Duplication of inferior vena cava and coagulation mutations with left-sided iliofemoral venous thrombosis (original) (raw)
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Acta clinica Croatica, 2017
Although venous thromboembolism (VTE) including deep venous thrombosis (DVT) and pulmonary embolism is a major health problem in the world, it is an infrequent disease among young people. It is always mandatory to look at the underlying conditions for VTE, and in young patients, inherited prothrombotic factors should also be evaluated, especially in case of unprovoked VTE. Anomalies of inferior vena cava (IVC) are very rare in the general population. In this case report we describe rare occurrence of extensive DVT in a young male patient with rare anomaly of IVC - duplication of IVC - as a predisposition factor for DVT. Physicians need to be reminded of the IVC anomalies that should be considered in young patients with idiopathic DVT of lower extremity, which may require extended anticoagulant treatment.
Journal of Hematology & Oncology, 2008
The etiology of venous thromboembolism in young patients is frequently associated with hereditary coagulation abnormalities, immunologic diseases, and neoplasia. The advent of radiological advances, namely Computed Tomography (CT) scans and venography has identified vena cava malformations as a new etiologic factor worthy of consideration. In this case report, we describe the unusual occurrence of venous thromboembolism in association with a duplicated inferior vena cava. Duplications of the inferior vena cava (IVC) are seen with an incidence of 0.2% to 3.0% in the general population. Embryogenesis of the IVC is a complex process involving the intricate formation and regression of numerous anastomoses, potentially leading to various anomalies. We present a 23-year-old Caucasian woman with IVC duplication who developed a deep venous thrombosis and multiple pulmonary emboli. Anomaly of the IVC is a rare example of a congenital condition that predisposes to thromboembolism, presumably by favoring venous stasis. This diagnosis should be considered in patients under the age of 30 with spontaneous occurrence of blood clots.
Venous thromboembolism, presenting as deep vein thrombosis (DVT) is a disease affected by aging, with a low rate of about 1 per 10,000 annually before the fourth decade of life, rising rapidly after age 45 years, and approaching 5–6 per 1000 annually by age 80. We present the case of a 69-years old woman who presented to our emergency department with unilateral lower limb pain and swelling. Subsequent imaging revealed a right iliofemoral deep vein thrombosis, with associated duplication of her inferior vena cava. Thrombophilic screening revealed a prothrombin 20210A gene mutation. She was treated conservatively with Low Molecular Weight Heparin (LMWH) and elastic stockings.
Angiojet thrombolysis and vena cava filter insertion in a case of a duplicated inferior vena cava
SAGE open medical case reports, 2015
Duplication of the inferior vena cava (IVC) complicates interventional procedures. This case report aims to shed light on this unusual anomaly and the preoperative considerations necessary when treatment of venous thromboembolism is undertaken. An IRB approved case report of a 58 year old woman presented emergently with right lower extremity phlegmasia due to extensive thrombosis of her right iliofemoral and infrarenal portion of her duplicated IVC. The patient underwent IVC filter placement and rheolytic thrombectomy with thrombolysis using the Angiojet device followed by venoplasty and stenting of the iliofemoral system and right IVC. Complete symptomatic and radiographic resolution on duplex imaging was achieved at 1 year follow up. With adequate preoperative awareness of IVC anomalies and treatment options available satisfactory results can be achieved and complications minimized for this unique patient population.
Deep Vein Thrombosis, Inferior Vena Cava Interruption and Multiple Thrombophilic Gene Mutations
The American Journal of the Medical Sciences, 2011
Interruption or hypoplasia of the inferior vena cava, with associated azygos continuation, is an uncommon congenital vascular malformation (Ellis et al, Comput Radiol 1986;10:15-22). Although this anomaly causes venous stasis, few patients present with history of deep vein thrombosis (DVT). The exact role of coexisting thrombophilic gene mutations, also heterozygotic, is far from being completely understood. However, in these cases, because of a probable additive effect, treatment of complications and careful prophylaxis for recurrent DVT are recommended lifelong. The authors report a case of inferior vena cava interruption with azygos continuation in a 30-year-old woman who presented with a history of recurrent lower limb DVT. In addition, heterozygosis for the H1299R polymorphism of the factor V gene (Factor V HR2), for the C677T polymorphism of the methylenetetrahydrofolate reductase gene (MTHFR C677T) and for the 4G/5G polymorphism of the plasminogen activator inhibitor-1 gene (PAI-1 4G/5G) was found in DNA analyses.
Iliofemoral Thrombosis Secondary to Iliac Compression Syndrome in Double Inferior Vena Cava
Vascular Disease Management
Duplication of the inferior vena cava (D-IVC) joined by a pelvic connector is a rare congenital anomaly. May-Thurner syndrome (MTS), also known as iliac compression syndrome, is caused by a localized stricture at the point where the left common iliac vein is crossed by the right common iliac artery resulting in left common femoral deep venous thrombosis. The combination pathology of D-IVC and MTS is rarely described. We describe a case of a patient with iliofemoral thrombosis precipitated by MTS with D-IVC, heterozygous mutation of factor V Leiden, and describe our successful treatment approach.
Duplication of the inferior vena cava in thromboembolic disease
CHEST Journal, 1986
Congenital artery anomalies: Clinical and therapeutic implications. In Vidt DG, ed, Cardiovascular therapy, 1982, 43-58 2Donaldson RM, Raphael M, Radley-Smith R, Yacoub MH, Ross DN. Angiographic identification of primary coronary anomalies causing impaired myocardial perfusion. Catheterization and Cardiovascular Diagnosis 1983; 9:237-49 3 Cheitlin MD, DeCastro CM, McAllister HA. Sudden death as a complication of anomalous left coronary origin from the anterior sinus of Valsalva. Circulation 1974; 50:780-87 4 Benson PA. Anomalous aortic origin of coronary artery with sudden death: Case report and review.
The first reported case of factor V Leiden mutation with agenesis of superior vena cava
Rationale: Total absence of superior vena cava (ASVC) is a very rare anomaly, and the patient usually suffers from superior vena cava syndrome (SVCS) or conduction disturbances. Patient concerns: We report a 36-year-old white male, born and living in Brazil, without comorbidities presented to hematologist thrombotic episodes even under anticoagulant therapy. On his first hematologic appointment, he had no active complaints except by the fullness after meals, and his physical examination presented remarkable collateral circulation in the chest. Diagnoses: Congenital ASVC associated with factor V Leiden mutation. Outcomes: In his magnetic resonance angiography of the thorax, a great amount of collateral circulation and communication of the azygos and hemiazygos veins with inferior vena cava were evident, as well as the absence of the upper cava vein. Furthermore, heterozygous genetic mutation was found for Leiden factor V. Lessons: This case gives us the lesson that we need to include ASVC in the differential diagnosis of SVCS. The importance of the V-Leiden factor as a joint risk with this congenital defect for venous thromboembolism episodes was also highlighted. Abbreviations: aPTT = activated partial thromboplastin time, ASVC = absence of superior vena cava, CT = computed tomography, DVT = deep venous thrombosis, HC = Hospital das Clínicas, SAH = systemic arterial hypertension, SVC = superior vena cava, SVCS = superior vena cava syndrome.
Anomaly of the inferior vena cava causing recurrent deep vein thrombosis in a young male
European Journal of Internal Medicine, 2004
Anomaly of the inferior vena cava (IVC) as a cause of (recurrent) deep vein thrombosis (DVT) is uncommon. We report on a 33-year-old patient suffering from this unusual cause of DVT without the presence of known predisposing factors (immobilization, trauma, surgery, or underlying thrombophilia). Thus, in young patients with recurrent DVT, anomaly of the IVC should be regarded as an independent risk factor. D