Project description:Inferior vena cava (IVC) filter in venous thromboembolism (VTE) is an alternative to anticoagulation when the latter is contraindicated. The use of IVC filter in pediatrics continues to be rare and has not increased despite the ever-increasing rates of childhood VTE. Historically, septic VTE was regarded as a contraindication to IVC filter. Safety and efficacy of IVC filters in septic VTE have been reported in adult patients but not in pediatric patients. In this study, we reported a safe use of IVC filter in a critically ill 12-year-old patient with a large IVC thrombus and multiple pulmonary embolisms with favorable outcome.
Project description:Intravenous lipoma of the inferior vena cava is an incidental finding on contrast-enhanced computed tomography in 0.5% of individuals. We report a case of multiple intravenous lipomas discovered during diagnosis of cholangitis in a 39-year-old woman. Imaging revealed three fatty masses that appeared connected by cordlike structures: one in the left renal vein with wide mural attachment and two in the inferior vena cava, the higher of which was mobile. We hypothesize that these originated as a single lipoma that subsequently divided into three distinct masses. Because mobile masses may cause pulmonary thromboembolism, surgery is recommended in these cases.
Project description:Patients with inferior vena cava (IVC) filters - particularly permanent filters - are at increased risk for recurrent deep venous thrombosis (DVT). Judicious use of IVC filters, as well as the prompt retrieval of temporary IVC filters, substantially reduces the risk of IVC thrombosis.
Project description:Congenital saccular aneurysms of the inferior vena cava (IVC) are extremely rare, with 23 cases reported so far. We present a case of a 55-year-old woman with an acute episode of back pain that mimicked aortic dissection. Computed tomography ruled out aortic dissection but demonstrated a saccular aneurysm of the infrarenal IVC and a circumaortic left renal vein. The saccular aneurysm was excised, and the postoperative anatomopathologic examination revealed that it was congenital in nature. Surprisingly, preoperative symptoms of recurrent palpitations, dyspnea, and positional abdominal discomfort resolved after resection. This is the first reported case of a symptomatic congenital saccular aneurysm of the IVC with an associated circumaortic left renal vein.
Project description:BackgroundTransseptal puncture and pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF) are generally performed via the inferior vena cava (IVC). However, in cases where the IVC is inaccessible, a specific strategy may be needed.Case summaryAn 86-year-old woman with paroxysmal AF and an IVC filter in situ was referred to our hospital for ablation therapy. An IVC filter for pulmonary embolism and deep venous thrombosis had been implanted 15 years prior, therefore we selected a transoesophageal echocardiography (TOE)-guided transseptal puncture using a superior vena cava (SVC) approach. After the single transseptal puncture, we performed fast anatomical mapping, voltage mapping by multipolar mapping catheter, and then PVI by contact force-guided radiofrequency catheter using a steerable sheath. Following the ablation, bidirectional conduction block between the four pulmonary veins and the left atrium was confirmed by both radiofrequency and mapping catheter. No complications occurred and no recurrence of AF was documented in the 12 months after the procedure.DiscussionWhen performing a transseptal puncture during AF ablation, an SVC approach, via access through the right internal jugular vein, enables the sheath to directly approach the left atrium without angulation and improves operability of the ablation catheter. Combining the use of general anaesthesia, TOE, a steerable sheath, and contact force-guided ablation may contribute to achieving minimally invasive PVI with a single transseptal puncture via an SVC approach.
Project description:Congenital arteriovenous fistulas involved with the abdominal aorta are very rare. Left-sided subrenal inferior vena cava (IVC) with normal connection to the heart is also rare and has not been reported prenatally. In this article, we described a fetus with aorta-porto-umbilical vein fistulas combined with a left-sided IVC.