta la variabilidad del drenaje venoso de las extremidades inferiores para mejorar la conciencia para los radiólogos vasculares y proporcionar además una opción adicional en la cirugía de bypass de la arteria coronaria para evitar las várices iatrogénicas. A double great saphenous vein has been associated with varicosity in a number of studies. During routine undergraduate dissection of the lower limb a unilateral double great saphenous was found in the left lower limb of a male cadaver. The incidence of this variation was 1.3% of all specimens. This paper reports the variability of lower limb venous drainage to increase the awareness for vascular radiologists and provide further an additional option in coronary artery bypass surgery to avoid iatrogenic varicosity.

Maintenance of pulmonary vasculature tone by blood derived from the inferior vena cava in a rabbit model of cavopulmonary shunt.

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Ikai, Akio; Shirai, Mikiyasu; Nishimura, Kazunobu; Ikeda, Tadashi; Kameyama, Takayuki; Ueyama, Koji; Komeda, Masashi

2005-01-01

After cavopulmonary shunt in which the superior vena cava is anastomosed to the right pulmonary artery, the right lung is in a unique condition without flow pulsatility and hepatic venous effluent. In a previous study, we reported that hypoxic pulmonary vasoconstriction disappeared in the pulmonary circulation after cavopulmonary shunt. In this study, however, to investigate the influence of pulsatility and hepatic venous effluent on hypoxic pulmonary vasoconstriction in the pulmonary circulation, we developed an alternative cavopulmonary shunt rabbit model that included hepatic venous effluent in the pulmonary circulation and reduced the pulsatility of the pulmonary arterial blood flow. We then observed the physiologic characteristics of the peripheral pulmonary artery after cavopulmonary shunt, specifically the disappearance of hypoxic pulmonary vasoconstriction. Sixteen Japanese white rabbits (12-16 weeks old) were used in this study. With general anesthesia, a cavopulmonary shunt was established by anastomosing the right superior vena cava to the right pulmonary artery in an end-to-side fashion. Of the 16 rabbits for the study, the proximal right pulmonary artery was completely ligated in 5 (atresia group) and partially ligated in 6 (stenosis group). Sham operation was performed in the remaining 5 rabbits. Two weeks later, we analyzed the response of the pulmonary artery (which was divided into three categories: segmental, lobular, and acinar level artery) to hypoxia (8% oxygen inhalation) with a specially designed video radiographic system. Morphometric analysis of the resistance pulmonary artery was done in each group after angiography. Mean pressure and pulse pressure in the right pulmonary artery were not significantly different between the atresia and stenosis groups. The mean pulmonary artery pressures in the atresia and stenosis groups were 8 and 11 mm Hg, respectively. However, the pulse pressure was less than 2 mm Hg in both groups. The baseline

Retrievable Inferior Vena Cava Filters: Factors that Affect Retrieval Success

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Geisbuesch, Philipp, E-mail: philippgeisbuesch@gmx.de; Benenati, James F.; Pena, Constantino S.; Couvillon, Joseph; Powell, Alex; Gandhi, Ripal; Samuels, Shaun; Uthoff, Heiko [Baptist Cardiac and Vascular Institute, Division of Vascular and Interventional Radiology (United States)

2012-10-15

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

Retrievable Inferior Vena Cava Filters: Factors that Affect Retrieval Success

International Nuclear Information System (INIS)

Geisbüsch, Philipp; Benenati, James F.; Peña, Constantino S.; Couvillon, Joseph; Powell, Alex; Gandhi, Ripal; Samuels, Shaun; Uthoff, Heiko

2012-01-01

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

Parotidectomía y vena facial Parotidectomy and facial vein

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F. Hernández Altemir

2009-10-01

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

Clinical review: inferior vena cava filters in the age of patient-centered outcomes.

Science.gov (United States)

Wang, Stephen L; Lloyd, Allen J

2013-11-01

Inferior vena cava filter (IVCF) use continues to increase in the United States (US) despite questionable clinical benefit and increasing concerns over long-term complications. For this review we comprehensively examine the randomized, prospective data on IVC filter efficacy, compare relative rates of IVCF placement in the US and Europe, compare commonly considered guidelines for IVCF indications, and the current data on IVCF complications. Searches of MEDLINE and Cochrane databases were conducted for randomized prospective IVCF studies. Only three randomized prospective studies for IVCFs were identified. Commonly cited IVCF guidelines were reviewed with attention to their evolution over time. No evidence has shown a survival benefit with IVCF use. Despite this, continued rising utilization, especially for primary prophylactic indications, is concerning, given increasing evidence of long-term filter-related complications. This is particularly noted in the US where IVCF placements for 2012 are projected to be 25 times that of an equivalent population in Europe (224,700 versus 9,070). Pending much-needed randomized controlled trials that also evaluate long-term safety, we support the more stringent American College of Chest Physicians (ACCP) guidelines for IVCF placement indications and advocate a close, structured follow-up of retrievable IVCFs to improve filter retrieval rates.

Assessment of Snared-Loop Technique When Standard Retrieval of Inferior Vena Cava Filters Fails

International Nuclear Information System (INIS)

Doody, Orla; Noe, Geertje; Given, Mark F.; Foley, Peter T.; Lyon, Stuart M.

2009-01-01

Purpose To identify the success and complications related to a variant technique used to retrieve inferior vena cava filters when simple snare approach has failed. Methods A retrospective review of all Cook Guenther Tulip filters and Cook Celect filters retrieved between July 2006 and February 2008 was performed. During this period, 130 filter retrievals were attempted. In 33 cases, the standard retrieval technique failed. Retrieval was subsequently attempted with our modified retrieval technique. Results The retrieval was successful in 23 cases (mean dwell time, 171.84 days; range, 5-505 days) and unsuccessful in 10 cases (mean dwell time, 162.2 days; range, 94-360 days). Our filter retrievability rates increased from 74.6% with the standard retrieval method to 92.3% when the snared-loop technique was used. Unsuccessful retrieval was due to significant endothelialization (n = 9) and caval penetration by the filter (n = 1). A single complication occurred in the group, in a patient developing pulmonary emboli after attempted retrieval. Conclusion The technique we describe increased the retrievability of the two filters studied. Hook endothelialization is the main factor resulting in failed retrieval and continues to be a limitation with these filters.

VARIACIONES EN BAJA FRECUENCIA DE LA PRECIPITACIÓN ESTACIONAL EN LA REGIÓN PAMPA AMARILLA Y POSIBLES FORZANTES

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Germán Russián

2015-06-01

Full Text Available Se estudia el ciclo anual de precipitación en la región Pampa Amarilla (RPA. La mayor parte de la RPA presenta máximo en marzo, seguido de noviembre y diciembre, y mínimo en invierno. El acumulado octubre-marzo (verano resulta significativamente distinto al acumulado abril- septiembre (invierno. Se analizan las variaciones, tendencias y cambios de las series temporales en verano e invierno. Las series más largas seleccionadas sobre el centro y norte de La Pampa, muestran cambio positivo y significativo por tendencia lineal, del orden del 44% de la media regional en verano. Tras una prolongada sequía (1930-1950 el cambio estival irrumpe en la década de los setenta (centro-norte de La Pampa, y en la década de los sesenta (centro-este de La Pampa. Este cambio brusco ha producido una larga fase húmeda extendida hasta comienzos de los dos mil. El cambio de la década del setenta puede estar asociado al cambio de las condiciones medias de la Temperatura superficial del mar (TSM del Pacífico central ecuatorial. Para el período de prolongada fase húmeda (1969-2009 en el sector centro y norte de la RPA hay un aumento (disminución de las precipitaciones de verano (invierno mientras que hacia el centro-sudoeste de la RPA, los cambios son negativos y significativos. La exploración de la circulación troposférica y la TSM revela que la variabilidad interanual de la precipitación está modulada por teleconexiones remotas trópico-extratrópico. Se descarta cualquier posible relación con el Modo Anular del Sur. En verano, el mecanismo de interacción es la modulación de la corriente en chorro subtropical en el Pacífico Sur hacia Sudamérica, generada por anomalías en la circulación de la celda de Hadley sobre el Pacifico ecuatorial central. El mecanismo podría estar asociado a la baja y la alta frecuencia del fenómeno El Niño. En invierno, la teleconexión está dada por la propagación de ondas cuasi estacionarias de Rossby desde la

Mazatlán, 1883

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Javier E. García de Alba García

2006-01-01

Full Text Available A propósito de una serie de telegramas emitidos durante la epidemia de fiebre amarilla de 1883 en Mazatlán, reproducidos en el semanario médico de la ciudad de México La Voz de Hipócrates, se hace una reflexión histórico-epidemiológica sobre el desarrollo de la fiebre amarilla en esta área del país y acerca del conocimiento prevaleciente.

Aedes Aegypti en zona rural del municipio de La Mesa (Cundinamarca Colombia, S. A.

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Alberto Morales

1981-12-01

Full Text Available Es bien sabida la importancia del mosquito Aedes aegypti en la transmisión, de los cuatro tipos conocidos del virus del Dengue y del virus de la Fiebre Amarilla Urbana. El Último episodio de Fiebre Amarilla Urbana en Colombia ocurrió en el año de 1929 en la población de Socorro (Santander; sin embargo, la presencia del mosquito en áreas urbanas cercanas a focos enzoóticos de Fiebre Amarilla Selvática constituye un peligro potencial. Desde el año de 1972 se vienen presentando en el país epidemias de Dengue debidas al virus tipo II, más tarde hizo su aparición el tipo III y más recientemente el tipoI, todos transmitidos por A. aegypti, el único vector conocido de Dengue en las Américas.

Brain Abscess Associated with Isolated Left Superior Vena Cava Draining into the Left Atrium in the Absence of Coronary Sinus and Atrial Septal Defect

International Nuclear Information System (INIS)

Erol, Ilknur; Cetin, I. Ilker; Alehan, Fuesun; Varan, Birguel; Ozkan, Sueleyman; Agildere, A. Muhtesem; Tokel, Kursad

2006-01-01

A previously healthy 12-year-old girl presented with severe headache for 2 weeks. On physical examination, there was finger clubbing without apparent cyanosis. Neurological examination revealed only papiledema without focal neurologic signs. Cerebral magnetic resonance imaging showed the characteristic features of brain abscess in the left frontal lobe. Cardiologic workup to exclude a right-to-left shunt showed an abnormality of the systemic venous drainage: presence of isolated left superior vena cava draining into the left atrium in the absence of coronary sinus and atrial septal defect. This anomaly is rare, because only a few other cases have been reported

Endovascular Treatment of Ruptured Abdominal Aneurysm into the Inferior Vena Cava in Patient After Stent Graft Placement

International Nuclear Information System (INIS)

Juszkat, Robert; Pukacki, Fryderyk; Zarzecka, Anna; Kulesza, Jerzy; Majewski, Waclaw

2009-01-01

We report the case of a patient who underwent endovascular repair and then reintervention as a result of the presence of a persistent endoleak complicated by an aortocaval fistula. A 76-year-old patient with a history of endovascular treatment for abdominal aortic aneurysm 2 years earlier had a palpable abdominal mass, high-output cardiac failure, and renal failure. A computed tomographic scan and angiography revealed bending of the right iliac limb, a type I endoleak, and rupture of the aneurysm into the inferior vena cava with aortocaval fistula formation. An iliac extension was positioned in the right external iliac artery. The procedure was finished successfully. Control angiography showed normal flow within the endoprosthesis, and both iliac arteries were without signs of endoleakage and aortocaval fistula. Ectatic common iliac artery may lead to a late distal attachment site endoleak. The application of a stent graft in cases of secondary aortocaval fistula after stent graft repair is a good option, particularly in emergency cases.

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

International Nuclear Information System (INIS)

Zhang, Wen; Yan, Zhiping; Luo, Jianjun; Fang, Zhuting; Wu, Linlin; Liu, QingXin; Qu, Xudong; Liu, Lingxiao; Wang, Jianhua

2013-01-01

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

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

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Zhang, Wen; Yan, Zhiping; Luo, Jianjun; Fang, Zhuting; Wu, Linlin; Liu, QingXin; Qu, Xudong; Liu, Lingxiao; Wang, Jianhua [Fudan University, Department of Interventional Radiology, Zhongshan Hospital (China)

2013-10-15

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

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

International Nuclear Information System (INIS)

Le Blanche, Alain F.; Pautas, Eric; Gouin, Isabelle; Baguees, Audrey; Piette, Francois; Chaibi, Pascal

2005-01-01

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

Percutaneous treatment of superior vena cava syndrome using metallic stents

International Nuclear Information System (INIS)

De Gregorio Ariza, Miguel Angel; Gimeno, Maria Jose; Alfonso, Eduardo; Mainar, Antonio; Medrano, Joaquin; Lopez-Marin, Paloma; Gamboa, Pablo; Tobio, Ricardo; Herrera, Marcos

2003-01-01

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

Inferior vena cava segmentation with parameter propagation and graph cut.

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Yan, Zixu; Chen, Feng; Wu, Fa; Kong, Dexing

2017-09-01

The inferior vena cava (IVC) is one of the vital veins inside the human body. Accurate segmentation of the IVC from contrast-enhanced CT images is of great importance. This extraction not only helps the physician understand its quantitative features such as blood flow and volume, but also it is helpful during the hepatic preoperative planning. However, manual delineation of the IVC is time-consuming and poorly reproducible. In this paper, we propose a novel method to segment the IVC with minimal user interaction. The proposed method performs the segmentation block by block between user-specified beginning and end masks. At each stage, the proposed method builds the segmentation model based on information from image regional appearances, image boundaries, and a prior shape. The intensity range and the prior shape for this segmentation model are estimated based on the segmentation result from the last block, or from user- specified beginning mask if at first stage. Then, the proposed method minimizes the energy function and generates the segmentation result for current block using graph cut. Finally, a backward tracking step from the end of the IVC is performed if necessary. We have tested our method on 20 clinical datasets and compared our method to three other vessel extraction approaches. The evaluation was performed using three quantitative metrics: the Dice coefficient (Dice), the mean symmetric distance (MSD), and the Hausdorff distance (MaxD). The proposed method has achieved a Dice of [Formula: see text], an MSD of [Formula: see text] mm, and a MaxD of [Formula: see text] mm, respectively, in our experiments. The proposed approach can achieve a sound performance with a relatively low computational cost and a minimal user interaction. The proposed algorithm has high potential to be applied for the clinical applications in the future.

Outcome of inferior vena cava and noncaval venous leiomyosarcomas.

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Illuminati, Giulio; Pizzardi, Giulia; Calio', Francesco; Pacilè, Maria Antonietta; Masci, Federica; Vietri, Francesco

2016-02-01

Leiomyosarcoma (LMS) is a rare tumor arising from the smooth muscle cells of arteries and veins. LMS may affect both the inferior vena cava (IVC) and non-IVC veins. Because of its rarity, the experience with the outcome of the disease originating from the IVC compared with that with non-IVC offspring is overall limited. In this study, we compared the clinical features and outcomes after operative resection of IVC and non-IVC LMS to detect possible significant differences that could affect treatment and prognosis. Twenty-seven patients undergoing operative resection of a venous LMS at a single tertiary care center and one secondary care hospital were reviewed retrospectively and divided into 2 groups: IVC-LMS (Group A, n = 18) and non-IVC LMS (Group B, n = 9). As primary end points, postoperative mortality and morbidity, disease-specific survival and, if applicable, patency of venous reconstruction were considered. Bivariate differences were compared with the χ(2) test. Disease-specific survival was expressed by a life-table analysis and compared using the log-rank test. No postoperative mortality was observed in either group. Postoperative morbidity was 28% in group A and 11% in group B (P = .33). The mean duration of follow-up was 60 months (range, 13-140). Disease-specific survival was 60% in group A and 75% in group B at 3 years (P = .48), and it was 54% in group A and 62% in group B at 5 years (P = .63). Seven grafts were occluded in group A (39%) and 1of 3 were occluded in group B (33%) (P = .85). IVC and non-IVC LMS exhibit similar outcomes in terms of postoperative course and survival. Operative resection associated with vascular reconstruction, if applicable, eventually followed by radiation and chemotherapy may be curative and is associated with good functional results. Copyright © 2016 Elsevier Inc. All rights reserved.

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

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

2011-01-15

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

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

International Nuclear Information System (INIS)

Ganeshalingam, S.; Rajeswaran, G.; Jones, R.L.; Thway, K.; Moskovic, E.

2011-01-01

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

Prenatal Diagnosis of Persistent Left Superior Vena Cava and its Clinical Significance

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Aytül Çorbacıoğlu Esmer

2014-03-01

Full Text Available Background: Persistent left superior vena cava (PLSVC is a variant of systemic venous return which is observed in 0.3% of autopsies in the general population and in 4-8% of patients with congenital heart disease. Aims: To evaluate associated cardiac, extracardiac and chromosomal anomalies in prenatally diagnosed cases of PLSVC and to review their outcome. Study Design: Retrospective comparative study. Methods: The data of patients with a prenatal diagnosis of PLSVC between May 2008 and January 2013 were reviewed retrospectively. Results: Data of 31 cases were reviewed. Fifteen (48.4% cases were associated with cardiac defects and 17 (54.8% cases had associated extracardiac sonographic or postpartum findings. Two fetuses had karyotype anomalies. Outcome was significantly more favorable in cases not associated with cardiac defects in comparison to those associated with cardiac anomalies (84.6% vs. 33.3%, p=0.009. All cases with isolated PLSVC survived, while among the cases associated with extracardiac anomalies, with cardiac anomalies and with both extracardiac and cardiac anomalies, the survival rate was 75%, 50% and 22.2%, respectively. The most frequent group of cardiac anomalies associated with PLSVC was septal defects and VSD was the most common heart defect individually, being observed in nine fetuses. Conclusion: Prenatally diagnosed PLSVC is associated with cardiac and extracardiac anomalies in the majority of cases. Outcome is significantly worse if PLSVC is associated with a cardiac defect, and the prognosis is excellent in isolated cases.

Intrahepatic venous collaterals forming via the inferior right hepatic vein in 3 patients with obstruction of the inferior vena cava

International Nuclear Information System (INIS)

Takayasu, K.; Moriyama, N.; Muramatsu, Y.

1985-01-01

When the inferior vena cava is obstructed, collateral veins enlarge, connecting with the inferior (acessory) right hepatic vein (IRHV) and thence through various hepatic veins to the right atrium. Three such cases are described. In one patient, most contrast material flowed into the IRHV and from there to the left hepatic vein. The second patient had several large collaterals arising from the IRHV and flowing into the right and middle hepatic veins, while the third patient demonstrated anastomoses between the IRHV and the middle hepatic vein. All of these hepatic venous shunts eventually drained into the right atrium. There were no clinical manifestations such as ascites, edema, or dilatation of the abdominal veins. Cavography alone or combined with computed tomography proved to be diagnostic in the assessment of these intrahepatic collaterals

Inferior vena cava collapsibility detects fluid responsiveness among spontaneously breathing critically-ill patients.

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Corl, Keith A; George, Naomi R; Romanoff, Justin; Levinson, Andrew T; Chheng, Darin B; Merchant, Roland C; Levy, Mitchell M; Napoli, Anthony M

2017-10-01

Measurement of inferior vena cava collapsibility (cIVC) by point-of-care ultrasound (POCUS) has been proposed as a viable, non-invasive means of assessing fluid responsiveness. We aimed to determine the ability of cIVC to identify patients who will respond to additional intravenous fluid (IVF) administration among spontaneously breathing critically-ill patients. Prospective observational trial of spontaneously breathing critically-ill patients. cIVC was obtained 3cm caudal from the right atrium and IVC junction using POCUS. Fluid responsiveness was defined as a≥10% increase in cardiac index following a 500ml IVF bolus; measured using bioreactance (NICOM™, Cheetah Medical). cIVC was compared with fluid responsiveness and a cIVC optimal value was identified. Of the 124 participants, 49% were fluid responders. cIVC was able to detect fluid responsiveness: AUC=0.84 [0.76, 0.91]. The optimum cutoff point for cIVC was identified as 25% (LR+ 4.56 [2.72, 7.66], LR- 0.16 [0.08, 0.31]). A cIVC of 25% produced a lower misclassification rate (16.1%) for determining fluid responsiveness than the previous suggested cutoff values of 40% (34.7%). IVC collapsibility, as measured by POCUS, performs well in distinguishing fluid responders from non-responders, and may be used to guide IVF resuscitation among spontaneously breathing critically-ill patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Evidence-Based Evaluation of Inferior Vena Cava Filter Complications Based on Filter Type

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Deso, Steven E.; Idakoji, Ibrahim A.; Kuo, William T.

2016-01-01

Many inferior vena cava (IVC) filter types, along with their specific risks and complications, are not recognized. The purpose of this study was to evaluate the various FDA-approved IVC filter types to determine device-specific risks, as a way to help identify patients who may benefit from ongoing follow-up versus prompt filter retrieval. An evidence-based electronic search (FDA Premarket Notification, MEDLINE, FDA MAUDE) was performed to identify all IVC filter types and device-specific complications from 1980 to 2014. Twenty-three IVC filter types (14 retrievable, 9 permanent) were identified. The devices were categorized as follows: conical (n = 14), conical with umbrella (n = 1), conical with cylindrical element (n = 2), biconical with cylindrical element (n = 2), helical (n = 1), spiral (n = 1), and complex (n = 1). Purely conical filters were associated with the highest reported risks of penetration (90–100%). Filters with cylindrical or umbrella elements were associated with the highest reported risk of IVC thrombosis (30–50%). Conical Bard filters were associated with the highest reported risks of fracture (40%). The various FDA-approved IVC filter types were evaluated for device-specific complications based on best current evidence. This information can be used to guide and optimize clinical management in patients with indwelling IVC filters. PMID:27247477

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

International Nuclear Information System (INIS)

Athanasoulis, C.A.; Roberts, A.C.; Brown, K.; Geller, S.C.; Waltman, A.C.; Eckstein, M.R.

1987-01-01

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

Disintegration of the 'waterfall phenomenon' in the inferior vena cava due to right heart failure.

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Kira, S; Dambara, T; Mieno, T; Tamaki, S; Natori, H

1996-03-01

The concept of the waterfall phenomenon in Zone 2 in the pulmonary vasculature is well known from West's lung model. It is believed that the flow through this zone is determined by the pressure difference between the pulmonary artery and alveoli, and the left atrial pressure is not transmissible to the alveolar capillaries. However, it is impossible to see whether alveolar capillaries are really displaying the waterfall phenomenon or not. In this review, the interrelation between the flow and geometry of the alveolar capillaries in the waterfall phenomenon is analyzed based on physiological studies using a model system and isolated lung lobe experiments. Further, extending the concept to the analysis of ventilatory changes of the inferior vena cava (IVC) configuration, it is ascertained that the waterfall phenomenon normally occurs in the IVC during inspiration just before it enters the thorax and the waterfall phenomenon in the IVC disintegrates with elevation of the central venous pressure. Because these configurations of the IVC in normal and abnormal conditions are visible with ultrasonography, the technique is very useful as a noninvasive approach to diagnose right heart failure.

Systematic review and meta-analysis of persistent left superior vena cava on prenatal ultrasound: associated anomalies, diagnostic accuracy and postnatal outcome.

Science.gov (United States)

Gustapane, S; Leombroni, M; Khalil, A; Giacci, F; Marrone, L; Bascietto, F; Rizzo, G; Acharya, G; Liberati, M; D'Antonio, F

2016-12-01

To quantify the prevalence of chromosomal anomalies in fetuses with persistent left superior vena cava (PLSVC), assess the strength of the association between PLSVC and coarctation of the aorta and ascertain the diagnostic accuracy of antenatal ultrasound in correctly identifying isolated cases of PLSVC. MEDLINE, EMBASE, CINHAL and the Cochrane databases were searched from the year 2000 onwards using combinations of keywords 'left superior vena cava' and 'outcome'. Two authors reviewed all abstracts independently. Quality assessment of the included studies was performed using the Newcastle-Ottawa Scale for cohort studies. The rates of the following outcomes were analyzed: chromosomal abnormalities; associated intracardiac anomalies (ICAs) and extracardiac anomalies (ECAs) diagnosed prenatally; additional ICAs and ECAs detected only at postnatal imaging or clinical evaluation but missed at prenatal imaging; and association of PLSVC and coarctation of the aorta. Meta-analyses of proportions were used to combine data. In total, 2708 articles were identified and 13 (n = 501) were included in the systematic review. Associated ICAs and ECAs were detected at the prenatal ultrasound examination or at a follow-up assessment in 60.7% (95% CI, 44.2-75.9%) and 37.8% (95% CI, 31.0-44.8%) of cases, respectively. Chromosomal anomalies occurred in 12.5% (95% CI, 9.0-16.4%) of cases in the overall population of fetuses with PLSVC and in 7.0% (95% CI, 2.7-13.0%) of isolated cases. Additional ICAs and ECAs were detected only after birth and missed at ultrasound in 2.4% (95% CI, 0.5-5.8%) and 6.7% (95% CI, 2.2-13.2%) of cases, respectively. Coarctation of the aorta was associated with isolated PLSVC in 21.3% (95% CI, 13.6-30.3%) of cases. PLSVC is commonly associated with ICAs, ECAs and chromosomal anomalies. Fetuses with isolated PLSVC should be followed up throughout pregnancy in order to rule out coarctation of the aorta. As most of the data in this review were derived from

Leiomyosarcoma of inferior vena cava involving bilateral renal veins: Surgical challenges and reconstruction with upfront saphenous vein interposition graft for left renal vein outflow

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Rishi Nayyar

2010-01-01

Full Text Available Leiomyosarcoma of inferior vena cava (IVC involving bilateral renal veins presents a surgical challenge. Herein, we report the successful management of two such cases using restoration of left renal venous outflow by saphenous vein interposition graft as first step of surgery. Then radical resection of tumor and right kidney was done. IVC was lastly reconstructed using Gore-Tex graft. This report highlights the surgical challenges to ensure radical resection. Furthermore, the importance of restoring left renal outflow in presence of concomitant right nephrectomy is discussed. Both the patients were disease free at six months with no loss of left renal glomerular filtration rate.

Efecto de la aplicación de 1-Metilciclopropeno por inmersión sobre las características físicas, químicas y fisiológicas de pitahaya amarilla (Selenicereus megalanthus How mínimamente procesada Effect of the immersion in 1-Metylciclopropene on the physicochemical and physiological properties of yellow pitahaya fruit (Selenicereus megalanthus How with minimum processing

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Liliana Serna-Cock

2011-07-01

Full Text Available La pitahaya amarilla (Selenicereus megalanthus How es una fruta exótica con gran potencial comercial. No obstante, sólo ha sido aprovechada comercialmente como fruta entera, sin procedimientos que le den valor agregado y mayor tiempo de vida de anaquel. En este trabajo se evaluó la aplicación de 200 mg%lt de 1-MCP (Metylciclopropene en pitahaya amarilla mínimamente procesada (rodajas con cáscara y sin cáscara, empacada al vacío y almacenada bajo refrigeración, sobre la intensidad respiratoria y parámetros de calidad como sólidos solubles, acidez total titulable, pérdida de peso, azúcares totales, firmeza y color. La aplicación de 1-MCP aumentó la producción de CO2, lo cual se manifestó en mayores contenidos de sólidos solubles y azúcares totales, pero no incidió en la pérdida de peso, variación de la acidez total titulable, cambios de color y retención de la firmeza. En ambos tipos de procesamientos se logró reducir durante el almacenamiento la pérdida de vitamina C.Yellow pitahaya (Selenicereus megalanthus How, is an exotic fruit with great commercial potential, it has been commercialized without using methods that add value and%or prolong its shelf-life. The effect the application of 200 mg%lt 1-MCP on the respiratory rate and quality properties of vacuum sealed minimally processed yellow pitahaya slices during shelf-life under refrigeration was evaluated. Soluble solids, total titratable acidity, weight loss, total sugars, firmness and color were measured in fruit slices with and without skin. The application of 1-MCP before storage increased the respiratory rate and consequently increased soluble solids and total sugars, and did not show any detrimental on weight loss, total titratable acidity, color changes and firmness. However, the application of 1-MCP reduced loss of vitamin C in yellow pitahaya slices with and without skin during storage time.

El veneno y el mosquito: aspectos epistemológicos de la etiología y la profilaxis de la fiebre amarilla Poison and the mosquito: epistemological aspects of the etiology and prophylactics of yellow fever

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Sandra Caponi

2000-10-01

Full Text Available En el II Congreso Médico Latinoamericano (Buenos Aires, 1904 se discutieron las estrategias que Argentina y Brasil delinearon para combatir la fiebre amarilla. El análisis de la controversia entre sanitaristas brasileños y argentinos en torno a los modelos explicativos y a las estrategias de profilaxis internacional de esa enfermedad, nos permite una comprensión epistemológica de la ruptura operada por la emergencia de la medicina de los vectores. Este capítulo de la historia de la medicina latinoamericana constituye una oportunidad privilegiada para analizar esa reorganización del saber que permitió integrar seres intermediarios vivos en el discurso médico y epidemiológico.The strategies against yellow fever developed by Argentina and Brazil were discussed at the Second Medical Congress of Latin America which was held in Buenos Aires in 1904. The study of the controversy between physicians from Argentina and Brazil around the existing explanatory models of this illness and the international prophylactic strategies in use at the time enables an epistemological understanding of the breakthrough brought about by the emergence of the medicine of vectors. This chapter of Latin American medicine history constitutes a unique opportunity to analyze that reorganization of knowledge, which permitted the inclusion of intermediary living beings into the medical and epidemiological discourse.

Inferior Vena Cava Filter Placement and Retrieval Rates among Radiologists and Nonradiologists.

Science.gov (United States)

Guez, David; Hansberry, David R; Eschelman, David J; Gonsalves, Carin F; Parker, Laurence; Rao, Vijay M; Levin, David C

2018-04-01

To evaluate inferior vena cava (IVC) filter placement and retrieval rates among radiologists, vascular surgeons, cardiologists, other surgeons, and all other health care providers for Medicare fee-for-service beneficiaries in the years 2012-2015. The nationwide Medicare Physician/Supplier Procedure Summary Master Files were used to determine the volume and utilization rate of IVC filter placement, IVC filter repositioning, and IVC filter retrieval, which correspond to procedure codes 37191, 37192, and 37193, respectively. Procedural code 37193 was not available before 2012, so data were reviewed for the years 2012-2015. The total volume of Medicare IVC filter placement decreased from 57,785 in 2012 to 44,378 in 2015, with radiologists responsible for 60% of all filter placements. Volume of IVC filter placement declined across all specialties, including radiologists, who placed 33,744 in 2012 and 27,957 in 2015. In contrast, total retrieval of IVC filters increased from 4,060 removals in 2012 to 6,166 in 2015. Retrieval rate per 100,000 Medicare beneficiaries increased from 11 in 2012 to 16 in 2015. Radiologists removed the bulk of the filters: 64% in both 2012 and 2015. Vascular surgeons, cardiologists, and other surgeons retrieved, respectively, 20%, 10%, and 5% of all IVC filters in 2012 and 22%, 9%, and 5% in 2015. From 2012 to 2015, IVC filter placement steadily decreased across all specialties. Retrieval rate of IVC filters continued to rise over the same period. Radiologists were responsible for the majority of IVC filter placements and retrievals. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

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

International Nuclear Information System (INIS)

Uberoi, Raman; Tapping, Charles Ross; Chalmers, Nicholas; Allgar, Victoria

2013-01-01

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

Retrieval characteristics of the Bard Denali and Argon Option inferior vena cava filters.

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Dowell, Joshua D; Semaan, Dominic; Makary, Mina S; Ryu, John; Khayat, Mamdouh; Pan, Xueliang

2017-11-01

The purpose of this study was to compare the retrieval characteristics of the Option Elite (Argon Medical, Plano, Tex) and Denali (Bard, Tempe, Ariz) retrievable inferior vena cava filters (IVCFs), two filters that share a similar conical design. A single-center, retrospective study reviewed all Option and Denali IVCF removals during a 36-month period. Attempted retrievals were classified as advanced if the routine "snare and sheath" technique was initially unsuccessful despite multiple attempts or an alternative endovascular maneuver or access site was used. Patient and filter characteristics were documented. In our study, 63 Option and 45 Denali IVCFs were retrieved, with an average dwell time of 128.73 and 99.3 days, respectively. Significantly higher median fluoroscopy times were experienced in retrieving the Option filter compared with the Denali filter (12.18 vs 6.85 minutes; P = .046). Use of adjunctive techniques was also higher in comparing the Option filter with the Denali filter (19.0% vs 8.7%; P = .079). No significant difference was noted between these groups in regard to gender, age, or history of malignant disease. Option IVCF retrieval procedures required significantly longer retrieval fluoroscopy time compared with Denali IVCFs. Although procedure time was not analyzed in this study, as a surrogate, the increased fluoroscopy time may also have an impact on procedural direct costs and throughput. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

A case of double inferior vena cava with renal, ovarian and iliac vein variation.

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Ito, Taro; Ikeda, Yayoi

2018-01-01

We encountered a rare case of an anatomic variant of inferior vena cava (IVC) duplication with renal, ovarian and iliac vein variation in an 81-year-old Japanese female cadaver during a student dissection course of anatomy at Aichi Gakuin University School of Dentistry. The two IVCs ran upwards bilaterally to the abdominal aorta. The left IVC joined with the left renal vein (RV) to form a common trunk that crossed anterior to the aorta and ended at the right IVC. We detected a vein [interiliac vein (IiV)] connecting the two IVCs at the level of the aortic bifurcation. The IiV was formed by the union of two tributaries from the left IVC and a tributary from the left internal iliac vein (IIV) and ran obliquely upwards from left to right. Two right ovarian veins, arising separately from the ipsilateral pampiniform plexus, ran vertically in parallel to each other, and each one independently terminated at the right IVC and the right RV. Two right IIVs, connecting each other with small branches, ascended and separately joined the right external iliac vein. The right and left IIVs were connected to each other. These variations cause abnormal drainage, which could lead to clinical symptoms associated with the dysfunction of the vascular and urogenital systems. Here we describe the detailed anatomical features of the area and discuss the related anatomical and developmental aspects.

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

International Nuclear Information System (INIS)

Vos, Louwerens D.; Tielbeek, Alexander V.; Bom, Ernst P.; Gooszen, Harm C.; Vroegindeweij, Dammis

1997-01-01

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

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

International Nuclear Information System (INIS)

Shao Guoliang; Wang Jianhua; Zhou Kangrong; Yan Zhiping

2001-01-01

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

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

International Nuclear Information System (INIS)

Morita, S.; Higuchi, M.; Saito, N.; Mitsuhashi, N.

2007-01-01

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

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

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Wang JY

2013-07-01

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

Asociación del tejido adiposo epicárdico con la fibrilación auricular y su pronóstico posterior a la ablación de venas pulmonares

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Viviana Quintero-Yepes

2017-05-01

Conclusiones: el aumento del tejido adiposo epicárdico se relaciona de manera independiente con el sobrepeso y la obesidad, así como con la severidad y el pronóstico de la fibrilación auricular. Deben hacerse estudios prospectivos de cohortes en los que se evalúe y establezcan valores de corte normales para nuestra población, al igual que seguimiento a largo plazo de la evolución posterior a ablación de venas pulmonares y a intervenciones como disminución de peso.

Yellow fever in Brazil: thoughts and hypotheses on the emergence in previously free areas Fiebre amarilla en Brasil: reflexiones e hipótesis sobre la emergencia en áreas previamente libres Febre amarela no Brasil: reflexões e hipóteses sobre a emergência em áreas previamente livres

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Pedro Fernando da Costa Vasconcelos

2010-12-01

Full Text Available This article describes and discusses factors associated to the reemergence of yellow fever and its transmission dynamics in the states of São Paulo (Southeastern Brazil and Rio Grande do Sul (Southern during 2008 and 2009. The following factors have played a pivotal role for the reemergence of yellow fever in these areas: large susceptible human population; high prevalence of vectors and primary hosts (non-human primates; favorable climate conditions, especially increased rainfall; emergence of a new genetic lineage; and circulation of people and/or monkeys infected by virus. There is a need for an effective surveillance program to prevent the reemergence of yellow fever in other Brazilian states.Son descritos y discutidos factores asociados con la emergencia y dinámica de la transmisión de la fiebre amarilla en los estados de Sao Paulo (Sureste de Brasil y Rio Grande do Sul (Sur de Brasil en los años 2008 y 2009. La interacción de los siguientes factores fue fundamental para la emergencia de fiebre amarilla en esos estados: la gran población humana susceptible; la elevada prevalencia de vectores y hospedadores (primates no humanos; condiciones climáticas favorables, principalmente el exceso de lluvias en el verano; la emergencia de un nuevo linaje viral; y la circulación de personas o monos infectados en fase virémica. Sólo un programa eficiente de vigilancia puede prevenir ocurrencias similares en esos estados brasileros.São descritos e discutidos fatores associados a emergência e dinâmica da transmissão da febre amarela nos estados de São Paulo e Rio Grande do Sul nos anos de 2008 e 2009. A interação dos seguintes fatores foi fundamental para a emergência de febre amarela nesses estados: a grande população humana suscetível; a elevada prevalência de vetores e hospedeiros (primatas não humanos; condições climáticas favoráveis, sobretudo o excesso de chuvas no verão; a emergência de uma nova linhagem viral; e a

Inferior Vena Cava Filter Limb Fracture with Embolization to the Right Ventricle.

Science.gov (United States)

Jackson, Bradley S; Sepula, Mykel; Marx, Jared T; Cannon, Chad M

2017-08-01

Inferior vena cava (IVC) filter and filter limb embolization is a known phenomenon, with a prevalence of up to 25% for certain filter types. Most commonly, the site of embolization is to the heart. Point-of-care ultrasound is an easily accessible imaging modality that should be utilized when considering IVC filter complications. A 28-year-old woman with a history of metastatic sarcoma and IVC filter placement for deep venous thrombosis presented to the Emergency Department (ED) for chest pain. Chest radiography was reviewed and originally thought to have no abnormalities. Chest computed tomography angiography was negative for filling defects or foreign bodies. A possible foreign body in the heart was noted by a radiologist's over-read of the original chest radiograph. An echocardiogram done by Cardiology was negative for foreign bodies or other abnormalities. Next, an emergency physician performed a bedside echocardiogram, with focused attention to the right side of the heart. An echogenic foreign body was visualized in the right ventricle. The patient was subsequently taken to the cardiac catheterization laboratory, where fluoroscopic visualization of a limb wire of an IVC filter within the right ventricle was obtained. That foreign body was subsequently removed successfully, along with removal of the broken IVC filter. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case report highlights the utility of point-of-care ultrasound in the work-up of a patient with an embolized IVC filter wire. Chest pain patients frequently receive point-of-care echocardiography in the ED, and these ultrasound findings should be recognized and used to guide further treatment and consultation. Copyright © 2017 Elsevier Inc. All rights reserved.

Stent therapy for malignant superior vena cava syndrome: Should be first line therapy or simple adjunct to radiotherapy

International Nuclear Information System (INIS)

Chatziioannou, A.; Alexopoulos, Th.; Mourikis, D.; Dardoufas, K.; Katsenis, K.; Lazarou, S.; Koutoulidis, V.; Ladopoulos, Ch.; Vlachos, L.

2003-01-01

The goal of this paper is to present our experience with superior vena cava (SVC) stenting, as first line procedure for immediate relief, in patients with malignancy, and its potential influence in the subsequent radiotherapy (XRT). Over a 1-year period, 18 patients with SVC syndrome due to severe stenosis secondary to mediastinal malignancy were referred for stent insertion. A SVC score was used to measure treatment effectiveness. Stent insertion had been successful in 18/18 patients (technical success 100%). All patients experienced symptomatic relief within few hours of the procedure. There were no major complications. In all patients we were able to start radiotherapy (XRT) the next day, after stenting according to our new institutional protocol. All patients were able to comply with the XRT program, perfectly well. Conclusions: SVC stenting provides immediate significant relief of the very annoying SVC syndrome symptoms, thus facilitating excellent compliance of all the patients to the subsequently XRT protocols. We strongly recommend SVC stenting as first line procedure, in patients with SVC syndrome due to malignancy prior to radiotherapy

El panorama epidémico en el Golfo de México. Los puertos de La Habana, Veracruz y New Orleans en la segunda mitad del siglo XIX

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José Ronzón León

1998-01-01

Full Text Available El artículo tiene como tema el estudio de la epidemia de fiebre amarilla, en 1905, en los puertos de Veracruz, La Habana y New Orleans. El objetivo de este artículo es analizar la epidemia de fiebre amarilla que se convirtió en una pandemia que afectó dichos puertos. La finalidad es comprender la presencia de esta enfermedad en estos puertos y los efectos que tuvo en las relaciones políticas y comerciales de la región, mismos que condujeron a la búsqueda de políticas sanitarias y de saneamiento urbano.

Denali, Tulip, and Option Inferior Vena Cava Filter Retrieval: A Single Center Experience.

Science.gov (United States)

Ramaswamy, Raja S; Jun, Emily; van Beek, Darren; Mani, Naganathan; Salter, Amber; Kim, Seung K; Akinwande, Olaguoke

2018-04-01

To compare the technical success of filter retrieval in Denali, Tulip, and Option inferior vena cava filters. A retrospective analysis of Denali, Gunther Tulip, and Option IVC filters was conducted. Retrieval failure rates, fluoroscopy time, sedation time, use of advanced retrieval techniques, and filter-related complications that led to retrieval failure were recorded. There were 107 Denali, 43 Option, and 39 Tulip filters deployed and removed with average dwell times of 93.5, 86.0, and 131 days, respectively. Retrieval failure rates were 0.9% for Denali, 11.6% for Option, and 5.1% for Tulip filters (Denali vs. Option p = 0.018; Denali vs. Tulip p = 0.159; Tulip vs. Option p = 0.045). Median fluoroscopy time for filter retrieval was 3.2 min for the Denali filter, 6.75 min for the Option filter, and 4.95 min for the Tulip filter (Denali vs. Option p Option p = 0.67). Advanced retrieval techniques were used in 0.9% of Denali filters, 21.1% in Option filters, and 10.8% in Tulip filters (Denali vs. Option p Option p Option filter when compared to both the Denali and Tulip filters. Retrieval of the Denali filter required significantly less amount of fluoroscopy time and use of advanced retrieval techniques when compared to both the Option and Tulip filters. The findings of this study indicate easier retrieval of the Denali and Tulip IVC filters when compared to the Option filter.

GAMBARAN RISIKO TROMBOSIS VENA PROFUNDA (TVP PADA SALES PROMOTION GIRL (SPG BERDASARKAN KRITERIA WELLS DI KOTA DENPASAR

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Shelly Silvia Bintang

2015-01-01

Full Text Available Pekerjaan sebagai sales promotion girl (SPG menuntut berdiri dalam posisi statis dalam waktu kerja yang cukup lama. Dalam sebuah jurnal kesehatan masyarakat tahun 2013 mendapatkan hasil semakin lama SPG bekerja maka semakin lama juga durasi mereka memakai sepatu hak tinggi semakin besar risiko untuk mengalami gangguan kesehatan yang disebabkan sepatu hak tinggi. Gangguan dari aliran darah atau trombosis vena profunda (TVP merupakan dampak yang ditimbulkan. Tujuan dari penelitian ini untuk mengetahui angka tinggi pemakaian sepatu hak tinggi, angka pemakaian stocking dan gambaran SPG di Kota Denpasar yang memiliki risiko rendah, menengah dan tinggi mengalami TVP. Penelitian ini menggunakan metode deskriptif potong lintang. Subyek penelitian ini adalah 62 pegawai SPG yang bekerja di swalayan di Kota Denpasar. Skor kriteria Wells didapatkan untuk mengetahui gambaran risiko probabilitas TVP. Hasil gambaran risiko TVP pada SPG di Kota Denpasar berdasarkan kriteria Wells didapatkan 30 orang pekerja (48,38% menunjukan risiko ringan, dan 30 orang pekerja lainnya (48,38% menunjukan risiko menengah menderita TVP, sedangkan 2 orang pekerja (3,24% menunjukan risiko tinggi. Sebagian besar pegawai SPG di kota Denpasar memiliki risiko rendah dan sedang probabilitas TVP.

Clinical application of hepatic vein percutaneous transluminal angioplasty and stent after stent placement in inferior vena cava

International Nuclear Information System (INIS)

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

2005-01-01

Objective: To investigate the feasibility and effect of recanalization of hepatic vein with percutaneous transluminal angioplasty (PTA) and stent after stent placement in inferior vena cava (IVC). Methods: Eleven patients with Budd-Chiari syndrome (BCS)were once performed metal stent placement in IVC at other hospital, but ascites was not subsided in 9 patients after the stent placement and occurred again in 2 patients in 3 months after the procedure. PTA and metal stent placement were used to treat the occlusion of the hepatic vein (HV) via stent in IVC. Results: Recanalization of occlusive HV was successful in all 11 patients, and symptoms disappeared or were obviously improved. The mean blood pressure in HV dropped from pre-operation (45.12 ± 1.57) cm H 2 O (1 cm H 2 O=0.098 kPa) to post-operation (17.53 ± 0.68) cm H 2 O (P<0.01). In a period of 4-30 months (mean: 13.6 months) following-up, no patient reoccurred symptoms. Conclusion: Recanalization of HV via stent in IVC is a feasible and effective method for occlusive HV, but it is difficult. (authors)

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

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Avradip Santra

2016-07-01

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

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

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Bornak, A.; Ris, H.-B.; Probst, H.; Corpataux, J.-M. [Department of Thoracic and Vascular Surgery, Centre Hospitalier Universitaire Vaudois, Bugnon 46, 1011 Lausanne (Switzerland); Wicky, S. [Department of Radiodiagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, Bugnon 46, 1011 Lausanne (Switzerland); Milesi, I. [Department of Angiology, Centre Hospitalier Universitaire Vaudois, Bugnon 46, 1011 Lausanne (Switzerland)

2003-05-01

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

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

International Nuclear Information System (INIS)

Bornak, A.; Ris, H.-B.; Probst, H.; Corpataux, J.-M.; Wicky, S.; Milesi, I.

2003-01-01

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

Impact of Physician Education and a Dedicated Inferior Vena Cava Filter Tracking System on Inferior Vena Cava Filter Use and Retrieval Rates Across a Large US Health Care Region.

Science.gov (United States)

Wang, Stephen L; Cha, Hsien-Hwa A; Lin, James R; Francis, Bolanos; Elizabeth, Wakley; Martin, Porras; Rajan, Sudhir

2016-05-01

To evaluate the effects of physician familiarity with current evidence and guidelines on inferior vena cava (IVC) filter use and the availability of IVC filter tracking infrastructure on retrieval rates. Fourteen continuing medical education-approved in-hospital grand rounds covering evidence-based review of the literature on IVC filter efficacy, patient-centered outcomes, guidelines for IVC filter indications, and complications were performed across a large United States (US) health care region serving more than 3.5 million members. A computer-based IVC filter tracking system was deployed simultaneously. IVC filter use, rates of attempted retrieval, and fulfillment of guidelines for IVC filter indications were retrospectively evaluated at each facility for 12 months before intervention (n = 427) and for 12 months after intervention (n = 347). After education, IVC filter use decreased 18.7%, with a member enrollment-adjusted decrease of 22.2%, despite an increasing IVC filter use trend for 4 years. Reduction in IVC filter use at each facility strongly correlated with physician attendance at grand rounds (r = -0.69; P = .007). Rates of attempted retrieval increased from 38.9% to 54.0% (P = .0006), with similar rates of successful retrieval (82.3% before education and 85.8% after education on first attempt). Improvement in IVC filter retrieval attempts correlated with physician attendance at grand rounds (r = 0.51; P = .051). IVC filter dwell times at first retrieval attempt were similar (10.2 wk before and 10.8 wk after). Physician education dramatically reduced IVC filter use across a large US health care region, and represents a learning opportunity for physicians who request and place them. Education and a novel tracking system improved rates of retrieval for IVC filter devices. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

Impact of consensus statements and reimbursement on vena cava filter utilization.

Science.gov (United States)

Desai, Sapan S; Naddaf, Abdallah; Pan, James; Hood, Douglas; Hodgson, Kim J

2016-08-01

Pulmonary embolism is the third most common cause of death in hospitalized patients. Vena cava filters (VCFs) are indicated in patients with venous thromboembolism with a contraindication to anticoagulation. Prophylactic indications are still controversial. However, the utilization of VCFs during the past 15 years may have been affected by societal recommendations and reimbursement rates. The aim of this study was to evaluate the impact of societal guidelines and reimbursement on national trends in VCF placement from 1998 to 2012. The National Inpatient Sample was used to identify patients who underwent VCF placement between 1998 and 2012. VCF placement yearly rates were evaluated. Societal guidelines and consensus statements were identified using a PubMed search. Reimbursement rates for VCF were determined on the basis of published Medicare reports. Statistical analysis was completed using descriptive statistics, Fisher exact test, and trend analysis using the Mann-Kendall test and considered significant for P < .05. The use of VCFs increased 350% between January 1998 and January 2008. Consensus statements in favor of VCFs published by the Eastern Association for the Surgery of Trauma (July 2002) and the Society of Interventional Radiology (March 2006) were temporally associated with a significant 138% and 122% increase in the use of VCFs, respectively (P = .014 and P = .023, respectively). The American College of Chest Physicians guidelines (February 2008 and 2012) discouraging the use of VCFs were preceded by an initial stabilization in the use of VCFs between 2008 and 2012, followed by a 16% decrease in use starting in March 2012 (P = .38). Changes in Medicare reimbursement were not followed by a change in VCF implantation rates. There is a temporal association between the societal guidelines' recommendations regarding VCF placement and the actual rates of insertion. More uniform consensus statements from multiple societies along with the use of level I�

De miasmas a mosquitos: el pensamiento médico sobre la fiebre amarilla en Yucatán, 1890-1920 From miasmas to mosquitoes: medical thought on yellow fever in Yucatan, 1890-1920

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Carlos Alcalá Ferráez

2012-03-01

Full Text Available La fiebre amarilla fue un problema de salud pública desde la época colonial debido a la frecuencia con que se presentaba en forma epidémica y a su alta letalidad. El objetivo de este trabajo es analizar el pensamiento médico y su evolución con respecto al vómito prieto entre 1890 y 1921 en Yucatán. Dos aspectos serán abordados: algunos antecedentes con respecto a la enfermedad y las ideas predominantes hasta 1881; y la propuesta de Carlos Finlay para vencer el escepticismo ante su teoría por parte de la comunidad médica. En segundo lugar se analizará la mezcla de las ideas miasmáticas y bacterianas. En tercer lugar, se mostrará cómo, a partir de la demostración de sus postulados, la mirada médica se dirigió al exterminio del mosquito transmisor de este padecimiento.Yellow fever has been a public health concern since colonial days because of its frequent epidemics and high mortality rate. This analysis of medical thought about "the black vomit" in the Yucatan and the evolution of this thinking from 1890 through 1921 first addresses some of the disease's antecedents and preponderant ideas prior to 1881 as well as Carlos Finlay's efforts to convince the medical community that his theory was right. The article goes on to analyze the co-existence of miasmatic and bacterial ideas and to show how medical initiatives began focusing on eradication of the mosquito transmitter once Finlay's postulates had been demonstrated.

Caracterización molecular de Fusarium asociado a pudrición basal del fruto en pitahaya (Selenicereus megalanthus.

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Claudia Salazar-González

2016-06-01

Full Text Available   El objetivo de este trabajo fue identificar aislamientos patogénicos de Fusarium en frutos de pitahaya amarilla afectados por pudrición basal. La caracterización molecular se realizó en diecisiete aislamientos asociados con la enfermedad, colectados en zonas productoras de pitahaya amarilla de los departamentos del Valle del Cauca, Risaralda, Boyacá y Cundinamarca, en Colombia. Se usó PCR con los cebadores ITS1 – ITS4 y TEF1α. Las secuencias de los productos de PCR se compararon con las registradas en el Cento Nacional de Información Biotecnológica (NCBI, por sus siglas en inglés, y se alinearon usando Clustal W2, se construyeron las relaciones filogenéticas con el programa MEGA 6 con el coeficiente de máxima verosimilitud. Los resultados de secuenciación para los marcadores mostraron que los aislamientos patogénicos correspondieron a F. oxysporum. El concepto filogenético confirmó que la pudrición basal de la pitahaya amarilla fue causada por F. oxysporum. Se identificó además una especie de Fusarium no reportada en el GenBank.

Pre-Clinical Model to Study Recurrent Venous Thrombosis in the Inferior Vena Cava.

Science.gov (United States)

Andraska, Elizabeth A; Luke, Catherine E; Elfline, Megan A; Henke, Samuel P; Madapoosi, Siddharth S; Metz, Allan K; Hoinville, Megan E; Wakefield, Thomas W; Henke, Peter K; Diaz, Jose A

2018-06-01

 Patients undergoing deep vein thrombosis (VT) have over 30% recurrence, directly increasing their risk of post-thrombotic syndrome. Current murine models of inferior vena cava (IVC) VT model host one thrombosis event.  We aimed to develop a murine model to study IVC recurrent VT in mice.  An initial VT was induced using the electrolytic IVC model (EIM) with constant blood flow. This approach takes advantage of the restored vein lumen 21 days after a single VT event in the EIM demonstrated by ultrasound. We then induced a second VT 21 days later, using either EIM or an IVC ligation model for comparison. The control groups were a sham surgery and, 21 days later, either EIM or IVC ligation. IVC wall and thrombus were harvested 2 days after the second insult and analysed for IVC and thrombus size, gene expression of fibrotic markers, histology for collagen and Western blot for citrullinated histone 3 (Cit-H3) and fibrin.  Ultrasound confirmed the first VT and its progressive resolution with an anatomical channel allowing room for the second thrombus by day 21. As compared with a primary VT, recurrent VT has heavier walls with significant up-regulation of transforming growth factor-β (TGF-β), elastin, interleukin (IL)-6, matrix metallopeptidase 9 (MMP9), MMP2 and a thrombus with high citrullinated histone-3 and fibrin content.  Experimental recurrent thrombi are structurally and compositionally different from the primary VT, with a greater pro-fibrotic remodelling vein wall profile. This work provides a VT recurrence IVC model that will help to improve the current understanding of the biological mechanisms and directed treatment of recurrent VT. Schattauer GmbH Stuttgart.

Practice patterns of retrievable inferior vena cava filters and predictors of filter retrieval in patients with pulmonary embolism.

Science.gov (United States)

Kang, Jieun; Ko, Heung-Kyu; Shin, Ji Hoon; Ko, Gi-Young; Jo, Kyung-Wook; Huh, Jin Won; Oh, Yeon-Mok; Lee, Sang-Do; Lee, Jae Seung

2017-12-01

Retrievable inferior vena cava (IVC) filters are increasingly used in patients with venous thromboembolism (VTE) who have contraindications to anticoagulant therapy. However, previous studies have shown that many retrievable filters are left permanently in patients. This study aimed to identify the common indications for IVC filter insertion, the filter retrieval rate, and the predictive factors for filter retrieval attempts. To this end, a retrospective cohort study was performed at a tertiary care center in South Korea between January 2010 and May 2016. Electronic medical charts were reviewed for patients with pulmonary embolism (PE) who underwent IVC filter insertion. A total of 439 cases were reviewed. The most common indication for filter insertion was a preoperative/procedural aim, followed by extensive iliofemoral deep vein thrombosis (DVT). Retrieval of the IVC filter was attempted in 44.9% of patients. The retrieval success rate was 93.9%. History of cerebral hemorrhage, malignancy, and admission to a nonsurgical department were the significant predictive factors of a lower retrieval attempt rate in multivariate analysis. With the increased use of IVC filters, more issues should be addressed before placing a filter and physicians should attempt to improve the filter retrieval rate.

Membranous obstruction of inferior vena cava(MOIVC): treatment with percutaneous transluminal angioplasty(PTA) and self expandable metallic stent

Energy Technology Data Exchange (ETDEWEB)

Lee, Ki Yeol; Kim, Baek Hyun; Cha, In Ho; Lee, Nam Joon; Kim, Yun Hwan; Kim, Jung Hyuk [College of Medicine, Korea University, Seoul (Korea, Republic of)

1994-03-15

Percutaneous transluminal angioplasty(PTA) with a balloon catheter is a standard method of treatment for membranous obstruction of inferior vena cava(MOIVC). But, correct therapeutic approach has not been established for MOIVC patients whose lesion is associated with extensive thrombotic IVC occlusion. We tried to treat MOIVC associated with or without thrombus. We treated 13 cases of MOIVC(associated with thrombus in 7 cases, no thrombus in 6 cases) with PTA, thrombolysis and self-expandable metallic stents. PTA was successful in 8 cases, but failed in 5 cases. The recurred cases were retreated with PTA, but follow-up study revealed recoiling restenosis in 4 cases and intimal hyperplasia in 1 case at previous PTA site which could be overcome with a self-expandable metallic stent. The complication were occurred in 3 cases which were hemothorax, hemopericardium, and hemoperitoneum respectively. However, those were resolved by conservative treatment only. Recanalization and dilatation could be done in MOIVC patients with or without thrombosis for improvement of patient's symptom. Gianturco self-expandable metallic stent is useful in treatment of recurred MOIVC after balloon dilatation and preventing reocclusion of the IVC after PTA.

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

International Nuclear Information System (INIS)

Koc, Zafer; Oguzkurt, Levent

2007-01-01

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

Successful management of multiple permanent pacemaker complications – infection, 13 year old silent lead perforation and exteriorisation following failed percutaneous extraction, superior vena cava obstruction, tricuspid valve endocarditis, pulmonary embolism and prosthetic tricuspid valve thrombosis

Science.gov (United States)

Kaul, Pankaj; Adluri, Krishna; Javangula, Kalyana; Baig, Wasir

2009-01-01

A 59 year old man underwent mechanical tricuspid valve replacement and removal of pacemaker generator along with 4 pacemaker leads for pacemaker endocarditis and superior vena cava obstruction after an earlier percutaneous extraction had to be abandoned, 13 years ago, due to cardiac arrest, accompanied by silent, unsuspected right atrial perforation and exteriorisation of lead. Postoperative course was complicated by tricuspid valve thrombosis and secondary pulmonary embolism requiring TPA thrombolysis which was instantly successful. A review of literature of pacemaker endocarditis and tricuspid thrombosis along with the relevant management strategies is presented. We believe this case report is unusual on account of non operative management of right atrial lead perforation following an unsuccessful attempt at percutaneous removal of right sided infected pacemaker leads and the incidental discovery of the perforated lead 13 years later at sternotomy, presentation of pacemaker endocarditis with a massive load of vegetations along the entire pacemaker lead tract in superior vena cava, right atrial endocardium, tricuspid valve and right ventricular endocardium, leading to a functional and structural SVC obstruction, requirement of an unusually large dose of warfarin postoperatively occasioned, in all probability, by antibiotic drug interactions, presentation of tricuspid prosthetic valve thrombosis uniquely as vasovagal syncope and isolated hypoxia and near instantaneous resolution of tricuspid prosthetic valve thrombosis with Alteplase thrombolysis. PMID:19239701

Successful management of multiple permanent pacemaker complications – infection, 13 year old silent lead perforation and exteriorisation following failed percutaneous extraction, superior vena cava obstruction, tricuspid valve endocarditis, pulmonary embolism and prosthetic tricuspid valve thrombosis

Directory of Open Access Journals (Sweden)

Javangula Kalyana

2009-02-01

Full Text Available Abstract A 59 year old man underwent mechanical tricuspid valve replacement and removal of pacemaker generator along with 4 pacemaker leads for pacemaker endocarditis and superior vena cava obstruction after an earlier percutaneous extraction had to be abandoned, 13 years ago, due to cardiac arrest, accompanied by silent, unsuspected right atrial perforation and exteriorisation of lead. Postoperative course was complicated by tricuspid valve thrombosis and secondary pulmonary embolism requiring TPA thrombolysis which was instantly successful. A review of literature of pacemaker endocarditis and tricuspid thrombosis along with the relevant management strategies is presented. We believe this case report is unusual on account of non operative management of right atrial lead perforation following an unsuccessful attempt at percutaneous removal of right sided infected pacemaker leads and the incidental discovery of the perforated lead 13 years later at sternotomy, presentation of pacemaker endocarditis with a massive load of vegetations along the entire pacemaker lead tract in superior vena cava, right atrial endocardium, tricuspid valve and right ventricular endocardium, leading to a functional and structural SVC obstruction, requirement of an unusually large dose of warfarin postoperatively occasioned, in all probability, by antibiotic drug interactions, presentation of tricuspid prosthetic valve thrombosis uniquely as vasovagal syncope and isolated hypoxia and near instantaneous resolution of tricuspid prosthetic valve thrombosis with Alteplase thrombolysis.

Cardiac variation of inferior vena cava: new concept in the evaluation of intravascular blood volume.

Science.gov (United States)

Nakamura, Kensuke; Tomida, Makoto; Ando, Takehiro; Sen, Kon; Inokuchi, Ryota; Kobayashi, Etsuko; Nakajima, Susumu; Sakuma, Ichiro; Yahagi, Naoki

2013-07-01

Evaluation of the intravascular blood volume is an important assessment in emergency and critical care medicine. Measurement of the inferior vena cava (IVC) respiratory variation by ultrasound echography is useful, but it entails subjective problems. We have hypothesized that IVC cardiac variation is also correlated with intravascular blood volume and analyzed it automatically using computer software of two kinds, later comparing the results. Snakes, software to track boundaries by curve line continuity, and template matching software were incorporated into a computer with an ultrasound machine to track the short-axis view of IVC automatically and analyze it with approximation by ellipse. Eight healthy volunteers with temporary mild hypovolemia underwent echography before and after passive leg raising and while wearing medical anti-shock trousers. IVC cardiac variation was visually decreased by both leg raising and medical anti-shock trousers. The collapse index (maximum - minimum/maximum) of area during three cardiac beats was decreased showing a good relationship to fluid load simulations; 0.24 ± 0.03 at baseline versus 0.11 ± 0.01 with leg raising and 0.12 ± 0.01 with medical anti-shock trousers. In conclusion, IVC cardiac variation has the potential to provide an evaluation of water volume. It presents some advantages in mechanical analysis over respiratory variation. At the very least, we need to exercise some caution with cardiac variation when evaluating respiratory variation.

Management of acute lower extremity deep venous thrombosis in a patient with duplicated inferior vena cava and contraindication to anticoagulation: case and review of the literature.

Science.gov (United States)

Patel, Shrinil; Cheema, Anmol; Karawadia, Tejas; Carson, Michael

2018-06-04

Duplication of the inferior vena cava (DIVC) is an uncommon embryological anatomic phenomenon.We report a 63-year-old woman with extensive right leg deep vein thrombosis who required an IVC filter due to contraindications for anticoagulation, but was found to have DIVC which required the placement of two IVC filters with good result. This report will review and summarise past reports of DIVC management to provide a guide for future clinicians, and review the embryological development, diagnosis and IVC filter placement options as they are based on the type of anatomic malformation encountered. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

International Nuclear Information System (INIS)

Jilintai; Hashiyama, S.; Gonda, Y.; Ishikawa, H.; Sato, M.; Miyahara, K.

2006-01-01

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

Statewide Inferior Vena Cava Filter Placement, Complications, and Retrievals: Epidemiology and Recent Trends.

Science.gov (United States)

Charalel, Resmi A; Durack, Jeremy C; Mao, Jialin; Ross, Joseph S; Meltzer, Andrew J; Sedrakyan, Art

2018-03-01

Public awareness of inferior vena cava (IVC) filter-related controversies has been elevated by the Food and Drug Administration (FDA) safety communication in 2010. To examine population level trends in IVC filter utilization, complications, retrieval rates, and subsequent pulmonary embolism (PE) risk. A retrospective cohort study. Patients receiving IVC filters during 2005-2014 in New York State. IVC filter-specific complications, new PE occurrences and IVC filter retrievals were evaluated as time-to-event data using Kaplan-Meier analysis. Estimated cumulative risks were obtained at various timepoints during follow-up. There were 91,873 patients receiving IVC filters between 2005 and 2014 in New York State included in the study. The average patient age was 67 years and 46.6% were male. Age-adjusted rates of IVC filter placement increased from 48 cases/100,000 in 2005 to 52 cases/100,000 in 2009, and decreased afterwards to 36 cases/100,000 in 2014. The estimated risks of having an IVC filter-related complication and filter retrieval within 1 year was 1.5% [95% confidence interval (CI), 1.4%-1.6%] and 3.5% (95% CI, 3.4%-3.6%). One-year retrieval rate was higher post-2010 when compared with pre-2010 years (hazard ratio, 2.70; 95% CI, 2.50-2.91). Among the 58,176 patients who did not have PE events before or at the time of IVC filter placement, the estimated risk of developing subsequent PE at 1 year was 2.0% (95% CI, 1.9%-2.1%). Our findings suggest that FDA communications may be effective in modifying statewide clinical practices. Given the 2% observed PE rate following prophylactic IVC filter placement, large scale pragmatic studies are needed to determine contemporary safety and effectiveness of IVC filters.

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.

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

International Nuclear Information System (INIS)

Looby, S.; Given, M.F.; Geoghegan, T.; McErlean, A.; Lee, M.J.

2007-01-01

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

Tromboflebitis séptica de la vena porta (pileflebitis): diagnóstico y manejo a propósito de tres casos Septic thrombophlebitis of the portal vein (pylephlebitis): diagnosis and management of three cases

OpenAIRE

E. Arteche; S. Ostiz; L. Miranda; P. Caballero; G. Jiménez López de Oñate

2005-01-01

Fundamento. La pileflebitis es la tromboflebitis séptica de la vena porta y/o de sus ramas, de manera aguda y generalmente como complicación de procesos inflamatorios intraabdominales o de intervenciones quirúrgicas en pacientes con discrasias sanguíneas. Siendo la clínica bastante inespecífica, los hallazgos radiológicos aunque no patognomónicos, son de gran utilidad para el diagnóstico precoz y un mejor pronóstico vital de estos pacientes. El objetivo de este trabajo es revisar la patogenia...

PO-38 - Young women with breast cancer and inferior vena cava thrombosis. Which is the best therapeutic option? And for how long?

Science.gov (United States)

Vilaseca, A B; Capmany, C L; Sabsay, F

2016-04-01

Thromboembolic disease (TED) is frequent, and, thromboembolic events are the second cause of death in active cancer patients Today we have knowledge of a lot of risk and predictor factors of thrombosis in cancer, although some mechanisms underlying this increased thromboembolic risk, still remains unclear. Knowing that cancer is today curable, we want to remark that not only old people but also young should be investigated about their personal burden of thromboembolic disease to improve prognosis, and at the same time remark the need to establish different therapeutic strategies in each stage of the disease to prevent or treat TED. We present the case of a young 28 old, female, with breast nodule and axillaries lymphadenopathies, highly suspicious of breast cancer. She has an acute Inferior Vena Cava Thrombosis in her Scan Tomography with a 40% occlusion clinically asymptomatic. Personal history: 2008 splenectomy by a refractory autoimmune hemolytic anemia Directed Coombs Positive (DC) to corticosteroids, 2010 hypothyroidism, 2011 anti lupus antibodies(LA) during traditional pre surgical coagulation test, that persist along time. Family history positive for breast cancer, mother and grandmother and negative for thromboembolic disease In this scenario we decide to put her in low molecular weight heparin 1mg/kg bid a day until we have the oncology diagnosis and then re evaluate our therapeutic anticoagulant decision. After breast cancer diagnosis with the axillaries biopsy she continued with LMWH at full doses to perform the surgery and complete treatment. The diagnosis after surgery was high grade intraductal carcinoma N1 Pos of 21. She performs chemotherapy with cyclophosphamide, doxorubicin and taxol and then radiotherapy. She has been controlled with doppler ultrasonography every three months, at month six shows vena cava recanalization. When she finished radiotherapy we stop HBPM one day and reevaluated for LA that persist positive. At this time we decided to

Occult Amebic Liver Abscess as Cause of Extensive Inferior Vena Cava and Hepatic Vein Thrombosis.

Science.gov (United States)

Martin, Leslie; Burute, Nishigandha; Haider, Ehsan; Serrano, Pablo E; O'Shea, Timothy; Siegal, Deborah

2017-10-01

The most common extraintestinal complication of Entamoeba histolytica is amebic liver abscess (ALA). Hepatic vein and inferior vena cava (IVC) thrombosis are rare but well-documented complications of ALA, typically attributed to mechanical compression and inflammation associated with a large abscess. We present a case of a previously healthy 43-year-old Canadian man presenting with constitutional symptoms and right upper quadrant abdominal pain. He was found to have thrombophlebitis of the IVC, accessory right hepatic vein, and bilateral iliac veins. Extensive investigations for thrombophilia were negative. Magnetic resonance imaging of the liver demonstrated a 3.2-cm focal area of parenchymal abnormality that was reported as presumptive hepatocellular carcinoma, and a 1.9-cm lesion in the caudate lobe with diffusion restriction and peripheral rim enhancement. Despite multiple biopsy attempts, a histopathological diagnosis was not achieved. Abdominal pain and fever 4 months later prompted repeat ultrasound demonstrating a 10.4- × 12.0-cm rim-enhancing fluid attenuation lesion felt to represent a liver abscess. Thick dark "chocolate brown" drainage from the lesion and positive serology for E. histolytica confirmed the diagnosis of ALA acquired from a previous trip to Cuba. The patient was started on treatment with metronidazole and paromomycin and repeat abdominal ultrasound demonstrated resolution of the abscess. This case is the first to demonstrate extensive IVC thrombosis secondary to a relatively small occult ALA and emphasizes the thrombogenic potential of ALA. Amebic infection should be considered as a rare cause of IVC thrombosis in the correct clinical context.

Fibrin Sheath Angioplasty: A Technique to Prevent Superior Vena Cava Stenosis Secondary to Dialysis Catheters

Science.gov (United States)

Hacker, Robert I.; Garcia, Lorena De Marco; Chawla, Ankur; Panetta, Thomas F.

2012-01-01

Fibrin sheaths are a heterogeneous matrix of cells and debris that form around catheters and are a known cause of central venous stenosis and catheter failure. A total of 50 cases of central venous catheter fibrin sheath angioplasty (FSA) after catheter removal or exchange are presented. A retrospective review of an outpatient office database identified 70 eligible patients over a 19-month period. After informed consent was obtained, the dialysis catheter exiting the skin was clamped, amputated, and a wire was inserted. The catheter was then removed and a 9-French sheath was inserted into the superior vena cava, a venogram was performed. If a fibrin sheath was present, angioplasty was performed using an 8 × 4 or 10 × 4 balloon along the entire length of the fibrin sheath. A completion venogram was performed to document obliteration of the sheath. During the study, 50 patients were diagnosed with a fibrin sheath, and 43 had no pre-existing central venous stenosis. After FSA, 39 of the 43 patient's (91%) central systems remained patent without the need for subsequent interventions; 3 patients (7%) developed subclavian stenoses requiring repeat angioplasty and stenting; 1 patent (2.3%) developed an occlusion requiring a reintervention. Seven patients with prior central stenosis required multiple angioplasties; five required stenting of their central lesions. Every patient had follow-up fistulograms to document long-term patency. We propose that FSA is a prudent and safe procedure that may help reduce the risk of central venous stenosis from fibrin sheaths due to central venous catheters. PMID:23997555

Sequence stratigraphic analysis of Cenomanian greenhouse palaeosols: A case study from southern Patagonia, Argentina

Science.gov (United States)

Varela, Augusto N.; Veiga, Gonzalo D.; Poiré, Daniel G.

2012-10-01

The aim of this contribution is to analyse extrinsic (i.e., tectonics, climate and eustasy) and intrinsic (i.e., palaeotopography, palaeodrainage and relative sedimentation rates) factors that controlled palaeosol development in the Cenomanian Mata Amarilla Formation (Austral foreland basin, southwestern Patagonia, Argentina). Detailed sedimentological logs, facies analysis, pedofeatures and palaeosol horizon identification led to the definition of six pedotypes, which represent Histosols, acid sulphate Histosols, Vertisols, hydromorphic Vertisols, Inceptisols and vertic Alfisols. Small- and large-scale changes in palaeosol development were recognised throughout the units. Small-scale or high-frequency variations, identified within the middle section are represented by the lateral and vertical superimposition of Inceptisols, Vertisols and hydromorphic Vertisols. Lateral changes are interpreted as the result of intrinsic factors to the depositional systems, such as the relative position within the floodplain and the distance from the main channels, that condition the nature of parent material, the sedimentation rate and eventually the palaeotopographic position. Vertical stacking of different soil types is linked to avulsion processes and the relatively abrupt change in the distance to main channels as the system aggraded. The large-scale or low-frequency vertical variations in palaeosol type occurring in the Mata Amarilla Formation are related to long-term changes in depositional environments. The lower and upper sections of the studied logs are characterised by Histosols and acid sulphate Histosols, and few hydromorphic Vertisols associated with low-gradient coastal environments (i.e., lagoons, estuaries and distal fluvial systems). At the lower boundary of the middle section, a thick palaeosol succession composed of vertic Alfisols occurs. The rest of the middle section is characterised by Vertisols, hydromorphic Vertisols and Inceptisols occurring on distal and

Estimation and tracking of AP-diameter of the inferior vena cava in ultrasound images using a novel active circle algorithm.

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Karami, Ebrahim; Shehata, Mohamed S; Smith, Andrew

2018-05-04

Medical research suggests that the anterior-posterior (AP)-diameter of the inferior vena cava (IVC) and its associated temporal variation as imaged by bedside ultrasound is useful in guiding fluid resuscitation of the critically-ill patient. Unfortunately, indistinct edges and gaps in vessel walls are frequently present which impede accurate estimation of the IVC AP-diameter for both human operators and segmentation algorithms. The majority of research involving use of the IVC to guide fluid resuscitation involves manual measurement of the maximum and minimum AP-diameter as it varies over time. This effort proposes using a time-varying circle fitted inside the typically ellipsoid IVC as an efficient, consistent and novel approach to tracking and approximating the AP-diameter even in the context of poor image quality. In this active-circle algorithm, a novel evolution functional is proposed and shown to be a useful tool for ultrasound image processing. The proposed algorithm is compared with an expert manual measurement, and state-of-the-art relevant algorithms. It is shown that the algorithm outperforms other techniques and performs very close to manual measurement. Copyright © 2018 Elsevier Ltd. All rights reserved.

A Retrospective Evaluation of Echocardiograms to Establish Normative Inferior Vena Cava and Aortic Measurements for Children Younger Than 6 Years.

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Stenson, Erin K; Punn, Rajesh; Ramsi, Musaab; Kache, Saraswati

2018-02-26

The ability to plot the inferior vena cava (IVC) size on a normal curve for pediatric patients may prove beneficial. First, in patients with normal cardiac anatomy who present in shock, assessing IVC size may be valuable for evaluating the degree of dehydration. Second, in children with heart disease, understanding how a child's IVC size compares to normal could be particularly beneficial for patients with right heart disease. We sought to create normal curves for the IVC and aorta in children younger than 6 years. Data were gathered from 347 echocardiograms of healthy children younger than 6 years in a retrospective study at a quaternary care children's hospital. From the subcostal long- and short-axis images, maximum diameters in the transverse and longitudinal views were obtained for both the IVC and the aorta. Both IVC and aortic dimensions increased in a linear fashion and had excellent correlations with the body surface area, body mass, and height (IVC, r = 0.78-0.81; P pediatric patient's hydration status or right heart function in patients with congenital heart disease. © 2018 by the American Institute of Ultrasound in Medicine.

Factors affecting Cook Gunther Tulip and Cook Celect inferior vena cava filter retrieval success.

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Glocker, Roan J; Novak, Zdenek; Matthews, Thomas C; Patterson, Mark A; Jordan, William D; Pearce, Benjamin J; Passman, Marc A

2014-01-01

Success rates vary for the retrieval of inferior vena cava filters (IVCFs). The optimal retrieval time and factors influencing retrieval success remain unproven. This study aims to determine optimal time and evaluate factors related to successful IVCF retrieval. An institutional prospectively maintained database was reviewed for all IVCF retrieval attempts from 2006 to 2012. Patient demographics, comorbidities, indications for procedure, placement technique, IVCF type, presence of angulation, and time to retrieval were evaluated with respect to success or failure of retrieval. Statistical analyses (t-test, χ(2), correlations, and Kaplan-Meier plots) were performed comparing successful and unsuccessful retrievals. Of 121 attempted IVCF retrievals, 92 (76%) were successful and 29 (24%) were unsuccessful. There were no significant differences between the successful and unsuccessful attempts in terms of patient demographics, comorbidities, indications for procedure, placement technique, or IVCF type, which included 93 Celect (77%) and 28 Gunther Tulip (23%). Time since IVCF placement was significantly different (P = .025) between the successful and unsuccessful retrieval groups (medians were 105 [7-368] and 162 [43-379] days, respectively). Time since IVCF placement greater than 117 days correlated significantly with unsuccessful IVCF retrieval (R = 0.218; P = .017; odds ratio, 2.88; P = .02). Angulation greater than 20 degrees on anteroposterior radiograph was noted in seven of 29 (24%) unsuccessful retrievals compared with seven of 92 (8%) successful retrievals and was significant (P = .012). Cook Gunther Tulip and Celect IVCF retrieval is most likely to be successful within 3 to 4 months of placement. Unsuccessful retrieval attempts are more likely to occur when IVCF position is angulated. Copyright © 2014 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Incidencia y severidad de las sigatokas negra (Mycosphaerella fijiensis Morelet y amarilla (Mycosphaerella musicola Leach et Mulder del plátano según los estados fenológicos

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Torrado-Jaime Mayary

2008-12-01

Full Text Available

En Colombia las sigatokas negra y amarilla, causadas por Mycosphaerella fijiensisy M. musicola, respectivamente, están entre las principales enfermedades que atacan al plátano. Aunque hay registros de su presencia, se desconoce la época en que aparecen de acuerdo con los estados fenológicos y condiciones ambientales. Esta investigación se realizó en la granja Montelindo (Universidad de Caldas, a 1.050 msnm, temperatura media anual 22,8 °C, precipitación anual 2.200 mm y humedad relativa 76%. Se sembraron cormos de Dominico Hartón, África, FHIA-20 y FHIA-21, en diseño de bloques al azar con cuatro repeticiones y 10 plantas por repetición. Desde siembra hasta cosecha se registraron incidencia, severidad, número de esporas y elementos climáticos. Se definieron cinco estados fenológicos: brotación y emergencia, plántula, prefloración, floración, y llenado del racimo y madurez fisiológica. Las sigatokas se presentaron desde la etapa de plántula hasta madurez fisiológica; fue más agresiva la sigatoka negra en el área de estudio. La mayor población de conidias en D. Hartón y África se presentó en etapas de prefloración y llenado del racimo; en los híbridos FHIA-20 y FHIA-21 coincidió con la etapa de floración. Incrementos graduales de temperatura, precipitación intensa intercalada con periodos secos y aumento en la humedad foliar favorecieron la incidencia y severidad de las sigatokas.

Differences in radial expansion force among inferior vena cava filter models support documented perforation rates.

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Robins, J Eli; Ragai, Ihab; Yamaguchi, Dean J

2018-05-01

Inferior vena cava (IVC) filters are used in patients at risk for pulmonary embolism who cannot be anticoagulated. Unfortunately, these filters are not without risk, and complications include perforation, migration, and filter fracture. The most prevalent complication is filter perforation of the IVC, with incidence varying among filter models. To our knowledge, the mechanical properties of IVC filters have not been evaluated and are not readily available through the manufacturer. This study sought to determine whether differences in mechanical properties are similar to differences in documented perforation rates. The radial expansion forces of Greenfield (Boston Scientific, Marlborough, Mass), Cook Celect (Cook Medical, Bloomington, Ind), and Cook Platinum filters were analyzed with three replicates per group. The intrinsic force exerted by the filter on the measuring device was collected in real time during controlled expansion. Replicates were averaged and significance was determined by calculating analysis of covariance using SAS software (SAS Institute, Cary, NC). Each filter model generated a significantly different radial expansion force (P filter, followed by the Cook Celect and Greenfield filters. Radial force dispersion during expansion was greatest in the Cook Celect, followed by the Cook Platinum and Greenfield filters. Differences in radial expansion forces among IVC filter models are consistent with documented perforation rates. Cook Celect IVC filters have a higher incidence of perforation compared with Greenfield filters when they are left in place for >90 days. Evaluation of Cook Celect filters yielded a significantly higher radial expansion force at minimum caval diameter, with greater force dispersion during expansion. Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Improving inferior vena cava filter retrieval rates with the define, measure, analyze, improve, control methodology.

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Sutphin, Patrick D; Reis, Stephen P; McKune, Angie; Ravanzo, Maria; Kalva, Sanjeeva P; Pillai, Anil K

2015-04-01

To design a sustainable process to improve optional inferior vena cava (IVC) filter retrieval rates based on the Define, Measure, Analyze, Improve, Control (DMAIC) methodology of the Six Sigma process improvement paradigm. DMAIC, an acronym for Define, Measure, Analyze, Improve, and Control, was employed to design and implement a quality improvement project to increase IVC filter retrieval rates at a tertiary academic hospital. Retrievable IVC filters were placed in 139 patients over a 2-year period. The baseline IVC filter retrieval rate (n = 51) was reviewed through a retrospective analysis, and two strategies were devised to improve the filter retrieval rate: (a) mailing of letters to clinicians and patients for patients who had filters placed within 8 months of implementation of the project (n = 43) and (b) a prospective automated scheduling of a clinic visit at 4 weeks after filter placement for all new patients (n = 45). The effectiveness of these strategies was assessed by measuring the filter retrieval rates and estimated increase in revenue to interventional radiology. IVC filter retrieval rates increased from a baseline of 8% to 40% with the mailing of letters and to 52% with the automated scheduling of a clinic visit 4 weeks after IVC filter placement. The estimated revenue per 100 IVC filters placed increased from $2,249 to $10,518 with the mailing of letters and to $17,022 with the automated scheduling of a clinic visit. Using the DMAIC methodology, a simple and sustainable quality improvement intervention was devised that markedly improved IVC filter retrieval rates in eligible patients. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

Results of a multicenter study of the retrievable Tulip vena cava filter: Early clinical experience

International Nuclear Information System (INIS)

Neuerburg, Joerg M.; Guenther, Rolf W.; Vorwerk, Dierk; Dondelinger, Robert F.; Jaeger, Horst; Lackner, Klaus J.; Schild, Hans H.; Plant, Graham R.; Joffre, Francis G.; Schneider, Pierre A.; Janssen, Johan H. A.

1997-01-01

Purpose. To evaluate clinically a new, retrievable vena caval filter in a multicenter study. Methods. The Tulip filter is a stainless steel half-basket that is suitable for antegrade or retrograde insertion via an 8.5 Fr introducer sheath. The filter can be retrieved via the jugular approach using an 11 Fr coaxial retrieval system. Forty-eight filters were implanted via the femoral approach and 38 via the jugular approach in 83 patients. Follow-up examinations (plain films, colorcoded duplex sonography) were performed up to 3 years after filter insertion (mean 136 days) in 75 patients. Twenty-seven patients were screened by colorcoded duplex sonography for insertion site thrombosis. Results. An appropriate filter position was achieved in all cases. Insertion problems occurred in 3 cases; these were not due to the filter design but to an imperfect prototype insertion mechanism that has now been modified (n=2) or a manipulation error (n=1). In 2 of these cases the filters were replaced percutaneously; 1 patient required venotomy for filter removal. No further complications due to filter insertion occurred. Two filters were used as temporary devices and were successfully removed after 6 and 11 days, respectively. There was 1 fatal recurrent pulmonary embolism (PE) and 2 non-fatal PE, 5 complete and 3 partial caval occlusions, and 3 caudal migrations of the filter. Insertion site venous thrombosis was not seen in the 27 patients monitored for this complication. Conclusion. Precise placement of the Tulip filter is feasible by either access route and the device appears mechanically stable. Further observations are needed to confirm that safe filter removal is practical up to 10 days after its insertion

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

International Nuclear Information System (INIS)

Cho, Young Hoon; Gwon, Dong Il; Ko, Gi Young; Ko, Heung Kyu; Kim, Jin Hyoung; Shin, Ji Hoon; Yoon, Hyun Ki; Sung, Kyu Bo

2014-01-01

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

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

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

2014-02-15

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

Effectiveness of stereotactic body radiotherapy for hepatocellular carcinoma with portal vein and/or inferior vena cava tumor thrombosis.

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Mian Xi

Full Text Available BACKGROUND: To report the feasibility, efficacy, and toxicity of stereotactic body radiotherapy (SBRT for the treatment of portal vein tumor thrombosis (PVTT and/or inferior vena cava tumor thrombosis (IVCTT in patients with advanced hepatocellular carcinoma (HCC. MATERIALS AND METHODS: Forty-one patients treated with SBRT using volumetric modulated arc therapy (VMAT for HCC with PVTT/IVCTT between July 2010 and May 2012 were analyzed. Of these, 33 had PVTT and 8 had IVCTT. SBRT was designed to target the tumor thrombosis and deliver a median total dose of 36 Gy (range, 30-48 Gy in six fractions during two weeks. RESULTS: The median follow-up was 10.0 months. At the time of analysis, 15 (36.6% achieved complete response, 16 (39.0% achieved partial response, 7 (17.1% patients were stable, and three (7.3% patients showed progressive disease. No treatment-related Grade 4/5 toxicity was seen within three months after SBRT. One patient had Grade 3 elevation of bilirubin. The one-year overall survival rate was 50.3%, with a median survival of 13.0 months. The only independent predictive factor associated with better survival was response to radiotherapy. CONCLUSIONS: VMAT-based SBRT is a safe and effective treatment option for PVTT/IVCTT in HCC. Prospective randomized controlled trials are warranted to validate the role of SBRT in these patients.

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

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McConville, R. M.; Kennedy, P. T.; Collins, A. J.; Ellis, P. K.

2009-01-01

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

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

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

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Zhang, Qingqiao; Huang, Qianxin; Shen, Bin; Sun, Jingmin; Wang, Xiaolong; Liu, Hongtao

2015-01-01

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

Strict sequential catheter ablation strategy targeting the pulmonary veins and superior vena cava for persistent atrial fibrillation.

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Yoshiga, Yasuhiro; Shimizu, Akihiko; Ueyama, Takeshi; Ono, Makoto; Fukuda, Masakazu; Fumimoto, Tomoko; Ishiguchi, Hironori; Omuro, Takuya; Kobayashi, Shigeki; Yano, Masafumi

2018-08-01

An effective catheter ablation strategy, beyond pulmonary vein isolation (PVI), for persistent atrial fibrillation (AF) is necessary. Pulmonary vein (PV)-reconduction also causes recurrent atrial tachyarrhythmias. The effect of the PVI and additional effect of a superior vena cava (SVC) isolation (SVCI) was strictly evaluated. Seventy consecutive patients with persistent AF who underwent a strict sequential ablation strategy targeting the PVs and SVC were included in this study. The initial ablation strategy was a circumferential PVI. A segmental SVCI was only applied as a repeat procedure when patients demonstrated no PV-reconduction. After the initial procedure, persistent AF was suppressed in 39 of 70 (55.7%) patients during a median follow-up of 32 months. After multiple procedures, persistent AF was suppressed in 46 (65.7%) and 52 (74.3%) patients after receiving the PVI alone and PVI plus SVCI strategies, respectively. In 6 of 15 (40.0%) patients with persistent AF resistant to PVI, persistent AF was suppressed. The persistent AF duration independently predicted persistent AF recurrences after multiple PVI alone procedures [HR: 1.012 (95% confidence interval: 1.006-1.018); pstrategies [HR: 1.018 (95% confidence interval: 1.011-1.025); pstrategies, respectively. The outcomes of the PVI plus SVCI strategy were favorable for patients with shorter persistent AF durations. The initial SVCI had the additional effect of maintaining sinus rhythm in some patients with persistent AF resistant to PVI. Copyright © 2018 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Informe sobre una investigación entomológica realizada en Colombia

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P. C. A. Antunes

1937-03-01

Full Text Available La investigación entomológica cuyo informe presentamos, se realizó en los municipios de Restrepo y Villavicencio, Intendencia del Meta, Colombia, del 12 de diciembre de 1934 al 30 de marzo de 1935 y coincidió con un brote epidémico de fiebre amarilla silvestre. Solamente sufrieron la fiebre personas residentes fuéra de las poblaciones. Ninguna infección fue adquirida dentro de éIlas. La poblaciones cabeceras de los municipios de Restrepo y Villa vicencio, hálIanse situadas al pie de la vertiente oriental de la Cordillera de los Andes, entre ésta y las grandes llanuras que al Oriente se dilatan hasta las fronteras con el Brasil y Venezuela. Junto a VilIavicencio y cortando el camino que lo une a Restrepo, corre el Río Guatiquía, Durante el período de la investigación ningún caso de fiebre amarilla se registró en el área de la margen derecha de este río, pero posteriormente se ha comprobado la presencia de fiebre amarilla silvestre en ambas márgenes del Guatiquía indistintamente. La epidemia en cuestión abarcó una extensa zona en el municipio de Restrepo, y en el de Villavicencio, apenas la vereda El Retiro sobre la margen izquierda del Guatiquía.

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

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

2013-12-15

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

Intra- and Inter-rater Agreement of Superior Vena Cava Flow and Right Ventricular Outflow Measurements in Late Preterm and Term Neonates.

Science.gov (United States)

Mahoney, Liam; Fernandez-Alvarez, Jose R; Rojas-Anaya, Hector; Aiton, Neil; Wertheim, David; Seddon, Paul; Rabe, Heike

2018-02-24

To explore the intra- and inter-rater agreement of superior vena cava (SVC) flow and right ventricular (RV) outflow in healthy and unwell late preterm neonates (33-37 weeks' gestational age), term neonates (≥37 weeks' gestational age), and neonates receiving total-body cooling. The intra- and inter-rater agreement (n = 25 and 41 neonates, respectively) rates for SVC flow and RV outflow were determined by echocardiography in healthy and unwell late preterm and term neonates with the use of Bland-Altman plots, the repeatability coefficient, the repeatability index, and intraclass correlation coefficients. The intra-rater repeatability index values were 41% for SVC flow and 31% for RV outflow, with intraclass correlation coefficients indicating good agreement for both measures. The inter-rater repeatability index values for SVC flow and RV outflow were 63% and 51%, respectively, with intraclass correlation coefficients indicating moderate agreement for both measures. If SVC flow or RV outflow is used in the hemodynamic treatment of neonates, sequential measurements should ideally be performed by the same clinician to reduce potential variability. © 2018 by the American Institute of Ultrasound in Medicine.

Diagnóstico inmunohistoquímico del dengue en cortes de parafina

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Ladys Sarmiento

1995-03-01

Full Text Available La demostración de antígenos de losvirus del dengue en tejidos de pacientes fallecidos por dengue hemorrágico y particularmente en aquellos casos en los que no se dispone de otras pruebas para confirmar la etiologíaviral, es una necesidad frecuente en nuestro medio. Por esta razón, estandarizamos una técnica inmunohistoquírnica para detectar antígenos de dengue en tejidos incluidos en parafina. Utilizamos anticuerpos antiflavivirus comúnmente usados para el diagnóstico serológico. Los antígenos empleados para estandarizar esta técnica incluyeron: 1 cerebros de ratón inoculados con los diferentes serotipos del dengue y con virus de la fiebre amarilla; 2 cortes de hígados de pacientes fallecidos con diagnóstico clínico de dengue hemorrágico, fiebre amarilla o hepatitis delta; y, 3 monocapas de c6lulas C6136 inoculadas también con los diferentes serotipos del dengue. Estos antígenos se enfrentaron a los anticuerpos antiflavivirus (fiebre amarilla o dengue preparados como líquidos ascíticos inmunes (MI de ratón, siguiendo procedimientos ya establecidos. Utilizamos LA1 preparados en el INS y LA1 suministrados por la OPS. Ladilución ideal de trabajocon la cual pudimos 0bse~alra presencia del antígeno, tanto en los tejidos como en las células, se obtuvo titulando los distintos LA1 frente a cortes de tejido desparafinado o frente a las c6lulas fijadas en etanol sobre la lámina de vidrio. Con los LA1 preparados en el INS, O ~ S ~ N ~ re~aOccSión cruzada entre todos los flavivirus, resultado que no se 0bseNó en los cortes de hígado con diagnóstico de hepatitis delta. Los resultados obtenidos con los MI de la OPS permitieron visualizar los antígenos virales más claramente y a diluciones más altas, sin la reacción cruzada entre el dengue y la fiebre amarilla. Sin embargo, la visualización de los mismos con los LA1 del INS es satisfactoria y con disponibilidad permanente. La reacción cruzada entre los virus del dengue y

Induction of mutation in peas (Pisum sativum) in Peru

International Nuclear Information System (INIS)

Gomez Pando, L.; Torres Aranda, M.; Romero Loli, M.

1984-01-01

The production of peas, a staple food in Peru, can be increased by crop rotation with cereals in high lands (3000 m and above). Cultivation in high lands not only gives cultivar of higher proteic content but also improves the fertility of the soils. However, the low temperature (in the freezing region) in the high lands and the associated plant diseases are the major problems for this kind of cultivation. The present report describes the development of freezing and disease resistant mutants through mutagenesis with gamma radiation. Two varieties, Alderman and Amarilla, which had been adopted to high lands are selected for the present study. Two doses were used, 14 and 18 Krad, employing 4600 seeds/dose for the Alderman variety and 3600 seeds/dose for Amarilla. Preliminary results are presented

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

International Nuclear Information System (INIS)

Guo Jinhe; Teng Gaojun; He Shicheng; Qiu Haibo; Fang Wen; Zhu Guangyu; Deng Gang

2002-01-01

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

Enfermedades de notificación obligatoria

OpenAIRE

Instituto Nacional de Salud

2005-01-01

Presenta enfermedades inmunoprevenibles como: Sarampión y rubéola, Tos Ferina; Enfermedades trnasmitidas por vectores: dengue, Fiebre amarilla, Leismaniosis; Enfermedades de transmisión sexual: VIH/SIDA; Enfermedades zoonóticas: rabia animal

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

Retrievable Inferior vena cava filters in pregnancy: Risk versus benefit?

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Crosby, David A; Ryan, Kevin; McEniff, Niall; Dicker, Patrick; Regan, Carmen; Lynch, Caoimhe; Byrne, Bridgette

2018-03-01

Venous thromboembolism remains one of the leading causes of maternal mortality in the developed world. Retrievable inferior vena cava (IVC) filters have a role in the prevention of lethal pulmonary emboli when anticoagulation is contraindicated or has failed [1]. It is unclear whether or not the physiological changes in pregnancy influence efficacy and complications of these devices. The decision to place an IVC filter in pregnancy is complex and there is limited information in terms of benefit and risk to the mother. The objective of this study was to determine the efficacy and safety of these devices in pregnancy and to compare these with rates reported in the general population. The aim of this study was report three recent cases of retrievable IVC filter use in pregnant women in our department and to perform a systematic review of the literature to identify published cases of filters in pregnancy. The efficacy and complication rates of these devices in pregnancy were estimated and compared to rates reported in the general population in a recent review [2]. Fisher's exact test was used for statistical analysis. In addition to our three cases, 16 publications were identified with retrievable IVC filter use in 40 pregnant women resulting in a total of 43 cases. There was no pulmonary embolus in the pregnant group (0/43) compared to 57/6291 (0.9%) in the general population. Thrombosis of the filter (2.3% vs. 0.9%, p = 0.33) and perforation of the IVC (7.0% vs 4.4%, p = 0.44) were more common in pregnancy compared to the general population but the difference was not statistically significant. Failure to retrieve the filter is more likely to occur in pregnancy (26% vs. 11%, p = 0.006) but this did not correlate with the type of device (p = 0.61), duration of insertion (p = 0.58) or mode of delivery (p = 0.37). Data for retrievable IVC filters in pregnancy is limited and there may be a publication bias towards complicated cases. This study

Primary Mediastinal Synovial Sarcoma Presenting as Superior Vena Cava Syndrome: A Rare Case Report and Review of the Literature

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Irappa Madabhavi

2015-01-01

Full Text Available Primary mediastinal sarcomas are aggressive tumors with a very rare incidence. This report describes the case of a 35-year-old male patient who presented with acute symptoms of dyspnoea, facial puffiness, voice-hoarseness, and engorged neck veins. With the clinical picture consistent with the superior vena cava (SVC syndrome, the patient was investigated with computed tomography of the chest. This revealed a large soft tissue density mass lesion compressing the SVC along with other critical superior mediastinal structures. Histopathological evaluation of the mass revealed features consistent with a soft tissue sarcoma and positive staining was observed for vimentin and S-100. Cytogenetic analysis by fluorescent in situ hybridisation (FISH demonstrated the t(X:18 translocation. Thus diagnosis was established as primary mediastinal synovial sarcoma. Patient was treated with three cycles of neoadjuvant chemotherapy, to which there was a partial response as per the RECIST criteria. Surgical excision of the mediastinal mass was performed, and further postoperative treatment with adjuvant chemoradiotherapy was provided. Patient currently is free of disease. This is to the best of our knowledge the first report in the world literature of a successfully treated case of “primary mediastinal sarcomas presenting as SVC syndrome.” Patient is under regular surveillance at our clinic and remains free of recurrence one year after treatment completion.

Retrospective analysis of outcomes following inferior vena cava (IVC) filter placement in a managed care population.

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Everhart, Damian; Vaccaro, Jamieson; Worley, Karen; Rogstad, Teresa L; Seleznick, Mitchel

2017-08-01

The role of inferior vena cava filter (IVC) filters for prevention of pulmonary embolism (PE) is controversial. This study evaluated outcomes of IVC filter placement in a managed care population. This retrospective cohort study evaluated data for individuals with Humana healthcare coverage 2013-2014. The study population included 435 recipients of prophylactic IVC filters, 4376 recipients of therapeutic filters, and two control groups, each matched to filter recipients. Patients were followed for up to 2 years. Post-index anticoagulant use, mortality, filter removal, device-related complications, and all-cause utilization. Adjusted regression analyses showed a positive association between filter placement and anticoagulant use at 3 months: odds ratio (ORs) 3.403 (95% CI 1.912-6.059), prophylactic; OR, 1.356 (95% CI 1.164-1.58), therapeutic. Filters were removed in 15.67% of prophylactic and 5.69% of therapeutic filter cases. Complication rates were higher with prophylactic procedures than with therapeutic procedures and typically exceeded 2% in the prophylactic group. Each form of filter placement was associated with increases in all-cause hospitalization (regression coefficient 0.295 [95% CI 0.093-0.498], prophylactic; 0.673 [95% CI 0.547-0.798], therapeutic) and readmissions (OR 2.444 [95% CI 1.298-4.602], prophylactic; 2.074 [95% CI 1.644-2.616], therapeutic). IVC filter placement in this managed care population was associated with increased use of anticoagulants and greater healthcare utilization compared to controls, low rates of retrieval, and notable rates of device-related complications, with effects especially pronounced in assessments of prophylactic filters. These findings underscore the need for appropriate use of IVC filters.

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

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M. Vahedian

2011-10-01

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

Productivity and Persistence of Yellow Serradela (Ornithopus compressus L. and Biserrula (Biserrula pelecinus L. in the Mediterranean Climate Region of Central Chile Productividad y Persistencia de Serradela Amarilla (Ornithopus compressus L. y Biserrula (Biserrula pelecinus L. en la Región Climática Mediterránea de Chile Central

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Alejandro del Pozo

2009-09-01

Full Text Available The production and sustainability of non-irrigated pastures in the Mediterranean climate region of central Chile is currently limited by the low diversity of valuable species and cultivars of annual forage legumes, able to persist in zones with highly variable annual rainfall, and low fertility or poorly drained soils. In this work, DM production, seed yield, hardseededness and pasture persistence were evaluated for cultivars of yellow serradella (Ornithopus compressus L. and biserrula (Biserrula pelecinus L., in field experiments conducted in the subhumid portion of the Mediterranean climate region of Chile. Burr medic (Medicago polymorpha L. and sub clover (Trifolium subterraneum L. were used as a reference plants. A remarkable DM production and seed yield were observed in biserrula (cvs. Mor96 and Casbah, and in some cultivars of yellow serradella (e.g. Madeira, Santorini; biserrula produced by far the largest number of seeds per m². As was expected for species that produce very high levels of hard-seeds, the regeneration of biserrula and serradella was low in second growing season, but plant density and productivity were high in the third growing season. The use of biserrula and serradela in monoculture or in mixture with other annual legumes, either in pasture-crop rotation or permanent pasture, would contribute to the improvement of the prevailing productive systems in the Mediterranean climate region of central Chile.La producción y la sostenibilidad de las praderas de secano en la región de clima mediterráneo de Chile central están actualmente limitadas por la baja diversidad de especies valiosas y cultivares de leguminosas forrajeras anuales, capaces de persistir en zonas con precipitaciones anuales sumamente variables, y suelos de baja fertilidad o de mal drenaje. En este trabajo se evaluó la producción de fitomasa, producción de semilla, dureza seminal y la persistencia de cultivares de serradela amarilla (Ornithopus

Microflora en semillas de frijol

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Jos\\u00E9 B. Membre\\u00F1o

2001-01-01

Full Text Available Microflora en semillas de frijol (Phaseolus vulgaris L.. Se estudió la microflora bacteriana presente en semillas de frijol y su relación con Xanthomonas campestris pv. phaseoli (Xcp, en 118 genotipos procedentes de VIDAC-98, INTA- Nicaragua, TARS-USDA e Isabela-P.R. Se utilizaron cinco métodos de aislamiento: semilla desinfectada con hipoclorito de sodio, semilla en caldo nutritivo refrigerada por una hora, dispersión de 0,1 ml de suspensión de semillas en medio sólido, siembra líquida de 1 ml de suspensión y semilla en caldo nutritivo, agitado y refrigerado por 24 horas. Se aislaron 104 colonias amarillas de 41 genotipos. Treinta y seis colonias fueron KOH positivo (Gram negativo, 68 negativo (Gram positivo y 34 hidrolizaron almidón. Las colonias de pigmentación amarilla resultaron no patogénicas bajo condiciones de invernadero. Estas se identificaron con el sistema BIOLOG como: Pantoea agglomerans (25, Xanthomonas campestris (2, Enterobacter agglomerans (2, Sphingomonas paucimobilis (2, Pseudomonas fluorescens y Flavimonas oryzihabitans. En adición, los genotipos portaron colonias con pigmentación distinta a la amarilla. En las pruebas de antagonismo se identificaron colonias con actividad de deoxyribonucleasa y de antibiosis a Xcp. De éstas, 15 colonias inhibieron a Xcp significativamente. Se identificaron los hongos Rhizoctonia solani, Penicillium spp., Fusarium spp., Aspergillus flavus, Rhizopus nigricans y Macrophomina phaseolina en un 52,9 % del total de genotipos evaluados

Late endovascular removal of Günther-Tulip inferior vena cava filter and stent reconstruction of chronic post-thrombotic iliocaval obstruction after 4753 days of filter dwell time: a case report with review of literature.

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Doshi, Mehul Harshad; Narayanan, Govindarajan

2016-12-01

Chronic post-thrombotic obstruction of the inferior vena cava (IVC) or iliocaval junction is an uncommon complication of long indwelling IVC filter. When such an obstruction is symptomatic, endovascular treatment options include stent placement with or without filter retrieval. Filter retrieval becomes increasingly difficult with longer dwell times. We present a case of symptomatic post-thrombotic obstruction of the iliocaval junction related to Günther-Tulip IVC filter (Cook Medical Inc, Bloomington, IN) with dwell time of 4753 days, treated successfully with endovascular filter removal and stent reconstruction. Filter retrieval and stent reconstruction may be a treatment option in symptomatic patients with filter-related chronic IVC or iliocaval junction obstruction, even after prolonged dwell time.

Non-retrieval of inferior vena cava filters as a patient safety concern: evaluation of a new process improvement project to increase retrieval rates in a vascular and interventional radiology clinic.

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Brown, Joshua; Talbert, Jeffery; Pennington, Ryan; Han, Qiong; Raissi, Driss

2018-01-01

Retrieval of inferior vena cava filters (IVCFs) is important to decrease the long-term risk of complications associated with indwelling devices. Our hospital experienced low retrieval rates and implemented a low-cost intervention and evaluation for quality improvement. The working hypothesis was that a simple, mailed letter intervention could increase retrieval rates by increasing patient and primary care provider knowledge of the need for retrieval. For all prospective patients who received a retrievable IVCF during the intervention period from January 1, 2014 to February 29, 2016, patients and their primary care providers were mailed letters encouraging contact with the clinic for evaluation of eligibility for retrieval. The main outcome was retrieval of the IVCF if clinically indicated with a secondary outcome of time-to-retrieval. A pre-intervention control group from October 1, 2011 to December 31, 2013 was used to evaluate the impact of the intervention. Competing risks, time-to-event analysis was used to compare the pre- and post-intervention period retrieval rates correcting for patients who died during follow-up. Between the pre- and post-intervention periods, crude retrieval rates increased from 4.4% to 8.1% with a 12-fold change at comparable time points. The time-to-retrieval in the pre-intervention period was a mean (SD) of 503 (207) days with a median (IQR) of 505 (301-742). In the post-intervention period, time-to-retrieval was a mean (SD) of 119 (83) days and with median (IQR) of 128 (38-164) days. This low-cost intervention significantly increased retrieval rates in a single clinic. However, retrieval rates remain low and can be further improved. Ongoing interventions, including improved patient follow-up and physician education, are being implemented to further improve retrieval and use of inferior vena cava filters. Implanting clinics should implement quality improvement initiatives to improve patient care and follow-up with IVCFs to ensure

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

International Nuclear Information System (INIS)

Deguchi, Juno; Nagayoshi, Mikiko; Onozuka, Atsuko

2008-01-01

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

La vacunación en la infancia

OpenAIRE

Cañas Giraldo, Camilo Augusto; Fundación Valle de Lili

2004-01-01

¿Qué es una vacuna?/Tuberculosis/Difteria/La tosferina/el tétanos/Poliomielitis/Hepatitis A/Hepatitis B/La varicela/Fiebre amarilla/Infecciones por neumococo/Infecciones por hemofilias influenza/Infecciones por meningococo/Influenza/Rubeola-sarampión-paperas/Consideraciones generales.

Successful treatment of central venous catheter induced superior vena cava syndrome with ultrasound accelerated catheter-directed thrombolysis.

Science.gov (United States)

Dumantepe, Mert; Tarhan, Arif; Ozler, Azmi

2013-06-01

Superior vena cava (SVC) syndrome results from obstruction of flow through the vessel either by external compression or thrombosis. External compression by intrathoracic neoplasms is the most common etiology, especially lung cancer and lymphoma. Thrombosis is becoming increasingly common due to the use of indwelling catheters and implantable central venous access devices. Most patients are unresponsive to anticoagulation alone which appears to be effective only in the mildest cases. However, recent advances in catheter-based interventions have led to the development of a variety of minimally invasive endovascular strategies to remove venous thrombus and accepted as an important first-line treatment given its high overall success rate and low morbidity as compared with medical and surgical treatments. Ultrasound accelerated catheter-directed thrombolysis (UACDT) has been developed to rapidly and completely resolve the existing thrombus. This technique integrates high frequency, low intensity ultrasound (US) with standard CDT in order to accelerate clot dissolution, reducing treatment time and the incidence of thrombolysis-related complications. An US wave enhances drug permeation through thrombus by disaggregating the fibrin matrix, exposing additional plasminogen receptor sites to the thrombolytic agent. The US energy affects thrombus in the entire venous segment, increasing the probability of complete thrombus clearing. We report the case of a 56-year-old man who presented with a 5 days history of SVC syndrome symptoms who had been receiving chemotherapy for colon cancer through a right subclavian vein port catheter. The patient successfully treated with UACDT with EkoSonic(®) Mach4e Endovascular device with an overnight infusion. © 2013 Wiley Periodicals, Inc. Copyright © 2013 Wiley Periodicals, Inc.