Systemic-to-Pulmonary Venous Shunt in a Hemodialysis Patient With Extensive Thrombosis of Superior and Inferior Vena Cava
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ABSTRACT:
SUBMITTER: Valle E
PROVIDER: S-EPMC8418945 | biostudies-literature |
REPOSITORIES: biostudies-literature
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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.
| S-EPMC4736520 | biostudies-other
Project description:BackgroundInferior vena cava thrombosis is a rare blunt abdominal trauma complication often associated with severe liver injury. We present two cases of inferior vena cava thrombosis due to mild liver injuries.Case presentationCase 1 was a 25-year-old woman taking oral contraceptives for dysmenorrhea who was injured in a motorcycle accident. Contrast-enhanced computed tomography revealed hepatic contusion of the sixth segment. At 1 week after the accident, inferior vena cava thrombosis was detected. Case 2 was a 58-year-old man injured in a motorcycle accident. Contrast-enhanced computed tomography showed traumatic subarachnoid hemorrhage, right hemothorax, and liver injury with hepatic contusion of the sixth segment. At 1 week after the accident, inferior vena cava thrombosis was observed.ConclusionInferior vena cava thrombosis can occur following liver injury, regardless of damage severity. When there are thrombogenic factors and damage near the inferior vena cava, follow-up examinations should be carried out.
| S-EPMC8448584 | biostudies-literature
Project description: Not available
| S-EPMC8307697 | biostudies-literature
Project description:Complete superior vena cava (SVC) and inferior vena cava (IVC) obstruction is not uncommon and most commonly associated with malignancy. The risk increases in patients with central lines and hypercoagulable states such as with malignancy, thrombophilia, or use of oral contraceptive pills. According to our knowledge, complete SVC and IVC obstruction associated with systemic-to-pulmonary venous shunts in patients with prothrombin G20210A gene mutation has not been reported in the literature. Here we report the case of a 34-year-old female with complete SVC and IVC obstruction presenting with oxygen desaturation and shortness of breath due to systemic-to-pulmonary venous shunts. The unusual collateral pathway was secondary to SVC obstruction. The patient was managed conservatively, and she remained stable.
| S-EPMC7265738 | biostudies-literature
Project description:Upper extremity deep venous thrombosis (UEDVT), though less common than lower extremity DVT, is a significant problem with several possible etiologies. The incidence of UEDVT is on the rise, primarily from the increasing use of central venous access devices. However, there are other causes of UEDVT, including primary venous thrombosis (Paget-Schroetter syndrome) and hypercoagulable states associated with underlying malignancy. The morbidity and mortality associated with UEDVT is largely from pulmonary embolism and the postphlebitic syndrome. Nevertheless, many UEDVTs are asymptomatic or patients may present with nonspecific clinical symptoms; therefore, a high index of suspicion is often necessary to make a correct diagnosis. Currently, there is no standard treatment algorithm for UEDVT. Treatment options may range from systemic anticoagulation to surgical correction depending on the etiology of the thrombus, as well as the patient's associated comorbidities, life expectancy and expected quality of life following treatment.
| S-EPMC3140252 | biostudies-other
Project description:BackgroundCentral Venous Catheters (CVC) are being used in both intensive care units and general wards for multiple purposes. A previous study Galante et al. (2017) observed that during CVC insertion through Subclavian Vein (SCV) or the Internal Jugular Vein (IJV) the guidewire is sometimes advanced to the Inferior Vena Cava (IVC), and at other times to the right atrium. The rate of IVC wire cannulation and the association with side and point of insertion is unknown.ObjectiveIn this study, we describe guidewire migration location during real time CVC cannulation (right atrium versus IVC) and report the association between the insertion site and side of the CVC and the location of guidewire migration, Right Atrium (RA)/Right Ventricle (RV) versus IVC guidewire migration.MethodsThis is a retrospective study in the medical intensive care unit among patients that have received CVC during the study years 2014-2020. The rate of IVC versus right atrium/right ventricle wire migration during the procedure were analyzed. The association between the side and point of CVC insertion and the wire migration site was analyzed as well.ResultsOne hundred and sixty-six patients were enrolled. 33.7% of wires migrated to the IVC and 66.3% to the versus right atrium/right ventricle. The rate of wire migration to the IVC was similar in the IJV site and the SCV site. There was no association between the side of CVC insertion and wire migration to the IVC.ConclusionAbout a third of all wire migrations, during CVC Seldinger technique insertion, were identified in the IVC, with no potential for wire associated arrhythmia. There was no association between CVC insertion point (SCV versus IJV) nor the side of insertion and the site of guidewire migration.
| S-EPMC8208537 | biostudies-literature
Project description:A patient planned to be performed catheter ablation. However, three-dimensional contrast-enhanced chest computed tomography revealed isolated persistent left superior vena cava. We should know such an anatomical abnormality especially when central venous catheter or peripherally inserted central catheter is inserted from right jugular vein or right subclavian vein.
| S-EPMC8245746 | biostudies-literature
Project description:BackgroundHepatocellular carcinoma (HCC) accompanied by a tumor thrombus is very common. However, the treatment strategy is controversial and varies by the location of the thrombus.Case summaryWe report herein a case of HCC with a tumor thrombus in the suprahepatic inferior vena cava (IVC), which was successfully treated by hepatectomy combined with thrombectomy following sorafenib chemotherapy. A 47-year-old woman with chronic hepatitis was diagnosed with HCC. Computed tomography and magnetic resonance imaging showed that the tumor lesion was located in the right half of the liver, and a tumor thrombus was detected in the suprahepatic IVC near the right atrium. After multi-departmental discussion and patient informed consent, right major hepatectomy and total removal of the tumor thrombus were successfully performed under cardiopulmonary bypass. There were no serious complications after surgery. Following sorafenib treatment, no recurrence has been detected so far (11 mo later).ConclusionSurgical treatment followed by adjuvant sorafenib therapy might be an acceptable choice for HCC patients with tumor thrombosis in the IVC.
| S-EPMC8717523 | biostudies-literature
Project description:Percutaneous nephrolithotomy (PCNL) remains an important method for treating upper urinary calculi. However, bleeding and peripheral vascular injury are serious complications of PCNL. Injury of the inferior vena cava accompanied by secondary thrombosis has rarely been reported clinically. We treated a patient who experienced bleeding during PCNL to establish a channel. A catheter was used to make a renal fistula, and the inferior vena cava was implanted. The wound was fixed and compressed by balloon injection, and secondary thrombosis and repeated infection occurred after the operation. A filter was then placed, the water balloon was released, and the fistula was removed. The anti-bacterial and anticoagulant filter was removed. This major complication was successfully managed. In our patient, during PCNL, the renal fistula entered the inferior vena cava by mistake. If this issue cannot be treated in time, it can easily lead to the formation of secondary thrombosis. A fistula can be extracted through an inferior vena cava filter, and anticoagulant treatment and other conservative treatment regimens can be used to treat patients in this situation. These treatments avoid the possibility of further damage from open surgery.
| S-EPMC8647260 | biostudies-literature
Project description:BackgroundUltrasound (US) assessment of intravascular volume may improve volume management of dialysis patients. We investigated the relationship of intravascular volume evaluated by inferior vena cava (IVC) US to net volume changes with intermittent hemodialysis (HD) in critically ill patients.MethodsA retrospective cohort of 113 intensive care unit patients in 244 encounters had clinical assessment of intravascular volume followed by US of respiratory/ventilatory variation of IVC diameter, and had HD within 24 h. IVC collapsibility index (IVC CI)=(IVCmax-IVCmin)/IVCmax*100%. Volume management was guided by clinical data plus IVC US findings. Intradialytic hypotension (IDH) was categorized by severity from none to inability to tolerate HD.ResultsLinear regression correlating n-weighted proportions of encounters achieving net volume removal of ?0.5 L, ?1.0 L, ?1.5 L, and ?2.0 L strongly correlated across the range of IVC CI (R2=0.87-0.64). Sensitivity and specificity analysis showed IVC CI was a better predictor than IVCmax of achieving net ultrafiltration (UF) volumes. Mean central venous pressure, pulmonary artery occlusion pressure, and cardiac output were poor predictors by logistic regression and receiver operating curve analyses. IVC CI <20% was the approximate optimal cutoff for achieving ?0.5 L to ?2.0 L net UF volumes. Net volume change achieved tended to be less than recommended and may have been limited by the development of IDH. Severity of IDH did not correlate with UF rate in mL/kg/h. ?2 analysis showed pre-US clinical intravascular volume assessments had poor concordance with IVC CI categories.ConclusionIVC US may be a useful tool for predicting whether critically ill patients will achieve volume removal with HD.
| S-EPMC6061398 | biostudies-literature