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1

Superior Vena Cava Syndrome Redirect Message  

Cancer.gov

Superior Vena Cava Syndrome Redirect Message The Superior Vena Cava Syndrome PDQ® information summary has been incorporated into the Cardiopulmonary Syndromes information summary. Use one of the links below to proceed.     [ patient ] [ health profes

2

Superior Vena Cava Syndrome PDQ Redirect Spanish  

Cancer.gov

Superior Vena Cava Syndrome PDQ Redirect Spanish El sumario de información del PDQ® Síndrome de la vena cava superior ha sido incorporado al sumario de información Síndromes cardiopulmonares. Para proseguir utilice unos de los siguientes enlaces.(The

3

Left superior vena cava: revisited.  

PubMed

The persistence of a left-sided superior vena cava is the most common variant of systemic venous drainage. Increased utility of cardiac imaging, in particular cross-sectional techniques such as computed tomography and magnetic resonance (MR), will result in increased detection of the anomaly and its variants. Whilst in the typical form it is often haemodynamically insignificant, its discovery may have clinical significance nonetheless, and its mimics require exclusion. During cardiac development the anomaly results from a failure of the left anterior cardinal vein to obliterate. Recognized anatomical variants include the absence of the right superior vena cava and of an innominate bridging vein. Typical drainage is to the coronary sinus, dilatation of which may be the first hint to the anomaly. Clinical implications with respect to vascular access and arrhythmia are well described. A significant minority drain into the left atrium, potentially creating a haemodynamically significant lesion. Additionally, differentiation from anomalous left upper pulmonary venous drainage via a vertical vein is mandatory. A newly discovered variant runs an intra-atrial course with subsequent typical drainage, and if not recognized as such, may be confused with a left atrial mass. The use of 3D contrast-enhanced MR venography has proven extremely helpful in characterizing anomalous vasculature, and we demonstrate how such techniques can help delineate the anomaly and differentiate from its mimics. PMID:22301985

Irwin, R B; Greaves, M; Schmitt, M

2012-04-01

4

Mediastinal goiter and superior vena cava syndrome.  

PubMed

Mediastinal goiter as a cause of superior vena cava syndrome and tracheal compression is rare. A case is presented, the literature is reviewed and the otolaryngologic implications are emphasized. PMID:703461

Steenerson, R L; Barton, R T

1978-10-01

5

Superior vena cava syndrome in children  

Microsoft Academic Search

Superior vena cava syndrome (SVCS) is rare in childhood. 18 cases of SVCS were seen in children ranging from 3-14 years with a mean age of 8.8 years. There were 15 males and 3 female children. Diagnosis could be con- fi rmed in 17 cases as one child succumbed to severe respira- tory distress without a defi nitive diagnosis. The

Vineeta Gupta; Srikanth R. Ambati; P. Pant; Baldev Bhatia

2008-01-01

6

Unique Venocaval Anomalies: Case of Duplicate Superior Vena Cava and Interrupted Inferior Vena Cava  

PubMed Central

Venocaval anomalies are uncommon in the general population and often go unrecognized, but physicians should be aware of their significance. Duplicate superior vena cava should be identified during cardiac imaging, surgery, and catheter insertions. While interrupted inferior vena cava can predispose to thrombus formation, they protect against pulmonary embolism from lower extremity deep vein thrombosis. We describe a unique case of a patient in which combined superior vena cava and inferior vena cava anomalies were found incidentally. This is the first reported case of a duplicate superior vena cava and interrupted inferior vena cava in a single patient in English literature. This article also provides a literature review on the topic.

Hagans, Iris; Markelov, Alexey; Makadia, Manthan

2014-01-01

7

Bilateral Absence of the Superior Vena Cava  

PubMed Central

Bilateral absence of the superior vena cava (SVC) is a very rarely detected, mainly asymptomatic congenital vascular anomaly. Though usually innocent, this anomaly may complicate cardiothoracic surgery and certain procedures like central venous catheter insertion. This SVC anomaly is poorly known, and we assume that its incidence in the general population may be higher than detected. In this paper, we summarize current knowledge on this anomaly and its clinical implications. In addition, we present a neonatal case with bilateral absence of the SVC associated with a fetal cystic hygroma. Conclusion. Totally absent SVC can cause unexpected problems during cardiothoracic surgery. Suspicion of SVC absence should arise in basic echocardiography. Our paper suggests that, like other congenital anomalies, bilateral absent SVC may be associated with a fetal cyctic hygroma.

Ylanen, Kaisa; Poutanen, Tuija; Savikurki-Heikkila, Paivi; Uotila, Jukka; Korppi, Matti; Eerola, Anneli

2012-01-01

8

Persistent left superior vena cava and pacemaker implantation.  

PubMed

Our study group read with interest the paper from Vijayvergiya et al describing the implantation of an implantable cardioverter-defibrillator lead in the presence of the persistence of the left superior vena cava. The issue of the identification a persistent left superior vena cava is of paramount importance in interventional cardiology, being the most common venous anomaly of the thoracic distribution, and because it may create some problem to any physician while performing a pacemaker lead implantation. In our letter we underscore the specific issues related to pacemaker implantation while encountering a persistent left superior vena cava (and maybe the absence of the right vena cava) and the workup that should be performed to obtain the preoperative diagnosis of the venous anomaly. More specifically, we consider avoiding any kind of defibrillator lead implantation through the coronary sinus for safety issues, and underscore the straightforward transthoracic ultrasound approach to identify the left superior vena cava. PMID:24109503

Pontillo, Daniele; Patruno, Nicolino

2013-09-26

9

Fatal Pericardial Tamponade After Superior Vena Cava Stenting  

Microsoft Academic Search

We discuss a fatal complication of percutaneous superior vena cava (SVC) self-expandable stent placement in a patient with\\u000a superior vena cava syndrome (SVCS). The SVCS was caused by a malignant mediastinal mass with total occlusion of the SVC. Twenty-four\\u000a hours after the procedure, the patient died of a hemopericardial tamponade. In the literature, only seven cases have been\\u000a described with

Marieke J. M. Ploegmakers; Matthieu J. C. M. Rutten

2009-01-01

10

Fatal pericardial tamponade after superior vena cava stenting.  

PubMed

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 of a hemopericardial tamponade. In the literature, only seven cases have been described with this life-threatening complication. Patients with a necrotic tumor mass are more likely to develop this complication. Knowledge of this complication may increase patient survival. PMID:18855048

Ploegmakers, Marieke J M; Rutten, Matthieu J C M

2009-05-01

11

Superior vena cava syndrome: role of the interventionalist.  

PubMed

Superior vena cava syndrome results from the obstruction of blood flow through the superior vena cava and is most often due to thoracic malignancy. However, benign etiologies are on the rise secondary to more frequent use of intravascular devices such as central venous catheters and pacemakers. Although rarely a medical emergency, the symptoms can be alarming, particularly to the patient. Traditionally, superior vena cava syndrome has been managed with radiotherapy and chemotherapy. But interventional endovascular techniques have made inroads that offer a safe, rapid, and durable response. In many cases, it may be the only reasonable treatment. Because of this, an approach to endovascular treatment of this condition must be in the armamentarium of the interventional radiologist. This review will provide the reader with an insight into the etiology, pathophysiology, and various management principles of superior vena cava syndrome. The focus will be on understanding the techniques used during various endovascular interventions, including angioplasty, stenting, and pharmacomechanical thrombolysis. Discussion will also be centred on possible complications and current evidence as well as controversies regarding these approaches. PMID:23415716

Rachapalli, Vamsidhar; Boucher, Louis-Martin

2014-05-01

12

Superior vena cava bypass with superficial femoral vein for benign superior vena cava syndrome.  

PubMed

Superior vena cava (SVC) syndrome can result from benign causes such as temporary hemodialysis catheters placed into the central veins. The indications for open, surgical revascularization are rare and usually reserved for patients whose symptoms are refractory to anticoagulation and endovascular treatment. The current report documents the case of a 54-year-old woman with recurrent SVC syndrome secondary to long-term indwelling central venous catheters for total parenteral nutrition. She presented to the vascular service with moderate head/neck edema and persistent headaches despite chronic anticoagulation and multiple previous endovascular attempts including both angioplasty and stenting. An internal jugular-SVC bypass was performed using autogenous superficial femoral vein (SFV), which resulted in the resolution of her symptoms and a patent graft 12 months postoperatively. Autogenous SFV is an ideal conduit for central vein revascularization secondary to its size, relative ease associated with harvesting, and handling characteristics. It may be the ideal conduit for revascularization in patients with SVC syndrome secondary to benign causes because of their favorable life expectancy, although documentation of long-term graft patency is necessary. PMID:16625418

Erbella, Jose; Hess, Philip J; Huber, Thomas S

2006-11-01

13

Implantation of pacemaker for sick sinus syndrome in a patient with persistent left superior vena cava and absent right superior vena cava  

Microsoft Academic Search

Absent right superior vena cava with persistent left superior vena cava in normal situs is an exceedingly rare congenital\\u000a anomaly. In such cases, pacemaker implantation (PMI) is very difficult or even impossible. We report the case of a patient\\u000a with sick sinus syndrome in whom PMI was easily performed via the left superior vena cava by using a steerable stylet.

Yujiro Fukuda; Teruhisa Yoshida; Tomohito Inage; Tomohiro Takeuchi; Yasutsugu Nagamoto; Takeki Gondo; Tsutomu Imaizumi

2008-01-01

14

Superior vena cava syndrome caused by embolisation of liquid Onyx  

PubMed Central

Superior vena cava syndrome (SVCS) is usually caused by a malignancy or the presence of an intravascular device in a central vein. A 74-year-old male with a history of a superior vena cava (SVC) stent underwent embolisation of a brain arterio-venous malformation through the right meningeal artery with liquid Onyx. Two weeks later he presented with acute respiratory failure, upper airway obstruction, plethora, varices of the chest wall and stridor. He was intubated and placed on mechanical ventilatory support. Chest imaging revealed a linear structure in the SVC, extending to the right atrium. Interventional radiology removed the material, which was determined to be liquid Onyx. Venous pressures of the right internal jugular vein decreased after removal of the material. The symptoms resolved and patient was successfully extubated. This is the first reported case of SVCS caused by liquid Onyx.

Crusio, Robbert; Ramachandran, Kishan; Ramachandran, Kavan; Kupfer, Yizhak; Tessler, Sidney

2011-01-01

15

Stereotactic body radiotherapy for superior vena cava syndrome  

PubMed Central

Superior vena cava syndrome (SVCS) is characterized by a spectrum of clinical findings that result from the occlusion of the superior vena cava (SVC), usually caused by extracaval compression of the SVC by either a bronchogenic tumor or an enlarged mediastinal lymph node. Most efforts at treatment for SVCS are palliative, and long-term survival for malignancy-related SVCS is very low. Therefore, radiotherapy treatment is usually delivered with palliative intent utilizing hypofractionated regimens. The use of high dose per fraction may result in more rapid and more durable responses to treatment. Similarly, the high dose per fraction utilized in stereotactic body radiotherapy (SBRT) has been proven highly efficacious in treating early stage non-small cell lung cancer (NSCLC). Here we report the first reported case of a patient with SVCS from NSCLC successfully treated with SBRT to alleviate SVCS.

McKenzie, Joshua T.; McTyre, Emory; Kunaprayoon, Dan; Redmond, Kevin P.

2013-01-01

16

Persistent left superior vena cava draining into the left atrium.  

PubMed

A 40-year-old man was admitted with necrotising fasciitis of the right thigh. Further workup to evaluate for an infectious source revealed an incidental finding of persistent left superior vena cava via transesophageal echocardiography. This finding was confirmed by cardiac MRI. During his hospitalisation, he also developed altered mental status which was found to be secondary to systemic emboli by a head MRI. The primary source of infection was likely his dental abscesses. He underwent intravenous antibiotic therapy for a total of 6 weeks and was then referred to a specialised vascular centre for further management of his congenital anomaly. PMID:23978521

Tobbia, Patrick; Norris, Leslie A; Lane, Timothy

2013-01-01

17

[A case of absent right and persistent left superior vena cava: echocardiographic diagnosis].  

PubMed

A 49-year-old man underwent transthoracic echocardiography for atypical chest pain. A dilated coronary sinus was found and venous contrast echocardiography raised the suspicion of absent right and persistent left superior vena cava. Transesophageal echocardiography showed no presence of right superior vena cava. The echocardiographic findings were confirmed by upper venous digital subtraction cavography. PMID:15782795

Pálinkás, Attila; Nagy, Endre; Varga, Albert; Morvay, Zita; Farkas, András; Csanády, Miklós; Forster, Tamás

2005-02-13

18

Superior vena cava obstruction associated with nephrogenic systemic fibrosis.  

PubMed

A 56-year-old woman with hypertension-induced end stage renal disease presented with skin thickening and mottled discoloration. Cutaneous biopsy showed increased dermal fibroblasts embedded in fibromyxoid stroma with scattered perivascular and interstitial mononuclear cells. Immunohistochemistry revealed prominent CD34+ dendritic cells in septal spaces, consistent with Nephrogenic Systemic Fibrosis (NSF). Seven years and two years prior she had received a gadolinium-based contrast agent (GBCA). She died due to NSF. Gross autopsy revealed a thickened and stenotic superior vena cava (SVC). Extensive fibrosis of the SVC, dermis, and subcutaneous tissue was noted, together with hyalinized collagen fibers within the muscular wall of the intestines and dura mater. These findings support the importance of skin changes in the recognition of life threatening extracutaneous tissue involvement in NSF. PMID:24809889

Holzem, Kassandra E; Nardone, Beatrice; Lomasney, Jon W; Yazdan, Pedram; Gerami, Pedram; West, Dennis P; Laumann, Anne E

2014-05-01

19

Catheter-Induced Thrombosis of the Superior Vena Cava  

PubMed Central

There has been an increase in the use of central venous catheters (CVCs) in clinical practice. One of the most dangerous complications associated with their use is symptomatic or asymptomatic thrombosis (T), sometimes associated with superior vena cava (SVC) syndrome, resulting from impaired venous drainage. The right heart clots can induce an increased risk of mortality due the potential pulmonary embolism (PE). We report a case of asymptomatic 83-year-old woman in whom the thrombosis was detected after an echocardiogram. Echocardiography demonstrated a cardiac mass, and the T was confirmed by (magnetic resonance imaging) MRI. The clinical scenario, a high index of suspicion and routine use of echocardiogram in patients with CVC, can lead to a correct diagnosis, preventing dangerous complications.

Venturini, Elio; Becuzzi, Lucia; Magni, Lucia

2012-01-01

20

Computed Tomography-Guided Central Venous Catheter Placement in a Patient with Superior Vena Cava and Inferior Vena Cava Occlusion  

Microsoft Academic Search

An 18-year-old man with a gastrointestinal hypomotility syndrome required lifelong parenteral nutrition. Both the superior and inferior vena cava were occluded. Computed tomography guidance was used to place a long-term central venous catheter via a large tributary to the azygos vein.

Maria A. Rivero; Dennis W. W. Shaw; Robert T. Jr. Schaller

1999-01-01

21

Combined tracheal sleeve and superior vena cava resections for non–small cell lung cancer  

Microsoft Academic Search

Background. Combined superior vena cava and tracheal sleeve resections are occasionally indicated in the treatment of non–small cell lung cancer. However, more effective induction therapy may potentially expand the benefit of locally extended resections.Methods. From January 1998 to December 1999, 6 consecutive patients had combined tracheal sleeve and superior vena cava resections for non–small cell lung cancer after induction treatment.

Lorenzo Spaggiari; Ugo Pastorino

2000-01-01

22

Successful Treatment of Malignant Superior Vena Cava Syndrome Using a Stent-Graft  

PubMed Central

We report successful outcomes after endovascular placement of a stent graft in a 74- and a 77-year-old men, both of whom had malignant superior vena cava syndrome caused by squamous cell carcinoma. In each patient, successful palliation of the malignant superior vena cava syndrome was achieved by placement of a stent graft. No procedure-related complications were observed. The patients were asymptomatic until their deaths, seven and 14 months after stent graft placement, respectively.

Gwon, Dong Il

2012-01-01

23

Prenatal diagnosis of isolated interrupted inferior vena cava with azygos continuation to superior vena cava  

PubMed Central

Absence of inferior vena cava is an uncommon congenital abnormality. It is usually associated with other structural anomalies, typically left isomerism. We report a case of interrupted inferior vena cava with azygos continuation diagnosed as an isolated finding during routine prenatal ultrasound scan, confirmed by post-natal echocardiography. Detailed ultrasound examination of the fetal anatomy failed to demonstrate other anomalies. The neonatal course of this fetus was uneventful.

Giang, Do Thi Cam; Rajeesh, Gayatri; Vaidyanathan, Balu

2014-01-01

24

[Results of surgical treatment of patients with solid malignant chest tumours and superior vena cava syndrome].  

PubMed

Superior vena cava syndrome results from blood flow disturbances caused by compression or tumour invasion of the superior vena cava and its tributaries. In most cases, malignant lung tumours are responsible for its development. In 1995-2010, we performed surgical treatment of 55 patients with malignant chest neoplasms and superior vena cave syndrome. Vertical sternotomy was employed most frequently. Some patients additionally underwent antero-lateral thoracotomy to facilitate the surgical approach. Polytetrafluoroethylene prostheses 18-20 mm in diameter (Russia) were used to superior vena cava. Radical and cytoreductive surgery was the method of choice in 60 and 40% of the patients respectively. The signs of obstruction disappeared in all patients immediately after surgery. 21.8% of the patients died during the early postoperative period, 5 ones survived without signs of relapses. Median survival was 21 months. PMID:23516849

Tarasov, V A; Bogdanovich, A S; Litvinov, A Iu; Larin, I A

2012-01-01

25

Side matters: An intriguing case of persistent left superior vena-cava.  

PubMed

Persistent left superior vena cava, usually an incidental finding, is the most common thoracic vein anatomical variation draining into the coronary sinus. Central venous catheter procedures may be complicated secondary to the presence of a persistent left superior vena cava, leading to life-threatening complications such as arrhythmias, cardiogenic shock, and cardiac arrest. We present a case of persistent superior vena cava diagnosed on transthoracic echocardiogram (TTE) in a patient with congestive heart failure. A dilated coronary sinus was identified on TTE, followed by injection of agitated saline into the left antecubital vein resulting in filling of the coronary sinus prior to the right atrium-an indication of persistent left superior vena-cava. This also was confirmed on cardiac computed tomography. Such a diagnosis is critical in patients who may undergo central venous catheter procedures such as our patient's potential requirement for an implantable cardiovertor defibrillator due to severe global left ventricular systolic dysfunction. The presence of a persistent left superior vena cava should always be suspected when the guidewire takes a left-sided downward course towards the right atrium at the level of the coronary sinus. Therefore, special attention should be paid to the imaging work-up prior to central venous catheter procedures. PMID:24303491

Siddiqui, Adeel M; Cao, Long-Bao; Movahed, Assad

2013-08-16

26

Superior vena cava syndrome in a patient with previous cardiac surgery: what else should we suspect?  

PubMed Central

Background Although mediastinal tumors compressing or invading the superior vena cava represent the major causes of the superior vena cava syndrome, benign processes may also be involved in the pathogenesis of this medical emergency. One of the rarest benign causes is a pseudoaneurysm developing in patients previously having heart surgery. Case report We present the case of a large pseudoaneurysm of the ascending aorta, five years after primary surgery, with a significant compression of the right mediastinal venous system causing superior vena cava syndrome, detected at chest CT angiography. Perioperative findings showed two rush out points both coming from the distal aortic suture line which was performed five years ago. The patient underwent reoperation under circulatory arrest facilitating safe exploration and repair of the distal anastomotic leaks Conclusion Enhanced chest CT should be always undertaken in all patients with superior vena cava syndrome, especially in those previously having cardiac or aortic surgery to correctly evaluate the presence of a pseudoaneurysm. Mass effect to the superior vena cava makes necessary an open surgical treatment of the pseudoaneurysm so as to concurrently resolve the right mediastinal venous system's compression. Surgery should be performed in terms of safe approach to avoid exsanguination and cerebral malperfusion.

2010-01-01

27

Superior vena cava replacement in thymic tumours treated with radio-chemotherapy.  

PubMed

From 1987 to 2000 108 patients were operated on for thymic tumours. Two of these underwent replacement of the superior vena cava with polytetrafluoroethylene prostheses because the tumours invaded the superior vena cava. One of these was affected by myasthenia gravis, and was treated preoperatively with concurrent radio-chemotherapy and lymphocytopheresis. The other received preoperative chemotherapy and post-operative radio-chemotherapy because of minimal residual disease. The clinical courses of the two patients are reported here and we conclude that eradication of thymic malignancies is suitable even when superior vena cava replacement is required, and that neither antimyasthenic therapy nor adjuvant and/or neoadjuvant treatment interfere with aggressive surgical management or vice versa. Moreover, the long-term survival of one of these patients despite relapse of disease shows that extended surgery is indicated in these cases. PMID:15916142

Muscolino, Giuseppe; Doria, Orietta; Vercellio, Gianni

2005-01-01

28

Superior Vena Cava Syndrome in a Patient with Polycytemia Vera: Diagnosis and Treatment  

PubMed Central

Polycythemia vera is a myeloproliferative disorder characterized by thrombotic complications both in the arterial and venous systems. We report the case of a 55-year-old patient affected by polycythemia vera, presenting with acute superior vena cava syndrome due to thrombosis of the upper part of the superior vena cava. Diagnosis was done clinically and by computed tomography scan and showed an unusual finding: an air bubble trapped in the brachiocephalic venous trunk. The patient underwent emergency surgery. Diagnosis and treatment of the case are discussed.

Lentini, Salvatore; Barone, Mario; Benedetto, Filippo; Spinelli, Francesco

2010-01-01

29

Leiomyosarcoma of the superior vena cava: Resection with vascular reconstruction - case report and review of the literature  

PubMed Central

The present report describes a case of pedunculated intraluminal leiomyosarcoma of the superior vena cava, extending to the right atrium, that was successfully resected surgically. Superior vena cava reconstruction was performed using bovine pericardial graft, saving the sinus node. The pathological variants of this neoplasm according to the anatomical site of the tumour are described.

Katz, Michael G; Dekel, Hagi; Elias, Sorin; Kravtsov, Vladimir; Didkovsky, Elena; Sasson, Lior

2007-01-01

30

Spontaneous rupture of a cystic mediastinal teratoma complicated by superior vena cava syndrome.  

PubMed

Spontaneous rupture of cystic mediastinal teratomas is rare but may cause serious complications. Here we report an unusual case of a cystic teratoma, which ruptured into the mediastinal and pleural cavities resulting in superior vena cava syndrome, acute mediastinitis, and pleural effusion. Early diagnosis and prompt surgical treatment of ruptured mediastinal teratomas are essential to preventing life-threatening complications. PMID:24484811

Liu, Chia-Hsin; Peng, Yi-Jen; Wang, Hong-Hau; Cheng, Yeung-Lung; Chen, Chien-Wen

2014-02-01

31

Behçet's disease with pulmonary involvement, superior vena cava syndrome, chyloptysis and chylous ascites  

Microsoft Academic Search

Behçet's disease is a chronic multisystem vasculitis of unknown aetiology. This case report describes a patient who applied to the hospital because of dyspnoea, ascites, oedema of lower extremities and recurrent episodes of haemoptysis. For the last 12 yr, he had superior vena cava syndrome (SVCS) and cardiac and pulmonary involvement of Behçet's disease, and biochemical examination of ascite fluid

Ö. Abado?lu; E. Osma; E. S. Uçan; C. Çavdar; N. Akkoç; A. Küpelïo?lu; H. Akbaylar

1996-01-01

32

MALIGNANT LYMPHOMA DEMONESTRATING SICK SINUS SYNDROME AND SUPERIOR VENA CAVA SYNDROME  

Microsoft Academic Search

Reports which describe sick sinus syndrome due to malignant lymphoma have been rare and only eight cases have been reported until now. This is a case of sick sinus syndrome and superior vena cava syndrome secondary to invasion of occult malignant lymphoma of the lung in a 60 years old male. There were no symptoms or signs of malignancy before

S. K. Forouzannia; M. H. Abdollahi; S. J. Mirhosseini; S. H. Moshtaghion; H. Hosseini; M. V. Jorat; M. Moeeni; M. A. Karimi-Zarchi

33

Comparison of superior vena cava and femoroiliac vein pressure according to intra-abdominal pressure  

PubMed Central

Background Previous studies have shown a good agreement between central venous pressure (CVP) measurements from catheters placed in superior vena cava and catheters placed in the abdominal cava/common iliac vein. However, the influence of intra-abdominal pressure on such measurements remains unknown. Methods We conducted a prospective, observational study in a tertiary teaching hospital. We enrolled patients who had indwelling catheters in both superior vena cava (double lumen catheter) and femoroiliac veins (dialysis catheter) and into the bladder. Pressures were measured from all the sites, CVP, femoroiliac venous pressure (FIVP), and intra-abdominal pressure. Results A total of 30 patients were enrolled (age 62?±?14?years; SAPS II 62 (52–76)). Fifty complete sets of measurements were performed. All of the studied patients were mechanically ventilated (PEP 3 cmH20 (2–5)). We observed that the concordance between CVP and FIVP decreased when intra-abdominal pressure increased. We identified 14?mmHg as the best intra-abdominal pressure cutoff, and we found that CVP and FIVP were significantly more in agreement below this threshold than above (94% versus 50%, P?=?0.002). Conclusions We reported that intra-abdominal pressure affected agreement between CVP measurements from catheter placed in superior vena cava and catheters placed in the femoroiliac vein. Agreement was excellent when intra-abdominal pressure was below 14?mmHg.

2012-01-01

34

Absent right and persistent left superior vena cava: troubleshooting during a challenging pacemaker implant: a case report  

PubMed Central

Background Venous anomalies of the thorax can occur in isolation or in association with complex congenital heart disease. The incidence of an absent right superior vena cava in the setting of a persistent left superior vena cava is very rare in the general population with only a dozen cases documented in the medical literature. Such venous anomalies can make for very challenging electronic cardiac device implantation. We report our challenging dual chamber pacemaker implant in a patient with such complex anatomy and focus on our implantation technique that helped achieve adequate lead positioning. Case presentation A 73-year-old Caucasian female with degenerative complete heart block presented for dual chamber permanent pacemaker implant. Lead implantation was very challenging due to abnormal and rare vena cava anatomy; a persistent left superior vena cava drained directly into the coronary sinus and the right brachiocephalic vein drained directly into the left persistent superior vena cava as the patient had an absent right superior vena cava . Adequate right ventricular lead positioning was achieved following numerous lead-stylet manipulations and careful looping in the atria to redirect its trajectory to the ventricular apex. Conclusion Abnormal superior vena cava development is uncommon and can lead to technical challenges when venous access is required during various interventional procedures. Pre-operative imaging can help identify such challenging anatomy allowing appropriate operative planning; careful patient selection is warranted for venography given the risk of contrast nephrotoxicity.

2014-01-01

35

Right nutcracker syndrome associated with left-sided inferior vena cava, hemiazygos continuation and persistant left superior vena cava: a rare combination.  

PubMed

The term nutcracker syndrome refers to compression of left renal vein between aorta and superior mesenteric artery causing renal venous hypertension. Right nutcracker syndrome associated with a left-sided inferior vena cava is an extremely rare anomaly. Reported two cases in English literature were diagnosed by ultrasonography and computed tomography angiography in adulthood. Herein, we present a case of right nutcracker syndrome with left-sided inferior vena cava and hemiazygos continuation in a 12-year-old girl. PMID:24461470

Yildiz, Adalet Elcin; Cayci, Fatma Semsa; Genc, Sinan; Cakar, Nilgun; Fitoz, Suat

2014-01-01

36

Absent right superior vena cava with persistent left superior vena cava which drains to unroofed coronary sinus in a child with atrioventricular septal defect and cor triatriatum sinister: preop correct diagnosis and successful surgery in a single session.  

PubMed

We report a unique case of a 4-year-old boy with intermediate-type atrioventricular septal defect, cor triatriatum sinister, persistent left superior vena cava, unroofed coronary sinus, and absent right superior vena cava. Persistent left vena cava draining into the unroofed coronary sinus was demonstrated easily using the agitated saline-contrast echocardiography. After conformation with angiographic evaluation, surgery was performed at a single session. Roofing of the coronary sinus with polytetrafluoroethylene patch, mitral cleft repair, tricuspid annuloplasty, atrioventricular defect repair with pericardial patch, and resection of the membrane in the left atrium was succeeded without complication. PMID:23602062

Doksöz, Önder; Güven, Bar??; Yozgat, Y?lmaz; Özdemir, Rahmi; Me?e, Timur; Tavl?, Vedide; Alayunt, Emin Alp

2014-01-01

37

Chylothorax secondary to obstruction of the superior vena cava: a complication of the LeVeen shunt.  

PubMed Central

A case of thrombosis of the superior vena cava was complicated by bilateral chylothoraces and a widened mediastinum. Removal of a clotted LeVeen shunt led to prompt resolution of the obstruction and chylothoraces. Images

Warren, W H; Altman, J S; Gregory, S A

1990-01-01

38

Right superior vena cava draining in the left atrium associated with tetralogy of Fallot and pulmonary atresia  

PubMed Central

We report a case of an anomalous drainage of the right superior vena cava to the left atrium with intact atrial septum associated with Tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collateral arteries.

Al-Biltagi, Mohammed A; Kouatli, Amjad; Al-Mousily, Faris

2013-01-01

39

Orthotopic heart transplantation in patients with persistent left superior vena cava: bicaval and biatrial techniques.  

PubMed

Persistent left superior vena cava (LSVC) is the most common congenital venous abnormality. With the increasing number of children who survive into adulthood with congenital heart malformations, the recognition of persistent LSVC among patients with advanced heart failure is likely to rise. We present two cases of orthotopic heart transplantation in the setting of LSVC successfully managed with biatrial and bicaval techniques. PMID:24580937

Neragi-Miandoab, Siyamek; Baran, David; Godelman, Alla; Goldstein, Daniel J

2014-03-01

40

Superior vena cava thrombosis after intravascular AICD lead extraction: a case report.  

PubMed

Pacemaker lead extraction has been shown to be an effective and safe treatment in the case of infected per-manent pacemaker leads. However, it can lead to potentially serious complications, usually occurring during the ex-traction procedure. This report describes a case of a 74-year-old male with a persistent superior vena cava thrombo-sis related to an infected permanent pacemaker lead transvenous extraction. Clinical and surgical management are discussed. PMID:16868904

Santangelo, L; Russo, V; Ammendola, E; De Crescenzo, I; Pagano, C; Savarese, C; Caruso, A; Utili, R; Calabrò, R

2006-01-01

41

[Superior vena cava thrombosis in a case with low serum factor XII].  

PubMed

The present case is 74 years old man who was hospitalized to treat lung tumor suspected of malignancy. Because the superior vena cava thrombus was also revealed by radiological examination, he was performed lobectomy and thrombectomy at the same time. He has past history of intravenous hyperalimentation for 15 days, and we supposed the event to be the cause of the thrombus. Venous thrombus has developed again in the left subclavian vein in spite of the anticoagulant therapy at the early postoperative period. The level of serum factor XII turned out to be low by the precise examination, of which possible contribution to thrombus formation was suspected. PMID:22242291

Shundo, Yasumasa; Takahashi, Tsuyoshi; Itaya, Toru; Neyatani, Hiroshi; Ishigami, Naoyuki; Sugimura, Hisao

2011-12-01

42

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

SciTech Connect

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.

Lanciego, Carlos [Hospital Virgen de la Salud, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Unit of Interventional Radiology (Spain)], E-mail: clanciego@eresmas.com; Rodriguez, Mario [Hospital Virgen de la Salud, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Unit of Intensive Care (Spain); Rodriguez, Adela; Carbonell, Miguel A. [Hospital Virgen de la Salud, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Unit of Geriatrics (Spain); Garcia, Lorenzo Garcia [Hospital Virgen de la Salud, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Unit of Interventional Radiology (Spain)

2003-11-15

43

Superior Vena Cava Stent Migration into the Pulmonary Artery Causing Fatal Pulmonary Infarction  

SciTech Connect

Migration of superior vena cava (SVC) stents is a well-recognised complication of their deployment, and numerous strategies exist for their retrieval. To our knowledge, only three cases of migration of an SVC stent to the pulmonary vasculature have previously been reported. None of these patients developed complications that resulted in death. We report a case of SVC stent migration to the pulmonary vasculature with delayed pulmonary artery thrombosis and death from pulmonary infarction. We conclude that early retrieval of migrated stents should be performed to decrease the risk of serious complications.

Anand, Girija, E-mail: gijanandm@hotmail.com; Lewanski, Conrad R.; Cowman, Steven A. [Charing Cross Hospital, Department of Clinical Oncology (United Kingdom); Jackson, James E. [Hammersmith Hospital, Department of Radiology (United Kingdom)

2011-02-15

44

Treatment of Superior Vena Cava (SVC) Syndrome and Inferior Vena Cava (IVC) Thrombosis in a Patient with Colorectal Cancer: Combination of SVC Stenting and IVC Filter Placement to Palliate Symptoms and Pave the Way for Port Implantation  

SciTech Connect

Thrombosis of the inferior vena cava is a life-threatening complication in cancer patients leading to pulmonary embolism. These patients can also be affected by superior vena cava syndrome causing dyspnea followed by trunk or extremity swelling. We report the case of a 61-year-old female suffering from an extended colorectal tumor who became affected by both of the mentioned complications. Due to thrombus formation within the right vena jugularis interna, thrombosis of the inferior vena cava, and superior vena cava syndrome, a combined interventional procedure via a left jugular access with stenting of the superior vena cava and filter placement into the inferior vena cava was performed As a consequence, relief of the patient's symptoms, prevention of pulmonary embolism, and paving of the way for further venous chemotherapy were achieved.

Sauter, Alexander; Triller, Juergen; Schmidt, Felix; Kickuth, Ralph, E-mail: ralph.kickuth@insel.c [Inselspital, University of Berne, Department of Diagnostic, Interventional and Pediatric Radiology (Switzerland)

2008-07-15

45

Fortuitously discovered persistent left superior vena cava in young competitive athletes. Clinical implications of sports physicians.  

PubMed

This report describes two athletes with persistent left superior vena cava (PLSVC) accidentally identified during preparticipation medical evaluation. The clinical implications of PLSVC for sports physicians are also discussed. A 16-year-old male ice hockey player and an 18-year-old male high-level field hockey player visited our institute for medical evaluation prior to participating in competition. Neither complained of palpitation, faintness or syncope, which would have suggested a possible cardiac rhythm disturbance, or had been informed of any abnormalities in previous physical examinations. Nonetheless, echocardiography revealed dilated coronary sinuses, and venography confirmed PLSVC and, in one case, showed the absence of the right superior vena cava. Electrocardiograms showed the field hockey player to have an ectopic atrial rhythm with left axis deviation of the frontal plane P-wave and the ice hockey player to have normal sinus rhythm. Symptom-limited treadmill testing revealed nothing abnormal, and after explaining the possible rhythm instability and the potential risk associated with cardiac surgery, the subjects were permitted full participation in competitive sports. Although information is scarce, available data on PLSVC suggest it is benign for competitive athletes. Nevertheless, complications arising from other cardiovascular anomalies, from potential cardiac rhythm disturbances, and from cardiac surgery necessitated by major injuries should be considered prior to participation in competitive sports. PMID:11447374

Kinoshita, N; Hasegawa, K; Oguma, Y; Katsukawa, F; Onishi, S; Yamazaki, H

2001-06-01

46

Perforation of the right ventricle during cardiac resynchronisation therapy upgrade not related to a coexisting persistent left superior vena cava.  

PubMed

Right ventricle (RV) perforation is a complication that may arise during device implants. We present the case of a patient undergoing cardiac resynchronisation therapy upgrade that was complicated with an RV perforation. The lead was successfully repositioned with a good final outcome. Despite being uncommon, persistence of the left superior vena cava is the most frequent venous cardiac anomaly and may pose challenges during the implant procedure, namely when the right superior vena cava (RSVC) is absent. Still, in this patient it was not related to the event, as the leads were advanced through the RSVC. PMID:22922915

Providência, Rui; Paiva, Luís V; Cação, Romeu; Mota, Paula

2012-01-01

47

A giant cardiac malignant peripheral nerve sheath tumor presenting with total obstruction of the superior vena cava.  

PubMed

A 16-year-old boy presenting with dyspnea, facial swelling, cyanosis, and fatigue was found to have a tumor involving the heart, causing superior vena cava and brachiocephalic venous trunk total obstruction. This was diagnosed as malignant peripheral nerve sheath tumor, a rare sarcoma of the heart. The patient underwent successful resection of the tumor, and reconstruction of the superior vena cava and right atrium. Immunohistochemistry was utilized to establish the diagnosis. The details of the patient's clinical course and imaging findings with morphologic and immunohistochemistry data are reported. PMID:24384222

Prifti, Edvin; Baboci, Arben; Ikonomi, Majlinda

2014-01-01

48

Coronary sinus ostial atresia and persistent left-sided superior vena cava: clinical significance and strategies for cardiac resynchronization therapy.  

PubMed

A 48-year-old male patient underwent cardiac resynchronization therapy defibrillator implantation, and he was found to have atresia of the coronary sinus ostium with venous drainage occurring via a persistent left-sided superior vena cava, which was connected to the right-sided superior vena cava by the innominate vein. This is a rare benign cardiac anomaly that can pose problems when the coronary sinus needs to be cannulated. To identify the course of the coronary sinus, a coronary angiogram can be performed with attention directed to the venous phase of the angiogram. Although the technical difficulty of coronary sinus cannulation increases, various catheters, wires, and delivery systems can be utilized and this anomaly does not usually prevent successful left ventricular lead placement in cardiac resynchronization therapy via a left-sided superior vena cava approach. There however needs to be consideration regarding caliber of the left-sided superior vena cava being sufficiently large to avoid compromise of venous drainage after lead insertion. PMID:24436612

Lim, Paul Chun Yih; Baskaran, Lohendran; Ho, Kah Leng; Teo, Wee Siong; Ching, Chi Keong

2013-09-01

49

Stenting through a portacath for totally occluded superior vena cava in a case of non-Hodgkin s lymphoma.  

PubMed

Superior vena cava (SVC) syndrome often presents with slowly progressive symptoms worsening over weeks or may cause abrupt symptoms and constitute a true medical emergency. Percutaneous intervention is the treatment of choice. We report a case of SVC stenting in a middle-aged woman with SVC obstruction secondary to portacath insertion for chemotherapy. PMID:12556622

Patel, Tejas M; Shah, Sanjay C; Ranjan, Alok; Malhotra, Hemant; Patel, Rajnikant; Gupta, Anoop K

2003-02-01

50

Accidental superior vena cava access to central venous system lately disclosed by thoracotomy.  

PubMed

We report the case of a 51-year-old woman who underwent hemicolectomy for colon cancer and subsequent hepatic metastasectomy for liver metastases. Right percutaneous infraclavicular subclavian venous port catheterization was performed during the initial operation for chemotherapy. She received chemotherapy after each operation with no reported complications. During a right thoracotomy for lung metastases 2 years after the catheter placement, we noticed the catheter perforating the right subclavian vein and directly entering the superior vena cava. To prevent hemorrhaging during catheter removal, we initially performed the lung metastasectomy, after which we decided to intrathoracically remove the catheter. No complication was observed. To the best of our knowledge, this case is the first of its kind to be reported in the published literature. PMID:24368184

Issaka, Adamu; Yildizeli, Bedrettin; Yuksel, Mustafa

2014-05-01

51

Coronary sinus atresia with persistent left superior vena cava: unusual clinical presentation and endovascular management.  

PubMed

Atresia of the coronary sinus (ACS) is a rare congenital anomaly. When associated with persistent left superior vena cava (PLSVC), this defect could have no significant hemodynamic effect, and the patient might remain asymptomatic. However, vascular interventions might induce changes or complications that could show the anomaly. Appropriate management requires a good understanding of this condition. We present the first reported case of ACS and PLSVC occurring after thrombosis of the innominate vein (IV) after central venous catheter placement. The patient presented with atypical subacute chest pain and recurrent extrasystoles. Diagnosis and characterization of vascular anomalies was made by computed tomography phlebography, and the patient was successfully managed by endovascular recanalization of the IV. PMID:23949240

Qanadli, Salah D; Rolf, Tanina; Glauser, Frederic; Delay, Dominique; Beigelman-Aubry, Catherine; Prêtre, René

2014-06-01

52

Dermatofibrosarcoma protuberans on the right neck with superior vena cava syndrome: case report and literature review.  

PubMed

Dermatofibrosarcoma protuberans (DFSP) is an uncommon dermal soft tissue tumour of intermediate malignancy. A 44-year-old man presented to the hospital with a large lesion on the right upper chest and neck. Despite eight previous surgical excisions, the tumour had continued to recur. Contrast-enhanced computed tomography showed recurrence of the tumour, associated with superior vena cava (SVC) syndrome. He declined radical surgical resection of the recurrent tumour, which may have required right upper limb amputation. Targeted therapy with sunitinib malate was therefore introduced. This case demonstrates the recurrent nature of DFSP and the association of this lesion on the upper chest/neck with SVC syndrome. Primary wide radical resection is essential for better local control and to avoid the development of SVC syndrome. PMID:23535006

Ong, H S; Ji, T; Wang, L Z; Yu, Z W; Zhang, C P

2013-06-01

53

A novel technique of single patch repair of right partial anomalous pulmonary venous return to the superior vena cava by right atrial edge rotation.  

PubMed

In patients with partial anomalous pulmonary venous return of the right superior pulmonary veins to the superior vena cava, surgical repair generally consists of either intraatrial baffle with or without caval enlargement, or superior caval transection and cavoatrial anastomosis to the right atrial appendage. We discuss here a novel technique of superior caval enlargement without need for patch material or reimplantation. PMID:24792287

Reyes, Karl G; Tan, Reina Bianca M; Reyes, Karen G

2014-05-01

54

Dialysis Catheter-Related Superior Vena Cava Syndrome with Patent Vena Cava: Long Term Efficacy of Unilateral Viatorr Stent-Graft Avoiding Catheter Manipulation  

PubMed Central

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.

Galli, Franco; Moramarco, Lorenzo Paolo; Corti, Riccardo; Leati, Giovanni; Fiorina, Ilaria; Maestri, Marcello

2014-01-01

55

An Unusual Case of Superior Vena Cava Syndrome Caused by the Intravascular Invasion of an Invasive Thymoma  

PubMed Central

Superior vena cava syndrome (SVCS) is usually caused by extrinsic compression or invasion of the superior vena cava (SVC) by malignant tumors involving mediastinal structures. Although thymomas are well-known causes of SVCS, cases of SVCS caused by malignant thymomas protruding into adjacent vessels draining the SVC with thrombosis have been very rarely reported worldwide. We experienced a 39-year-old female patient with SVCS that developed after the direct invasion of the left brachiocephalic vein (LBCV) and SVC by an anterior mediastinal mass with a high maximum standardized uptake value on the chest computed tomography (CT) and positron emission tomography-CT. Based on these results, she underwent en bloc resection of the tumor, including removal of the involved vessels, and was eventually diagnosed as having a type B2 thymoma permeating into the LBCV and SVC. We present this case as a very rare form of SVCS caused by an invasive thymoma.

Kim, Hyung Joon; Cho, Sun Young; Cho, Woo Hee; Lee, Do Hyun; Lim, Do Hyoung; Seo, Pil Won; Park, Mi-Hyun; Lee, Wonae; Lee, Jai Hyuen

2013-01-01

56

Obstruction of superior vena cava flow during transcatheter atrial septal defect closure with the Atriasept ASD occluder.  

PubMed

In this paper, we describe a patient with a large secundum atrial septal defect ASD (26 mm) with adequate rims that were suitable for percutaneous closure. While closing this ASD, the superior vena cava (SVC) was occluded with the right atrial disc of the Atriasept ASD occluder (Cardia) and thus the device was retrieved before its release. After retrieval of this device, an Amplatzer ASD occluder was successfully implanted without disturbing the caval flow. PMID:23666302

Kahya Eren, Nihan; Kocaba?, U?ur; Nazl?, Cem; Ergene, Oktay

2013-03-01

57

[Thymic cancer with superior vena cava invasion reconstructed by ready-made Y-graft].  

PubMed

A 57-year-old woman was admitted to our hospital with a complaint of left supraclavicular lymph node's swelling in January 2007. Computed tomography (CT) showed the lobulated tumor suspected of superior vena cava (SVC) invasion, located in the anterior mediastinum, 5 x 3 cm in size. The patient underwent thymectomy, resection of SVC, and partial resection of the right upper lobe. SVC was reconstructed by ready-made Y-graft (Hemashied phi 18 x 9 mm). Histopathological diagnosis was thymic cancer, poorly differentiated squamous cell carcinoma. The patient was discharged on 21st postoperative day. Postoperative radiotherapy (RT : 12.6 Gy) was canceled for the side effect. Alternatively, adjuvant chemotherapy [carboplatin (CBDCA) +paclitaxel (PTX)] was administered. Additional RT (50 Gy) was given to the lesion of local recurrence 1 and half year after the operation. The patient was alive without any signs of recurrence after RT. Left side bypass graft was patent at 8 months postoperatively, but was obliterated thereafter. Right side bypass is patent at more than 2 years postoperatively. Ready-made Y-graft can be one of the choices of SVC reconstruction. PMID:20446606

Matsuoka, T; Kobayashi, S; Oka, K; Sakano, H; Kawano, K; Katoh, T

2010-05-01

58

Prevalence of persistent superior vena cava and association with congenital heart anomalies.  

PubMed

A contralateral persistent superior vena cava (PSVC) can occur in a normal child or in association with congenital heart defects (CHDs). Its prevalence has been demonstrated in relatively small cohorts. We aim to assess the frequency of a PSVC in a large cohort of children with and without CHDs. To estimate its significance, we have searched for a PSVC in all children referred for echocardiography in our institution during a 16.5-year period. A group of 17,219 children comprised 8,140 children with a structural heart anomaly and 9,079 children with a structurally normal heart. Association between a PSVC and specific classes of CHD were looked for. A total of 288 children (1.7%) had a PSVC; 0.56% (51 of 9,079) in the normal heart group and 2.9% (237 of 8,140) in the congenital heart anomalies group. Odds ratio for having heart anomaly in the presence of PSVC was 5.2 (95% confidence interval 3.7 to 7.0). A PSVC was above all associated with atrioventricular septal defects, conotruncal malformations, and left-sided defects. The odds ratio of having PSVC in the aforementioned malformations compared with the normal heart group was 23.8, 13.6, and 11.0, respectively. In conclusion, although present in normal subjects, PSVC was more often associated with congenital heart and other anomalies, especially with atrioventricular septal defects, conotruncal malformations, and left-sided defects. PMID:23890574

Perles, Zeev; Nir, Amiram; Gavri, Sagui; Golender, Julius; Tashma, Asaf; Ergaz, Zivanit; Rein, Azaria J J T

2013-10-15

59

Partial absence of superior vena cava in an adult patient. Case report and literature review.  

PubMed

Absence of the superior vena cava (SVC) is a rare variety of vascular anomaly. The purpose of this report is to describe the computed tomography (CT) findings of the partial absence of the SVC without persistent left SVC in a patient with no evidence of congenital cardiovascular disease and no prior history of central venous instrumentation. A 77-year-old woman with a history of colon cancer underwent thoracoabdominal CT imaging because of abdominal pain of uncertain cause. No tumor recurrence was observed. A complicated"investigation" confirmed a thymoid cancer surgery back in 1976, which was accompanied by resection of the SVC and the left brachiocephalic vein because of their invasion. Owing to the absence of the SVC and bilateral brachiocephalic veins, caval hypertension developed in the patient, resulting in the dilation of cavo-caval anastomoses. In addition, new anastomoses were opened. The clinical significance and possible embryogenesis of this anomaly are discussed. The extremely rare condition of the partial absence of the SVC appeared with subcutaneous dilated, tortuous collaterals in an asymptomatic adult patient. This anomaly is becoming clinically more relevant with the increasing use of minimally invasive vascular surgery. PMID:23324916

Tarnoki, D L; Tarnoki, A D; Nemeth, K; Bata, P; Berczi, V; Karlinger, K

2013-11-01

60

Doppler evaluation of central venous lines in the superior vena cava.  

PubMed

Thrombus formation in the superior vena cava (SVC) complicates the use of central venous catheters. Visualizing the thrombus by two-dimensional echo-cardiography is often difficult. Flow in the SVC can be recorded by using color flow Doppler examinations. Hence SVC flow was evaluated by color flow Doppler in 12 patients before and within 48 hours of central venous catheters. Five patients with catheters in their SVCs, with suspected thrombus or obstruction to the SVC, were also studied. The SVC flow in the subjects before catheter placement was characterized by two distinct peaks, respiratory variability, and maximal velocities between 0.5 and 1.5 m/sec; these were unchanged by the catheters. The five patients with thrombus or obstruction had turbulent flow, loss of a distinct biphasic profile, and increased velocity downstream to the thrombus and decreased velocity upstream. It appears that Doppler study is a worthwhile adjunct to two-dimensional echocardiography in the evaluation of catheter-related thrombus, and that an altered SVC flow profile with increased velocity suggests thrombus formation or obstruction or both. PMID:8501547

Hammerli, M; Meyer, R A

1993-06-01

61

Superior vena cava thrombosis and paradoxical embolic stroke due to collateral drainage from the brachiocephalic vein to the left atrium.  

PubMed

Thrombosis involving a permanent infusion catheter in the subclavian vein and superior vena cava is relatively common, especially in cancer patients. Edema of the arms and head is a well-known clinical consequence of this thrombosis, with an intrinsic risk of pulmonary embolism; however, systemic embolization into the cerebral circulation has not been reported as a sequela. Herein, we describe the case of a 56-year-old man with metastatic prostate cancer who developed superior vena cava syndrome due to extensive thrombosis in the presence of a central venous catheter that was used for long-term chemotherapy. The patient's case was complicated by a cerebrovascular accident that was most likely caused by a paradoxical air embolism. A clear mechanism for the embolism was provided by a network of collateral veins, which developed between the brachiocephalic vein and the left atrium due to the superior vena cava obstruction and resulted in a right-to-left shunt. We discuss diagnosis and treatment of the condition in our patient and in general terms. PMID:21494530

Nascimbene, Angelo; Angelini, Paolo

2011-01-01

62

Superior Vena Cava Thrombosis and Paradoxical Embolic Stroke due to Collateral Drainage from the Brachiocephalic Vein to the Left Atrium  

PubMed Central

Thrombosis involving a permanent infusion catheter in the subclavian vein and superior vena cava is relatively common, especially in cancer patients. Edema of the arms and head is a well-known clinical consequence of this thrombosis, with an intrinsic risk of pulmonary embolism; however, systemic embolization into the cerebral circulation has not been reported as a sequela. Herein, we describe the case of a 56-year-old man with metastatic prostate cancer who developed superior vena cava syndrome due to extensive thrombosis in the presence of a central venous catheter that was used for long-term chemotherapy. The patient's case was complicated by a cerebrovascular accident that was most likely caused by a paradoxical air embolism. A clear mechanism for the embolism was provided by a network of collateral veins, which developed between the brachiocephalic vein and the left atrium due to the superior vena cava obstruction and resulted in a right-to-left shunt. We discuss diagnosis and treatment of the condition in our patient and in general terms.

Nascimbene, Angelo; Angelini, Paolo

2011-01-01

63

Narrowing of the superior vena cava–right atrium junction during radiofrequency catheter ablation for inappropriate sinus tachycardia: analysis with intracardiac echocardiography  

Microsoft Academic Search

OBJECTIVESThe study explored the potential for tissue swelling and venous occlusion during radiofrequency (RF) catheter ablation procedures using intracardiac echocardiography (ICE).BACKGROUNDTransient superior vena cava occlusion has been reported following catheter ablation procedures for inappropriate sinus tachycardia (IST). Presumably, venous occlusion could occur owing to thrombus formation or tissue swelling with resultant narrowing of the superior vena cava–right atrial (SVC-RA) junction.METHODSIntracardiac

David J Callans; Jian-Fang Ren; David Schwartzman; Charles D Gottlieb; Farooq A Chaudhry; Francis E Marchlinski

1999-01-01

64

Superior vena cava obstruction (SVCO) in patients with advanced non small cell lung cancer (NSCLC).  

PubMed

Introduction: To report on prognostic and treatment factors influencing the response of SVCO and related survival outcomes in advanced non small cell lung cancer. Material and Methods: From November 2008 through December 2011, 18 consecutively diagnosed NSCLC patients with SVCO were included in this study. The patient, tumor and treatment related factors were analyzed. Median overall survival (OS), Kaplan -Meier survival plots, T-test, Cox Proportional Hazards models were generated by multiple covariates (MVA) and analyzed on SPSS software (version 19.0; SPSS, Inc., Chicago, IL). Results: Thirteen patients (72%) had presented with SVCO before the pathological diagnosis of underlying lung malignancy, while 5 (28%) progressed to SVCO after initiating treatment with chemotherapy. Twelve (68%) patients achieved subjective relief from the obstruction at the completion of palliative radiation therapy. Treating oncologists preferred 4 Gy per fraction in 11 (62%), while the median biologically equivalent dose delivered was 28 Gy. Six (33%) patients received chemotherapy during the course of treatment. Median OS of the entire cohort was 3±1.85mths and 1-year survival rate of 7%. Univariate analysis confirmed that SVCO patients with good performance score (p=0.02), and partial response to chemotherapy (p= 0.001) have superior OS. However, Cox regression modeling for MVA demonstrated only good performance SVCO patients (p = 0.05) have a better OS. Conclusion: RT effectively relieves SVCO but overall poor survival associated in our clinical scenario needs to be improved with multimodality approach. Adjuvant chemotherapy is to be considered after initial radiation therapy in good performance patients. Keywords: superior vena cava obstruction (SVCO), radiation therapy, chemotherapy, non small cell lung cancer (NSCLC), BED (biologically equivalent dose). PMID:24610289

Lee, H N; Tiwana, M S; Saini, M; Verma, S K; Saini, M; Jain, N; Gupta, M; Chauhan, N

2014-01-01

65

Treatment of Superior Vena Cava (SVC) Syndrome and Inferior Vena Cava (IVC) Thrombosis in a Patient with Colorectal Cancer: Combination of SVC Stenting and IVC Filter Placement to Palliate Symptoms and Pave the Way for Port Implantation  

Microsoft Academic Search

Thrombosis of the inferior vena cava is a life-threatening complication in cancer patients leading to pulmonary embolism.\\u000a These patients can also be affected by superior vena cava syndrome causing dyspnea followed by trunk or extremity swelling.\\u000a We report the case of a 61-year-old female suffering from an extended colorectal tumor who became affected by both of the\\u000a mentioned complications. Due

Alexander Sauter; Jürgen Triller; Felix Schmidt; Ralph Kickuth

2008-01-01

66

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

PubMed Central

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.

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

2012-01-01

67

Persistent left superior vena cava draining into left atrium as a cause of persistent systemic desaturation after surgery.  

PubMed

Persistent left superior vena cava (LSVC) is a rare congenital anomaly which usually produces no physiologic derangements if it drains into the right atrium via the coronary sinus, but it may cause significant desaturation when it drains into the left atrium (LA). Failure to diagnose LSVC communicating with the LA preoperatively may lead to serious consequences. We are describing an interesting case of a boy who presented with systemic desaturation due to an undetected LSVC after having undergone corrective surgery for atrioventricular canal defect. We have demonstrated that echocardiography with agitated saline contrast is a simple, accurate, and inexpensive diagnostic modality. PMID:24372822

Agarwal, Ashish; K S, Ravindranath; Agrawal, Navin; Patra, Soumya; Agarwal, Neena; Manjunath, C N

2014-03-01

68

Transcatheter occlusion of a persistent left superior vena cava to the left atrium using the transseptal approach.  

PubMed

A persistent left superior vena cava (LSVC) is a common venous anomaly, occurring in up to 10% of patients with congenital heart defects. Usually, a LSVC drains into the coronary sinus, then to the right atrium. The LSVC can drain directly to the left atrium, resulting in a right-to-left shunt and systemic desaturation. Historically, surgery has been used to address this lesion. Transcatheter occlusion of the LSVC is an alternative to surgery. We report the novel use of the transseptal approach to access the LSVC, and device occlusion using the Amplatzer Vascular Plug-II. PMID:23436744

Zampi, Jeffrey D; Sznycer-Taub, Nathaniel R; Grifkamd, Ronald G

2014-01-01

69

A case of primary mediastinal Ewing's sarcoma / primitive neuroectodermal tumor presenting with initial compression of superior vena cava  

PubMed Central

Ewing's sarcomas and peripheral primitive neuroectodermal tumors (ES/PNETs) are high grade malignant neoplasms. These malignancies are characterized by a chromosome 22 rearrangement, arise from bone or soft tissue, predominantly affect children and young adults, and are grouped in the Ewing family of tumors. Multimodality treatment programs are the treatment of choice. Primary localization of ES/PNET in the mediastinum is extremely rare. We describe a case of ES/PNET presenting as a mediastinal mass with tracheal compression and initial signs of superior vena cava in a 66-year-old woman.

Reali, Alessia; Mortellaro, Gianluca; Allis, Simona; Trevisiol, Edoardo; Anglesio, Silvia Maria; Bartoncini, Sara; Redda, Maria Grazia Ruo

2013-01-01

70

Unusual cause of acute right ventricular dysfunction: rapid progression of superior vena cava aneurysm complicated by thrombosis and pulmonary thromboembolism.  

PubMed

Aneurysms of the major thoracic veins are rare. They are usually asymptomatic and thus treated conservatively. We report an extremely rare case of rapidly progressing superior vena cava (SVC) aneurysm complicated by thrombosis and acute pulmonary thromboembolism (PTE) with right ventricular dysfunction. Thrombolytic therapy for hemodynamically significant acute PTE was harmful to the patient in the present case, because it induced further thrombosis and mobilization of the thrombi within the aneurysm, subsequently causing de novo PTE. Surgical aneurysmectomy combined with pulmonary artery embolectomy would be a treatment of choice in patients with SVC aneurysm complicated by acute PTE. PMID:21532864

Oh, Sang Gi; Kim, Kye Hun; Seon, Hyun Ju; Yoon, Hyun Ju; Ahn, Youngkeun; Jeong, Myung Ho; Cho, Jeong Gwan; Park, Jong Chun; Kang, Jung Chaee

2011-05-01

71

Left persistent superior vena cava and paroxysmal atrial fibrillation: the role of selective radio-frequency transcatheter ablation.  

PubMed

Persistent left superior vena cava (LPSVC) is a rare congenital anomaly of the thoracic venous system that can trigger paroxysmal atrial fibrillation. The role of this venous anomaly must be carefully considered in patients undergoing conventional atrial fibrillation transcatheter ablation by pulmonary vein isolation to avoid unnecessary lesions, left atrium access and arrhythmia relapses. In fact, the present clinical perspective suggests sole LPSVC isolation is a well tolerated and effective approach in patients with paroxysmal atrial fibrillation and arrhythmic trigger originating from a LPSVC. PMID:24978664

Anselmino, Matteo; Ferraris, Federico; Cerrato, Natascia; Barbero, Umberto; Scaglione, Marco; Gaita, Fiorenzo

2014-08-01

72

Therapeutic approach to "downhill" esophageal varices bleeding due to superior vena cava syndrome in Behcet's disease: a case report  

PubMed Central

Background One of the rare presentations of superior vena cava syndrome is bleeding of "downhill" esophageal varices (DEV) and different approaches have been used to control it. This is a case report whose DEV was eradicated by band ligation for the first time. Case presentation We report a 42-year-old man who is a known case of Behcet's disease. The patient's first presentation was superior vena cava syndrome due to thrombosis followed by bipolar ulcers and arthralgia. He received warfarin, prednisolone and azathioprine. The clinical course of the patient was complicated by one episode of hematemesis without abdominal pain when the patient's PT was in therapeutic range. After resuscitation and correction of PT with fresh frozen plasma transfusion, upper gastrointestinal endoscopy was done. Prominent varices were seen in the upper third of the esophagus, tapering to the middle part without acute bleeding. Stomach and duodenum were normal. Color ultrasonography evaluation of the portal, hepatic and splenic veins was negative for thrombosis. Band ligation was done and the patient's bleeding did not recur. Conclusion Band ligation is a safe and effective method for controlling DEV bleeding in patients with uncorrectable underlying disorders.

Tavakkoli, Hamid; Asadi, Mehrnaz; Haghighi, Mahshid; Esmaeili, Abbas

2006-01-01

73

Complete resection of undifferentiated cardiac sarcoma and reconstruction of the atria and the superior vena cava: case report  

PubMed Central

Primary cardiac tumors are rare with an incidence ranging from 0.001% to 0.03% in autopsy series. The prognosis of cardiac sarcomas remains poor because it proliferates rapidly and distant metastases are often found at diagnosis. A 47-year-old male complained of persistent cough. The chest roentgenogram was normal. Subsequent computed tomography revealed a mass in the right atrium. Echocardiography and magnetic resonance imaging confirmed also a right atrial mass (34 x 35 mm) infiltrating the atrial septum. The tumor was completely resected en bloc, including the anterior and lateral right atrial walls, the left atrial dome, and a large segment of the superior vena cava, and reconstructed the atria and superior vena cava with bovine pericardium. The tumor was histologically and immunohistochemically diagnosed as undifferentiated pleomorphic sarcoma. This type of cardiac sarcoma is very rare and usually found in the left atrium. Twenty-seven months after surgery, the patient is doing well without metastasis or local tumor recurrence.

2012-01-01

74

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

PubMed

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. PMID:24505225

Sybilski, Adam J; Michalczuk, Ma?gorzata; Chudoba, Anna; Tolak-Omernik, Katarzyna; Bulski, Tomasz; Walecki, Jerzy

2013-10-01

75

Kawashima operation: functional modification of bidirectional Glen shunt with left superior vena cava in single ventricular morphology.  

PubMed

Single ventricle physiology offers limited options with significant morbidity and mortality. The Glenn shunt is a mid-stage procedure for the Fontan circulation. With persistent left Superior Vena Cava (SVC) and Azygos continuation of the Inferior Vena Cava (IVC) to the SVC, needs the development of bilateral bidirectional Glenn shunts. Fifteen patients underwent Bidirectional Glen shunt procedure over a period of ten years. Of these two were found to have left SVC along with interrupted IVC and its Azygos continuation to the SVC. These two patients underwent the Kawashima operation. A seven years old girl was admitted via emergency with severe cyanosis. She had tricuspid atresia, azygos continuation of IVC with single ventricle physiology. She had a complicated postoperative course with prolonged hospital stay after bilateral bidirectional Glen shunt (Kawashima operation). She successfully has completed Fontan after 5 years. The second case ofa 7 year old girl had elective surgery for DORV (double outlet right ventricle), pulmonary atresia and azygos continuation of IVC and persistent left SVC. She had an uneventful postoperative course. The Kawashima operation is an established surgical procedure to deal with bilateral SVCs. The procedure is safe; outcome is favourable and prepares the patient for total cavo-pulmonary shunt. PMID:19213378

Shahabuddin, Syed; Fatimi, Saulat; Atiq, Mehnaz; Amanullah, Muneer

2009-01-01

76

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

PubMed Central

Summary 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.

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

2013-01-01

77

Biatrial or Left Atrial Drainage of the Right Superior Vena Cava: Anatomic, Morphogenetic, and Surgical Considerations Report of Three New Cases and Literature Review  

Microsoft Academic Search

Since the posterior wall of the right superior vena cava (RSVC) is contiguous with the anterior wall of the right upper pulmonary veins, a localized defect in this common wall may create a cavopulmonary venous confluence without eliminating the normal connection of the same right pulmonary veins with the left atrium (LA). Through this defect, blood of the unroofed right

S. Van Praagh; T. Geva; J. E. Lock; P. J. del Nido; M. S. Vance; R. Van Praagh

2003-01-01

78

Superior vena cava (SVC) reconstruction using autologous tissue in two cases of differentiated thyroid carcinoma presenting with SVC syndrome  

PubMed Central

Herein, we report two extremely rare cases of differentiated thyroid carcinoma (DTC) with extended tumor thrombus or mediastinum lymph node metastasis (LNM) involving the superior vena cava (SVC), causing SVC syndrome. Both of these patients were successfully treated with radical resection and reconstruction of the SVC using autologous tissue instead of an expanded polytetrafluoroethylene (ePTFE) graft. The left brachiocephalic vein was used to reconstruct the SVC in a papillary thyroid carcinoma patient with mediastinum LNM and a pericardial patch was used in a follicular thyroid carcinoma patient with tumor thrombus. Our search of the English-language literature found sporadic reports of SVC resection with reconstruction by vascular graft (ePTFE), interposed between the brachiocephalic vein and the right atrium. However, SVC reconstruction using autologous tissue in thyroid carcinoma has not been reported to date. To our knowledge, this is the first report describing such an unusual technique in DTC patients.

Wada, Nobuyuki; Masudo, Katsuhiko; Hirakawa, Shohei; Woo, Tetsukan; Arai, Hiromasa; Suganuma, Nobuyasu; Iwaki, Hideyuki; Yukawa, Norio; Uchida, Keiichi; Imoto, Kiyotaka; Rino, Yasushi; Masuda, Munetaka

2009-01-01

79

Nutcracker syndrome due to left-sided inferior vena cava compression and treated with superior mesenteric artery transposition.  

PubMed

Left renal vein hypertension secondary to left renal vein compression has been described as a cause of persistent hematuria in nutcracker syndrome. Malformation of the inferior vena cava (IVC), although rare and frequently asymptomatic, may also result in left renal vein hypertension, with resultant hematuria when it is severely compressed. We report a 20-year-old man with persistent hematuria due to compression of left-sided IVC. The patient was successfully treated by means of superior mesenteric artery (SMA) transposition and division of the fibrous bundle at the origin of the SMA. His postoperative course was uneventful. Compression of the left IVC is a unique form of nutcracker syndrome. SMA transposition, together with division of a fibrous bundle at the origin of the SMA if present, is a safe and effective surgical procedure for this special entity. PMID:22819752

Yang, Bao-Zhong; Li, Zhen; Wang, Zhong-Gao

2012-09-01

80

Surgical management of superior vena cava syndrome following pacemaker lead infection: a case report and review of the literature.  

PubMed

Superior vena cava (SVC) syndrome is a known but rare complication of pacemaker lead implantation, accounting for approximately less than 0.5% of cases. Its pathophysiology is due to either infection or endothelial mechanical stress, causing inflammation and fibrosis leading to thrombosis, and therefore stenosis of the SVC. Due to the various risks including thrombo-embolic complications and the need to provide symptomatic relief, medical and surgical interventions are sought early. We present the case of a 48-year Caucasian male who presented with localised swelling and pain at the site of pacemaker implantation. Inflammatory markers were normal, but diagnostic imaging revealed three masses along the pacemaker lead passage. A surgical approach using cardiopulmonary bypass and circulatory arrest was used to remove the vegetations. Culture from the vegetations showed Staphylococcus epidermidis. The technique presented here allowed for safe and effective removal of both the thrombus and infected pacing leads, with excellent exposure and minimal post-procedure complications. PMID:24947452

Kokotsakis, John; Chaudhry, Umar A R; Tassopoulos, Dimitris; Harling, Leanne; Ashrafian, Hutan; Vernandos, Michail; Kanakis, Meletis; Athanasiou, Thanos

2014-01-01

81

Surgical management of superior vena cava syndrome following pacemaker lead infection: a case report and review of the literature  

PubMed Central

Superior vena cava (SVC) syndrome is a known but rare complication of pacemaker lead implantation, accounting for approximately less than 0.5% of cases. Its pathophysiology is due to either infection or endothelial mechanical stress, causing inflammation and fibrosis leading to thrombosis, and therefore stenosis of the SVC. Due to the various risks including thrombo-embolic complications and the need to provide symptomatic relief, medical and surgical interventions are sought early. We present the case of a 48-year Caucasian male who presented with localised swelling and pain at the site of pacemaker implantation. Inflammatory markers were normal, but diagnostic imaging revealed three masses along the pacemaker lead passage. A surgical approach using cardiopulmonary bypass and circulatory arrest was used to remove the vegetations. Culture from the vegetations showed Staphylococcus epidermidis. The technique presented here allowed for safe and effective removal of both the thrombus and infected pacing leads, with excellent exposure and minimal post-procedure complications.

2014-01-01

82

IgG4-Related Sclerosing Disease Involving the Superior Vena Cava and the Atrial Septum of the Heart  

PubMed Central

A 55-year-old woman presented with frequent episodes of syncope due to sinus pauses. During ambulatory Holter monitoring, atrial fibrillation and first-degree atrioventricular nodal block were observed. Magnetic resonance imaging and CT scans showed a tumor-like mass from the superior vena cava to the right atrial septum. Open chest cardiac biopsy was performed. The tumor was composed of proliferating IgG4-positive plasma cells and lymphocytes with surrounding sclerosis. The patient was diagnosed with IgG4-related sclerosing disease. Because of frequent sinus pauses and syncope, a permanent pacemaker was implanted. The cardiac mass was inoperable, but it did not progress during the one-year follow-up.

Song, Changho; Koh, Myoung Ju; Yoon, Yong-Nam; Joung, Boyoung

2013-01-01

83

Correlative anatomy for the electrophysiologist: ablation for atrial fibrillation. Part I: pulmonary vein ostia, superior vena cava, vein of Marshall.  

PubMed

Ablation procedures for atrial fibrillation (AF) have become an established and increasingly used option for managing patients with symptomatic arrhythmia. The anatomic structures relevant to the pathogenesis of AF and ablation procedures are varied and include the pulmonary veins (PVs), other thoracic veins, the left atrial myocardium, and autonomic ganglia. Exact regional anatomic knowledge of these structures is essential to allow correlation with fluoroscopy and electrograms, and, importantly, to avoid complications from damage of adjacent structures within the chest. We have presented this information in a 2-part series. In the present article, we examine the general anatomic characteristics of the PVs, superior vena cava, and vein of Marshall. Features of particular relevance for the invasive electrophysiologist are pointed out. In a subsequent article, we discuss the regional anatomy of the left and right atria and anatomic considerations in preventing complications during AF ablation. PMID:20158562

Macedo, Paula G; Kapa, Suraj; Mears, Jennifer A; Fratianni, Amy; Asirvatham, Samuel J

2010-06-01

84

Advanced Stage T-Cell Non-Hodgkin lymphoma in an 11-Month-Old Infant and Related Superior Vena Cava Syndrome: Importance of Transthoracic Echocardiography  

PubMed Central

Superior vena cava syndrome (SVCS) is rare in infants. Non-Hodgkin lymphoma is the most common cause of SVCS in children. Swelling in the face and neck are the most common clinical symptoms associated with this syndrome. However, these clinical findings are also observed in allergic diseases, which therefore often leads to misdiagnosis. Here, we reported the importance of echocardiography in diagnosing SVCS in an infant with advanced stage non-Hodgkin lymphoma.

YILMAZ, Osman; KARABAG, Kezban; KESKIN YILDIRIM, Zuhal; CALIK, Muhammet; KILIC, Omer

2014-01-01

85

Proton beam therapy for a patient with a giant thymic carcinoid tumor and severe superior vena cava syndrome.  

PubMed

Surgical resection is the first choice for treatment of a thymic carcinoid tumor and radiotherapy is often performed as adjuvant therapy. Here, we report a case of an unresectable and chemoresistant thymic carcinoid tumor that was treated successfully using standalone proton beam therapy (PBT). The patient was a 66-year-old woman in whom surgical resection of the tumor was impossible because of cardiac invasion. Therefore, chemotherapy was administered. However, the tumor grew to 15 cm in diameter and she developed severe superior vena cava (SVC) syndrome. She was referred to our hospital and received PBT at a dose of 74 GyE in 37 fractions. PBT was conducted without severe early toxicities. After PBT, the tumor mildly shrunk to 13 cm in diameter and SVC syndrome almost disappeared. Subsequently, the tumor has continued to decrease in size slowly over the last 2 years and late toxicities have not been observed. Our experience with this case suggests that PBT may be effective for an unresectable thymic carcinoid tumor. PMID:25002943

Sugawara, Kaori; Mizumoto, Masashi; Numajiri, Haruko; Ohno, Toshiki; Ohnishi, Kayoko; Ishikawa, Hitoshi; Okumura, Toshiyuki; Sakurai, Hideyuki

2014-05-13

86

[Successful resection and repair of the superior vena cava and right atrium in a patient with invasive thymoma].  

PubMed

A 45-year-old female, who suffered from Superior Vena Cava (SVC) syndrome, was diagnosed as invasive thymoma by means of trans-sternal aspiration cytology (TSAC). After preoperative radiotherapy and two courses of neoadjuvant chemotherapy, she underwent radical tumor resection combined with partial resection of both SVC and the right atrium followed by pericardial patch repair under the cardiopulmonary bypass. Complete resection is the most important procedure for the therapy of invasive thymoma, even if the tumor is in advanced stage invading to large vessels such as SVC. As far as our knowledges are concerned, complete resection of invasive thymoma combined with partial resection of the right atrium is very rare. Our case shows that partial resection of the right atrium is not risky operative procedure, if the invaded lesion of the right atrial wall is localized at the antero-lateral side to which the sinus node and the conducting system is not close. And we chose pericardial patch repair for the large defect of SVC. This patch repair was good method in this case because the blood flow through the Azygos vein was well maintained. We would also like to emphasize that TSAC is useful diagnostic procedure for the mediastinal mass lesion to which transcutaneous aspiration using the ultrasound or CT scan as a guide is impossible. PMID:7616035

Kohiyama, R; Hoshino, T; Miyata, M; Yamaguchi, A; Adachi, H; Yamada, S

1995-06-01

87

High prevalence rate of left superior vena cava determined by echocardiography in patients with congenital heart disease in Saudi Arabia  

PubMed Central

Background Persistent left superior vena cava (LSVC) is one of the common anomalies of the systemic veins. Its prevalence is 0.1–0.3% in the general population and is more common with congenital heart disease (CHD). The importance of detecting persistent LSVC prior to cardiac surgery is paramount for systemic veins cannulations. Aim The aim was to evaluate the prevalence of persistent LSVC in patients with CHD in Saudi Arabia. Methods All patients referred to our institution had echocardiography. All complete studies were reviewed for the presence of persistent LSVC. A computerized database was created including the demographic data, CHD diagnoses, and the presence of persistent LSVC. Results A total of 2,042 were examined with an age range of 1 day to 16 years. The complete echocardiographic studies were 1,832 (90%) of whom 738 (40%) patients had CHD. The prevalence of persistent LSVC in patients with CHD was 7.8% (OR 9.26, 95% CI 4.7–18.2, p<0.001). The most common cardiac defect associated with persistent LSVC was complete atrioventricular septal defect (AVSD); all patients with AVSD had Down syndrome. The total number of patients with AVSD was 41, and persistent LSVC was found in 11 (26%) of them (odds ratio 5.1, 95% CI 2.4–10.8, p<0.001). Conclusions The prevalence of persistent LSVC in the current population is almost double the reported prevalence obtained using the same echocardiographic screening tool.

Eldin, Ghada Shiekh; El-Segaier, Milad; Galal, Mohammed Omer

2013-01-01

88

Proton Beam Therapy for a Patient with a Giant Thymic Carcinoid Tumor and Severe Superior Vena Cava Syndrome  

PubMed Central

Surgical resection is the first choice for treatment of a thymic carcinoid tumor and radiotherapy is often performed as adjuvant therapy. Here, we report a case of an unresectable and chemoresistant thymic carcinoid tumor that was treated successfully using standalone proton beam therapy (PBT). The patient was a 66-year-old woman in whom surgical resection of the tumor was impossible because of cardiac invasion. Therefore, chemotherapy was administered. However, the tumor grew to 15 cm in diameter and she developed severe superior vena cava (SVC) syndrome. She was referred to our hospital and received PBT at a dose of 74 GyE in 37 fractions. PBT was conducted without severe early toxicities. After PBT, the tumor mildly shrunk to 13 cm in diameter and SVC syndrome almost disappeared. Subsequently, the tumor has continued to decrease in size slowly over the last 2 years and late toxicities have not been observed. Our experience with this case suggests that PBT may be effective for an unresectable thymic carcinoid tumor.

Sugawara, Kaori; Mizumoto, Masashi; Numajiri, Haruko; Ohno, Toshiki; Ohnishi, Kayoko; Ishikawa, Hitoshi; Okumura, Toshiyuki; Sakurai, Hideyuki

2014-01-01

89

Spiral vein graft for obstruction of the superior vena cava: a case report.  

PubMed

Catheter-induced superior vena caval thrombosis is a rare complication of the placement of transvenous pacemakers. The authors report such a case in a 44-year-old man. A composite spiral graft of saphenous vein was used to bypass the obstruction. It was anastomosed end to side to the innominate vein and then to the right atrial appendage. The patient improved remarkably immediately after the operation and had an uncomplicated postoperative course. The authors discuss the surgical technique involved and recommend for this rare condition an initial trial of anticoagulant therapy followed by bypass grafting, using the technique they describe, if anticoagulation fails. PMID:6627147

Miller, J D; Kinley, C E

1983-11-01

90

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

SciTech Connect

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.

Erol, Ilknur [Baskent University Faculty of Medicine, Department of Pediatrics, Pediatric Neurology Unit (Turkey)], E-mail: ilknur_erol@yahoo.co; Cetin, I. Ilker [Baskent University Faculty of Medicine, Department of Pediatrics, Pediatric Cardiology Unit (Turkey); Alehan, Fuesun [Baskent University Faculty of Medicine, Department of Pediatrics, Pediatric Neurology Unit (Turkey); Varan, Birguel [Baskent University Faculty of Medicine, Department of Pediatrics, Pediatric Cardiology Unit (Turkey); Ozkan, Sueleyman [Baskent University Faculty of Medicine, Department of Cardiovascular Surgery (Turkey); Agildere, A. Muhtesem [Baskent University Faculty of Medicine, Department of Radiology (Turkey); Tokel, Kursad [Baskent University Faculty of Medicine, Department of Pediatrics, Pediatric Cardiology Unit (Turkey)

2006-06-15

91

Persistent left superior vena cava in association with sinus venosus defect type of atrial septal defect and partial pulmonary venous return on 64-MDCT.  

PubMed

The most common venous abnormality of the thorax is persistent left superior vena cava (PLSVC), incidence being less than 0.5%. However, with congenital heart disease, it is about 6.1%. When the coronary sinus is dilated always search for PLSVC. The coronary sinus may communicate with the left atrium. This is known as an unroofed coronary sinus (UCS) and preoperatively documenting it is important. Of all the congenital cardiac anomalies, the sinus venosus defect (SVD) type of atrial septal defect (ASD) is most commonly associated with PLSVC and accounts for 4-11% of all ASDs. Multidetector CT can easily show all these abnormalities along with haemodynamics. On transoesophageal echocardiography it is difficult to characterise SVD and visualise a coronary sinus because of a limited window, contrast resolution and poor patient compliance. The complex of UCS and PLSVC is one such abnormality and its treatment requires careful assessment of other concomitant cardiac abnormalities to prevent post-treatment haemodynamic complications. PMID:24850552

Disha, Bansal; Prakashini, Koteshwara; Shetty, Ranjan K

2014-01-01

92

Normative MDCT Cross-Sectional Data Estimation of Superior Vena Cava and Innominate Vein in Growing Children Using Age as a Predictor.  

PubMed

This retrospective study aimed to determine the superior vena cava (SVC) and left innominate vein (INV) normative cross-sectional area in children noninvasively using age as a predictor and also to compare the correlation of the area measured with the diameter on multidetector computed tomography (MDCT). Analysis of the SVC-INV cross-sectional area was performed for 73 consecutive patients. The cross-sectional area of the SVC-INV was manually estimated. A regression analysis was performed for the cross-sectional area and age separately, and regression equations were compared. One-way analysis of variance (ANOVA) was performed to evaluate significant differences in the area means according to age groups. Regression analysis showed that age can be a predictor for the area of the SVC (50.6 mm(2) + 1.01 × age), te INV (48.3 mm(2) + 0.93 × age), and the left SVC-INV junction (47.2 mm(2) + 0.92 × age), with respective R (2) values of 93, 88 and 94 %. The comparative evaluation of the cross-sectional area and the diameter measurement of SVC showed that the cross-sectional area was more closely associated with the increasing age of the cohort (R (2) of 68 vs. 61 %) than the measured diameter. For a cohort of patients without congenital or acquired heart disease, MDCT can be used as a complementary test for a normative cross-sectional normogram area database of SVC-INV using age as a predictor. PMID:24647440

Das, Karuna M; Momenah, Tariq S; Singh, Rajvir; Raja, Shanker; AlMoukirish, Abdulrahman; AlZoum, Mohammad; Larsson, Sven G

2014-08-01

93

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  

PubMed Central

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.

Wang, Jianyang; Liang, Jun; Wang, Wenqing; Ouyang, Han; Wang, Luhua

2013-01-01

94

Filter placement for duplicated cava.  

PubMed

Anatomic variations of the inferior vena cava (IVC) are found in 3-5% of the population. IVC duplication is a well-known anatomic variation that is important when relevant procedures are being planed. Therefore, the identification of IVC anomalies should be checked prior to pertinent interventions. We report two cases of dual IVC filter placement for duplicated cava including a missing left inferior vena cava and subsequent pulmonary embolism. The rationale of one versus two filters and the current literature are discussed. PMID:21278173

Malgor, Rafael D; Oropallo, Alisha; Wood, Emily; Natan, Kristina; Labropoulos, Nicos

2011-04-01

95

21 CFR 870.3260 - Vena cava clip.  

Code of Federal Regulations, 2010 CFR

...Prosthetic Devices § 870.3260 Vena cava clip. (a) Identification. A vena cava clip is an implanted extravascular device designed to occlude partially the vena cava for the purpose of inhibiting the flow of thromboemboli through...

2009-04-01

96

21 CFR 870.3260 - Vena cava clip.  

Code of Federal Regulations, 2010 CFR

...Prosthetic Devices § 870.3260 Vena cava clip. (a) Identification. A vena cava clip is an implanted extravascular device designed to occlude partially the vena cava for the purpose of inhibiting the flow of thromboemboli through...

2010-04-01

97

A novel technique for inferior vena cava filter extraction.  

PubMed

Inferior vena cava (IVC) filters are used to protect against pulmonary embolism in high-risk patients. Whilst the insertion of retrievable IVC filters is gaining popularity, a proportion of such devices cannot be removed using standard techniques. We describe a novel approach for IVC filter removal that involves snaring the filter superiorly along with the use of flexible forceps or laser devices to dissect the filter struts from the caval wall. This technique has used to successfully treat three patients without complications in whom standard techniques failed. PMID:23636251

Johnston, Edward William; Rowe, Luke Michael Morgan; Brookes, Jocelyn; Raja, Jowad; Hague, Julian

2014-02-01

98

Update on vena cava filters  

Microsoft Academic Search

Opinion statement  Inferior vena cava (IVC) filter placement has increased dramatically over the past two decades. Filters are indicated to prevent\\u000a pulmonary embolism in patients with venous thromboembolism (VTE) and a contraindication to anticoagulation or a complication\\u000a of anticoagulation. Some of this increased use is the result of expanding relative indications for filter placement, including\\u000a placement for primary prophylaxis. The US

Teresa L. Carman; Alaa Alahmad

2008-01-01

99

Leiomyosarcoma of the inferior vena cava.  

PubMed

The thirty-second case of leiomyosarcoma of the inferior vena cava and the twelfth resectable patient in the series is presented. A review of the literature demonstrates a marked female preponderance (5 to 1). The most common presenting symptom is right abdominal pain and a palpable mass. The different surgical problems generated by the involved segment of the cava are discussed. Noteworthy is the high incidence of Budd-Chiari syndrome owing to hepatic vein obstruction with involvement of the upper third of the cava in the postmortem cases. An argument is developed for debulking the tumor for palliation when it is not completely removable. PMID:95619

Diamond, H M; Lyon, E S; Hui, N T; De Pauw, A P

1976-10-01

100

Superior Mesenteric Artery Injury during en bloc Excision of a Massive Left Adrenal Tumor  

Microsoft Academic Search

Superior mesenteric artery (SMA) injury is a rare event during abdominal surgery. We report the first case of inadvertent injury of the superior mesenteric artery during surgery of a large malignant adrenocortical tumor with inferior vena cava thrombus. The cause of inadvertent injury was anatomical distortion of the great vessels due to the massive nature of the tumor. The case

Santosh Kumar; A. K. Mandal; Naveen Acharya; S. K. Thingnam; Vidur Bhalla; S. K. Singh

2007-01-01

101

Nutcracker syndrome in a patient with a history of inferior vena cava ligation.  

PubMed

We report the case of a child with clinical and radiological signs of nutcracker syndrome who had a history of inferior vena cava ligation during a previous surgery. He was referred for evaluation of abdominal pain and hematuria. Entrapment of the left renal vein between the superior mesenteric artery and the aorta with aneurysmal dilatation was detected on Doppler ultrasonography. Magnetic resonance angiography revealed paravertebral and epidural collateral vessels. PMID:21449002

Peker, Ahmet; Yagmurlu, Aydin; Ekim, Mesiha; Gokcora, Haluk; Fitoz, Suat

2011-09-01

102

Aneurysms of the inferior vena cava.  

PubMed

Two cases of saccular aneurysms of the infrarenal inferior vena cava (IVC) associated with retrohepatic IVC obstruction are described. Ultrasonographic, computerized tomographic and inferior venacavography findings in these cases are presented. PMID:12581068

Sheth, Rahul; Hanchate, Vijay; Rathod, Krantikumar; Ahmed, Iftikhar; Deshmukh, Hemant; Chaubal, Nitin

2003-03-01

103

Leiomyosarcoma of the inferior vena cava incidentally detected.  

PubMed

This report presents the case of a 78-year-old man affected by retroperitoneal tumor arising from the lower segment of the inferior vena cava. The patient underwent excision of the tumor and resection of the vena cava. Postoperative histopathologic examination revealed the diagnosis of leiomyosarcoma of the inferior vena cava, a rare tumor of mesenchymal origin. PMID:23711977

Lovisetto, Federico; Corradini, Carmen; De Cesare, Fabio; Geraci, Orazio; Manzi, Mario; Emidi, Roberto; Arceci, Francesco

2013-08-01

104

Leiomyosarcoma of inferior vena cava.  

PubMed

Malignancy arising from the blood vessels is a very rare finding in daily clinical practice. In addition, the finding can often be misdiagnosed and ill-treated. These tumors usually go unnoticed unless it has metastasized to distant tissues. Among these rare tumors, leiomyosarcoma is the most common. It mostly arises in the inferior vena cava (IVC). Clinical signs and symptoms are very vague. Usually it is often misdiagnosed as an abscess cavity in the liver or primary hepatic malignancy (when present at level II) or as a thrombus in the IVC. Radiological investigations are the key to proper diagnosis. Depending upon the exact location, further treatment options vary. Generally, it is believed that level II and level III tumors are amenable to surgery followed by chemo or radiotherapy. We present a rare case of leiomyosarcoma of IVC at level II being diagnosed with proper radiological investigations and its management with further stress on offering chemo-radiotherapy after its surgical removal as compared to only surgery performed earlier. This case report will throw some light on the proper management of such rare tumors in terms of their exact diagnosis and treatment in order to prolong patient survival. PMID:22120864

Jadhav, S A; Atluri, V S; Prajapati, R; Satoskar, R R

2011-01-01

105

Vena Cava ?nvasion by Adrenal Leiomyosarcoma  

PubMed Central

Primary adrenal mesenchymal tumors are extremely rare. These tumors are hard to diagnose, and similar to certain adrenal tumors, as they do not produce hormones, and they can only manifest themselves when the tumor reaches an advanced size. These tumors are generally detected incidentally. This study reports a rare case of primary leiomyosarcoma of the right adrenal gland with vena cava invasion, in a 70-year-old woman who presented with right flank pain. Computerized tomography showed an adrenal mass with a diameter of 78 mm, which exerted pressure on the vena cava inferior. The invasive part was excised by using adrenalectomy and cavatomy. Tumor invasion was determined on the wall of the vena cava. Histopathological examination on 10× magnification showed 8-10 mitotic events. Immunohistochemical staining showed that the cells were SMA (+), desmin (+), cytokeratin (-), and Bcl-2 (-). The Ki67 proliferation index was 70%. Widespread metastasis developed six months after the adrenalectomy.

Ozturk, Hakan

2014-01-01

106

Spanish sparkling wines (Cavas) as inhibitors of in vitro human low-density lipoprotein oxidation.  

PubMed

Forty-seven dealcoholized sparkling wines (cava) from the Penedès area in Spain were tested for their antioxidant activity in a low-density lipoprotein system. The effect of different quality-related parameters, such as harvest year or grape variety, was investigated. Twenty-two phenolic compounds were separated by high-performance liquid chromatography and identified by comparing their retention time and their ultraviolet spectra with those of pure standards. When tested at the same total phenol concentration, the antioxidant activity of these white sparkling wines was found to be similar to that reported for red wines. This activity was positively correlated with the total phenolic content, trans-caffeic acid, coumaric acid, protocatechuic acid, and quercetin 3-glucuronide. The wines made of the classic cava wine coupage had superior antioxidant activity compared to those of other cultivars. PMID:10794609

Satué-Gracia, M T; Andrés-Lacueva, C; Lamuela-Raventós, R M; Frankel, E N

1999-06-01

107

Overview of current inferior vena cava filters.  

PubMed

Inferior vena cava (IVC) filter technology has expanded dramatically over the past decade. Improvements in catheter and filter technology have allowed for the safe and rapid insertion of IVC filters from multiple venous access sites, using increasingly lower-profile percutaneous delivery systems. While the currently available filters have slightly different designs and insertion techniques, all function in a similar fashion to prevent venous thromboembolic propagation through the inferior vena cava. This article describes the construction and deployment mechanisms of the various filters that are currently on the market. PMID:12953819

Kercher, Kent; Sing, Ronald F

2003-08-01

108

Complex malformation of the inferior vena cava.  

PubMed

Malformations of the inferior vena cava (IVC) are rare presentations, exceptional in children, and are usually asymptomatic.They are caused by disturbances in the embryological formation of the venous system or can develop as a result of perinatal venous thrombosis with secondary impairment of the venous development. We report the case of a 14 year old boy,admitted for pediatric evaluation before undergoing plastic surgery in order to remove superficial varicose veins of the lower abdomen. The patient presents with inequality in circumference and length of the legs. Laboratory investigations are normal and the abdominal ultrasound describes hypoplasia of the retrohepatic segment of the inferior vena cava. The diagnosis of complex malformation of the abdominal deep venous system (retrohepatic vena cava atresia, cavo-caval anastomosis through azygos veins, abnormal formation of the inferior vena cava with the absence of the left iliac vein) was established through a CT angiography. The presence of abdominal varicose dilations should indicate the necessity to closely look for malformations of the portal and/or caval venous systems. PMID:24742422

Lesanu, G; Balanescu, R; Pacurar, D; Iaru, O; Vlad, R M; Topor, L; Oraseanu, D

2014-01-01

109

An anomalous left superior venacava draining into left atrium in association with fetal valproate syndrome.  

PubMed

Prenatal exposure of mother to valproic acid causes teratogenic effects on fetus. The authors report an 18 h-old girl with typical facial and limbs features of fetal valproate syndrome (FVS) along with abnormal draining of left superior vena cava into left atrium. PMID:22678520

Sarkar, Suman; Sardar, Shyamal Kumar; Munian, Dinesh; Bhattacharya, Subham; Majhi, Bhuban

2013-07-01

110

Neuroblastoma presenting like a Wilms' tumor with thrombus in inferior vena cava and pulmonary metastases: a case series.  

PubMed

Neuroblastomas and Wilms' tumors are frequent pediatric solid tumors. The first is frequently detected in the adrenal gland and the second develops in the kidneys. The extension through the vena cava and the lung metastases are frequent in Wilms' tumors and are rarely seen in neuroblastoma. We present the cases of three children with abdominal tumors with thrombus in the inferior vena cava and pulmonary metastases demonstrating a stage 4 neuroblastoma. The three male patients were between 23 to 48 months old. They presented an abdominal mass, near the superior pole of the kidney. Thrombus of the vena cava was showed on imaging studies in all cases and pulmonary metastases were always found. Catecholamine metabolites were present in the first case and negative in the two others. Two out of three patients had a radical nephrectomy. The pathological analysis always found a poorly differentiated or undifferentiated neuroblastoma without MYCN amplification and confirmed the vein tumoral thrombus in the second case. The evolution of the first two patients was unfavorable and the third is alive. Invasion of the inferior vena cava and pulmonary metastases in children with neuroblastoma is uncommon and can modify the surgical management. PMID:25077062

Gaetan, Genevieve; Ouimet, Alain; Lapierre, Chantale; Teira, Pierre; Sartelet, Herve

2014-01-01

111

Penetrating trauma of colon, cava, and cord.  

PubMed

A case is presented of a young police officer shot in the abdomen, sustaining injuries to colon, cava, and cord. Each injury was surgically managed in what was felt to be an appropriate manner, with early antibiotic therapy. As complications developed, aggressive measures were taken to correct them, with some success as far as pulmonary and renal failure were concerned, but with complete inability to reverse the meningitis and cerebritis caused by E. coli, and leading to a fatal outcome. PMID:775116

Wilson, T H

1976-05-01

112

Leiomyosarcoma of the Inferior Vena Cava  

PubMed Central

Vascular leiomyosarcoma (LMS) are unique. The inferior vena cava (IVC) is the most affected organ (about 38% cases). We report the observation of a 50-year old woman who consulted for right upper quadrant pain. Imaging studies revealed a retroperitoneal mass that mimic a LMS of the IVC. The patient was operated. A resection of the IVC along with the tumor was performed without reconstruction. The management of LMS is surgical and depends upon the location and tumor characteristics.

Sadri, Ben Abid; Amine, Attaoui Mohamed; Zeineb, Mzoughi; Nizar, Miloudi; Lassad, Gharbi; Khalfallah, Mohamed Tahar

2013-01-01

113

[Vena cava filters in cancer patients].  

PubMed

Cancer patients with venous thromboembolism (VTE) have more complications related to the anticoagulation treatment than the general population. Vena cava filters are a useful tool in cancer patients, but their use in advanced disease is controversial. In this paper, we reviewed the indications, complications and frequency of retrieval of vena cava filters in cancer patients with VTE. Twenty seven patients with vena cava filter placements were analyzed. Twenty five had solid tumors and two non Hodgkin lymphomas. Twenty five were under active treatment (surgery and/or chemotherapy). Nineteen were classified as stage IV of disease. Indications for filter placement were perioperative prophylaxis in 14 cases (51.9%), hemorrhage (n = 5), thrombocytopenia (n = 4), central nervous system metastases (n = 2), stroke (n = 1) and previous neurosurgery (n = 1). Eight (29.6%) filters were retrieved. The median time to retrieval was 21 days (range: 6-75). There was no statistically significant difference in the frequency of retrieval between perioperative prophylaxis placement (6/14) and other contraindications for anticoagulation treatment (2/13; p = 0.2087). There were no adverse events related to the placement or retrieval procedures. PMID:22892079

Díaz Couselo, Fernando A; Crerar, Silvina; Cravero, Patricia; Santaera, Omar; Eisele, Guillermo; Zylberman, Marcelo

2012-01-01

114

Caudal vena cava thrombosis-like syndrome in a horse  

PubMed Central

A 9-year-old Quarter horse was presented for chronic refractory pneumonia. On necropsy, an hepatic abscess, caudal vena cava thrombosis, pulmonary thromboembolism, and embolic pneumonia were identified. Similar lesions have been reported in cattle as caudal vena cava thrombosis syndrome, however this syndrome has not previously been reported in horses.

Schoster, Angelika; Anderson, Maureen E.C.

2010-01-01

115

Malignant renal tumor with extension to the inferior vena cava  

Microsoft Academic Search

Background: Management of malignant renal tumors involving the inferior vena cava (IVC) depends on tumor extension within the cava.Methods: Of 295 patients treated for renal cancer, propagation of tumor mass through the renal vein to IVC was seen in 22 (7%) patients. Cephalad extension of the tumor was suprarenal: infrahepatic in 12, retrohepatic in 6, and within the right atrium

Sateesh C. Babu; Tim Mianoni; Pravin M. Shah; Arun Goyal; Muhammad Choudhury; Magid Eshghi; Richard A. Moggio; Mohan R. Sarabu; Rocco J. Lafaro

1998-01-01

116

Mesoaortic entrapment of a left inferior vena cava  

PubMed Central

A persistent left inferior vena cava (IVC) is a rare anomaly, with a reported incidence of only 0.2-0.5%. When present, it courses between the superior mesenteric artery and the aorta to continue as the right IVC, similar to the course of a left renal vein (LRV). This anomaly is usually asymptomatic, but there may be vague abdominal complaints if the IVC is compressed in the mesoaortic angle. Although symptomatic compression of the LRV (anterior nutcracker syndrome) is well recognized, there has been only one report in the literature of a similar compression of a persistent left IVC. Because of its rarity, this anomaly may be missed or mistaken for other conditions on imaging. An accurate diagnosis is crucial as the presence of this anomaly may have implications for surgical treatment of aortic lesions or placement of an IVC filter. Magnetic resonance angiography and, more recently, multidetector computed tomography scan, can provide an exquisite three-dimensional demonstration of vascular abnormalities.

Gupta, Ashish; Naik, Nitish; Gulati, Gurpreet Singh

2010-01-01

117

Capacitance of the rabbit portal vein and inferior vena cava.  

PubMed Central

1. We used vessel strips and whole vessels in vitro to determine the length-tension and pressure-volume relationships of two veins with similar diameter and wall thickness, the portal vein and inferior vena cava of rabbits. 2. Length-tension studies indicate that longitudinal and circular strips of the portal vein have significantly smaller elastic moduli than similar strips of the inferior vena cava (P less than 0.05). 3. Pressure-volume relationships of intact vessels indicate that pressures greater than 5 mmHg do not produce significant increases in volume of the inferior vena cava, whereas volume of the portal vein increases significantly over a range of pressures from 2 to 15 mmHg. 4. Activation of smooth muscle with noradrenaline reduces the volume of the vena cava at distending pressures less than or equal to 5 mmHg. In contrast, noradrenaline reduces the volume of the portal vein at pressures up to 10 mmHg. During inactivation in calcium-free solution and activation with noradrenaline, the portal vein is more compliant than the inferior vena cava (P less than 0.05). 5. Morphometric studies demonstrate more collagen in the inferior vena cava than in the portal vein. Differences in capacitance of the vessels may be related, in part, to greater collagen content in the inferior vena cava.

Brown, B P; Heistad, D D

1986-01-01

118

Osteosarcoma invasion of the inferior vena cava and right atrium.  

PubMed

We present a woman with chondroblastic osteosarcoma of the left ilium extending to the L4 epidural space and invading the inferior vena cava and right atrium, misdiagnosed as deep venous thrombosis. After neoadjuvant chemotherapy, two stage resection was planned. During the anterior approach, a mass in the left common iliac vein and inferior vena cava was found and tumor thromboembolism was diagnosed. Frozen sections showed chondroblastic osteosarcoma. The patient denied further surgery and had palliative intensity modulated radiation therapy. PMID:22995361

Mavrogenis, Andreas F; Angelini, Andrea; Sakellariou, Vasileios I; Skarpidi, Evangelia; Ruggieri, Pietro; Papagelopoulos, Panayiotis J

2012-01-01

119

Symplastic Leiomyoma in the Suprarenal Inferior Vena Cava  

PubMed Central

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.

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

2012-01-01

120

Superior vena cava perforation in a child from a lawnmower projectile.  

PubMed

Lawnmowers are one of the most frequent causes of mutilating injuries to children. The majority of accidents are caused by negligence of the operator. Most injuries of this type are caused by direct contact with the spinning blade and, less frequently, by projectiles propelled by the blade. Such projectiles usually produce bruises, but can penetrate skin and soft tissues. This report presents a 6-year-old child who suffered a small, outwardly insignificant puncture wound of the chest from a lawnmower-propelled projectile who presented with fever and chest pain the following day. The diagnostic work up and treatment of this deceptively life-threatening wound are discussed. PMID:17641123

McKamie, Wesley A; Schmitz, Michael L; Johnson, Charles E; Ray, Trenda; Sanford, Garrett B; Dyamenahalli, Umesh; Imamura, Michiaki

2007-11-01

121

A case of absent right and persistent left superior vena cava  

Microsoft Academic Search

BACKGROUND AND PURPOSE:: Our case report deals with the importance of detailed echocardiographic examination for differential diagnosis of coronary sinus dilation and development of abnormalities of great thoracic veins. CASE PRESENTATION:: A 49-year-old man underwent transthoracic echocardiography for atypical chest pain. A dilated coronary sinus was found and venous contrast echocardiography raised the suspicion of absent right and persistent left

Attila Pálinkás; Tamás Forster; Zita Morvai; Endre Nagy; Albert Varga

2006-01-01

122

Inverted nutcracker syndrome: a case of persistent hematuria and pain in the presence of a left-sided inferior vena cava.  

PubMed

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. PMID:21552767

Ekwenna, Obi; Gorin, Michael A; Castellan, Miguel; Casillas, Victor; Ciancio, Gaetano

2011-01-01

123

The North Atlantic Oscillation affects the quality of Cava (Spanish sparkling wine).  

PubMed

This study explores the possible effects of the North Atlantic Oscillation (NAO) on the quality of Spanish Cava. We found a significant negative relationship between the mean NAO for the months of March through August of each year between 1970 and 2008 and the probability of obtaining a top quality Cava. The NAO is associated with temperature and rainfall variations in the Cava region, which affect vine physiological processes during grape maturity. The probability of obtaining a top quality Cava was highest when the mean value of the NAO was negative, which causes the mean temperature in the Cava area to decrease, with positive consequences on Cava quality. Although the overall discrimination capacity and explanatory power of the model were low, 80% of clearly favorable years were classified correctly as corresponding to top quality Cava, and 70% of clearly unfavorable years were classified correctly as non top quality Cava. PMID:22825404

Real, Raimundo; Báez, José Carlos

2013-05-01

124

Immunomodulatory Effects of an Enzymatic Extract from Ecklonia cava on Murine Splenocytes  

Microsoft Academic Search

We investigated whether the brown seaweed Alariaceae Ecklonia cava (E. cava) has immunological effects on splenocytes in vitro. For that purpose, we prepared an enzymatic extract from E. cava (ECK) by using the protease, Kojizyme. Here, ECK administered to ICR mice dramatically enhanced the proliferation of their\\u000a splenocytes and increased the number of their lymphocytes, monocytes and granulocytes. In flow

Ginnae Ahn; Insun Hwang; Eunjin Park; Jinhe Kim; You-Jin Jeon; Jehee Lee; Jae Woo Park; Youngheun Jee

2008-01-01

125

Leiomyosarcoma of the inferior vena cava.  

PubMed

The purpose of this article is to present the CT features in five cases of pathologically verified Inferior vena cava (IVC) leiomyosarcoma. In this retrospective analysis, we reviewed CT features in 5 cases of clinicopathologically confirmed IVC leiomyosarcoma with respect to its location (infra renal, trans renal, supra renal), its extent (with or without involvement of renal vein, hepatic IVC with or without involvement of hepatic vein, right atrial & extra caval extension) and pattern of enhancement. CT guided biopsy was performed in four patients while the last patient underwent successful resection of the tumor. Three male and two female patients (aged 45 to 72 years) were included in the study. Heterogeneously enhancing retroperitoneal mass involving IVC is the most common imaging feature. The intra and extra luminal extension was demonstrated excellently in all patients. IVC leiomyosarcoma is a rare neoplasm often presenting very late with non-specific symptoms. Cross sectional imaging establishes the exact location and extension and plays a vital role in determining the resectibility and planning the management. PMID:24784870

Naphade, Prashant S; Raut, Abhijit A; Hira, Priya; Vaideeswar, Pradip; Vadeyar, Hemant

2014-05-01

126

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

PubMed Central

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.

Subramanian, Venkateshwaran; Mahadevan, Krishnamoorthy Kavassery; Sivasubramonian, Sivasankaran; Tharakan, Jaganmohan

2014-01-01

127

Primary leiomyosarcoma of the inferior vena cava: a case report.  

PubMed

Primary leiomyosarcoma of the inferior vena cava (IVC) is a rare malignant tumor originating from the vein smooth muscle. We present one case of primary leiomyosarcoma of the IVC. The patient benefited of surgical exploration at seventh day after admission. Tumor located in the junction of the anterior wall of the IVC and the left and right renal vein. We carried out the tumor resection, vena cava artificial vascular patch prosthetics. The patient did not take anticoagulant drugs after surgery and was discharged at 12 days after surgery. Currently, the patient had survived for nearly six months, repeated abdominal computed tomography examinations showed no clear recurrence. PMID:23747672

Xu, Tu-bing; Liu, Wen-yuan; Chen, Geng; Wang, Huai-zhi; Bie, Ping

2013-01-01

128

Use of inferior vena cava filters in the Medicare population  

Microsoft Academic Search

To examine the use of inferior vena cava (IVC) filters, we performed a population-based study using a 5% random sample of the United States Medicare population (1.25 million persons). Filter placement and its timing relative to diagnosis of venous thromboembolism (VTE) were determined using both hospital and physician Medicare billing codes after detailed review of large samples of complete individual

Daniel B. Walsh; John D. Birkmeyer; Jane A. Barrett; Wayne D. Kniffin; Jack L. Cronenwett; John A. Baron

1995-01-01

129

Inferior Vena Cava Filters in the Management of Venous Thromboembolism  

Microsoft Academic Search

Inferior vena cava (IVC) filters, both retrievable and permanent, are indicated for the prevention of pulmonary embolism (PE) in patients contraindicated for anticoagulant therapy, in those with anticoagulant therapy complications, and perhaps for those with recurrent PE despite therapeutic anticoagulation. Because of the lack of randomized controlled trials (only 1 has been published), clinicians have little evidence-based information to assist

Mark A. Crowther

2007-01-01

130

Duodenal perforation caused by an inferior vena cava filter.  

PubMed

The inferior vena cava (IVC) filter is known as an effective and safe method for preventing fatal pulmonary thromboembolism in patients with deep vein thrombosis. Usually, the remaining IVC filters are asymptomatic and do not cause clinical problems. We report a case of duodenal perforation caused by a remaining IVC filter. PMID:22363914

Bae, Mi Ju; Chung, Sung Woon; Lee, Chung Won; Kim, Sangpil; Song, Seunghwan

2012-02-01

131

Adjunctive Inferior Vena Cava Filter Placement for Acute Pulmonary Embolism  

Microsoft Academic Search

Inferior vena cava (IVC) filters are sometimes placed as an adjunct to full anticoagulation in patients with significant pulmonary embolism (PE). We aimed to determine the prevalence of adjunctive IVC filter placement in individuals diagnosed with PE, as well as the effect of adjunctive filter placement on mortality in patients with right heart strain associated with PE. This was a

V. M. Jha; J. Lee-Llacer; J. Williams; H. Ubaissi; G. Gutierrez

2010-01-01

132

Three Different Morphologies of Inferior Vena Cava Thrombosis: Case Reports  

PubMed Central

Inferior vena cava (IVC) thrombosis is a rare but significant complication in hospitalized patients. However, relevant information regarding IVC thrombosis, especially on its morphology, remains scarce. We present three cases of IVC thrombosis, with each showing a different morphology: mural, floating, and small polyp-like thrombus.

Okayama, Satoshi; Nakada, Yasuki; Uemura, Shiro; Saito, Yoshihiko

2014-01-01

133

Asymptomatic Lumbar Vertebral Erosion from Inferior Vena Cava Filter Perforation  

Microsoft Academic Search

In 2002, a 24-year-old female trauma patient underwent prophylactic inferior vena cava filter placement. Recurrent bouts of\\u000a renal stones prompted serial CT imaging in 2004. In this brief report, we describe erosion and ossification of the L3 vertebral\\u000a body by a Greenfield filter strut.

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

2007-01-01

134

Leiomyosarcoma of the inferior vena cava--an unusual case.  

PubMed

Primary tumors arising from great vessels like the aorta, pulmonary artery or inferior vena cava (IVC) are rare. The latter is the commonest site of its occurrence. It arises from the smooth muscle cells of the vessel wall. Aggressive surgical management should be attempted to excise it whenever possible. We describe a case of primary inferior vena cava tumor involving all three segments of the abdominal inferior vena cava infrarenal, suprarenal and retrohepatic vena cava, along with right kidney, right adrenal as well as right hepatic vein and left renal vein. We resected it completely without reconstruction of the IVC. The patient is doing well seven months after surgery without having any renal insufficiency, hepatic insufficiency or leg edema and having optimum quality of life. To our knowledge, this is the first case of such a long segment IVC leiomyosarcoma treated without IVC reconstruction, and despite its extent and concomitant involvement of the right kidney, right adrenal, right hepatic vein and left renal vein, it had a favorable response combining prolongation of survival and satisfactory quality of life. PMID:17591047

Lygidakis, N J; Bhagat, Anand D; Sharma, Sandesh K; Kefalourous, H; Porfiris, T; Grigorakos, L; Vrachnos, P; Mihalopoulos, A; Bleta, A; Bodozoglou, N; Voulgari, K; Vlachos, L

2007-01-01

135

Bilateral anomalous pulmonary venous connection to bilateral superior caval veins.  

PubMed

A four-year-old girl presented with superior vena cava (SVC) type of sinus venosus defect, right upper pulmonary vein draining into right SVC-right atrium junction, left upper lobe pulmonary veins draining into the lower part of persistent left SVC (LSVC), and a patent ductus arteriosus. The anomalous pulmonary venous drainage to LSVC was overlooked in the preoperative evaluation and was found intraoperatively. Warden procedure was performed for right-sided veins. Lower LSVC draining the anomalous pulmonary veins was anastomosed to the left atrial appendage. The short stump of LSVC was diverted to left pulmonary artery. Anomalous pulmonary venous connections to LSVC are rare. Embryology of venous development is analyzed with respect to this rare anomaly, and options for surgical correction are discussed. PMID:24403371

Sasikumar, Navaneetha; Ramanan, Sowmya; Chidambaram, Shanthi; Rema, Krishna Manohar Soman; Cherian, Kootturathu Mammen

2014-01-01

136

Superior Mesenteric Artery Syndrome  

PubMed Central

A 63-year-old female presented to our department complaining of epigastric pain, nausea and vomiting. Symptoms started after a significant loss of weight and persisted despite treatment, leading to hospitalization for dehydration and renal failure due to protracted vomiting. During hospitalization, no pathology could be identified and the patient was discharged. Symptoms persisted and she was eventually readmitted. Superior mesenteric artery syndrome was diagnosed based upon clinical suspicion and barium studies. She was subjected to duodenojejunostomy after failure of conservative treatment. Her immediate postoperative course was uneventful and the patient was well during her two-year follow-up. Clinicians should be suspicious of superior mesenteric artery syndrome, albeit rare, and be aware of its treatment, which is either conservative or surgical.

Matheos, Efthimiou; Vasileios, Kouritas; Ioannis, Baloyiannis; Dimitrios, Zacharoulis; Kostas, Hatzitheofilou

2009-01-01

137

Clinical Sequelae of Thrombus in an Inferior Vena Cava Filter  

Microsoft Academic Search

The purpose of this study was to assess the long-term clinical sequelae of inferior vena cava (IVC) filter thrombus and the\\u000a effect of anticoagulation on filter thrombus. Of 1,718 patients who had IVC filters placed during 2001–2008, 598 (34.8%) had\\u000a follow-up abdominal CT. Filter thrombus was seen in 111 of the 598 (18.6%). There were 44 men (39.6%). The mean

Iftikhar Ahmad; Kalpana Yeddula; Stephan Wicky; Sanjeeva P. Kalva

2010-01-01

138

“Recovery™” Vena Cava Filter: Experience in 96 Patients  

Microsoft Academic Search

The purpose of the study was to assess the clinical safety and efficacy of the “RecoveryTM” (Bard) inferior vena cava (IVC) filter. We retrospectively evaluated the clinical and imaging data of patients who had a\\u000a “RecoveryTM” IVC filter placed between January 2003 and December 2004 in our institution. The clinical presentation, indications, and\\u000a procedure-related complications during placement and retrieval were

Sanjeeva P. Kalva; Christos A. Athanasoulis; Chieh-Min Fan; Marcio Curvelo; Stuart C. Geller; Alan J. Greenfield; Arthur C. Waltman; Stephan Wicky

2006-01-01

139

Management of the thrombosed filter-bearing inferior vena cava.  

PubMed

Inferior vena cava (IVC) filter thrombosis is a complex problem. Thrombus within an IVC filter may range from an asymptomatic small thrombus to critical IVC occlusion that affects both lower extremities. The published experience of IVC thrombosis management in relation to filters is either anecdotal or limited to a small group of patients; however, endovascular treatment methods appear to be safe and effective in patients with IVC thrombosis. This review focuses on filter-related IVC thrombosis and its endovascular management. PMID:23449290

Sildiroglu, Onur; Ozer, Harun; Turba, Ulku Cenk

2012-03-01

140

Adjunctive Inferior Vena Cava Filter Placement for Acute Pulmonary Embolism  

Microsoft Academic Search

Inferior vena cava (IVC) filters are sometimes placed as an adjunct to full anticoagulation in patients with significant pulmonary\\u000a embolism (PE). We aimed to determine the prevalence of adjunctive IVC filter placement in individuals diagnosed with PE, as\\u000a well as the effect of adjunctive filter placement on mortality in patients with right heart strain associated with PE. This\\u000a was a

V. M. Jha; J. Lee-Llacer; J. Williams; H. Ubaissi; G. Gutierrez

2010-01-01

141

Early enhancement of the inferior vena cava on helical CT.  

PubMed

Arteriovenous fistulas (AVFs) are abnormal communications between the arterial and the venous systems. We describe two cases in which an aortocaval fistula (ACF) and a deep femoral AVF were diagnosed on dynamic computer tomography (CT) by early transient enhancement of the inferior vena cava (IVC). Awareness of the specific CT features found in central and peripheral AVFs and the effects on the arterial and venous systems may enable the radiologist to make the diagnosis. PMID:12823918

Cura, Marco; Cura, Alejandro; Bugnone, Alejandro

2003-01-01

142

Management of the Thrombosed Filter-Bearing Inferior Vena Cava  

PubMed Central

Inferior vena cava (IVC) filter thrombosis is a complex problem. Thrombus within an IVC filter may range from an asymptomatic small thrombus to critical IVC occlusion that affects both lower extremities. The published experience of IVC thrombosis management in relation to filters is either anecdotal or limited to a small group of patients; however, endovascular treatment methods appear to be safe and effective in patients with IVC thrombosis. This review focuses on filter-related IVC thrombosis and its endovascular management.

Sildiroglu, Onur; Ozer, Harun; Turba, Ulku Cenk

2012-01-01

143

Primary adrenal leiomyosarcoma with inferior vena cava thrombosis.  

PubMed

We report a primary adrenal leiomyosarcoma in a 59-year-old man. Computed tomography demonstrated a poorly enhanced mass, measuring 10 cm, between the left kidney and the normal left adrenal gland, with tumor thrombus in the inferior vena cava (IVC). The patient underwent left radical nephroadrenalectomy with IVC thrombectomy. The histological diagnosis was adrenal leiomyosarcoma. Adrenal leiomyosarcomas are extremely rare. Only seven cases have been reported previously in the English-language literature. PMID:15221604

Kato, Tomonori; Kato, Tomonori; Sakamoto, Shinichi; Kobayashi, Takashi; Ikeda, Ryoichi; Nakamura, Takeshi; Akakura, Koichiro; Hikage, Takashi; Inoue, Tohru

2004-06-01

144

Modeling Flow Past a Tilted Vena Cava Filter  

SciTech Connect

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.

Singer, M A; Wang, S L

2009-06-29

145

Òpera i educació superior  

Microsoft Academic Search

A propòsit del projecte «Òpera Oberta» de la temporada 2006-2007 del Liceu, en aquest article farem una anàlisi de la categoria artística de l’òpera i la seva importància social en l’educació superior. Les diferents visions sobre el personatge de Manon, que vam tenir l’oportunitat de veure en aquella temporada, serviran de fil conductor per abordar la dimensió educativa, artística i

Enrique Fuentes Goyanes; Jordi Solé Blanch

2007-01-01

146

Lake Superior Rift basins  

NASA Astrophysics Data System (ADS)

Sedimentary basins of late Precambrian age have been identified beneath Lake Superior using seismic reflection profiles leased by Argonne National Laboratory, Argonne, Ill., from Grant Norpac, Inc. [McGinnis et al., 1989]. These data, along with 650 km of Great Lakes International Multidisciplinary Program for Crustal Evolution (GLIMPCE) profiles [Behrendt et al., 1988], are being used to develop an understanding of failed rift processes, from initial plate separation, through basin evolution, to final quiescence.

McGinnis, L. D.

147

Lake Superior, Duluth, MN  

NASA Technical Reports Server (NTRS)

This view shows the west end of Lake Superior and Duluth, MN (47.0N, 91.0W). Portions of Minnesota, Michigan and Ontario, Canada are in the scene. The Duluth metropolitan area is at the west end of the lake. The discoloration plume in the water at Duluth is the result of tailings from the iron ore smelters that process the iron ore from the nearby open pit mines seen near the upper left corner of the photo.

1973-01-01

148

Evaporation From Lake Superior  

NASA Astrophysics Data System (ADS)

Evaporation is a critical component of the water balance of each of the Laurentian Great Lakes, and understanding the magnitude and physical controls of evaporative water losses are important for several reasons. Recently, low water levels in Lakes Superior and Michigan/Huron have had socioeconomic, ecological, and even meteorological impacts (e.g. water quality and quantity, transportation, invasive species, recreation, etc.). The recent low water levels may be due to increased evaporation, but this is not known as operational evaporation estimates are currently calculated as the residual of water or heat budgets. Perhaps surprisingly, almost nothing is known about evaporation dynamics from Lake Superior and few direct measurements of evaporation have been made from any of the Laurentian Great Lakes. This research is the first to attempt to directly measure evaporation from Lake Superior by deploying eddy covariance instrumentation. Results of evaporation rates, their patterns and controlling mechanisms will be presented. The direct measurements of evaporation are used with concurrent satellite and climate model data to extrapolate evaporation measurements across the entire lake. This knowledge could improve predictions of how climate change may impact the lake's water budget and subsequently how the water in the lake is managed.

Spence, C.; Blanken, P.; Hedstrom, N.; Leshkevich, G.; Fortin, V.; Charpentier, D.; Haywood, H.

2009-05-01

149

Endovascular reconstruction of an interrupted inferior vena cava?  

PubMed Central

INTRODUCTION Inferior vena cava (IVC) interruption was established as a procedure to treat refractory venous thromboembolism (VTE) complicated by pulmonary embolism. Ilio-caval thrombosis and lower limb chronic venous insufficiency (CVI) are well known long-term complications of IVC interruption, where subsequent treatments may carry significant morbidity and mortality. PRESENTATION OF CASE We present here a case of chronic venous insufficiency resulting from IVC interruption with a vascular clip placed forty years previously. A novel approach utilising endovascular stents was used to reconstruct the iliocaval confluence and interrupted distal IVC without the need for laparotomy to remove the plicating clip. This procedure was associated with minimal morbidity and resulted with a quick resolution of the patient's CVI symptoms. DISCUSSION Endovascular angioplasty and stenting is an alternative to open reconstruction of the interrupted inferior vena cava. We have demonstrated successful opening of a plication vascular clip using only endovascular utilities. Advantages include a shorter hospital stay, and reduced morbidity and mortality when compared to a re-do laparotomy. CONCLUSION Endovascular stents may be used safely and effectively to reconstruct the surgically interrupted inferior vena cava in the treatment of chronic venous insufficiency.

Thomas, Shannon D.; Ofri, Adam; Tang, Tjun; Englund, Raymond

2013-01-01

150

Asymptomatic melanoma of the superior cavo-atrial junction: The challenge of imaging  

PubMed Central

Metastatic lesions in the superior vena cava and the right atrium are difficult to diagnose: in computed tomography (CT), they are easily misinterpreted as artifacts, and the same region may be difficult to access using echocardiography. We present a case of asymptomatic metastasis of a malignant melanoma which was overlooked initially due to deficiencies in imaging. Using 18F-fluorodeoxyglucose positron emission tomography-CT, the metastasis was clearly identified and finally treated successfully. We discuss the diagnostic value of the various imaging modalities for intracardiac masses.

Kruger, Tobias; Heuschmid, Martin; Kurth, Ralf; Stock, Ulrich A; Wildhirt, Stephen M

2012-01-01

151

An unusual case of leiomyosarcoma of the inferior vena cava in a patient with a duplicated inferior vena cava.  

PubMed

Leiomyosarcoma of primary vascular origin is a rare primary soft tissue tumour, which arises mainly from the inferior vena cava (IVC). Clinical symptoms depend upon the size and location of the tumour and presents usually with abdominal pain, palpable mass and weight loss. Complete surgical resection with clear surgical margin plays a central therapeutic role. The effect of chemotherapy and radiation therapy remains to be evaluated. We report a 64 year old Chinese female who presented with abdominal mass and pain associated with weight loss and was subsequently diagnosed with inferior vena cava leiomyosarcoma. She underwent successful surgical resection but unfortunately developed recurrence of tumour 12 month post-operative. She was also found to have a duplicated inferior vena cave which allowed reconstitution of venous return from the lower limbs after surgical resection of the IVC tumour. We discuss the surgical treatment and results of leiomyosarcoma of the IVC. PMID:18809279

Tan, Glenn Wei Leong; Chia, Kok Hoong

2009-03-01

152

Three-Dimensional Rotational Angiography of the Inferior Vena Cava as an Adjunct to Inferior Vena Cava Filter Retrieval  

Microsoft Academic Search

The objective of this study was to explore the role of three-dimensional (3-D) rotational angiography (RA) of the inferior vena cava (IVC; 3-D CV) before filter retrieval and its impact on treatment planning compared with standard anteroposterior cavography (sCV). Thirty patients underwent sCV and 3-D CV before IVC filter retrieval. Parameters assessed were: projection of filter arms or legs beyond

Ugur Bozlar; J. Stewart Edmunds; Ulku C. Turba; Gary D. Hartwell; Ahmed M. Housseini; Klaus D. Hagspiel

2009-01-01

153

Three-Dimensional Rotational Angiography of the Inferior Vena Cava as an Adjunct to Inferior Vena Cava Filter Retrieval  

Microsoft Academic Search

The objective of this study was to explore the role of three-dimensional (3-D) rotational angiography (RA) of the inferior\\u000a vena cava (IVC; 3-D CV) before filter retrieval and its impact on treatment planning compared with standard anteroposterior\\u000a cavography (sCV). Thirty patients underwent sCV and 3-D CV before IVC filter retrieval. Parameters assessed were: projection\\u000a of filter arms or legs beyond

Ugur Bozlar; J. Stewart Edmunds; Ulku C. Turba; Gary D. Hartwell; Ahmed M. Housseini; Klaus D. Hagspiel

2009-01-01

154

The curious case of the disappearing IVC: A case report and review of the aetiology of Inferior Vena Cava Agenesis  

PubMed Central

We report the case of a previously well 18-year-old male who presented to the Emergency Department with lower limb pain. An ultrasound demonstrated extensive left sided deep vein thrombosis and computed tomography demonstrated inferior vena cava agenesis, leading to the diagnosis of inferior vena cava agenesis associated deep vein thrombosis. The aetiology of inferior vena cava agenesis is explored in depth.

Paddock, Michael; Robson, Nicola

2014-01-01

155

Superior orbital fissure syndrome  

PubMed Central

A patient is described with features of a superior orbital fissure (Tolosa Hunt) syndrome and a coexistent intraorbital lesion. There was radiological evidence both of narrowing of the carotid artery and of an intraorbital obstruction of venous return from the orbit. The diagnostic value of orbital venography and carotid angiography in the investigation of granulomata in the region of the orbit is stressed. The condition described here is responsive to corticosteroids and it is also inferred that there may be a clinicopathological spectrum encompassing both the Tolosa Hunt syndrome and pseudotumour of the orbit. Images

Hallpike, J. F.

1973-01-01

156

Renal Vein and Vena cava Involvement Does Not Affect Prognosis in Patients with Renal Cell Carcinoma  

Microsoft Academic Search

Objectives: The prognostic value of tumor extension into the renal vein or vena cava is still a controversial issue. The aim of this study is to report our experience with radical surgery in patients with renal cell carcinoma (RCC) extending into the renal vein or subdiaphragmatic vena cava. Methods: We evaluated 142 patients with RCC involving the renal vein or

Vincenzo Ficarra; Rita Righetti; Antonio D’Amico; Emanuele Rubilotta; Giovanni Novella; Gianni Malossini; Gaetano Mobilio

2001-01-01

157

Surgery Insight: management of renal cell carcinoma with associated inferior vena cava thrombus  

Microsoft Academic Search

Renal cell carcinoma with inferior vena cava thrombus can be a diagnostic and therapeutic challenge; however, the surgical resection of these tumors can be facilitated by appropriate preoperative imaging and planning. First and foremost, we believe that this procedure should be considered an operation on the inferior vena cava rather than on the kidney. The level and extent of the

R Jeffrey Karnes; Michael L Blute

2008-01-01

158

Deep venous thrombosis in a young woman with hypoplastic inferior vena cava.  

PubMed

We present a 33-year-old woman with deep venous thrombosis of the left iliac vein and the left lower limb. A computed tomography scan of her abdomen revealed a hypoplastic inferior vena cava and agenesis of the right kidney. Congenital anomalies of the inferior vena cava are uncommon and are sometimes an unrecognized cause of deep venous thrombosis. PMID:24216406

Lavens, Matthias; Moors, Boudewijn; Thomis, Sarah

2014-05-01

159

Radiological evidence of anatomical variation of the inferior vena cava: Report of two cases  

Microsoft Academic Search

The inferior vena cava (IVC) is a retroperitoneal key structure whose location and integrity must be checked in every scan. A number of studies are reported in the literature concerning congenital variations of the inferior vena cava. Anatomical variations of this main venous trunk are relatively infrequent clinical findings during surgery or diagnostic procedures in patients without symptoms such as

M. Artico; D. Lorenzini; P. Mancini; P. Gobbi; S. Carloia; V. David

2004-01-01

160

Statistics of superior records  

NASA Astrophysics Data System (ADS)

We study statistics of records in a sequence of random variables. These identical and independently distributed variables are drawn from the parent distribution ?. The running record equals the maximum of all elements in the sequence up to a given point. We define a superior sequence as one where all running records are above the average record expected for the parent distribution ?. We find that the fraction of superior sequences SN decays algebraically with sequence length N, SN˜N-? in the limit N??. Interestingly, the decay exponent ? is nontrivial, being the root of an integral equation. For example, when ? is a uniform distribution with compact support, we find ?=0.450265. In general, the tail of the parent distribution governs the exponent ?. We also consider the dual problem of inferior sequences, where all records are below average, and find that the fraction of inferior sequences IN decays algebraically, albeit with a different decay exponent, IN˜N-?. We use the above statistical measures to analyze earthquake data.

Ben-Naim, E.; Krapivsky, P. L.

2013-08-01

161

A case of thoracic esophageal cancer with an unusual type of duplicated inferior vena cava.  

PubMed

We describe here a thoracic esophageal cancer with an unusual type of duplicated inferior vena cava. A 58-year-old man was referred to our hospital because a tumor in his lower esophagus had been identified by endoscopy and radiology. Computed tomography scans showed an unusual type of duplicated inferior vena cava characterized by both common iliac veins flowing back into the left-sided inferior vena cava, which drained into the azygos vein, whereas the right-sided one had no drainage. Esophagectomy was performed 3 weeks later after preoperative chemotherapy. Because the patient could have developed thrombosis of the left-sided inferior vena cava and severe hypotension caused by decreased venous return to the heart if the azygos vein had been severed, the azygos vein was preserved. Thus, when performing surgery for thoracic esophageal cancer, the surgeon should check for a duplicated inferior vena cava and preserve the azygos vein if necessary. PMID:24470167

Shintakuya, Ryuta; Mukaida, Hidenori; Mimura, Takeshi; Ikeda, Takuhiro; Takiyama, Wataru; Yoshimitsu, Masanori; Saeki, Syuji; Hirabayashi, Naoki

2014-05-01

162

Perforated inferior vena cava filters as the cause of unclear abdominal pain.  

PubMed

Inferior vena cava filters are considered a valuable therapeutic option in patients with deep vein thrombosis, subsequent pulmonary emboli, and contraindication for anticoagulation. However, these filters bear the risk of rare but serious complications (e.g., symptomatic caval perforation). We report our experiences with retrievable vena cava filters by means of an actual case and review the recent literature with special regard to filter-dependent delayed symptomatic vena cava perforations. Here, an inferior vena cava filter could be identified as the source of a patient's abdominal pain; after an interventional retrieval approach had failed, open surgical removal became necessary and led to the instant relief of this patient's symptoms. Retrievable vena cava filter removal should be performed in all cases as soon as no longer needed to avoid fatal complications. PMID:23498323

Meyer, Alexander; Schönleben, Frank; Heinz, Marco; Lang, Werner

2013-04-01

163

PORCINE VENA CAVA AS AN ALTERNATIVE TO BOVINE PERICARDIUM IN BIOPROSTHETIC PERCUTANEOUS HEART VALVES  

PubMed Central

Percutaneous heart valves are revolutionizing valve replacement surgery by offering a less invasive treatment option for high-risk patient populations who have previously been denied the traditional open chest procedure. Percutaneous valves need to be crimped to accommodate a small-diameter catheter during deployment, and they must then open to the size of heart valve. Thus the material used must be strong and possess elastic recoil for this application. Most percutaneous valves utilize bovine pericardium as a material of choice. One possible method to reduce the device delivery diameter is to utilize a thin, highly elastic tissue. Here we investigated porcine vena cava as an alternative to bovine pericardium for percutaneous valve application. We compared the structural, mechanical, and in vivo properties of porcine vena cava to those of bovine pericardium. While the extracellular matrix fibers of pericardium are randomly oriented, the vena cava contains highly aligned collagen and elastin fibers that impart strength to the vessel in the circumferential direction and elasticity in the longitudinal direction. Moreover, the vena cava contains a greater proportion of elastin, whereas the pericardium matrix is mainly composed of collagen. Due to its high elastin content, the vena cava is significantly less stiff than the pericardium, even after crosslinking with glutaraldehyde. Furthermore, the vena cava’s mechanical compliance is preserved after compression under forces similar to those exerted by a stent, whereas pericardium is significantly stiffened by this process. Bovine pericardium also showed surface cracks observed by scanning electron microscopy after crimping that were not seen in vena cava tissue. Additionally, the vena cava exhibited reduced calcification (46.64 ± 8.15 ?g Ca/mg tissue) as compared to the pericardium (86.79 ± 10.34 ?g/mg). These results suggest that the vena cava may enhance leaflet flexibility, tissue resilience, and tissue integrity in percutaneous heart valves, ultimately reducing the device profile while improving the durability of these valves.

Munnelly, Amy; Cochrane, Leonard; Leong, Joshua; Vyavahare, Naren

2011-01-01

164

Retrievable Inferior Vena Cava Filters for Venous Thromboembolism  

PubMed Central

Inferior vena cava (IVC) filters are used as an alternative to anticoagulants for prevention of fatal pulmonary embolism (PE) in venous thromboembolic disorders. Retrievable IVC filters have become an increasingly attractive option due to the long-term risks of permanent filter placement. These devices are shown to be technically feasible in insertion and retrieval percutaneously while providing protection from PE. Nevertheless, there are complications and failed retrievals with these retrievable filters. The aim of the paper is to review the retrievable filters and their efficacy, safety, and retrievability.

Win, Lei Lei

2013-01-01

165

Retrievable inferior vena cava filters for venous thromboembolism.  

PubMed

Inferior vena cava (IVC) filters are used as an alternative to anticoagulants for prevention of fatal pulmonary embolism (PE) in venous thromboembolic disorders. Retrievable IVC filters have become an increasingly attractive option due to the long-term risks of permanent filter placement. These devices are shown to be technically feasible in insertion and retrieval percutaneously while providing protection from PE. Nevertheless, there are complications and failed retrievals with these retrievable filters. The aim of the paper is to review the retrievable filters and their efficacy, safety, and retrievability. PMID:24967292

Ni, Han; Win, Lei Lei

2013-01-01

166

Improving retrieval rates for retrievable inferior vena cava filters.  

PubMed

The introduction of retrievable inferior vena cava (IVC) filters was an important step in the evolution of deep vein thrombosis/pulmonary embolism management. Their removability makes them preferred to permanent filters in many cases. IVC filter retrieval often occurs at a suboptimal rate, leading to complications associated with long-term placement. Improving retrievability includes solutions for patients being lost to follow-up, filter malpositioning, need arising for permanent IVC filtration, filtration requiring longer than the filter's window of retrievability, and filter compromise by the presence of a large trapped clot. This review explores these strategies for retrieval in detail in hopes of improving IVC filter retrieval rates. PMID:23278230

Dixon, Austin; Stavropoulos, S William

2013-01-01

167

Inferior vena cava filter presenting as chronic low back pain.  

PubMed

Our purpose is to report a rare complication of an inferior vena cava (IVC) filter with vertebral bone penetration, interval fracture, subsequent endovascular management and outcome. We report a case of an IVC filter embedded within the second lumbar vertebral body and in which one of the primary struts fractured, which presented as chronic low back pain. The filter was retrieved percutaneously approximately 2 years after placement. A fractured small strut remained within the vertebral bone; patient's pain resolved. Symptomatic filter in situ should be retrieved even when fractured. PMID:22542386

Kendirli, Mustafa T; Sildiroglu, Onur; Cage, Dorothy L; Turba, Ulku C

2012-01-01

168

Inferior vena cava filter placement before ECMO decannulation.  

PubMed

Venous thromboembolism (VTE), particularly thrombi in the inferior vena cava (IVC) and pulmonary embolism, can occur after successful extracorporeal membrane oxygenation (ECMO) and can be associated with adverse outcomes including death. VTE is related to the presence of a venous cannula and in some cases inadequate anticoagulation caused by clinical bleeding. We have developed a simple method for guidewire exchange of the femoral venous ECMO cannula to a working catheter for intravascular ultrasound (IVUS) IVC filter placement, and describe the specific methodology. PMID:23103700

Obi, Andrea; Park, Pauline K; Rectenwald, John; Novelli, Paula; Waldvogel, John; Haft, Jonathan W; Napolitano, Lena M

2012-01-01

169

Inferior vena cava filter migration to the right ventricle.  

PubMed

Inferior vena cava (IVC) filter placement is recommended for acute proximal deep venous thrombosis if anticoagulation is contraindicated. A 52-year-old man presented with weakness, dyspnea, syncope, and renal failure 8 months after IVC filter placement. Imaging revealed migration of the IVC filter to the right ventricle. Endovascular retrieval was not feasible, thus surgical extraction and tricuspid valve repair was performed. IVC filter migration to the heart is a rare, but a potentially life-threatening complication. Retrieval can be accomplished using endovascular or open surgical technique. PMID:21303410

Jassar, Arminder S; Nicotera, Saila P; Levin, Neil; Vernick, William J; Szeto, Wilson Y

2011-03-01

170

Perforation of inferior vena cava during filter placement.  

PubMed

The placement of an inferior vena cava (IVC) filter is a therapeutic method for selected patients with deep venous thrombosis and pulmonary embolism. However, insertion and placement of the filter may be associated with certain complications. For instance, retroperitoneal hematoma resulting from perforation of the wall by the filter is such a very rare but serious complication. We report the case of a 64-year-old woman with perforation of the IVC wall and consecutive hematoma caused by the filter who was treated surgically. PMID:21500182

Piecuch, J; Wiewiora, M; Nowowiejska-Wiewiora, A; Szkodzinski, J; Polonski, L

2011-03-01

171

Thoracoabdominal intestinal duplication with absent inferior vena cava.  

PubMed

We report a rare case of thoracoabdominal intestinal duplication with absent inferior vena cava (IVC). The patient was initially explored with a mistaken diagnosis of diaphragmatic hernia on the basis of a chest radiograph and barium meal. However, a subsequent computed tomography scan revealed a mediastinal mass with an air-fluid level, a hugely dilated azygos vein, and an absent IVC. Thoracoabdominal exploration was required to excise the duplication cyst arising from the jejunum. We believe that this is the first report of this association. PMID:11666055

Bhat, N A; Agarwala, S; Wadhwa, S; Gupta, A K; Bhatnagar, V

2001-09-01

172

Rare case of reninoma with double inferior vena cava.  

PubMed

A 16-year-old boy suffered from headaches and dizziness for 2 years. He was found to have remarkably elevated blood pressure (BP) of 180/110 mmHg. Laboratory findings showed a low level of serum potassium and markedly increased plasma renin activity. A solid mass at the periphery of the right kidney and double inferior vena cava (IVC) were detected by abdominal computer tomography (CT). Right partial nephrectomy via laparoscopy was performed on the patient. The histologic and electron microscopic findings comfirmed a diagnosis of juxtaglomerlar cell tumor. The patient had no headache or dizziness with normal BP after surgery. PMID:21649530

Jiang, Yan; Duan, Lian; Lu, Lin; Zhao, Wei-Gang; Zeng, Zheng-Pei; Li, Han-Zhong; Zhang, Xiao-Bo

2011-01-01

173

Surgical resection of the inferior vena cava for leiomyosarcoma.  

PubMed

Our case of primary leiomyosarcomas involved retrohepatic, suprarenal, and infrarenal inferior vena cava (IVC). Preoperative phlebography proved that there was adequate collateral circulation formed, which allowed us to achieve en bloc resection including segment I and II IVC without either extracorporeal circulation or prosthetic revascularization of the IVC and renal vessels. Our choice of en bloc resection including segment I and II IVC without extracorporeal circulation or prosthetic replacement of the vessels was justified as the patient had normal liver and kidney function after the operation. PMID:20494550

Liu, Changwei; Zheng, Yuehong; Yang, Xue; Shao, Jiang; Song, Xiaojun; Liu, Bao; Guan, Heng

2010-08-01

174

Superior semicircular canal dehiscence syndrome by the superior petrosal sinus  

Microsoft Academic Search

Thinning or dehiscence of the superior semicircular canal may occur on the middle cranial fossa floor or adjacent to the superior petrosal sinus (SPS). However, no symptomatic cases of superior canal dehiscence by SPS have been previously described. A 45-year-old woman presented with left-side pulsating tinnitus, autophony and disequilibrium. Examination showed conductive hearing loss and decreased threshold of vestibular evoked

Ja-Won Koo; Sung Kwang Hong; Dong-Kyu Kim; Ji Soo Kim

2010-01-01

175

Inferior vena cava reconstruction using fresh inferior vena cava allograft following caval resection for leiomyosarcoma: midterm results.  

PubMed

We present a 56-year-old woman affected by a large leiomyosarcoma originating from the suprarenal inferior vena cava (IVC). A computed tomography (CT) scan revealed near obstruction of the IVC and involvement of the right renal vein. The patient underwent successful en bloc resection of the tumor, right kidney, right adrenal gland, and IVC. Caval reconstruction was performed using a non-type specific allograft, followed by left renal vein re-implantation. The patient tolerated the procedure well without any complications. The use of an IVC allograft allowed for continued graft patency, without the need of immunosuppression or long-term anticoagulation. However, local recurrence did occur. PMID:17606132

Guerrero, Marlon A; Cross, Chadrick A; Lin, Peter H; Keane, Thomas E; Lumsden, Alan B

2007-07-01

176

Advanced techniques for removal of retrievable inferior vena cava filters.  

PubMed

Inferior vena cava (IVC) filters have proven valuable for the prevention of primary or recurrent pulmonary embolism in selected patients with or at high risk for venous thromboembolic disease. Their use has become commonplace, and the numbers implanted increase annually. During the last 3 years, in the United States, the percentage of annually placed optional filters, i.e., filters than can remain as permanent filters or potentially be retrieved, has consistently exceeded that of permanent filters. In parallel, the complications of long- or short-term filtration have become increasingly evident to physicians, regulatory agencies, and the public. Most filter removals are uneventful, with a high degree of success. When routine filter-retrieval techniques prove unsuccessful, progressively more advanced tools and skill sets must be used to enhance filter-retrieval success. These techniques should be used with caution to avoid damage to the filter or cava during IVC retrieval. This review describes the complex techniques for filter retrieval, including use of additional snares, guidewires, angioplasty balloons, and mechanical and thermal approaches as well as illustrates their specific application. PMID:21674279

Iliescu, Bogdan; Haskal, Ziv J

2012-08-01

177

Leiomyosarcoma of the inferior vena cava: a case report and review of the literature  

PubMed Central

A 68-year-old white female presented with two years of progressively worsening dyspnea. Echocardiography revealed a large right atrial mass and partial obstruction of the inferior vena cava. Further imaging revealed a cystic dense mass in the inferior vena cava and right atrium. Immunohistochemical stains were consistent with leiomyosarcoma. Intraoperatively, the tumor was noted to originate from the posterior aspect of the inferior vena cava. The patient underwent successful resection of the mass. Adjuvant radiation therapy was completed. The patient's dyspnea gradually improved and she continues to remain disease free five years post-resection.

2010-01-01

178

[Massive inferior vena cava thrombosis in a patient with autosomal dominant polycystic hepatorenal disease].  

PubMed

We report a 68-year-old man with autosomal dominant polycystic kidney disease, who developed multiple venous thromboses (inferior vena cava, left renal vein and iliofemoral veins) caused by local compression of the intrahepatic inferior vena cava by hepatic cysts. To our knowledge this is the first reported case of inferior vena cava thrombosis caused by hepatic cysts compression. Doppler ultrasound, computed tomography, and magnetic resonance imaging were effective in documenting the venous thromboses and the underlying lesions non-invasively. Long-term anticoagulation was an efficient and safe treatment. PMID:11987689

Peces, R; Gil, F; Costero, O; Pobes, A

2002-01-01

179

Superior pellucid marginal corneal degeneration  

Microsoft Academic Search

Purpose To report the clinical features and topographic findings of superior pellucid marginal corneal degeneration (PMCD).Methods Retrospective chart review of 15 eyes of eight patients of superior PMCD. Detailed history, visual acuity at presentation, degree of astigmatism, slit-lamp examination findings, topographic features, and Orbscan findings were noted where available. Improvement in visual acuity with spectacles or contact lens correction, surgical

M S Sridhar; S Mahesh; A K Bansal; G N Rao; Sridhar

2004-01-01

180

Duplication of the inferior vena cava and thrombosis: A rare case  

PubMed Central

Duplication of inferior vena cava (IVC) is a rare finding in radiologic studies and its coincidence with thrombosis is even rarer. Here we described a rare case with duplication of IVC and symptomatic venous thrombosis of her lower extrimity.

Tamizifar, Babak; Seilani, Parisa; Zadeh, Maryam Rismankar

2013-01-01

181

Acute Budd-Chiari syndrome secondary to leiomyosarcoma of the inferior vena cava  

Microsoft Academic Search

The authors report a case of leiomyosarcoma of the inferior vena cava, responsible for an acute Budd-Chiari syndrome. The\\u000a diagnosis, suggested by lower limb edema, ascites, and renal failure, was confirmed by sonography, CT scan, and pathological\\u000a examination. A mesoatrial shunt and right atrial thrombectomy were performed under extracorporeal circulation. The inferior\\u000a vena cava was ligated because the tumor was

Matthias Kracht; Jean-Pierre Becquemin; Marie-Christine Anglade; Didier Mathieu; Marie-Line Hillion; Jean-Louis Teboul

1989-01-01

182

Current Indications for Preoperative Inferior Vena Cava Filter Insertion in Patients Undergoing Surgery for Morbid Obesity  

Microsoft Academic Search

Background: Pulmonary embolus is a potentially lethal complication in patients undergoing surgery for morbid obesity. In a\\u000a select group of patients at high risk for venous thromboembolic events (VTE), we have chosen to prophylactically insert inferior\\u000a vena cava filters via a jugular percutaneous approach. We propose guidelines for preoperative insertion of inferior vena cava\\u000a filters in patients with clinically significant

W. Brent Keeling; Krista Haines; Patrick A. Stone; Paul A. Armstrong; Michel M. Murr; Murray L. Shames

2005-01-01

183

Inferior vena cava hypoplasia with right hepatic vein and accessory inferior hepatic vein shunt.  

PubMed

Inferior vena cava (IVC) hypoplasia is a rare condition. Venous blood flow is usually provided through collaterals in the azygos or hemiazygos venous systems. However, portosystemic shunts with intrahepatic venous collateral are extremely rare. The case is presented here of a large shunt between the right hepatic vein, accessory inferior hepatic vein, and inferior vena cava in a 37-year-old female patient with IVC hypoplasia. PMID:24590531

Cullu, N; Yeniçeri, O; Deveer, M; Tetiker, H

2014-01-01

184

Inferior Vena Cava Torsion and Stenosis Complicated by Compressive Pericaval Regional Ascites following Orthotopic Liver Transplantation  

PubMed Central

Inferior vena cava (IVC) stenosis and torsion are well-described rare complications following orthotopic liver transplantation (OLT). We present a case of inferior vena cava intermittent torsion and stenosis complicated by compressive regional ascites. To the best of our knowledge, this is the second case of post-OLT regional ascites related compressive IVC stenosis reported and the first reported case of torsion complicated by regional ascites compression.

Gilroy, Richard; Johnson, Philip

2013-01-01

185

Transcatheter arterial chemoembolization for advanced hepatocellular carcinoma with inferior vena cava and right atrial tumors.  

PubMed

Advanced hepatocelluar carcinoma (HCC) with invasion of venous systems usually indicates not only a poor prognosis but also a contraindication for transcatheter arterial chemoembolization (TACE). This study evaluated the feasibility of TACE for advanced HCC with inferior vena cava (IVC) and right atrium (RA) tumors and, also, to search for the ideal embolization particle size. Twenty-six patients who had HCC invasion into the IVC included five patients with coexistent RA tumors that were treated with TACE. The chemoembolization method was cisplatin, doxorubicin, and mitomycin C mixed with Lipiodol and Ivalon. The selection of Ivalon particles was divided into two groups based on their size: (A) >180 microm, N = 9; and (B) 47-180 microm, N = 17. The overall response rate was 53.8% (14/26). Based on the response to TACE, the median survival period of the entire group was 4.2 months (range, 1.5 to 76.7 months). The median survival period of the 14 responders was 13.5 months (1.5-76.7 months), and that of the 12 nonresponders, 3.3 months (2.1 to 24.3 months) (p < 0.002). Comparing the two Ivalon particle sizes, the response rate was 12.5% (1/8 [corrected] patients) for group A and 72.2% [corrected] for group B (13/18 [corrected] patients) (p < 0.01). [corrected] No serious complication was observed post-chemoembolization. In conclusion, TACE is a safe and effective treatment for advanced HCC with IVC and RA tumors, and small Ivalon particles (47-180 microm) are superior to large ones (>180 microm). PMID:18427894

Chern, M C; Chuang, V P; Cheng, T; Lin, Z H; Lin, Y M

2008-01-01

186

Leiomyosarcoma of the infra-renal inferior vena cava.  

PubMed

Leiomyosarcoma of the inferior vena cava (IVC) is a rare slow-growing retroperitoneal tumor. Two percent of leiomyosarcomas are vascular in origin, and tumors of the IVC account for the majority of the cases. The diagnosis is frequently delayed, because affected patients remain asymptomatic for a long period. It has an extremely poor prognosis, with 5-year actuarial malignancy-free survival rates of 30% to 50% after a wide surgical resection. The authors present the case of a patient with IVC leiomyosarcoma who underwent en bloc resection of the tumor along with the involved segment of the infrarenal IVC without caval reconstruction. Complete surgical resection offers the only potential of long-term survival, but survival of unresected patients is generally measured in months. Palliative resections may temporarily improve symptoms but do not offer long-term survival. PMID:21266212

Al-Saif, Osama H; Sengupta, Bodhisatwa; Amr, Samir; Meshikhes, Abdul-Wahed

2011-02-01

187

Superior semicircular canal dehiscence syndrome by the superior petrosal sinus.  

PubMed

Thinning or dehiscence of the superior semicircular canal may occur on the middle cranial fossa floor or adjacent to the superior petrosal sinus (SPS). However, no symptomatic cases of superior canal dehiscence by SPS have been previously described. A 45-year-old woman presented with left-side pulsating tinnitus, autophony and disequilibrium. Examination showed conductive hearing loss and decreased threshold of vestibular evoked myogenic potential in the left side. Sound and vibration stimuli and positive pressure insufflations into the left ear evoked mainly torsional nystagmus instead of vertical-torsional nystagmus. High-resolution temporal bone CT revealed a dehiscence of the superior canal close to the common crus, which was encased by SPS. Symptoms and signs resolved after plugging the dehiscence through a middle fossa approach. Deep groove of SPS may cause superior canal dehiscence close to the common crus, and costimulation of the superior and posterior canals may explain the mainly torsional nystagmus induced by sound and vibration stimuli. PMID:20176603

Koo, Ja-Won; Hong, Sung Kwang; Kim, Dong-Kyu; Kim, Ji Soo

2010-04-01

188

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

SciTech Connect

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.

Veerapong, Jula [University of Chicago Hospitals, Department of General Surgery (United States); Wahlgren, Carl Magnus, E-mail: carl.wahlgren@karolinska.s [University of Chicago Hospitals, Section of Vascular Surgery, Department of Surgery (United States); Jolly, Neeraj [University of Chicago Hospitals, Section of Interventional Cardiology, Department of Medicine (United States); Bassiouny, Hisham [University of Chicago Hospitals, Section of Vascular Surgery, Department of Surgery (United States)

2008-07-15

189

Selecting Superior Yellow Birch Trees.  

National Technical Information Service (NTIS)

The report describes procedures to follow and characteristics to consider in selecting superior yellow birch trees. The first selection should be on the basis of tree quality. Characteristics to consider are as follows: for the stem - straightness, roundn...

K. E. Clausen R. M. Godman

1967-01-01

190

Renal cell carcinoma invading the inferior vena cava: use of a “temporary” vena cava filter to prevent tumor emboli during nephrectomy  

Microsoft Academic Search

Renal cell carcinoma with tumor thrombus extension into the inferior vena cava (IVC) remains a difficult operative challenge. Placement of a suprarenal “temporary” IVC filter, with its ease of insertion and removal, makes it the ideal treatment to prevent pulmonary embolism in these difficult cases. We report the first 2 cases of temporary suprarenal IVC filters placed at the time

Eric Wellons; David Rosenthal; Thomas Schoborg; Fredrick Shuler; Adam Levitt

2004-01-01

191

Endovascular management of venous ulcer in a patient with occluded duplicated inferior vena cava and review of inferior vena cava development.  

PubMed

Duplication of inferior vena cava (IVC) is the most common IVC anomaly. We report a successful iliac vein and collateral stenting for venous decompression in a patient with an occluded right femorocaval graft with a duplicated IVC. We also review the literature of embryological development of IVC. PMID:24226789

Verma, Himanshu; Hiremath, Niranjan; George, Robbie K; Tripathi, Ramesh K

2014-02-01

192

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

PubMed

The current study was designed to investigate whether edible brown seaweed Ecklonia cava extracts exhibits analgesic effects in plantar incision and spared nerve injury (SNI) rats. To evaluate pain-related behavior, we performed the mechanical withdrawal threshold (MWT) and thermal hypersensitivity tests measured by von Frey filaments and a hot/cold plate analgesia meter. Pain-related behavior was also determined through analysis of ultrasonic vocalization. The results of experiments showed MWT values of the group that was treated with E. cava extracts by 300 mg/kg significantly increased; on the contrary, number of ultrasonic distress vocalization of the treated group was reduced at 6 h and 24 h after plantar incision operation (62.8%, p < 0.05). Moreover, E. cava 300 mg/kg treated group increased the paw withdrawal latency in hot-and cold-plate tests in the plantar incision rats. After 15 days of continuous treatment with E. cava extracts at 300 mg/kg, the treated group showed significantly alleviated SNI-induced hypersensitivity response by MWT compared with the control group. In conclusion, these results suggest that E. cava extracts have potential analgesic effects in the case of postoperative pain and neuropathic pain in rats. PMID:24918539

Kim, Jae Goo; Lim, Dong Wook; Cho, Suengmok; Han, Daeseok; Kim, Yun Tai

2014-01-01

193

Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patients  

Microsoft Academic Search

Objective To evaluate the extent to which respiratory changes in inferior vena cava (IVC) diameter can be used to predict fluid responsiveness. Design Prospective clinical study. Setting Hospital intensive care unit. Patients Twenty-three patients with acute circulatory failure related to sepsis and mechanically ventilated because of an acute lung injury. Measurements Inferior vena cava diameter (D) at end-expiration (Dmin) and

Christophe Barbier; Yann Loubières; Christophe Schmit; Jan Hayon; Jean-Louis Ricôme; François Jardin; Antoine Vieillard-Baron

2004-01-01

194

Inferior vena cava resection with hepatectomy: challenging but justified  

PubMed Central

Objective The aim of this study was to evaluate the clinical outcome of hepatectomy combined with inferior vena cava (IVC) resection and reconstruction for treatment of invasive liver tumours. Methods From February 1995 to September 2010, 2146 patients underwent liver resections in our hospital's hepatopancreatobiliary unit. Of these, 35 (1.6%) patients underwent hepatectomy with IVC resection. These patients were included in this study. Data were analysed from a prospectively collected database. Results Resections were carried out for colorectal liver metastasis (CRLM) (n = 21), hepatocellular carcinoma (n = 6), cholangiocarcinoma (n = 3) and other conditions (n = 5). Resections were carried out with total vascular occlusion in 34 patients and without in one patient. In situ hypothermic perfusion was performed in 13 patients; the ante situm technique was used in three patients, and ex vivo resection was used in six patients. There were four early deaths from multiple organ failure. Postoperative complications occurred in 14 patients, three of whom required re-operation. Median overall survival was 29 months and cumulative 5-year survival was 37.7%. Rates of 1-, 2- and 5-year survival were 75.9%, 58.7% and 19.6%, respectively, in CRLM patients. Conclusions Aggressive surgical management of liver tumours with IVC involvement offers the only hope for cure in selected patients. Resection by specialist teams affords acceptable perioperative morbidity and mortality rates.

Malde, Deep J; Khan, Aamir; Prasad, K Rajendra; Toogood, Giles J; Lodge, J Peter A

2011-01-01

195

Simple hepatic cyst causing inferior vena cava thrombus  

PubMed Central

INTRODUCTION Thrombosis of the inferior vena cava (IVC) is governed by Virchow's triad of stasis of blood flow, endothelial damage and hypercoagulability. Causes may be secondary to malignancy, congenital anomalies or other infrequent events such as external compression. We present a case of external compression of the IVC leading to extensive thrombus burden secondary to a benign hepatic cyst. PRESENTATION OF CASE A 72 year old African American female presented to the emergency department with new onset shortness of breath, right lower extremity weakness and swelling. CT imaging demonstrated multiple hepatic cysts compressing the IVC, leading to extensive clot burden. Treatment with heparin drip was initiated without resolution of her symptoms. Transcatheter mechanical thrombectomy and tPA infusion was performed. After 24 h, swelling and weakness were nearly resolved. The patient was bridged to therapeutic low molecular weight heparin in preparation for surgery. DISCUSSION Management of IVC thrombosis has typically been with a heparin drip and transition to oral anticoagulants. Thrombolysis has been shown to promote complete clot lysis more often than compared to standard anticoagulant therapy. In addition, venous patency was better maintained. CONCLUSION We feel that the added benefit of short term effects of improved venous patency and long term benefits of less post thrombotic syndrome, catheter based tPA administration and mechanical thrombectomy for thrombus offers an adjuvant treatment in the setting of large clot burden refractory to standard treatment.

Musielak, Matthew Christopher; Singh, Ranjodh; Hartman, Elizabeth; Bernstein, Joseph

2014-01-01

196

Morphofunctional characterization of decellularized vena cava as tissue engineering scaffolds.  

PubMed

Clinical experience for peripheral arterial disease treatment shows poor results when synthetic grafts are used to approach infrapopliteal arterial segments. However, tissue engineering may be an option to yield surrogate biocompatible neovessels. Thus, biological decellularized scaffolds could provide natural tissue architecture to use in tissue engineering, when the absence of ideal autologous veins reduces surgical options. The goal of this study was to evaluate different chemical induced decellularization protocols of the inferior vena cava of rabbits. They were decellularized with Triton X100 (TX100), sodium dodecyl sulfate (SDS) or sodium deoxycholate (DS). Afterwards, we assessed the remaining extracellular matrix (ECM) integrity, residual toxicity and the biomechanical resistance of the scaffolds. Our results showed that TX100 was not effective to remove the cells, while protocols using SDS 1% for 2h and DS 2% for 1h, efficiently removed the cells and were better characterized. These scaffolds preserved the original organization of ECM. In addition, the residual toxicity assessment did not reveal statistically significant changes while decellularized scaffolds retained the equivalent biomechanical properties when compared with the control. Our results concluded that protocols using SDS and DS were effective at obtaining decellularized scaffolds, which may be useful for blood vessel tissue engineering. PMID:24929113

Bertanha, Matheus; Moroz, Andrei; Jaldin, Rodrigo G; Silva, Regina A M; Rinaldi, Jaqueline C; Golim, Márjorie A; Felisbino, Sérgio L; Domingues, Maria A C; Sobreira, Marcone L; Reis, Patricia P; Deffune, Elenice

2014-08-01

197

LAKE SUPERIOR ORGANIC CARBON BUDGET  

EPA Science Inventory

The organic carbon concentration of Lake Superior is discussed in terms of a simple mathematical model that treats the lake as a well mixed basin. Major sources, outflows, and biochemically mediated removal of organic carbon are analyzed in the time frame of yearly average values...

198

Air Superiority: Blunting Nearsighted Criticism.  

National Technical Information Service (NTIS)

'Everything is possible if you have air superiority-little is possible if you lose it.' General Charles Horner, architect of the decisive DESERT STORM Air Campaign, clearly articulates a need to control the medium of air. While the logic of General Horner...

J. D. Corley

1993-01-01

199

Inferior Vena Cava Filter Placement during Pregnancy: An Adjuvant Option When Medical Therapy Fails  

PubMed Central

The authors present a case of a 27-year-old multiparous woman, with multiple thrombophilia, whose pregnancy was complicated with deep venous thrombosis requiring placement of a vena cava filter. At 15th week of gestation, following an acute deep venous thrombosis of the right inferior limb, anticoagulant therapy with low-molecular-weight heparin (LMWH) was instituted without improvement in her clinical status. Subsequently, at 18 weeks of pregnancy, LMWH was switched to warfarin. At 30th week of gestation, the maintenance of high thrombotic risk was the premise for placement of an inferior vena cava filter for prophylaxis of pulmonary embolism during childbirth and postpartum. There were no complications and a vaginal delivery was accomplished at 37 weeks of gestation. Venal placement of inferior vena cava filters is an attractive option as prophylaxis for pulmonary embolism during pregnancy.

Serrano, Fatima; Torres, Rita; Borges, Augusta

2013-01-01

200

Resection of a malignant paraganglioma located behind the retrohepatic segment of the inferior vena cava  

PubMed Central

Background Resection of a retrocaval paraganglioma is technically challenging due to limited tumor accessibility and proximity to the vena cava. Case presentation A large, malignant paraganglioma was found behind the retrohepatic segment of the inferior vena cava of a 60-year-old male. During resection of this rare paraganglioma, the left lateral lobe of the liver, a portion of the caudate lobe of the liver, and the gallbladder were also removed. Unfortunately, the patient died six months after surgery due to hepatic metastasis. Conclusion This case demonstrates that a partial hepatectomy may be necessary to improve tumor accessibility during resection of a retrocaval paraganglioma, particularly if the tumor is proximal to the vena cava. Furthermore, palliative treatments may help prevent tumor recurrence and metastasis of malignant paragangliomas.

2013-01-01

201

Computed tomography manifestations of common inferior vena cava dysplasia and its clinical significance  

PubMed Central

This study aimed to review and analyse the computed tomography (CT) imaging results of frequently encountered developmental anomalies of the inferior vena cava (IVC). The underlying clinical significance was evaluated with reference to the relevant literature. CT images of patients who received abdominal or thoracic scanning between July 2009 and September 2011 were reviewed. Developmental anomalies observed in the IVC were identified and categorised. Images of the cases with typical anomalies were presented and their developmental mechanism, as well as clinical significance, was discussed. The most frequently encountered IVC developmental anomalies include the left vena cava, double vena cava, azygos continuation of the IVC, left circumaortic renal vein, left retroaortic renal vein and retrocaval ureter. The embryogenesis of the IVC is a complex process that results in various congenital anomalies. The developmental anomalies of the IVC are distinguished using a CT scan and have significant implications on clinical perspective.

QIAN, ZHEN-YU; YANG, MING-FENG; ZUO, KE-QIANG; CHENG, JIE; XIAO, HONG-BING; DING, WEI-XING

2013-01-01

202

Inferior Vena Cava Filter Placement during Pregnancy: An Adjuvant Option When Medical Therapy Fails.  

PubMed

The authors present a case of a 27-year-old multiparous woman, with multiple thrombophilia, whose pregnancy was complicated with deep venous thrombosis requiring placement of a vena cava filter. At 15th week of gestation, following an acute deep venous thrombosis of the right inferior limb, anticoagulant therapy with low-molecular-weight heparin (LMWH) was instituted without improvement in her clinical status. Subsequently, at 18 weeks of pregnancy, LMWH was switched to warfarin. At 30th week of gestation, the maintenance of high thrombotic risk was the premise for placement of an inferior vena cava filter for prophylaxis of pulmonary embolism during childbirth and postpartum. There were no complications and a vaginal delivery was accomplished at 37 weeks of gestation. Venal placement of inferior vena cava filters is an attractive option as prophylaxis for pulmonary embolism during pregnancy. PMID:23781361

Valadares, Sara; Serrano, Fátima; Torres, Rita; Borges, Augusta

2013-01-01

203

[Radical surgical resection of leiomyosarcoma of the inferior vena cava with intracardial tumour growth].  

PubMed

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 1 x 1 cm in the wall of the vena cava while the intracaval tumour was 12 cm long with a diameter of 5 cm and 1.5 cm in the right atrium. Using venovenous bypass with circulatory support, the tumour was excised in toto and the caval vein closed with a pericardial patch. The patient was discharged in good condition after 19 days. PMID:16277928

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

2005-11-01

204

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

SciTech Connect

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.

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

2009-12-03

205

Laparoscopic transposition of the left renal vein into the inferior vena cava for nutcracker syndrome.  

PubMed

Reimplantation of the left renal vein into the infrarenal inferior vena cava is the standard surgical procedure for nutcracker syndrome. A 40-year-old woman with a solitary left kidney suffered from left lumbar pain and hematuria. Imaging techniques found a large kidney with nutcracker syndrome. A totally laparoscopic transposition of the left renal vein was performed. Twelve months later, the patient is improved and has no more hematuria. Duplex scan showed no residual stenosis. Laparoscopic transposition of the left renal vein into the inferior vena cava is feasible with short length of stay and good short-term result. PMID:20576393

Hartung, Olivier; Azghari, Amine; Barthelemy, Pierre; Boufi, Mourad; Alimi, Yves S

2010-09-01

206

Intravascular ultrasound-guided bedside placement of inferior vena cava filters.  

PubMed

Pulmonary emboli in a critically ill patient population is an occurrence that may be reduced with appropriate utilization of inferior vena cava (IVC) filters. Complications both during transfer or transport of critically ill patients who are dependent upon multiple intravenous drips, ventilators and intensive monitoring may be reduced with bedside placement of inferior vena cava filters. Over the last decade, investigators have been developing techniques for bedside IVC filter placement based on intravascular ultrasound techniques. We discuss and detail a single venous access technique of IVC filter placement using intravascular ultrasound. PMID:16996417

Chiou, Andy C

2006-09-01

207

Excision of a permanent inferior vena cava filter with multiple vena caval perforations.  

PubMed

Perforation of an inferior vena cava filter by one the filter device hooks is a recognized possible complication of this device. We describe a case of surgical excision of a permanent inferior vena cava filter associated with multiple perforations of surrounding structures by each of the 6 hooks of the device. Structures affected include the third lumbar vertebral body, transverse mesocolon, the infrarenal aorta, the duodenum, and the psoas muscle. A thorough understanding of the filter design and adequate preoperative imaging were vital in planning the safe surgical excision of this device. PMID:24084266

Georg, Yannick; Khalife, Theresa; Alomran, Faris; Gaudric, Julien; Chiche, Laurent; Koskas, Fabien

2014-01-01

208

ALN inferior vena cava filter upside down rotation with chest caval migration in an asymptomatic patient.  

PubMed

Percutaneous placement of an inferior vena cava (IVC) filter is indicated in patients affected by pulmonary embolism or proximal deep venous thrombosis when anticoagulation therapy is contraindicated or there is evidence of thromboembolic recurrence during anticoagulation. Several complications have been reported using IVC filters. Migration is a rare but known and potentially lethal complication of IVC filter placement. In this patient, an ALN IVC filter (ALN Implants Chirurgicaux Ghisonaccia, France) proximal migration occurred from the inferior cava vein to a zone just below the right atrium; it was associated with a complete 180 degrees rotation, and we describe here the procedure employed to successfully remove this filter. PMID:20679682

Cappelli, Francesco; Vignini, Simone; Baldereschi, Giorgio Jacopo

2010-08-01

209

Liver trauma and transection of the inferior vena cava. Sentinel contrast sign and hepatic perivenous tracking.  

PubMed

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 hypoattenuating 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. PMID:1591129

Radin, D R

1992-05-01

210

Fucoidans from brown seaweeds Sargassum hornery, Eclonia cava, Costaria costata: structural characteristics and anticancer activity.  

PubMed

Fucoidans were isolated by water extraction and ion-exchange chromatography from brown algae Eclonia cava, Sargassum hornery, and Costaria costata collected near of Korean coasts. The structures of fucoidans were investigated. Fucoidan from E. cava was mixture of sulfated rhamnogalactofucan and galactofucan. Fucoidan from C. costata was a sulfated galactofucan. Fucoidan isolated from S. hornery was separated into three fractions: a homofucan sulfate, a homofucan but without sulfate groups, and a sulfated rhamnofucan. The results clearly showed that fucoidans play an inhibitory role in colony formation in human melanoma and colon cancer cells and may be effective antitumor agents. PMID:21302149

Ermakova, Svetlana; Sokolova, Roza; Kim, Sang-Min; Um, Byung-Hun; Isakov, Vladimir; Zvyagintseva, Tatyana

2011-07-01

211

Thermoregulatory catheter-associated inferior vena cava thrombus.  

PubMed

The use of thermoregulatory catheters (TRCs) in critically ill patients has become increasingly popular. TRCs have been shown to be effective in regulating patient body temperature with improved outcomes. Critically ill patients, especially multitrauma patients and those with femoral catheters, are at high risk for deep vein thrombosis (DVT). Among patients for whom chemical DVT prophylaxis is not an option, inferior vena cava (IVC) filters are often placed prophylactically. The development of intravascular ultrasound (IVUS) has allowed placement of IVC filters at the bedside for patients who are too ill for transport to the operating room or cardiac catheterization lab. After encountering several patients with occult DVT of the IVC during bedside IVC filter placement, we performed a retrospective review to determine the incidence of DVT or pulmonary embolus (PE) in patients who had been treated with a TRC at Baylor University Medical Center at Dallas. Since 2008, IVC filters have been deployed at the bedside with the use of IVUS at Baylor University Medical Center. During that same time period, 83 patients had a TRC placed for either intravascular warming or cooling during their resuscitation. Forty-seven out of 83 patients who had a TRC placed survived their injuries. Ten of 47 patients (21%) were diagnosed with DVT or PE, and 6 of these 10 (60%) were found to have caval thrombus. We present this case series as evidence that undiagnosed IVC thrombus associated with TRCs may be higher than previously suspected, given that 5 out of 10 patients who had IVUS of their IVC for prophylactic IVC filter placement, as well as one patient diagnosed with PE, were found to have caval thrombus. PMID:23543961

Gierman, Joshua L; Shutze, William P; Pearl, Gregory J; Foreman, Michael L; Hohmann, Stephen E; Shutze, William P

2013-04-01

212

Artifacts of vena cava filters ex vivo on MR angiography.  

PubMed

We evaluated magnetic susceptibility artifacts of nine types of vena cava filters in MR angiography (MRA) at 1.0T ex vivo in order to assess the filters' compatibility with MRA. Each filter (tulip filter, tulip MReye filter, stainless Greenfield filter, titanium Greenfield filter, TrapEase filter, Simon filter, LGM Vena-Tech filter, Antheor temporary filter, and Bird's nest filter) was inserted into an acrylic tube (20 or 25 mm in diameter, 15 or 30 cm in length). Gd-DTPA was poured into each tube at a concentration of 1/500 and each was placed in a water-filled container for imaging. We evaluated artifacts of the filters according to the following criteria: signal void beyond the tube, 3+; signal void within the tube but at more than one-half the diameter of the tube, 2+; and signal void within the tube but at less than one-half the diameter of the tube, 1+. We evaluated artifacts originating at the tip, intermediate portion, and distal end of the filters. We judged the artifacts as follows: tulip (3+, 3+, 3+); tulip MReye (2+, 1+, 1+); stainless Greenfield (2+, 1+, 2+); titanium Greenfield (1+, 1+, 1+); TrapEase (1+, 2+, 1+); Simon (2+, 2+, 1+); LGM (2+, 2+, 1+); Antheor (2+, 2+, 2+); and Bird's nest (3+, 3+, 3+). The numbers in parentheses refer to the degree of signal void at the tip, intermediate portion, and distal end of the filter, respectively. The tulip filter and Bird's nest filter made of 304 stainless steel caused extensive signal voids beyond the areas defined by the filters. The signal voids in the remaining seven filters were limited to within the tube. We concluded that seven of the nine filters were compatible with MRA ex vivo. PMID:16210823

Honda, Minoru; Obuchi, Masao; Sugimoto, Hideharu

2003-07-01

213

Ryanodine receptors are uncoupled from contraction in rat vena cava  

PubMed Central

Ryanodine receptors (RyR) are Ca2+-sensitive ion channels in the sarcoplasmic reticulum (SR) membrane, and are important effectors of SR Ca2+ release and smooth muscle excitation–contraction coupling. While the relationship between RyR activation and contraction is well characterized in arteries, little is known about the role of RyR in excitation–contraction coupling in veins. We hypothesized that RyR are present and directly coupled to contraction in rat aorta (RA) and vena cava (RVC). RA and RVC expressed mRNA for all 3 RyR subtypes, and immunofluorescence showed RyR protein was present in RA and RVC smooth muscle cells. RA and RVC rings contracted when Ca2+ was re-introduced after stores depletion with thapsigargin (1 ?M), indicating both tissues contained intracellular Ca2+ stores. To assess RyR function, contraction was then measured in RA and RVC exposed to the RyR activator caffeine (20 mM). In RA, caffeine caused contraction that was attenuated by the RyR antagonists ryanodine (10 ?M) and tetracaine (100 ?M). However, caffeine (20 mM) did not contract RVC. We next measured contraction and intracellular Ca2+ (Ca2+i) simultaneously in RA and RVC exposed to caffeine. While caffeine increased Ca2+i and contracted RA, it had no significant effect on Ca2+i or contraction in RVC. These data suggest that ryanodine receptors, while present in both RA and RVC, are inactive and uncoupled from Ca2+ release and contraction in RVC.

Tykocki, N.R.; Thompson, J.M.; Jackson, W.F.; Watts, S.W.

2014-01-01

214

Leiomyosarcoma of the inferior vena cava: experience in 22 cases.  

PubMed

From 1979 to 2004, 22 patients were seen with leiomyosarcomas of the inferior vena cava (IVC). Twenty were treated surgically. Involvement of the IVC included the infrarenal segment in 3 cases, the suprarenal and/or retrohepatic segment in 13, and the suprahepatic segment in 4. Nineteen patients underwent wide tumor resection followed by ligation of the IVC in 5 cases, replacement with a PTFE prosthesis in 13, and cavoplasty in 1. An intracardiac tumor extension was resected during hypothermic circulatory arrest in 1 patient. Vascular exclusion of the liver was used in 5 cases and simple clamping of the IVC in 13 cases. There were 1 intraoperative death due to cardiac failure and 3 postoperative deaths due to multiple organ failure, liver failure, and duodenal fistula after treatment of a bleeding ulcer. Fifteen of the 16 surviving patients underwent adjuvant chemotherapy associated with radiation therapy in 4 cases. One patient was lost from follow-up at 10 months. Four patients including one with metastasis are still alive with a mean follow-up of 18.3 months. Eleven patients died after a mean follow-up period of 43.7 months due to local recurrence and/or distant metastasis in 9 cases and complications of chemotherapy in 2. The 3- and 5-year mean actuarial survival rates in patients who underwent resection were 52.0% and 34.8%, respectively. Leiomyosarcoma of the IVC is a serious disease. Although surgical resection combined with chemotherapy is usually not curative, it can achieve reasonably long-term survival. We recommend aggressive operative management using the latest vascular surgery and oncology techniques. PMID:16858193

Kieffer, Edouard; Alaoui, Mustapha; Piette, Jean-Charles; Cacoub, Patrice; Chiche, Laurent

2006-08-01

215

Blepharoptosis-induced superior keratoconus  

Microsoft Academic Search

PURPOSE: This clinical case report demonstrates blepharoptosis-induced corneal steepening and its subsequent resolution after blepharoptosis surgery.METHODS: A 62-year-old man complaining of blurred vision without apparent cause on clinical examination underwent keratometry and computerized corneal topography, which revealed superior corneal steepening in both eyes. Bilateral upper eyelid blepharoptosis surgery was performed.RESULTS: Three months after blepharoptosis surgery, repeat computerized corneal topography revealed

Terry Kim; Bobbie Khosla-Gupta; Christopher Debacker

2000-01-01

216

Writing superiority in cued recall  

PubMed Central

In list learning paradigms with free recall, written recall has been found to be less susceptible to intrusions of related concepts than spoken recall when the list items had been visually presented. This effect has been ascribed to the use of stored orthographic representations from the study phase during written recall (Kellogg, 2001). In other memory retrieval paradigms, by contrast, either better recall for modality-congruent items or an input-independent writing superiority effect have been found (Grabowski, 2005). In a series of four experiments using a paired associate learning paradigm we tested (a) whether output modality effects on verbal recall can be replicated in a paradigm that does not involve the rejection of semantically related intrusion words, (b) whether a possible superior performance for written recall was due to a slower response onset for writing as compared to speaking in immediate recall, and (c) whether the performance in paired associate word recall was correlated with performance in an additional episodic memory recall task. We observed better written recall in the first half of the recall phase, irrespective of the modality in which the material was presented upon encoding. An explanation for this effect based on longer response latencies for writing and hence more time for memory retrieval could be ruled out by showing that the effect persisted in delayed response versions of the task. Although there was some evidence that stored additional episodic information may contribute to the successful retrieval of associate words, this evidence was only found in the immediate response experiments and hence is most likely independent from the observed output modality effect. In sum, our results from a paired associate learning paradigm suggest that superior performance for written vs. spoken recall cannot be (solely) explained in terms of additional access to stored orthographic representations from the encoding phase. Our findings rather suggest a general writing-superiority effect at the time of memory retrieval.

Fueller, Carina; Loescher, Jens; Indefrey, Peter

2013-01-01

217

Detection of atrial septal defect with left-to-right shunt by inferior vena cava contrast echocardiography.  

PubMed Central

Contrast echocardiography was used before cardiac catheterisation in 37 patients with atrial septal defect and a left-to-right shunt and in 18 patients with a raised right atrial and ventricular pressure to assess the contrast echo effect in the inferior vena cava. Using two dimensional contrast apical echocardiography we found a negative contrast echo effect within the right atrium in many but not all patients with atrial defect. Contrast echoes entering the inferior vena cava during presystole or early to mid-diastole were detected in patients with heart disease causing raised right atrial and ventricular pressures and also in all patients with atrial septal defect. No contrast echo effect in the inferior vena cava was detected in 10 normal subjects. The sensitivity of this contrast pattern in the inferior vena cava in diagnosing atrial septal defect was 100%. When other conditions causing raised right atrial pressure were excluded, the specificity and predictive accuracy were 100% for both. The presystolic contrast echo effect in the inferior vena cava, semiquantitatively graded, correlated with the size of the shunt determined by oximetry. In 20 patients re-examined after the surgical correction of the atrial septal defect, no presystolic contrast echo effect was detected in the inferior vena cava. Contrast echocardiography of the inferior vena cava is a valuable and reliable method for diagnosing atrial septal defect with left-to-right shunt. Images

Gullace, G; Savoia, M T; Ravizza, P; Knippel, M; Ranzi, C

1982-01-01

218

Surgical management of renal cell carcinoma with inferior vena cava tumor thrombus  

Microsoft Academic Search

Background: The successful excision of a renal cell carcinoma (RCC) invading the inferior vena cava (IVC) remains a technical intraoperative challenge and requires a careful preoperative surgical management planning. Although a radical operation remains the mainstay of the therapy for RCC, the optimal management of the patients with RCC causing IVC tumor thrombus remains unresolved. In this study, we reviewed

Sadi Kaplan; Sinan Ekici; R?za Do?an; Metin Demircin; Haluk Özen; Ilhan Pa?ao?lu

2002-01-01

219

Long-term follow-up of Greenfield inferior vena cava filter placement in children  

Microsoft Academic Search

Objective: The long-term results of Greenfield inferior vena cava (IVC) filter placement have been well documented in adults; however, similar data do not exist for pediatric patients. The potential for growth and the increased life expectancy in younger patients may contribute to a difference in the natural history of filters placed in children. The objective of this study was to

Mitchell D. Cahn; Michael J. Rohrer; Mary Beth Martella; Bruce S. Cutler

2001-01-01

220

Use of Retrievable Compared to Permanent Inferior Vena Cava Filters: A Single-Institution Experience  

Microsoft Academic Search

The purpose of this study was to review the use, safety, and efficacy of retrievable inferior vena cava (IVC) filters in their first 5 years of availability at our institution. Comparison was made with permanent filters placed in the same period. A retrospective review of IVC filter implantations was performed from September, 1999, to September, 2004, in our department. These

Thuong G. Van Ha; Andy S. Chien; Brian S. Funaki; Jonathan Lorenz; Giancarlo Piano; Maxine Shen; Jeffrey Leef

2008-01-01

221

Inferior vena cava filter penetration resulting in renal pelvis rupture with urinoma formation.  

PubMed

Inferior vena cava (IVC) filter penetration is common and most often asymptomatic. However, penetration may potentially result in a variety of complications, including aortic trauma and small bowel perforation. Described is a case of IVC filter penetration resulting in renal pelvis perforation with urinoma formation. PMID:23129578

Kassis, Christine; Kalva, Sanjeeva P

2013-01-01

222

Need for Inferior Vena Cava Filters in Cancer Patients: A Surrogate Marker for Poor Outcome  

Microsoft Academic Search

Background. Cancer patients have an increased incidence of venous thromboembolism (VTE). Inferior vena cava (IVC) filters are used extensively in the US, and more than 40 000 are inserted annually. The impact on survival of cancer patients receiving IVC filters has not been studied. Methods. A retrospective study examined 206 consecutive cancer patients with VTE to compare the effects of

Myra F. Barginear; Martin Lesser; Meredith Lukin Akerman; Marianna Strakhan; Iuliana Shapira; Thomas Bradley; Daniel R. Budman

2009-01-01

223

Duplication of the inferior vena cava and thrombosis: A rare case.  

PubMed

Duplication of inferior vena cava (IVC) is a rare finding in radiologic studies and its coincidence with thrombosis is even rarer. Here we described a rare case with duplication of IVC and symptomatic venous thrombosis of her lower extrimity. PMID:24497866

Tamizifar, Babak; Seilani, Parisa; Zadeh, Maryam Rismankar

2013-10-01

224

Long survival of a patient with paratesticular rhabdomyosarcoma with inferior vena cava involvement  

Microsoft Academic Search

A 13-year-old boy with a paratesticular embryonal rhabdomyosarcoma and a large thrombus into the inferior vena cava reaching the suprahepatic vein is presented. We used cardiopulmonary bypass with deep hypothermic circulatory arrest to realize a complete exeresis of the tumor and thrombus, followed by systemic chemotherapy and radiotherapy. Ten years later the patient is alive and doing well without any

Federico I. Rodríguez-Rubio; José I. Abad; Gregorio Rábago; José M. Berián

1997-01-01

225

Azygos continuation of interrupted inferior vena cava in association with sick sinus syndrome  

Microsoft Academic Search

Various diagnostic and therapeutic procedures of the right side of the heart and the systemic venous system have increased the need for ready access to the inferior vena cava (IVC) through the transfemoral route. Anatomical variations or obstruction of the IVC can make these procedures difficult. The case of 47 year old woman with an interrupted infrahepatic IVC with azygos

R Vijayvergiya; M N Bhat; R M Kumar; S G Vivekanand; A Grover

2005-01-01

226

Symptomatic interrupted inferior vena cava: report of a case presenting with haematochezia  

Microsoft Academic Search

Interrupted inferior vena cava (IVC) is a rare developmental defect. IVC interruption is usually accompanied with azygos and hemiazygos continuation, and is asymptomatic. Here, we report the imaging findings of a patient with an interrupted IVC with diffuse collaterals between the infrarenal IVC and large renal veins, left gonadal, and perirectal haemorrhoidal-portal collateral veins with associated haematochezia. Depending on the

Z Koc; S Ulusan; L Oguzkurt; E Serin

2007-01-01

227

Inferior vena cava thrombosis in a pediatric patient of amebic liver abscess  

PubMed Central

Amebic liver abscess (ALA) in pediatric age group is rare. We describe a successful thrombectomy and open drainage of a large left lobe ALA associated with thrombus in the hepatic veins and inferior vena cava extending into the right atrium in a 6-year-old boy.

Gupta, Anubhav; Dhua, Anjan Kumar; Siddiqui, Mansoor Ahmed; Dympep, Badamutlang; Grover, Vijay; Gupta, Vijay Kumar; Sen, Amita

2013-01-01

228

Intracardiac migration of nitinol TrapEase™ vena cava filter and paradoxical embolism  

Microsoft Academic Search

The nitinol TrapEase™ inferior vena cava filter is a new device for pulmonary embolism prophylaxis. No cases of filter migration or filter-related complications with this type of device have so far been described. We report a case of intracardiac migration of this filter in a patient with a patent foramen ovale, resulting in severe cardiogenic shock, cerebral and right arm

Massimo Porcellini; Paolo Stassano; Antonino Musumeci; Giancarlo Bracale

2002-01-01

229

One case of leiomyosarcoma of the inferior vena cava treated with radical resection and vascular reconstruction.  

PubMed

A 48-year-old Chinese woman with primary leiomyosarcoma of the inferior vena cava (IVC) who succesfully underwent resection of a long length of the affected IVC and the right kidney together with graft replacement of the IVC is reported. PMID:16235776

Shen, Zhou-Jun; Zhou, Xie-Lai; Yu, Yan-Lan; Li, Ming

2005-08-01

230

Inferior vena cava thrombus removal using hypothermic circulatory arrest in two patients with osteosarcoma.  

PubMed

In this case report, the technique of deep hypothermia and circulatory arrest (DHCA) is used to successfully extract extensive symptomatic tumor thrombus from the inferior vena cava (IVC) in two patients with osteosarcoma. This is the first description of the use of this modality for treatment of osteosarcoma involving the IVC. Osteosarcoma and the use of DHCA are discussed. PMID:14738095

Garcia, Nicholas D; Morasch, Mark D; Sam, Albert D; Satcher, Robert L; Blum, Matthew G; Fullerton, David A

2003-11-01

231

Clinical Sequelae of Thrombus in an Inferior Vena Cava Filter  

SciTech Connect

The purpose of this study was to assess the long-term clinical sequelae of inferior vena cava (IVC) filter thrombus and the effect of anticoagulation on filter thrombus. Of 1,718 patients who had IVC filters placed during 2001-2008, 598 (34.8%) had follow-up abdominal CT. Filter thrombus was seen in 111 of the 598 (18.6%). There were 44 men (39.6%). The mean age at filter placement was 64 years. The medical diseases included cancer in 64, trauma in 15, stroke in 12, and others in 20. The frequency of filter thrombus on CT and asymptomatic filter thrombus on CT was calculated. The frequency of pulmonary embolism (PE) in patients with filter thrombus was calculated. The frequency of thrombus progression or regression (on CT, available in 56) was calculated. The effect of anticoagulation on filter thrombus regression/progression was evaluated using the Fisher exact test by comparing the group of patients who received anticoagulants versus those who did not. A P-value of <0.05 was considered significant. The overall frequency of filter thrombus was 18.6%. Total occlusion of the IVC filter was seen in 12 of 598 (2%). The filter thrombus was asymptomatic in 110 (18.3%). Filter thrombus was detected after a median of 35 days (range, 0-2082) following filter placement. Thrombus extended above the filter in 4 (3.6%); IVC thrombus below the filter was seen in 35(31.5%). Thrombus in the filter occluded <25% of the filter volume in 58 (52.3%), 25-50% in 21 (18.9%), and 50-75% in 20 (18%). Total IVC occlusion was seen in 12 (10.8%). Eighty-three patients received anticoagulation. Sixteen patients developed symptoms of PE. PE was confirmed on CT in 3 of 15 (2.7%). On follow-up, filter thrombus regressed completely in 19 (33.9%) after a median of 6 months. Filter thrombus decreased in size in 13 (23.2%) and it progressed without IVC occlusion in 7 (12.6%). In one (1.7%), filter thrombus progressed to IVC occlusion. Filter thrombus remained stable in 16 (28.6%). There was no significant difference in thrombus regression or progression rates whether or not the patients received anticoagulation for filter thrombus. In conclusion, asymptomatic thrombus in the filter is common and it rarely progresses to complete caval occlusion. Anticoagulation has little effect on the resolution of filter thrombosis and future occurrence of PE.

Ahmad, Iftikhar; Yeddula, Kalpana; Wicky, Stephan; Kalva, Sanjeeva P., E-mail: skalva@partners.or [Massachusetts General Hospital and Harvard Medical School, Department of Radiology (United States)

2010-04-15

232

Results From the TICO-CAVA Land Seismic Refraction Survey  

NASA Astrophysics Data System (ADS)

Project TICO-CAVA (Transects to Investigate the Crustal Origin of the Central American Volcanic Arc) is a key part of the MARGINS Subduction Factory initiative to quantify, characterize, and understand the volcanic crust produced in Costa Rica by seismically imaging its volume, extent, seismic properties, and lateral variability. From this information we hope to estimate the major-element composition of the arc crust and draw inferences about the processes controlling volcanic output of the subduction factory in Central America. We will do this with two intimately linked seismic surveys, an onshore explosion refraction survey (2005), and an onshore-offshore airgun survey (2008). Here we present results from Phase I of the project, an onshore explosion seismic refraction survey of the volcanic arc and look forward to phase II, a large onshore-offshore seismic survey in both the Atlantic and Pacific oceans. We acquired seismic refraction/wide-angle reflection data on two lines. Line 1 is 154 km long from the Pacific Ocean to the Caribbean Sea in central Costa Rica, intersecting the main volcanic arc at Volcán Barva. Line 2 is 280 km long and spans the entire length of the active arc in Costa Rica, from north of Volcán OrosÃÆ'í near the Nicaraguan border, to south of Volcán IrazÃÆ'ú. 748 seismometers were deployed on each transect, resulting in a ~200 m receiver spacing on Line 1 and ~370 m spacing on Line 2. Data quality ranges from fair to excellent. Data on the cross-arc line (Line 1) show upper-crustal refractions that can be tracked from coast to coast and, at the longest offsets, deep reflections that may be Moho reflections. Sediments on the Atlantic coastal plain (2-3 km/s) are about 1.5 km thick; beneath this and beneath the volcanic arc is a low-velocity carapace of volcanic material (3-5 km/s) that is 2-4 km thick. Beneath the low-velocity velocities reach 6.0-6.4 km/s at 5-10 km depth. Deeper structure will become better resolved as analysis continues and the onshore-offshore data are collected. The along-arc line (Line 2) shows evidence for distinctly different crustal structure beneath the Guanacaste volcanos and the Cordillera Central. In addition, low-velocity zones that may represent magma chambers exist beneath Poás volcano and between Irazu and Turrialba volcanoes.

Bullock, A. D.; Holbrook, W. S.; Lizarralde, D.; van Avendonk, H.; Mora, M. M.; Harder, S.; Alvarado, G.

2007-12-01

233

INTERDEPENDENT SUPERIORITY AND INFERIORITY FEELINGS  

PubMed Central

It is postulated that in neurotic persons who have unrealistic feelings of superiority and inferiority the two are interdependent. This is a departure from the concept of previous observers that either one or the other is primary and its opposite is overcompensation. The author postulates considerable parallelism, with equal importance for each. He submits that the neurotic person forms two logic-resistant compartments for the two opposed self-estimates and that treatment which makes inroads of logic upon one compartment, simultaneously does so upon the other. Two examples are briefly reported. The neurotic benefits sought in exaggeration of capability are the same as those sought in insistence upon inferiority: Presumption of superiority at once bids for approbation and delivers the subject from the need to prove himself worthy of it in dreaded competition; exaggeration of incapability baits sympathy and makes competition unnecessary because failure is conceded. Some of the characteristics of abnormal self-estimates that distinguish them from normal are: Preoccupation with self, resistance to logical explanation of personality problems, inconsistency in reasons for beliefs in adequacy on the one hand and inadequacy on the other, unreality, rationalization of faults, and difficulty and vacillation in the selection of adequate goals.

Ingham, Harrington V.

1949-01-01

234

Dysgenesis of the inferior vena cava associated with deep venous thrombosis and a partial Protein C deficiency  

PubMed Central

Dysgenesis of the inferior vena cava is rare but it is being increasingly diagnosed by cross-sectional imaging techniques. Patients are usually asymptomatic with abnormalities detected incidentally. An 11 year old boy presented with a 10 day history of fever, vomiting and abdominal pain, which progressed to his back and lower limbs. Magnetic resonance imaging, computerised tomography and Doppler ultrasonography showed the absence of a suprarenal inferior vena cava with bilateral superficial femoral vein thrombi extending cranially to the end of the aberrant inferior vena cava. Haematological testing revealed a partial Protein C deficiency. The presenting clinical picture in this case is unique within the English literature and highlights that deep venous thrombosis associated with inferior vena cava dysgenesis may not present with typical symptoms in children. Early use of advanced imaging modalities would expedite diagnosis and subsequent treatment.

Tribe, Howard; Borgstein, Rudi

2013-01-01

235

Technical aspects of insertion and removal of an inferior vena cava IVC filter for prophylactic treatment of pulmonary embolus  

Microsoft Academic Search

We report the successful insertion and subsequent retrieval of a Gunther-Tulip vena cava filter in a patient with an anomalous\\u000a left-sided inferior vena cava, who developed a right ilio-femoral venous thrombosis prior to planned surgical resection of\\u000a a right femoral osteosarcoma. The indication was for short-term prophylaxis against pulmonary embolism during manipulative\\u000a leg surgery.

Pek L. Khong; Philip R. John

1997-01-01

236

Laparoscopic Treatment of Superior Mesenteric Artery Syndrome  

PubMed Central

Background: Superior mesenteric artery syndrome is caused by compression of the third portion of the duodenum by the superior mesenteric artery. Many disease states predispose one to this condition. Methods: We present a case report of a young female patient who presented with gastro-duodenal obstruction from superior mesenteric artery syndrome and subsequently underwent surgical treatment with minimally invasive techniques. Pathophysiology of SMA syndrome is reviewed. Results: The cause of superior mesenteric artery syndrome is variable but always results in duodenal obstruction. Surgery is one treatment option that is effective and can be performed laparoscopically. Conclusion: Laparoscopic duodenojejunostomy is an acceptable method of treating superior mesenteric artery syndrome.

Shen, Roy; Ren, Christine

2004-01-01

237

[Seminal vesicle cyst associated with ipsilateral renal dysplasia and vena cava malformation : a case report].  

PubMed

We report a rare case of seminal vesicle cyst associated with ipsilateral renal dysplasia and vena cava malformation. A 76-year-old man was hospitalized because of difficulty in urination. We diagnosed benign prostate hyperplasia with vesical diverticulum and administered medication that was found to improve urination. However, positron emission tomography-computed tomography showed a large mass in the pelvic region ; therefore, additional examinations were performed. Urethrocystography showed a filling defect in the bladder. Computed tomography revealed the absence of the right kidney and the presence of a double vena cava and a large seminal vesicle cyst on the same side. Magnetic resonance imaging showed a cystic ectopic ureter associated with the seminal vesicle cyst. Therefore, we diagnosed the patient with a seminal vesicle cyst associated with ipsilateral renal dysplasia and performed cyst puncture. The patient is currently free from urinary symptoms at 12 months after surgery. PMID:23070393

Fujita, Masahiro; Goto, Takayasu; Saiki, Shigeru

2012-09-01

238

Computed Tomography Angiography of Situs Inversus, Portosystemic Shunt and Multiple Vena Cava Anomalies in a Dog  

PubMed Central

ABSTRACT A 5-year-old Shih Tzu was presented with intermittent vomiting and anorexia. Microhepatica and reversed position of the abdominal organs were observed on radiography. Ultrasonographically, portosystemic shunt (PSS) was tentatively diagnosed. Computed tomography (CT) revealed that the distended portal vein drained into the left hepatic vein. The caudal vena cava (CdVC) split postrenally and converged at the renal level. Cranial to this, the azygos continuation of the CdVC was confirmed. In the thorax, a persistent left cranial vena cava (CrVC) was found along with right CrVC. This is the first report of a dog with persistent left CrVC and multiple abdominal malformations. CT angiography was useful in evaluating the characteristics of each vascular anomaly and determining the required surgical correction in this complex case.

OUI, Heejin; KIM, Jisun; BAE, Yeonho; OH, Juyeon; PARK, Seungjo; LEE, Gahyun; JEON, Sunghoon; CHOI, Jihye

2013-01-01

239

An interesting anatomic variant of inferior vena cava duplication: case report and review of the literature.  

PubMed

Congenital anomalies of the inferior vena cava (IVC) occur in roughly 4% of the population. We report an interesting case of an atypical variant of duplicated IVC. A 20-year-old man presented with orthopedic injuries and intracranial hemorrhage following a motorcycle accident. He was taken to the fluoroscopy suite for IVC filter placement; duplication of the IVC was noted. The right and left iliac veins shared a normal confluence but two IVCs drained independently into renal veins before reuniting into a single structure. Both IVC filters were placed via a single puncture in the groin. We performed a search of the PubMed database using‘ inferior vena cava duplication’ and reviewed common anomalies of the IVC. Several variants of duplicated IVC exist; the most common of which is two distinct IVCs that arise from each iliac vein without a normal confluence. Our patient had a unique anomaly which allowed filter placements from a single puncture. PMID:23518845

Pineda, Danielle; Moudgill, Neil; Eisenberg, Joshua; DiMuzio, Paul; Rao, Atul

2013-06-01

240

Entrapment of guide wire in an inferior vena cava filter: a technique for removal.  

PubMed

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. PMID:22526100

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

2013-04-01

241

Percutaneous retrieval of an inferior vena cava filter causing right ureter obstruction.  

PubMed

Retrievable inferior vena cava filters (IVCFs) are known to provide safe and effective pulmonary embolism protection when used appropriately. Long-term complications have been reported over the past 10 years, including vena cava perforation, filter migration, strut fracture, and injury to adjacent structures. This article describes the case of a 44-year-old woman who presented with right ureteral obstruction from strut impingement by a Bard Recovery IVCF (Tempe, AZ, USA). The filter had been in place for 6 years, and the authors were successful in retrieving it using a percutaneous endovascular approach, despite an unexpected chronic right innominate vein occlusion. In addition to highlighting the technical feasibility of long-term retrieval, this case underscores the importance of an IVCF registry to improve retrieval rates. This close monitoring and timely retrieval of filters may help prevent serious long-term complications. PMID:24332261

Thornburg, Kristina; Obmann, Melissa; Batool, Amber; Nikam, Shivprasad; Mariner, David

2014-01-01

242

Simultaneous pulmonary and inferior vena cava thromboembolism secondary to pelvic osteosarcoma.  

PubMed

Thromboembolism presenting with malignancy is common in adults but rare in children. We describe the case of a 17-year-old boy admitted to our hospital with syncope. Computed tomography revealed thromboembolism in both the lungs. Magnetic resonance imaging found thromboembolism in the inferior vena cava and a large heterogeneous mass in the pelvis. Pelvic osteosarcoma was confirmed by computed tomography-guided biopsy. Despite intensive chemotherapy and local radiation, only transient response was noted, the tumor remaining unresectable. To our knowledge, this is the first reported case of simultaneous pulmonary and inferior vena cava thromboembolism secondary to pelvic osteosarcoma in children. We also emphasize syncope as a unique feature of pulmonary thromboembolism. Accordingly, thromboembolism should be kept in mind as the first manifestation of occult malignancy, even in children. PMID:23274375

Lin, Wei-Ching; Lin, Chien-Heng; Chao, Yu-Hua; Lin, Hsiao-Chuan; Chen, Pei-Yu; Wu, Han-Ping; Wu, Kang-Hsi

2013-11-01

243

Leiomyosarcoma of the inferior vena cava: report of a case and review of the literature.  

PubMed Central

Leiomyosarcoma of the inferior vena cava is a rare and usually fatal disease. Only 45 cases have been reported in the world literature. The authors add one case and review all previous reports. The disease is one primarily of elderly women, arising from the middle third of the inferior vena cava with a wide range of symptomatology, varying form the Budd-Chiari syndrome to a few asymptomatic cases. The tumor may grow very slowly or occasionally very rapidly, shows extensive local invasion, and metastasizes more frequently than previously believed. While radiotherapy and chemotherapy have not been adequately studied, aggresive surgical intervention using the recent advances in vascular surgery appears to offer long term palliation and hopefully cures of this disease in the future. Images Fig. 1. Fig. 2. Fig. 3.

Bailey, R V; Stribling, J; Weitzner, S; Hardy, J D

1976-01-01

244

Successful surgical management of a recurrent leiomyosarcoma of the inferior vena cava.  

PubMed

The leiomyosarcoma of the inferior vena cava (IVC) is a rare malignant tumour of the venous system. The recurrence of the tumour after previous initial surgical resection is common and occurs in more than half of the patients. Surgical resection of a local recurrence is poorly described in the literature and the available data are restricted to a small number of cases. We report the case of a 62 year old woman, who was referred to our vascular surgical unit for recurrence of a leiomyosarcoma of the inferior vena cava, 35 months after diagnosis and initial surgical treatment. We performed an extensive local resection and circumferencial replacement of the IVC. 18 months after the second operation and adjuvant radiotherapy, the patient is in a very good physical condition and CT-scans show no evidence of tumour recurrence. PMID:21283976

Rascanu, C; Duran, M; Grabitz, K; Weis-Müller, B; Sandmann, W

2011-01-01

245

A caval homograft for Budd-Chiari syndrome due to inferior vena cava obstruction.  

PubMed

Transjugular intrahepatic portosystemic shunt (TIPS) is the standard treatment of Budd-Chiari syndrome (BCS) non responsive to medical therapy. However, patients with inferior vena cava (IVC) obstruction proximal to the atrium do not benefit from TIPS and a surgical approach is mandatory. We report the case of BCS due to intrapericardial IVC obstruction. We describe a novel surgical approach using a fresh caval homograft. An attempt to balloon dilatation of the IVC obstruction was complicated by right atrial disruption with tamponade and ventricular fibrillation. Lately, the patient successfully underwent a reconstruction of the cavo-atrial continuity by the interposition of a fresh caval homograft, a novel surgical approach never described before for BCS. Further follow-up revealed progressive reduction and resolution of ascites, and overall clinical improvement. IVC obstruction near to the atrium can be surgically approached with a new technique consisting in inferior vena cava resection and replacement with a caval homograft. PMID:23717741

Mancuso, Andrea; Martinelli, Luigi; De Carlis, Luciano; Rampoldi, Antonio Gaetano; Magenta, Giovanni; Cannata, Aldo; Belli, Luca Saverio

2013-05-27

246

[MR angiography of pelvic veins and the inferior vena cava using 0.5 tesla].  

PubMed

The pelvic veins and/or the inferior vena cava were examined in 15 patients with pelvic vein thrombosis or retroperitoneal tumours, using phlebography or cavography and MR angiography. The latter was carried out using 0.5 Tesla with an inflow technique TR/TE 30/8 ms, flip angle 70 degrees). 3-D projection angiograms were obtained from the 2-D angiograms in the coronary plane. Image quality was generally satisfactory and the veins up to the internal iliac could be demonstrated in all cases; below this, the examination was unreliable. Comparison of the methods with reference to information of therapeutic relevance has shown that in two-thirds of all examinations (8/13) MR angiography and phlebography were of equal diagnostic value. In the presence of a renal cell carcinoma, MR angiography was unable to distinguish between thrombosis and infiltration of the vena cava. PMID:7948977

Haubold-Reuter, B; Nicolas, V

1994-10-01

247

MAGNETIC RESONANCE IMAGING OF THE HUMAN INFERIOR VENA CAVA DURING LOWER BODY NEGATIVE PRESSURE  

Microsoft Academic Search

Magnetic Resonance Imaging (MRI) was used to determine changes in the size of the Inferior Vena Cava (IVC) as a result of blood pooling induced by lower body negative pressure (LBNP). Images of the IVC of supine human subjects (10 males, 10 females) were obtained under four conditions: 1) steady-state 0 mmHg LBNP, 2) steady-state –35 mmHg LBNP, 3) ramping

Venu Madhav Pothini

2004-01-01

248

Antiproliferative and antioxidant properties of an enzymatic hydrolysate from brown alga, Ecklonia cava  

Microsoft Academic Search

The potential antiproliferative and antiradical activities of an enzymatic extract of Ecklonia cava together with its crude polysaccharide (CpoF) and crude polyphenolic fractions (CphF) were evaluated in vitro. Tested extracts showed strong selective cell proliferation inhibition on all cancer cell lines tested, especially CphF extract, containing high polyphenol amount, showed 5.1?g\\/ml of IC50 value on murine colon cancer (CT-26) cell

Yasantha Athukorala; Kil-Nam Kim; You-Jin Jeon

2006-01-01

249

Value-added fermentation of Ecklonia cava processing by-product and its antioxidant effect  

Microsoft Academic Search

The interest in the extraction of polyphenolic compounds from plant materials is focused on upgrading of the large amount\\u000a of by-products coming from food or cosmetics industries from which the press residues have particularly high contents of phenolics.\\u000a In this study, for value-added use of the brown seaweed Ecklonia cava processing by-product (ECPB), which can be obtained after polyphenolic extraction

W. A. J. P. Wijesinghe; Lee Won-Woo; Kim Young-Mog; Kim Young-Tae; Kim Se-Kwon; Jeon Byong-Tae; Kim Jin-Soo; Heu Min-Soo; Jung Won-Kyo; Ginnae Ahn; Ki-Wan Lee; You-Jin Jeon

250

Technique for retrieval of a guidewire lodged in a vena cava filter.  

PubMed

A case in which the guidewire used to place a percutaneous jugular central line became entangled in the limbs of a Trapease inferior vena cava filter is presented. A 7F sheath introducer was fashioned into a monorail system to uncurl the wire's J tip and remove the wire without disturbing the filter's position. This report highlights an increasingly frequent clinical scenario and an inexpensive effective method for resolution. PMID:12244428

Wholey, Michael; Toursarkissian, Boulos; Velez, George; Morales, Robert P; Cadavid, Gilberto

2002-01-01

251

[Inferior vena cava thrombosis responsible for chronic Budd-Chiari syndrome during hepatic and digestive amyloidosis].  

PubMed

The case of a 39 year old woman with amyloidosis of the liver and the digestive tract presenting with obstruction of the inferior vena cava is reported. Computed tomography after bolus injection of contrast material revealed a typical patchy fan-shaped image, of hepatic vein obstruction. The association of Budd-Chiari's syndrome with amyloidosis may be related to the increased risk of thrombosis observed in the latter disease. PMID:6653979

Paliard, P; Bretagnolle, M; Collet, P; Vannieuwenhyse, A; Berger, F

1983-11-01

252

Early Placement of Optional Vena Cava Filter in High-Risk Patients with Traumatic Brain Injury  

Microsoft Academic Search

Objectives:   Patients sustaining severe trauma are at high risk for the development of venous thromboembolic events (VTE). Pharmacologic\\u000a VTE prophylaxis may be contraindicated early after trauma due to potential bleeding complications. The purpose of this study\\u000a was to evaluate safety and feasibility of early prophylactic vena cava filter (VCF) placement and subsequent retrieval in\\u000a multiple injured patients with traumatic brain

Christoph Meier; Thomas Pfammatter; Reto Stocker; Ludwig Labler; Emanuel Benninger; Philipp Lenzlinger; John Stover; Otmar Trentz; Hans G. Imhof

2007-01-01

253

Use of Retrievable Compared to Permanent Inferior Vena Cava Filters: A Single-Institution Experience  

Microsoft Academic Search

The purpose of this study was to review the use, safety, and efficacy of retrievable inferior vena cava (IVC) filters in their\\u000a first 5 years of availability at our institution. Comparison was made with permanent filters placed in the same period. A\\u000a retrospective review of IVC filter implantations was performed from September, 1999, to September, 2004, in our department.\\u000a These

Thuong G. Van Ha; Andy S. Chien; Brian S. Funaki; Jonathan Lorenz; Giancarlo Piano; Maxine Shen; Jeffrey Leef

2008-01-01

254

Endovascular removal of a permanent "TrapEase" inferior vena cava filter.  

PubMed

Inferior vena cava (IVC) filter placement has seen a rising trend over the past decade. Although effective in the prevention of future pulmonary emboli, filters are associated with several long-term complications including deep venous thrombosis, filter migration, filter fracture, and caval thrombosis. The IVC filters have evolved over the years to minimize these unwarranted sequelae. We describe a technique to remove a permanent IVC filter in a patient who no longer required mechanical protection. PMID:23645394

Yallampalli, Sasidhar; Irani, Zubin; Kalva, Sanjeeva P

2013-07-01

255

Duplex scan–directed placement of inferior vena cava filters: A five-year institutional experience  

Microsoft Academic Search

Purpose: The purpose of this study was the assessment of the safety, efficacy, and hospital charges of bedside duplex ultrasound–directed inferior vena cava (IVC) filter placement. Methods: All duplex ultrasound–directed IVC filters that were placed from August 8, 1995, to December 31, 2000, are reviewed. Chart review combined with mailed questionnaires and telephone follow-up examinations were used to collect demographic

Michael S. Conners; Stacey Becker; Raul J. Guzman; Marc A. Passman; Rosanna Pierce; Tina Kelly; Thomas C. Naslund

2002-01-01

256

Delayed complications of inferior vena cava filters: case report and literature review.  

PubMed

Inferior vena cava (IVC) filters are frequently placed to prevent pulmonary embolism in patients in whom anticoagulation is contraindicated or ineffective. Delayed erosion of the filter into adjacent vital structures is a rare complication. We report 3 complications of IVC filters managed with both surgical and endovascular therapies. A review of the available literature addresses incidence of delayed IVC filter complications, the approach to these problems, and the role of retrievable IVC filters. PMID:21278177

Shang, Eric K; Nathan, Derek P; Carpenter, Jeffrey P; Fairman, Ronald M; Jackson, Benjamin M

2011-04-01

257

Inferior vena cava clip migration: unusual cause of duodenal foreign body.  

PubMed

Before the development of the inferior vena cava (IVC) filter, various techniques of IVC interruption were described for the management of patients at high risk for thromboembolic events, and for whom anticoagulation was either inadequate or contraindicated. In this report, we describe the enteric migration of a Miles IVC clip, occurring 27 years after IVC interruption. This previously undescribed complication and the patient's prolonged follow-up period render this case of significant interest. PMID:22981011

Antonoff, Mara B; Beilman, Gregory J

2012-11-01

258

The Use of Inferior Vena Cava Filters in Pediatric Patients for Pulmonary Embolus Prophylaxis  

Microsoft Academic Search

Purpose: To report our experience with inferior vena cava (IVC) filters in pediatric patients. Methods: Over a 19-month period, eight low-profile percutaneously introducible IVC filters were placed in four male and four female patients aged 6-16 years (mean 11 years). Indications were contraindication to heparin in six patients, anticoagulation failure in one, and idiopathic infrarenal IVC thrombosis in one. Six

Richard A. Reed; George P. Teitelbaum; Philip Stanley; Murray J. Mazer; Ina L. D. Tonkin; Nancy K. Rollins

1996-01-01

259

Inferior vena cava filter strut perforation discovered during right robotic-assisted laparoscopic partial nephrectomy.  

PubMed

Inferior vena cava (IVC) filters are a relatively safe and effective treatment designed to prevent pulmonary emboli. Late complications of IVC filters include filter migration, tilting, strut fracture, strut perforation, and IVC thrombosis. We present a case of a 67-year-old male undergoing a right robotic-assisted laparoscopic partial nephrectomy whose IVC filter strut had perforated the vena caval wall. PMID:22014963

Kappa, Stephen F; Morgan, Todd M; Keegan, Kirk A; Cookson, Michael S

2012-04-01

260

Successful thrombolytic therapy for acute kidney injury secondary to thrombosis of suprarenal inferior vena cava filter  

Microsoft Academic Search

Inferior vena cava (IVC) thrombosis is a complication that occurs in 1–32% of patients inserted with IVC filters (IVCF). Deployment\\u000a of the filter in the suprarenal position is advocated in certain clinical conditions, and some reports suggest a higher incidence\\u000a of renal complications in that position, especially among patients with malignancy. We report a case of acute kidney injury\\u000a (AKI)

Azra Bihorac; Craig S. Kitchens

2009-01-01

261

Anatomical observations on the renal veins and inferior vena cava at magnetic resonance angiography  

Microsoft Academic Search

Purpose: To describe the renal vein and inferior vena cava (IVC) anatomy found at abdominal magnetic resonance (MR) angiography. Methods: Gadolinium-enhanced, three-dimensional, time-of-flight MR angiograms of 150 patients were evaluated for the number and configuration of the renal veins, and the number, configuration, and dimensions of the IVC. Data were analyzed with the Student's ttest. Results: Retroaortic left renal veins

John A. Kaufman; Arthur C. Waltman; S. Mitchell Rivitz; Stuart C. Geller

1995-01-01

262

Inferior Vena Cava Duplication and Deep Venous Thrombosis: Case Report and Review of Literature  

Microsoft Academic Search

Duplications of the inferior vena cava (IVC) are seen with an incidence of 0.2% to 3.0%. Duplications causing symptoms are rare, with only six reported cases of IVC duplication associated with a deep venous thrombosis. We present a 78-year-old caucasian woman with an IVC duplication who developed a deep venous thrombosis. The etiologies of IVC duplication include failure of anastomosis

Nirupama Anne; Ratnakishore Pallapothu; Raymond Holmes; Moses Degraft Johnson

2005-01-01

263

Successful Management of Pulmonary and Inferior Vena Cava Tumor Embolism from Renal Cell Carcinoma  

PubMed Central

Pulmonary tumor embolism can be a cause of respiratory failure in patients with cancer even though it occurs rarely. We describe a 56-year-old man who underwent a pulmonary tumor embolectomy using cardiopulmonary bypass on beating heart combined with inferior vena cava embolectomy and right radical nephrectomy. Aggressive surgical treatment in this severe case is necessary not only to reduce the fatal outcome of pulmonary embolism in the short run, but also to improve the oncological prognosis in the long term.

Shim, Hunbo; Kim, Young-Wook; Yang, Shin-Seok; Kim, Duk-Kyung

2012-01-01

264

Right gonadal arteries passing dorsally to the inferior vena cava: embryological hypotheses  

Microsoft Academic Search

The right gonadal artery (RGA) usually arises from the anterior wall of the abdominal aorta below the level of the renal arteries\\u000a and veins, passes ventrally to the inferior vena cava (IVC), and then runs obliquely downward to reach the pelvic cavity.\\u000a In this study, we observed 59 Japanese cadavers and found that in eight of them (13.6%), the RGA’s

Hayato Terayama; Shuang-Qin Yi; Munekazu Naito; Ning Qu; Shuich Hirai; Miyuki Kitaoka; Akira Iimura; Hiroshi Moriyama; Hanno Steinke; Masahiro Itoh

2008-01-01

265

Anatomy of retrohepatic segment of inferior vena cava and termination of hepatic veins  

Microsoft Academic Search

Background  Information on anatomy of intrahepatic inferior vena cava (IVC) and hepatic vein openings in it is limited.\\u000a \\u000a \\u000a \\u000a Methods  We studied the retrohepatic segment of IVC and hepatic vein openings in it in 69 livers obtained from cadavers. The retrohepatic\\u000a portion of the IVC was opened posteriorly by a vertical cut, the exposed surface was divided into 12 quadrants and the position,

S. D. Joshi; S. S. Joshi; A. U. Siddiqui

2009-01-01

266

Long-term results of the Simon nitinol inferior vena cava filter  

Microsoft Academic Search

.   The aim of this study was to evaluate the clinical efficacy, mechanical stability, and safety of the Simon nitinol inferior\\u000a vena cava filter (SNF). The SNF was inserted in 114 consecutive patients at two institutions for prophylaxis of pulmonary\\u000a embolism (PE). Clinical follow-up data were obtained retrospectively on all patients, and 38 patients underwent a dedicated\\u000a radiologic follow-up protocol

P. A. Poletti; C. D. Becker; L. Prina; P. Ruijs; H. Bounameaux; D. Didier; P. A. Schneider; F. Terrier

1998-01-01

267

Amoebic liver abscesses complicated by inferior vena cava and right atrium thrombus.  

PubMed

Amoebiasis is a common protozoal infection that is endemic in South Asia. Hepatic involvement that manifests as abscess formation occurs in approximately 10% of all patients. Identified expeditiously, this can be treated with metronidazole. We present a case of multiple, large amoebic liver abscesses, that were complicated by thrombus formation in the inferior vena cava extending to the right atrium, requiring surgical removal. PMID:19535761

Khan, Sadaf; Ameen Rauf, Muhammad

2009-07-01

268

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

PubMed Central

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.

Mazensky, David; Petrovova, Eva; Danko, Jan

2013-01-01

269

Bedside insertion of the inferior vena cava filter in the intensive care unit.  

PubMed

Historically, inferior vena cava (IVC) filters have been inserted in the Radiology Department or the Operating Room. When initially designed, vena cava filters required surgical cut down of the internal jugular vein to insert a large (24 French) introducer and it was therefore necessary to perform this procedure in the operating room. Percutaneous methods (e.g., the Seldinger technique) with smaller profile sheath-dilator devices (6 to 12 French) have made IVC filter insertion a much easier procedure. Furthermore, the remaining equipment is simple, portable, and readily available throughout most hospitals (e.g., C-arm, contrast, sterile drapes, gowns, gloves, catheters, etc.). These factors have made it easy to "bring the procedure to the patient." This is particularly advantageous in critically ill ICU patients. Complication rates of "road trips" for critically ill patients from the ICU to other parts of the hospital (i.e., radiology department or operating room) can result in a mishap rate of 5-30. Secondary benefits of bedside insertion of vena cava filters include cost-effectiveness. PMID:12953822

Sing, Ronald F; Heniford, B Todd

2003-08-01

270

Immunomodulatory effects of an enzymatic extract from Ecklonia cava on murine splenocytes.  

PubMed

We investigated whether the brown seaweed Alariaceae Ecklonia cava (E. cava) has immunological effects on splenocytes in vitro. For that purpose, we prepared an enzymatic extract from E. cava (ECK) by using the protease, Kojizyme. Here, ECK administered to ICR mice dramatically enhanced the proliferation of their splenocytes and increased the number of their lymphocytes, monocytes and granulocytes. In flow cytometry assays performed to identify in detail the specific phenotypes of these proliferating cells after ECK treatment, the numbers of CD4(+) T cells, CD8(+) T cells and CD45R/B220(+) B cells increased significantly compared to those in untreated controls. In addition, the mRNA expression and production level of Th1-type cytokines, i.e., TNF-alpha and IFN-gamma, were down-regulated, whereas those of Th2-type cytokines, i.e., IL-4 and IL-10, were up-regulated by ECK. Overall, this dramatic increase in numbers of splenocytes indicated that ECK could induce these cells to proliferate and could regulate the production of Th1- as well as Th2-type cytokines in immune cells. These results suggest that ECK has the immunomodulatory ability to activate the anti-inflammatory response and/or suppress the proinflammatory response, thereby endorsing its usefulness as therapy for diseases of the immune system. PMID:18172723

Ahn, Ginnae; Hwang, Insun; Park, Eunjin; Kim, Jinhe; Jeon, You-Jin; Lee, Jehee; Park, Jae Woo; Jee, Youngheun

2008-01-01

271

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

PubMed Central

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.

2012-01-01

272

Comparison of Ecklonia cava, Ecklonia stolonifera and Eisenia bicyclis for phlorotannin extraction.  

PubMed

Phlorotannins are polyphenols of marine algae, particularly brown seaweed, having multiple biological activities. A reverse phase-high performance liquid chromatography method was developed for rapid and routine quantification of two major phlorotannins, dieckol and phlorofucofuroeckol-A (PFE-A), from boiling water- and organic solvent-extracts of brown seaweeds Ecklonia cava, E. stolonifera and Eisenia bicyclis. The regression equations for dieckol and PFE-A were as follows: the concentration (mg ml(-1)) = 16.56 x peak height (cm) + 0.44, and the concentration = 20.60 x peak height (cm) + 0.11, with correlation coefficients of 0.996 and 0.999, respectively. Compared to organic solvent extraction, the recovery yield of dieckol from boiling water extracts of E. cava, E. stolonifera and E. bicyclis was 86%, 93%, and 98%, respectively. The recovery yield of PFE-A was 74%, 86% and 62%, respectively. Antioxidant activity was detected in each E. bicyclis water extract (91%), followed by E. stolonifera (90%) and E. cava (74%). Dieckol and PFE-A showed almost 9- and 7-fold stronger antioxidant activity than the standard butylhydroxytoluene, and 6-and 4-fold greater than L-ascorbic acid in molar concentration, respectively. PMID:25004758

Chowdhury, Muhammad Tanvir Hossain; Bangoura, Issa; Kang, Ji-Young; Cho, Ji Young; Joo, Jin; Choi, Yoo Seong; Hwang, Dong Soo; Hong, Yong-Ki

2014-07-01

273

Sodium nitroprusside activates potassium channels in the vena cava in normotensive but not in hypertensive rats.  

PubMed

Despite the importance of the venous system in the regulation of blood pressure, there are few studies that evaluate venous function in health and disease, and the effects of drugs on venous function. Blood pressure depends directly on the peripheral resistance and cardiac output. Unlike the peripheral resistance, in which the contractile activity of the arteries is the key factor, cardiac output depends primarily on the venomotor tone. An increase in cardiac blood pressure can be caused by an increase in blood volume, structural changes in the walls of the veins, leading to a reduced compliance thereof, or an increase in the contractile activity of venous smooth muscle. This study examined the effect of sodium nitroprusside (SNP), a classical nitric oxide donor, on vascular relaxation in the vena cava from normotensive (2K) and renal hypertensive (2K-1C) rats. We studied the effect of this compound in vena cava rings from normotensive and renal hypertensive rats. We showed for the first time that the vascular relaxation induced by SNP is impaired in vena cavas from hypertensive rats because of an impaired functional activity of potassium channels. Another relevant finding of this study is that the sarcoplasmic reticulum Ca(2+) ATPase is not involved in the venorelaxation induced by SNP. PMID:23784507

Paulo, Michele; Araujo, Alice Valença; Bendhack, Lusiane Maria

2013-09-01

274

Isolated dissection of superior mesenteric artery.  

PubMed

Isolated dissection of the superior mesenteric artery is a rare occurrence with a hitherto unknown exact etiology. Patients may present with abdominal symptoms or hemodynamic instability.We herein present a case of spontaneous isolated superior mesenteric artery dissection in a 48-year-old man, who was admitted with epigastric pain. Due to an undiagnosed paced rhythm on the electrocardiogram, he was given fibrinolysis treatment for acute myocardial infarction. On further evaluation, angiography revealed that the cause of pain was the dissection of the superior mesenteric artery. The patient's symptoms were diminished with conservative management, obviating the need for the angioplasty of the superior mesenteric artery. PMID:23304184

Taherkhani, Maryam; Hashemi, Seyyed Reza; Nikpoor, Shahryar

2012-08-01

275

Isolated Dissection of Superior Mesenteric Artery  

PubMed Central

Isolated dissection of the superior mesenteric artery is a rare occurrence with a hitherto unknown exact etiology. Patients may present with abdominal symptoms or hemodynamic instability. We herein present a case of spontaneous isolated superior mesenteric artery dissection in a 48-year-old man, who was admitted with epigastric pain. Due to an undiagnosed paced rhythm on the electrocardiogram, he was given fibrinolysis treatment for acute myocardial infarction. On further evaluation, angiography revealed that the cause of pain was the dissection of the superior mesenteric artery. The patient’s symptoms were diminished with conservative management, obviating the need for the angioplasty of the superior mesenteric artery.

Taherkhani, Maryam; Hashemi, Seyyed Reza; Nikpoor, Shahryar

2012-01-01

276

Clinical Manifestations of Superior Semicircular Canal Dehiscence  

Microsoft Academic Search

Objectives\\/Hypotheses: To determine the symp- toms, signs, and findings on diagnostic tests in pa- tients with clinical manifestations of superior canal dehiscence. To investigate hypotheses about the ef- fects of superior canal dehiscence. To analyze the out- comes in patients who underwent surgical repair of the dehiscence. Study Design: Review and analysis of clinical data obtained as a part of

Lloyd B. Minor

2005-01-01

277

Lake Effects: The Lake Superior Curriculum Guide.  

ERIC Educational Resources Information Center

This curriculum guide was launched in response to a need for Lake Superior-specific educational materials and contains lessons and activities that can be used to teach about Lake Superior. The lessons in this book are divided into four sections. Each of the first three sections has a background section that provides basic information about Lake…

Beery, Tom; And Others

278

STATUS OF MYSIS RELICTA IN LAKE SUPERIOR  

EPA Science Inventory

The status of different components of the lower food web is reported for Lake Superior. Results are preliminary summaries from the Binational collaboration in 2005, which measured the lower food web at the request of the Lake Superior Fisheries Technical Committee and Lake Superi...

279

Traumatic Superior Orbital Fissure Syndrome: Current Management  

PubMed Central

Traumatic superior orbital fissure syndrome is an uncommon complication of craniomaxillofacial trauma with an incidence of less than 1%. The syndrome is characterized by ophthalmoplegia, ptosis, proptosis of eye, dilation and fixation of the pupil, and anesthesia of the upper eyelid and forehead. This article describes a detailed anatomy of the superior orbital fissure as it related to pathophysiology and clinical findings. Etiology and diagnosis are established after detailed physical and radiographic examination. On the basis of our clinical experience in the management of superior orbital fissure syndrome and from the data reported previously in the literature, an algorithm for treatment of traumatic superior orbital fissure syndrome including use of steroid, surgical decompression of superior orbital fissure, and reduction of concomitant facial fracture is presented and its rationale discussed.

Chen, Chien-Tzung; Chen, Yu-Ray

2010-01-01

280

Long-term cannulation of the vena cava of rats for blood sampling: local and systemic effects observed by histopathology after six weeks of cannulation  

Microsoft Academic Search

Summary A cannulation system with fixation by a metal cuff around the tail was used for blood sampling. The cannula was guided subcutaneously and positioned in the vena cava after entering the body via the femoral vein. Histopathology was performed after long-term cannulation of up to 35 and 45 days. The presence of the cannula in the vena cava induced

W. H. De Jong; A. Timmerman; M. T. M. Van Raaij

2001-01-01

281

Remodelling of the Superior Caval Vein After Angioplasty in an Infant with Superior Caval Vein Syndrome  

SciTech Connect

An 8-month old girl was presented with superior caval vein syndrome early after cardiac surgery. Angiography showed severe stenosis of the superior caval vein with 50 mmHg pressure gradient. Following balloon angioplasty, the pressure gradient was reduced to 7 mmHg with some residual stenosis of the superior caval vein. When the patient was reevaluated 5 months after the procedure, angiography revealed a normal diameter of the superior caval vein without a pressure gradient.

Mert, Murat [Istanbul University, Institute of Cardiology, Department of Cardiovascular Surgery (Turkey)], E-mail: mmert@superonline.com; Saltik, Levent [Istanbul University, Cerrahpasa Medical School, Department of Pediatric Cardiology (Turkey); Gunay, Ilhan [Istanbul University, Institute of Cardiology, Department of Cardiovascular Surgery (Turkey)

2004-08-15

282

A Rare Presentation of the Double Inferior Vena Cava with an Anomalous Retrocaval Right Ureter: Embryogenesis and Clinical Implications  

PubMed Central

On dissection of the abdomen of an adult male cadaver, in addition to the normal inferior vena cava on the right side, an unusual venous channel which connected the left renal vein with the left common iliac vein was found; (probably the left inferior vena cava). The left testicular and the left suprarenal veins were opening into the left renal vein as usual. Other than this, a retrocaval ureter was found on the right side. The works of previous authors have highlighted the incidence of a venacaval duplication and its surgical implications, but here, we are presenting a unique case of a double inferior vena cava with an anomalous retrocaval ureter. A conglomeration of such vascular malformations is of immense surgical importance, and it is indicative of a grossly defective angiogenesis. Keeping in mind the clinical relevance of the variations which were observed, an attempt was made to explain them in the light of the embryogenic development.

Gupta, Pratibha; Khullar, Meenakshi; Sharma, Ravikant; Singh, Richhpal

2013-01-01

283

Superior oblique surgery: when and how?  

PubMed Central

Background The purpose of this paper is to review different types of superior oblique muscle surgeries, to describe the main areas in clinical practice where superior oblique surgery is required or preferred, and to discuss the preferred types of superior oblique surgery with respect to their clinical outcomes. Methods A consecutive nonrandomized retrospective series of patients who had undergone superior oblique muscle surgery as a single procedure were enrolled in the study. The diagnosis, clinical features, preoperative and postoperative vertical deviations in primary position, type of surgery, complications, and clinical outcomes were reviewed. The primary outcome measures were the type of strabismus and the type of superior oblique muscle surgery. The secondary outcome measure was the results of the surgeries. Results The review identified 40 (20 male, 20 female) patients with a median age of 6 (2–45) years. Nineteen patients (47.5%) had Brown syndrome, eleven (27.5%) had fourth nerve palsy, and ten (25.0%) had horizontal deviations with A pattern. The most commonly performed surgery was superior oblique tenotomy in 29 (72.5%) patients followed by superior oblique tuck in eleven (27.5%) patients. The amount of vertical deviation in the fourth nerve palsy and Brown syndrome groups (P = 0.01 for both) and the amount of A pattern in the A pattern group were significantly reduced postoperatively (P = 0.02). Conclusion Surgery for the superior oblique muscle requires experience and appropriate preoperative evaluation in view of its challenging nature. The main indications are Brown syndrome, fourth nerve palsy, and A pattern deviations. Superior oblique surgery may be effective in terms of pattern collapse and correction of vertical deviations in primary position.

Sekeroglu, Hande Taylan; Sanac, Ali Sefik; Arslan, Umut; Sener, Emin Cumhur

2013-01-01

284

New approach of assessing hypovolemic shock class 1 during acute emergencies: Ultrasonographic inferior vena cava and abdominal aorta diameter ratio  

NASA Astrophysics Data System (ADS)

In a patient with hypovolemic shock class 1, the vital signs and biochemical properties are almost normal. The alteration of hemodynamic parameters and biochemical values occurs mainly in advanced hypovolemia state (neuroendocrine response). The availability of ultrasound machine at healthcare centers makes the measurement of vascular calibre feasible and possible. Inspiration and expiration inferior vena cava diameter changes predict hypovolemic shock class 1 but in acute emergencies this method is impractical. The purpose of this study is to develop a new approach in identifying hypovolemic shock at early phase by measuring the inferior vena cava and aorta diameter ratio using bedside ultrasound machine.

Ahmad, Rashidi; Kunji, Mohamad Iqhbal; Hj Abd Kareem, Meera Mohaideen; Halim, Shamimi A.

2013-09-01

285

Left common iliac artery to inferior vena cava abdominal wall arteriovenous graft for hemodialysis access.  

PubMed

We describe a novel arteriovenous graft configuration in the abdominal wall for hemodialysis in a 51-year-old woman with sickle cell disease. Upper extremity access sites were exhausted, and intrathoracic central veins occluded. Because of diminished quality of the left groin due to scar tissue from previous infected access, inadequate vasculature, and the presence of functional femoral catheter in the right groin with common iliac vein stenosis, we decided to create an arteriovenous graft from the left common iliac artery to the inferior vena cava. Adequate thrill and uneventful postoperative recovery was observed. At 4 months, the patient has been successfully using her graft. PMID:22494692

Zamani, Nader; Anaya-Ayala, Javier E; Ismail, Nyla; Peden, Eric K

2012-08-01

286

Endovascular treatment of late aortic perforation due to vena cava filter.  

PubMed

Perforation of inferior vena cava (IVC) by filter struts ranges from 9% to 24%, and clinical sequelae and complications are unpredictable. The aim of this article was to report an unusual case of late complication of IVC filter that caused an IVC wall perforation and penetration of the filter's hooks in the aorta, which was treated by endovascular procedure. Molding strut tip by balloon angioplasty, its accommodation with a bare stent, and its coverage and protection with an endoprosthesis is probably the first technique reported so far in this situation. PMID:22717360

Yoshida, Ricardo de Alvarenga; Yoshida, Winston Bonetti; Kolvenbach, Ralf; Vieira, Paulo Roberto Bahdur

2012-08-01

287

Lumbar artery pseudoaneurysm caused by a Gunther Tulip inferior vena cava filter.  

PubMed

Inferior vena cava (IVC) filters are widely used to decrease the risk of pulmonary embolism in patients with contraindications to anticoagulation. Complications include local hematoma, access site deep venous thrombosis (DVT), filter migration and embolization, leg penetration through the IVC wall, IVC occlusion, and filter fracture with embolization. Other rare complications include leg penetration into adjacent organs including duodenum and ureter. Lumbar artery pseudoaneurysms are rare and may be spontaneous, iatrogenic, or traumatic. To date, there have been 3 case reports of lumbar artery pseudoaneurysms caused by IVC filters. We present an additional case of a lumbar artery pseudoaneurysm caused by a Gunther Tulip IVC filter treated successfully with selective embolization. PMID:22262118

Skeik, Nedaa; McEachen, James C; Stockland, Andrew H; Wennberg, Paul W; Shepherd, Roger F J; Shields, Raymond C; Andrews, James C

2011-11-01

288

Duodenocaval fistula from inferior vena cava filter penetration masquerading as lower gastrointestinal bleeding.  

PubMed

Asymptomatic penetration of the inferior vena cava (IVC) wall with retrievable filters is not uncommon. Occasionally, this can be a cause for morbidity, and rarely for mortality. We present a case of duodenocaval fistula, secondary to penetration from a strut of retrievable IVC filter that presented as lower gastrointestinal bleeding and discuss the subsequent management. Although newer generation retrievable filters provide a longer time for retrieval, they are associated with an increased incidence of IVC wall penetration, caudal migration, and occasionally symptomatic presentation, thereby necessitating surgical intervention. Close follow-up is warranted, and prompt retrieval of such devices should be done when their use is no longer indicated. PMID:21835583

Bathla, Lokesh; Panwar, Aru; Fitzgibbons, Robert J; Balters, Marcus

2011-11-01

289

Late gastrointestinal complications of inferior vena cava filter placement: case report and literature review.  

PubMed

In current practice, inferior vena cava (IVC) filters are commonly used in the prevention of pulmonary embolism. Despite their widespread use, periprocedural as well as late complications do occur. Filter penetration of the IVC wall into surrounding structures, including bowel, is a known although rare complication. This complication may manifest with abdominal pain, gastrointestinal bleeding, duodenocaval fistula, or small bowel obstruction. The authors present a case of abdominal pain from duodenal penetration by a Greenfield IVC filter 13 years after insertion. A detailed operative description and pertinent review of the literature is provided. PMID:21810813

Vandy, Frank; Rectenwald, John E; Criado, Enrique

2011-12-01

290

Thrombectomy under Cardiopulmonary Bypass for Inferior Vena Cava Thrombosis Induced by Liver Injury  

PubMed Central

Inferior vena cava thrombosis (IVCT) caused by liver injury is a rare and challenging condition. A 32-year-old man sustained a severe liver injury in a traffic accident. Emergent thromboembolic procedure for the affected hepatic arteries was performed for hemostasis, resulting in hemodynamic stabilization of the patient. One month later, however, computed tomography (CT) showed liver congestion caused by IVCT from the suprahepatic IVC to the bilateral common iliac veins. As liver function deteriorated quickly despite heparin administration, surgical thrombectomy was performed under hypothermic circulatory arrest through sternotomy and laparotomy. After this operation, the liver was decongested and its function improved rapidly.

2013-01-01

291

Retrievable inferior vena cava filters may be safely applied in gastric bypass surgery  

Microsoft Academic Search

Introduction  Pulmonary embolus (PE) is a potentially devastating and fatal postoperative complication in morbidly obese patients. This\\u000a study was undertaken to review the safety and efficacy of retrievable prophylactic inferior vena cava (IVC) filters in high-risk\\u000a morbidly obese patients undergoing gastric bypass.\\u000a \\u000a \\u000a \\u000a Methods  Patients who underwent gastric bypass surgery and preoperative insertion of retrievable IVC filters had their records reviewed.\\u000a Indications for

Rob Schuster; Judith C. Hagedorn; Myriam J. Curet; John M. Morton

2007-01-01

292

Fibrin cap disruption: an adjunctive technique for inferior vena cava filter retrieval.  

PubMed

Various adjunctive techniques have been reported for challenging inferior vena cava (IVC) filter retrievals (1-4). One particularly challenging obstacle to successful IVC filter retrieval is the formation of a radiolucent fibrin cap over the embedded apex of the IVC filter. This obstacle is a result of filter tilting that creates turbulent blood flow, which promotes fibrin cap formation. The aim of this brief report is to depict a novel technique for IVC filter retrieval: guide wire-manipulated disruption of the fibrin cap. PMID:22920982

Esparaz, Anthony M; Ryu, Robert K; Gupta, Ramona; Resnick, Scott A; Salem, Riad; Lewandowski, Robert J

2012-09-01

293

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

Microsoft Academic Search

Purpose  To evaluate clinically the Günther temporary inferior vena cava (IVC) filter.\\u000a \\u000a \\u000a \\u000a Methods  Eleven IVC filters were placed in 10 patients. Indications for filter placement were surgical pulmonary embolectomy in seven\\u000a patients, pulmonary embolism in two patients, and free-floating iliofemoral thrombus in one patient. Eight filters were inserted\\u000a from the right femoral approach, three filters from the left. Follow-up was by plain

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

1997-01-01

294

The use of inferior vena cava filters in pediatric patients for pulmonary embolus prophylaxis  

Microsoft Academic Search

Purpose  To report our experience with inferior vena cava (IVC) filters in pediatric patients.\\u000a \\u000a \\u000a \\u000a Methods  Over a 19-month period, eight low-profile percutaneously introducible IVC filters were placed in four male and four female\\u000a patients aged 6–16 years (mean 11 years). Indications were contraindication to heparin in six patients, anticoagulation failure\\u000a in one, and idiopathic infrarenal IVC thrombosis in one. Six of the

Richard A. Reed; George P. Teitelbaum; Philip Stanley; Murray J. Mazer; Ina L. D. Tonkin; Nancy K. Rollins

1996-01-01

295

Rates and Predictors of Plans for Inferior Vena Cava Filter Retrieval in Hospitalized Patients  

Microsoft Academic Search

BACKGROUND  Use of inferior vena cava (IVC) filters has been increasing over time. However, because of the increased risk of deep vein\\u000a thrombosis with permanent filters, placement of retrievable filters has been recommended. Little is known about the factors\\u000a associated with planned retrieval of IVC filters.\\u000a \\u000a \\u000a \\u000a \\u000a OBJECTIVE  To describe rates and predictors of plans to retrieve IVC filters in hospitalized patients.\\u000a \\u000a \\u000a \\u000a DESIGN  We

John F. Mission; Robert K. Kerlan; Justin H. Tan; Margaret C. Fang

2010-01-01

296

Patient with a massive idiopathic thrombosis in the inferior vena cava.  

PubMed

A 50?year-old man with no significant medical history was admitted for dyspnea and left femoral swelling. Contrast-enhanced computed tomography revealed pulmonary thromboembolism (PTE) and a thrombus in the inferior vena cava (IVC). The thrombus extended from the proximal IVC to the left popliteal vein. Therefore, we decided that an IVC filter insertion was difficult to indicate. Urgent IVC and peripheral vein thrombectomy was performed under cardiopulmonary bypass. On postoperative day 1, venous ultrasonography showed residual deep vein thrombosis in the left external iliac-femoral vein and the popliteal vein. The IVC filter insertion was performed to prevent the recurrence of PTE. PMID:23555494

Kusuyama, Takanori; Iida, Hidetaka; Takeshita, Hiroaki; Wake, Ryotaro; Shimodozono, Shinichi; Kanamitsu, Hitoshi; Mitsui, Hideya; Yamada, Yukio

2012-01-01

297

Recurrent fracture of a recovery inferior vena cava filter with pulmonary migration.  

PubMed

Inferior vena cava (IVC) filters are indicated in patients with venous thromboembolic disease in whom standard anticoagulation therapy is contraindicated or ineffective. A 32-year-old female presented to our hospital with chest pain 5 years after IVC filter placement. Imaging revealed sequential fracturing and embolization of two of the IVC filter arms to the pulmonary arteries. IVC filter fracture and subsequent migration to the lung is a rare complication. Systematic long-term follow-up in patients with IVC filters and, if possible, filter removal should be considered to prevent possible complications. PMID:22737054

Vossen, Josephina Anna; Thawait, Shrey Kumar; Golia, Jennifer Susan; Chamarthy, Murthy; Cholewczynski, Walter; Velasco, Noel

2012-06-01

298

Percutaneous removal of a Bard Simon nitinol permanent inferior vena cava filter.  

PubMed

Inferior vena cava (IVC) filters are used to treat thromboembolic disease when there is a contraindication to anticoagulation or failure of therapeutic anticoagulation therapy. Although there are retrievable IVC filters available, permanent IVC filters remain the most commonly placed IVC filters worldwide. Permanent IVC filters have been associated with long-term complications such as IVC thrombosis and obstruction, migration, and erosion into surrounding structures. Such complications may require removal of permanent IVC filters, which has been previously described with open surgery involving venotomy of the IVC. We report a case of a Bard Simon Nitinol permanent IVC filter that was removed by using percutaneous endovascular techniques. PMID:23820181

Johnstone, Jill K; Fleming, Mark D; Costopoulos, Mark G; Bjarnason, Haraldur

2012-12-01

299

Successful Thrombolysis of Occluded Inferior Vena Cava Filter with IVC Syndrome.  

PubMed

Thrombosis of Inferior Vena Cava (IVC) following filter insertion can occur in up to 30% of the cases. The optimal management of such cases is unknown. We describe a simple and less expensive method of achieving successful recanalization of the IVC in a 40 year old hypertensive man who developed recurrent pulmonary embolism after his orthopedic treatment. An IVC filter was inserted, which developed extensive thrombosis of the whole IVC and venous system of the lower limbs. Catheter directed thrombolysis using a multiple side-hole multipurpose catheter and balloon angioplasty was carried out in order to "crush and lyse" the IVC thrombi. PMID:24250999

Srinivas, Bc; Pal Singh, Ajit

2012-01-01

300

Guide wire entrapment in a vena cava filter: techniques for dislodgement.  

PubMed

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 IVC filters, 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. In this article, we review the various preferred techniques reported in the literature for removal of the entrapped guide wire in particular situations, along with their indications, advantages, and disadvantages. We present simple useful recommendations to prevent this complication. PMID:23275482

Abdel-Aal, Ahmed K; Saddekni, Souheil; Hamed, Maysoon F

2013-02-01

301

A case of hepatic cyst-induced inferior vena cava thrombosis  

PubMed Central

A 92-year-old woman visited the hospital with edema of both lower extremities. Computed tomography revealed her inferior vena cava (IVC) was compressed by a massive hepatic cyst. A massive IVC thrombosis and pulmonary thromboembolism (PTE) were also observed. Medical treatment rather than radiologic intervention was preferred because of the patient’s advanced age and poor performance status. IVC thrombosis and PTE disappeared after 6 months of anticoagulation therapy. To the best of our knowledge, this is the first study in the English literature to report IVC thrombosis caused by congenital hepatic cysts that was treated without vascular intervention.

Moon, Jaecheol; Heo, Dahee; Han, Sanghoon

2014-01-01

302

Cement Embolus Trapped in the Inferior Vena Cava Filter during Percutaneous Vertebroplasty  

PubMed Central

A 58-year-old female patient, diagnosed with adenocarcinoma of the lung, underwent percutaneous vertebroplasty at the L4 vertebral body due to painful spinal metastases. Because of deep venous thrombosis of the left femoral and iliac veins, an inferior vena cava filter had been placed before vertebroplasty. Bone cement migrated into the venous bloodstream and then was being trapped within the previously placed filter. This case illustrates that caval filter could capture the bone cement and prevent it from migrating to the pulmonary circulation.

Li, Zhi; Zhao, Xin; Yang, Chao; Li, Ming-ming

2013-01-01

303

Deep venous thrombosis and inferior vena cava agenesis causing double crush sciatic neuropathy in Behçet's disease.  

PubMed

We report here the case of a 18-year-old young man with Behçet's disease who had suffered deep venous thrombosis of the right femoral and popliteal veins. Consequently, right sciatic nerve injury, drop foot and tightness of the achilles tendon also ensued. The clinical scenario was further challenged by demonstration of the agenetic inferior vena cava and epidural vein dilatations compressing the lumbar nerve roots. To the best notice of the authors, this is the first patient encompassing all these complications in the literature concerning Behçet's disease. PMID:18848486

Kara, Murat; Ozçakar, Levent; Eken, Güne?; Ozen, Gülsen; Kiraz, Sedat

2008-12-01

304

Primary retroperitoneal extraskeletal mesenchymal chondrosarcoma involving the vena cava: A case report  

PubMed Central

The current study presents a case of extraskeletal mesenchymal chondrosarcoma (ESMC) involving the vena cava that originally occurred in the retroperitoneum of a 61-year-old female. Following excision of the masses, pathological examination confirmed a diagnosis of primary ESMC. Mesenchymal chondrosarcomas are extremely rare in comparison to conventional chondrosarcomas and even more so when arising in an extraskeletal location. In the current report, the major characteristics of ESMC are discussed and a review of the current knowledge regarding this rare disease entity is presented.

HU, HUI-JUAN; LIAO, MEI-YAN; XU, LI-YING

2014-01-01

305

Placement of a vena cava filter in term pregnancy: case report and review of the literature.  

PubMed

During pregnancy there are hemostatic changes that may result in a hypercoagulable state producing thrombotic consequences. This condition may be aggravated in women who are carriers of congenital thrombophilic factors. These factors may increase obstetric complications such as miscarriages, fetal growth restriction, placental abruption and preeclampsia. Trombophilic factors may also cause venous thromboembolism, which is the leading cause of maternal morbidity and mortality. We report a case of a 22-year-old woman with factor V Leiden mutation, whose pregnancy was complicated with deep venous thrombosis requiring placement of a vena cava filter. PMID:21485739

Zeybek, B; Terek, M C; Guven, C; Cinar, C

2011-01-01

306

[Compression of the inferior vena cava with thrombus: a rare complication of solitary liver cyst].  

PubMed

Because of the increase of ultrasonographic exams, nonparasitic cyst of the liver is frequently encountered. Some giant cysts have complications. The surgical treatment for complicated forms consists in resection of the protruding part. We report a case of a giant non parasitic cyst of the liver which was responsible of a compression of the inferior vena caval with thrombus. The resection of the thrombus was performed after a double control of the vena cava and a control of the aorta. The fenestration of the cyst was performed in a second time. PMID:12538099

Lermite, E; Pessaux, P; Jousset, Y; Aubé, C; Regenet, N; Hennekinne-Mucci, S; Arnaud, J P

2002-12-01

307

125I Brachytherapy Seeds Implantation for Inoperable Low-Grade Leiomyosarcoma of Inferior Vena Cava  

PubMed Central

A 60-year-old female presented with abdominal pain and tenderness of five-day duration. Contrast enhanced CT showed a mass of 9 × 6 × 5.5 cm in size with almost complete obliteration of the inferior vena cava and massive extension to the extravascular space. CT-guided biopsy demonstrated a low-grade leiomyosarcoma. The patient underwent 125Iodine seeds implantation in two sessions, and another balloon cavoplasty. Abdominal pain and tenderness gradually improved and the patient continues to remain as disease free state for three years after the procedures.

Wang, Yongzheng; Liu, Bin; Li, Zheng; Wang, Wujie

2013-01-01

308

Inferior vena cava thrombosis following endovascular repair of acute aortocaval fistula: a word of caution.  

PubMed

Acute aortocaval fistula (ACF) is a rare, life-threatening condition with a complex clinical presentation, making prompt diagnosis challenging. Primary ACF is believed to be associated with abdominal aortic aneurysm (AAA) rupture in 80% of the cases. Thrombotic complications following endovascular repair for acute ACF are rare and less widely recognized. A high index of suspicion is required for diagnosis of this postoperative complication. We describe a novel, staged management approach using endovascular aortic stent grafts (Gore Excluder; Flagstaff, CA) in both the abdominal aorta and the inferior vena cava (IVC) in a patient with a ruptured AAA and acute ACF with subsequent acute IVC thrombosis. PMID:23709272

Bernstein, Jeffrey; Jimenez, Juan Carlos

2013-08-01

309

Giant liposarcoma elongating mediastinal vessels with intrathoracic inferior vena cava replacement.  

PubMed

Intrathoracic infiltration of the inferior vena cava (IVC) is rare; mobilization and prosthetic replacement may increase the risk of cardiac arrest and postoperative complications. We report a case of a giant liposarcoma which elongated and grew around the IVC, invading both hemithoraces. The removal of this mass required a bypass between the left femoral and ipsilateral axillary vein to guarantee an adequate venous return. The IVC was replaced by a polytetrafluoroethylene prosthesis. A postoperative paralysis of patient's lower limbs occurred. Hypotension or involvement of aberrant medullary artery origin could be responsible for this complication. PMID:23509230

Billè, Andrea; Garofalo, Giuseppe; Leo, Francesco; Pastorino, Ugo

2013-09-01

310

78 FR 21116 - Superior Supplier Incentive Program  

Federal Register 2010, 2011, 2012, 2013

...Assessment of contractors for designation as Superior Suppliers will be conducted by teams consisting of members from the DoN's Echelon II contracting activities. These contracting activities are identified in Defense Federal Acquisition Regulation...

2013-04-09

311

Reducción y reciclaje de residuos sólidos urbanos en centros de educación superior: Estudio de caso  

Microsoft Academic Search

The municipal waste generated by CINVESTAV-Mérida was characterized for a period of three years. The municipal solid waste was composed of 48 % organics; 20% cardboard and paper; 8 % soft drinks or purified water plastic bottles (polyethylene terephthalate, PET) and diverse plastics; 5 % glass bottles or containers and broken laboratory glass; 2 % aluminium cans, and 17 %

L. Maldonado

2006-01-01

312

Interventional approaches in VTE treatment (vena cava filters, catheter-guided thrombolysis, thrombosuction).  

PubMed

Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is the third most common cardiovascular pathology after coronary disease and cerebrovascular diseases and is responsible for significant morbidity and mortality in the general population. Full-dose anticoagulation is the standard therapy for VTE, both the acute phase and the prolonged treatment. The latest guidelines of the American College of Chest Physicians recommend treatment with a full-dose of unfractionated heparin (UFH), low-molecular-weight-heparin (LMWH), fondaparinux, vitamin K antagonist (VKA), or systemically administered thrombolytics for most of the patients with objectively confirmed VTE. Catheter-guided thrombolysis and thrombosuction are interventional approaches that should be used only in selected populations; interruption of the inferior vena cava (IVC) with a filter can be performed to prevent life-threatening PE in patients with VTE and contraindications to anticoagulant treatment, bleeding complications during antithrombotic treatment, or VTE recurrences, despite optimal anticoagulation. This review summarizes the currently available literature regarding interventional approaches in VTE treatment (vena cava filters, catheter-guided thrombolysis, thrombosuction), discusses their efficacy and safety, and reviews the appropriate indications for their use in daily clinical practice. PMID:22648490

Imberti, Davide; Maraldi, Cinzia; Gallerani, Massimo

2012-04-01

313

Modeling hemodynamics in an unoccluded and partially occluded inferior vena cava under rest and exercise conditions.  

PubMed

Pulmonary embolism is the third leading cause of death in hospitalized patients in the US. Vena cava filters are medical devices inserted into the inferior vena cava (IVC) and are designed to trap thrombi before they reach the lungs. Once trapped in a filter, however, thrombi disturb otherwise natural flow patterns, which may be clinically significant. The goal of this work is to use computational modeling to study the hemodynamics of an unoccluded and partially occluded IVC under rest and exercise conditions. A realistic, three-dimensional model of the IVC, iliac, and renal veins represents the vessel geometry and spherical clots represent thombi trapped by several conical filter designs. Inflow rates correspond to rest and exercise conditions, and a transitional turbulence model captures transitional flow features, if they are present. The flow equations are discretized and solved using a second-order finite-volume method. No significant regions of transitional flow are observed. Nonetheless, the volume of stagnant and recirculating flow increases with partial occlusion and exercise. For the partially occluded vessel, large wall shear stresses are observed on the IVC and on the model thrombus, especially under exercise conditions. These large wall shear stresses may have mixed clinical implications: thrombotic-like behavior may initiate on the vessel wall, which is undesirable; and thrombolysis may be accelerated, which is desirable. PMID:22354383

Ren, Zhuyin; Wang, Stephen L; Singer, Michael A

2012-03-01

314

Alleviating Effects of Baechu Kimchi Added Ecklonia cava on Postprandial Hyperglycemia in Diabetic Mice  

PubMed Central

In this study, we investigated the inhibitory effects of Baechu kimchi added Ecklonia cava on the activities of ?-glucosidase and ?-amylase and its alleviating effect on the postprandial hyperglycemia in STZ-induced diabetic mice. Baechu kimchi added Ecklonia cava (BKE, 15%) was fermented at 5°C for 28 days. Optimum ripened BKE was used in this study as it showed the strongest inhibitory activities on ?-glucosidase and ?-amylase by fermentation time among the BKEs in our previous study. The BKE was extracted with 80% methanol and the extract solution was concentrated, and then used in this study. The BKE extract showed higher inhibitory activities than Baechu kimchi extract against ?-glucosidase and ?-amylase. The IC50 values of the BKE extract against ?-glucosidase and ?-amylase were 0.58 and 0.35 mg/mL, respectively; BKE exhibited a lower ?-glucosidase inhibitory activity but a higher ?-amylase inhibitory activity than those of acarbose. The BKE extract alleviated postprandial hyperglycemia caused by starch loading in normal and streptozotocin-induced diabetic mice. Furthermore, the BKE extract significantly lowered the incremental area under the curve in both normal and diabetic mice (P<0.05). These results indicated that the BKE extract may delay carbohydrate digestion and thus glucose absorption.

Lee, Hyun-Ah; Song, Yeong-Ok; Jang, Mi-Soon; Han, Ji-Sook

2013-01-01

315

Alleviating Effects of Baechu Kimchi Added Ecklonia cava on Postprandial Hyperglycemia in Diabetic Mice.  

PubMed

In this study, we investigated the inhibitory effects of Baechu kimchi added Ecklonia cava on the activities of ?-glucosidase and ?-amylase and its alleviating effect on the postprandial hyperglycemia in STZ-induced diabetic mice. Baechu kimchi added Ecklonia cava (BKE, 15%) was fermented at 5°C for 28 days. Optimum ripened BKE was used in this study as it showed the strongest inhibitory activities on ?-glucosidase and ?-amylase by fermentation time among the BKEs in our previous study. The BKE was extracted with 80% methanol and the extract solution was concentrated, and then used in this study. The BKE extract showed higher inhibitory activities than Baechu kimchi extract against ?-glucosidase and ?-amylase. The IC50 values of the BKE extract against ?-glucosidase and ?-amylase were 0.58 and 0.35 mg/mL, respectively; BKE exhibited a lower ?-glucosidase inhibitory activity but a higher ?-amylase inhibitory activity than those of acarbose. The BKE extract alleviated postprandial hyperglycemia caused by starch loading in normal and streptozotocin-induced diabetic mice. Furthermore, the BKE extract significantly lowered the incremental area under the curve in both normal and diabetic mice (P<0.05). These results indicated that the BKE extract may delay carbohydrate digestion and thus glucose absorption. PMID:24471127

Lee, Hyun-Ah; Song, Yeong-Ok; Jang, Mi-Soon; Han, Ji-Sook

2013-09-01

316

Right Double Inferior Vena Cava (IVC) with Preaortic Iliac Confluence - Case Report and Review of Literature  

PubMed Central

Anomalies of the inferior vena cava (IVC) are uncommon and most of them remain asymptomatic. Though rare, anomalies of IVC can lead to severe hemorrhagic complications especially during aortoiliac surgery. Prior knowledge of these variations facilitates proper interpretation of radiological images and safe performance of interventional procedures and surgeries. During routine anatomical dissection of abdomen in a female cadaver we observed the presence of right sided duplication of IVC. Both IVCs were present on the right side of abdominal aorta, one ventral and the other more dorsal in position and named ventral right IVC and dorsal right IVC. The ventrally and medially placed IVC, which appeared to be the main IVC was formed by the union of two common iliac veins in front of the right common iliac artery (Preaortic iliac confluence-“Marsupial Cava”). The right external iliac vein continued as the more dorsally and laterally placed dorsal right IVC. The right internal iliac vein after receiving a transverse anastomotic vein from the external iliac continued as the right common iliac vein. This transverse anastomosis was present behind the right common iliac artery. The narrower dorsal right IVC joined the wider ventral right IVC just below the level of renal veins to form a single IVC. The abdominal aorta presented a convexity to the left.

Babu, C.S. Ramesh; Lalwani, Rekha; Kumar, Indra

2014-01-01

317

Pancreatic and multiorgan resection with inferior vena cava reconstruction for retroperitoneal leiomyosarcoma  

PubMed Central

Background Inferior vena cava (IVC) leiomyosarcoma is a rare tumor of smooth muscle origin. It is often large by the time of diagnosis and may involve adjacent organs. A margin-free resection may be curative, but the resection must involve the tumor en bloc with the affected segment of vena cava and locally involved organs. IVC resection often requires vascular reconstruction, which can be done with prosthetic graft. Case presentation We describe a 39-year-old man with an IVC leiomyosarcoma that involved the adrenal gland, distal pancreas, and blood supply to the spleen and left kidney. Tumor excision involved en bloc resection of all involved organs with reimplantation of the right renal vein and reconstruction of the IVC with a polytetrafluoroethylene graft. The patient recovered without renal insufficiency, graft infection, or other complications. Follow-up abdominal imaging at 1 year showed a patent IVC graft and no locally recurrent tumor. Prosthetic graft provides a sufficient diameter and length for replacement conduit in extensive resection of IVC leiomyosarcoma. Conclusion To our knowledge, this is the first case of resection of an IVC sarcoma with prosthetic graft reconstruction in combination with pancreatic resection. Aggressive surgical resection including vascular reconstruction is warranted for select IVC tumors to achieve a potentially curative outcome.

Stauffer, John A; Fakhre, G Peter; Dougherty, Marjorie K; Nakhleh, Raouf E; Maples, William J; Nguyen, Justin H

2009-01-01

318

Excessive venous bleeding in a patient with acetabular pelvic fracture secondary to inferior vena cava filter occlusion.  

PubMed

Inferior vena cava (IVC) filters can be used to prevent pulmonary embolism in cases where anticoagulation is contraindicated. Filter obstruction remains one of the major complications after its insertion. This is the rare case demonstrating excessive venous bleeding during attempted open reduction internal fixation of an acetabular fracture secondary to subcomplete IVC filter thrombosis day 1 postinsertion of the device. PMID:23203175

Nahas, Sam; Yeoh, Clarence; Velayudham, Senthil

2012-01-01

319

The Inferior Vena Cava Filter is Effective in Preventing Fatal Pulmonary Embolus After Hip and Knee Arthroplasties  

Microsoft Academic Search

Thromboembolic disease is a relatively common and potentially devastating complication of joint arthroplasty. Mechanical and chemical prophylaxes are effective in reducing the incidence of this complication. Inferior vena cava (IVC) filters have been used to prevent the propagation and\\/or migration of venous emboli into the pulmonary circulation. This article reports on a cohort of joint arthroplasty patients either with confirmed

Matthew S. Austin; Javad Parvizi; Seth Grossman; Camilo Restrepo; Gregg R. Klein; Richard H. Rothman

2007-01-01

320

Catheter-directed thrombolysis for double inferior vena cava with deep venous thrombosis: A case report and literature review.  

PubMed

Double inferior vena cava (DIVC) with deep venous thrombosis (DVT) is rare, and there is only one reported case of DIVC with DVT treated by catheter-directed thrombolysis. We report a case of a 32-year-old man with an extensive venous clot involving the infrarenal segment of a double IVC who received filter implantation and catheter-directed thrombolysis. PMID:23761872

Wang, Xiaodong; Chen, Zhengxin; Cai, Qianrong

2013-05-17

321

"Acute pseudo-pericardial tamponade": the compression of the thoracal inferior vena cava--a case report.  

PubMed

We describe a case of 68-year-old woman which was admitted to our hospital for mitral valve replacement (MVR), in whom acute compression of the vena cava inferior developed after repair of lacerated atrio-caval junction with hemostatic tissue sealant, biologic glue (BioGlue, Cryolife, inc, Kennesaw, Ga). Removal of the BioGlue relieved the unexpected problem. PMID:19239687

Cavolli, Raif; Kaya, Kaan; Elalmis, Altay Omer

2009-01-01

322

Exploring the superior colliculus in vitro.  

PubMed

The superior colliculus plays an important role in the translation of sensory signals that encode the location of objects in space into motor signals that encode vectors of the shifts in gaze direction called saccades. Since the late 1990s, our two laboratories have been applying whole cell patch-clamp techniques to in vitro slice preparations of rodent superior colliculus to analyze the structure and function of its circuitry at the cellular level. This review describes the results of these experiments and discusses their contributions to our understanding of the mechanisms responsible for sensorimotor integration in the superior colliculus. The experiments analyze vertical interactions between its superficial visuosensory and intermediate premotor layers and propose how they might contribute to express saccades and to saccadic suppression. They also compare and contrast the circuitry within each of these layers and propose how this circuitry might contribute to the selection of the targets for saccades and to the build-up of the premotor commands that precede saccades. Experiments also explore in vitro the roles of extrinsic inputs to the superior colliculus, including cholinergic inputs from the parabigeminal and parabrachial nuclei and GABAergic inputs from the substantia nigra pars reticulata, in modulating the activity of the collicular circuitry. The results extend and clarify our understanding of the multiple roles the superior colliculus plays in sensorimotor integration. PMID:19710376

Isa, Tadashi; Hall, William C

2009-11-01

323

Acute pancreatitis and superior mesenteric artery syndrome.  

PubMed

Superior mesenteric artery syndrome (SMAS) has been proposed as a rare cause of proximal bowel obstruction resulting from compression of the third portion of the duodenum secondary to narrowing of the space between the aorta and superior mesenteric artery. The main risk factors associated with SMAS are significant weight loss, corrective spinal surgery and congenital or acquired anatomic abnormalities. Its association with acute pancreatitis has been reported in very few cases. We present a critical review of this topic, with the report of a patient allegedly diagnosed of SMAS and acute pancreatitis. PMID:24641461

Sihuay-Diburga, Denisse Joan; Accarino-Garaventa, Anna; Vilaseca-Montplet, Jaime; Azpiroz-Vidaur, Fernando

2013-01-01

324

No-touch en bloc right lobe living-donor liver transplantation with inferior vena cava replacement for hepatocellular carcinoma close to retrohepatic inferior vena cava: case report.  

PubMed

Current studies have shown that living-donor liver transplantation (LDLT) for hepatocelluar carcinoma (HCC) satisfying the Milan criteria does not compromise patient survival or increase HCC recurrence compared with deceased-donor liver transplantation (DDLT). For patients with HCC beyond the Milan criteria, however, worse outcomes are expected after LDLT than after DDLT, despite insufficient data to reach a conclusion. Regarding operative technique, LDLT might be a less optimal cancer operation for HCC located at the hepatic vein confluence and/or paracaval portion. The closeness to the wall of the retrohepatic inferior vena cava (IVC) is greater than in conventional DDLT, rendering it difficult to perform a no-touch en bloc total hepatectomy. An LDLT, which must preserve the native IVC for the piggyback technique during engraftment, may lead to tumor remnants. To reduce recurrences after LDLT, we successfully performed a no-touch en bloc total hepatectomy including the retrohepatic IVC and all 3 hepatic veins. IVC replacement with an artificial vascular graft together with a modified right-lobe LDLT was performed for a patient having advanced HCC close to the hepatic vein confluence and paracaval portion. There was no artificial vascular graft-related complication, such as thrombosis or infection. Despite the limitations of LDLT, requiring the piggyback technique for graft implantation, IVC replacement using an artificial graft led us to perform a no-touch en bloc total hepatectomy as with a conventional DDLT. PMID:24157050

Moon, D-B; Lee, S-G; Hwang, S; Kim, K-H; Ahn, C-S; Ha, T-Y; Song, G-W; Jung, D-H; Park, G-C; Namkoong, J-M; Park, H-W; Park, Y-H; Park, C-S

2013-10-01

325

Superior Semicircular Canal Dehiscence: Auditory Mechanisms  

Microsoft Academic Search

Superior semicircular canal dehiscence (SCD) syndrome aords a unique oppor- tunity to study a novel pathology in otolaryngology (rst dened in 1998) and the mechanisms by which it aects hearing. Patients with SCD syndrome present with a wide variety of symptoms: some present with vestibular symptoms (vertigo, oscillosp- sia, disequilibrium) others present with auditory symptoms (autophony, hyperacusis, low frequency conductive

Jocelyn Songer

2004-01-01

326

COSEE Superior Creates Passion for Science  

EPA Science Inventory

COSEE was a transformative educational experience that has changed the way I teach. In July, I participated in the COSEE Lake Superior Shipboard and Shoreline Science program. I spent a week on the US EPA?s R/V Lake Guardian with 14 other teachers and a crew of sailors and scient...

327

Significant Reading Experiences of Superior English Students.  

ERIC Educational Resources Information Center

Superior high school students (975 finalists in the NCTE Achievement Awards Program) were surveyed to find what one book was most significant to each of them in their high school experiences, and the reason for the significance. In response to questionnaires, the students cited 416 different titles, 72% of which were novels. The top 10 books were…

Whitman, Robert S.

1964-01-01

328

The Superior Ophthalmic Vein in Carotid Angiograms  

Microsoft Academic Search

Examination of routine carotid angiograms from 1,000 patients gave 52 definite and 80 possible cases in which the superior ophthalmic vein was filled with contrast medium. Only one of these cases suffered from sinus thrombosis. In the other cases no certain correlation could be found between the angiographic or clinical diagnosis and the filling of the orbital vein. However, the

M. Brüderlin; R. Wüthrich

1973-01-01

329

Ecology of Lake Superior: Preface and Prospectus  

EPA Science Inventory

This Special Issue of Aquatic Ecosystem Health and Management (AEHM) is the first of a two-volume set based on papers presented at a three-day International Conference in Duluth MN held in June 2010, and titled ?Ecology of Lake Superior: Integrated Approaches and Challenges for t...

330

Mig Alley: The Fight for Air Superiority.  

National Technical Information Service (NTIS)

The fight for air superiority began the day the Korean War started and only ended with the armistice 3 years later. Once the shock of the North Koreans' invasion wore off, it did not take long for the United States Air Force, assisted by other United Nati...

W. T. Y'Blood

2000-01-01

331

Superior mesenteric artery dissection: Case report  

Microsoft Academic Search

Spontaneous dissections of the superior mesenteric artery are exceptional events because only 26 reports have been published. We present a new case, revealed with an acute abdominal syndrome. Computed tomographic angiography and arteriography allowed a rapid diagnosis and urgent surgical intervention. Progress in imagery makes diagnosis and follow-up examination easier. Surgery is indicated for acute symptomatic forms with suspicion of

Yann Gouëffic; Alain Costargent; Marie-Françoise Heymann; Philippe Chaillou; Philippe Patra

2002-01-01

332

Isolated dissection of the superior mesenteric artery  

Microsoft Academic Search

Dissection of the superior mesenteric artery (SMA) not associated with aortic dissection is rare. The purpose of this study is to describe the computed tomographic (CT) findings of this condition. We studied the CT findings of six patients with isolated dissection of the SMA. CT demonstrated thrombosis of the false lumen or intramural hematoma ( n = 4) and\\/or intimal

S. Suzuki; S. Furui; H. Kohtake; T. Sakamoto; M. Yamasaki; A. Furukawa; K. Murata; R. Takei

2004-01-01

333

Spontaneous Dissection of the Superior Mesenteric Artery  

Microsoft Academic Search

Spontaneous dissection of the superior mesenteric artery (SMA) is a rare occurrence, especially when not associated with aortic dissection [1]. Currently, only 28 cases appear to have been reported. Due to the scarcity of cases in the literature, the natural history of isolated, spontaneous SMA dissection is unclear. CT has been reported to be useful for the initial diagnosis of

Patrick J. Sheldon; James B. Esther; Elana L. Sheldon; Steven R. Sparks; David P. Brophy; Steven B. Oglevie

2001-01-01

334

[Isolated dissection of the superior mesenteric artery].  

PubMed

Isolated spontaneous dissection of the superior mesenteric artery is uncommon. We report a case complicated by arterial rupture and discuss diagnostic imaging work-up. Diagnosis is usually made by conventional arteriography. But, dissection can also be diagnosed noninvasively by computed tomography angiography and ultrasound. PMID:12910178

Gomez, M-A; Tchokonte, M; Delhommais, A; Bretagnol, F; Bleuet, F; Besson, M; Roger, R; Alison, D

2003-06-01

335

Perturbation Resilience and Superiorization of Iterative Algorithms  

PubMed Central

Iterative algorithms aimed at solving some problems are discussed. For certain problems, such as finding a common point in the intersection of a finite number of convex sets, there often exist iterative algorithms that impose very little demand on computer resources. For other problems, such as finding that point in the intersection at which the value of a given function is optimal, algorithms tend to need more computer memory and longer execution time. A methodology is presented whose aim is to produce automatically for an iterative algorithm of the first kind a “superiorized version” of it that retains its computational efficiency but nevertheless goes a long way towards solving an optimization problem. This is possible to do if the original algorithm is “perturbation resilient,” which is shown to be the case for various projection algorithms for solving the consistent convex feasibility problem. The superiorized versions of such algorithms use perturbations that steer the process in the direction of a superior feasible point, which is not necessarily optimal, with respect to the given function. After presenting these intuitive ideas in a precise mathematical form, they are illustrated in image reconstruction from projections for two different projection algorithms superiorized for the function whose value is the total variation of the image.

Censor, Y; Davidi, R; Herman, G T

2010-01-01

336

Melanocyte-Stimulating Hormone Plasma Levels and Environmental Illumination in the Cuttlefish, Sepia officinalis: A Role for the Neurosecretory System of the Vena Cava in Cephalopods  

Microsoft Academic Search

A melanotropin-like peptide (?-melanocyte-stimulating hormone or ?-MSH) is suggested to be released into the circulatory system of cephalopods via the neurosecretory system of the vena cava or NSV, where neurosecretory vesicles contained within the axons of the NSV-neuropil on the inner surface of the vena cava lie in close contact with the venous circulation. Radioimmunoassay of blood plasma samples taken

Christopher S. Cobb; Juriaan R. Metz; Gert Flik; Roddy Williamson

2002-01-01

337

A huge metastatic liver tumor from leiomyosarcoma of the inferior vena cava: report of a case.  

PubMed

Leiomyosarcoma of the inferior vena cava (IVC) is a rare malignant tumor, and only a few cases of the resection of IVC leiomyosarcomas with synchronous liver metastases have been reported. This report describes a female patient who initially presented with a solitary, huge liver tumor and a retroperitoneal tumor. Following our preoperative diagnosis of primary liver cancer with a retroperitoneal lymph node metastasis, the patient underwent combined resection of both tumors. The surgical findings revealed that the retroperitoneal tumor originated from the IVC wall. The pathological and immunohistochemical findings revealed that both tumors were leiomyosarcomas. Although the liver tumor was much larger than the IVC tumor, we considered that the metastatic liver tumor arose from the IVC leiomyosarcoma. This was an instructive case because the metastatic liver tumor from the IVC leiomyosarcoma was so large as to be mistaken for a primary liver tumor. PMID:22127537

Hashimoto, Masakazu; Kobayashi, Tsuyoshi; Tashiro, Hirotaka; Amano, Hironobu; Oshita, Akihiko; Tanimoto, Yoshisato; Kuroda, Shintaro; Tazawa, Hirofumi; Aikata, Hiroshi; Chayama, Kazuaki; Fujii, Masayoshi; Arihiro, Koji; Ohdan, Hideki

2012-05-01

338

Inferior vena cava filter thrombosis: a review of current concepts, evidence, and approach to management.  

PubMed

The increased risk of venous thrombosis within and below the inferior vena cava (IVC) is the main long-term complication of IVC filter placement. In this article, we discuss current concepts regarding the incidence, risks, and management of IVC filter thrombosis. Evidence of the association of each of the following factors is reviewed: type and design of the filter device, population demographics, underlying hypercoagulable states/anticoagulation, modality used to assess for thrombosis, and length of time elapsed since filter placement. Certain double-basket filter designs and a hypercoagulable state are associated with increased incidence of IVC filter thrombosis. Most cases of IVC filter thrombosis are asymptomatic. While large series data on the use of magnetic resonance imaging for the detection of filter thrombosis remain unavailable, evidence suggests that contrast-enhanced computed tomography is preferable to Doppler sonography. A proposed algorithm for the management of IVC filter thrombosis is provided. PMID:21881395

Habito, Cicero R; Kalva, Sanjeeva P

2011-08-01

339

Inferior vena cava filter use as pulmonary embolism prophylaxis in trauma.  

PubMed

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in trauma. What is known regarding VTE prophylaxis has been extrapolated from nontrauma data. Optimal methods of VTE prevention for trauma remain controversial and unknown. Trauma patients are unique and heterogeneous rendering many forms of treatment inappropriate. The most fatal complication of VTE is a pulmonary embolism (PE). There is a long history of protection against PE as vena caval interruption. Inferior vena cava (IVC) filters were designed to protect against PE. Since the approval by the Food and Drug Administration for the use of retrievable filters, trauma care specialists are increasingly choosing this form of prophylaxis. Indications for use, efficacy, and safety of IVC filters remain debated. There is lack of rigor in studies concerning IVC filters. Filters are not without complications. Removal rates for retrievable filters are poor. Nursing is instrumental in IVC filter prophylaxis, efficacy, and safety success. PMID:21422890

Welle, Mary Kay

2011-01-01

340

Benefit vs. Risk of a Permanent Inferior Vena Cava Filter in Pulmonary Embolism with Anticoagulation Contraindication  

PubMed Central

ABSTRACT Cases of pulmonary embolism (PE) with contraindication of anticoagulation have low incidence. Under these circumstances the placement of an inferior vena cava (IVC) filter may be life-saving. Paradoxically, the presence of the filter imposes anticoagulation itself, due to the risk of filter thrombosis, promoting stasis and increasing the risk of filter related deep venous thrombosis (DVT) and PE recurrence by means of a substantial collateral venous return that bypasses the IVC filter (1,2). We present the case of a woman with DVT, complicated with high risk PE. After thrombolysis with alteplase the patient develops retroperitoneal hematoma originating from undiagnosed renal angiomyolipoma. Therefore long term anticoagulation is considered contraindicated and an IVC filter is installed. Shortly after hospital release the patient presents occlusion of the IVC filter with DVT recurrence. The initiation of low molecular weight heparin and afterwards of acenocumarol has a favorable outcome, and after six months of follow up the patient is completely recovered.

CALIN, Ionela-Simona; MAGDA, Lucia-Stefania; CINTEZA, Mircea

2013-01-01

341

Inferior vena cava filtration in the management of venous thromboembolism: filtering the data.  

PubMed

Venous thromboembolism (VTE) is a common cause of morbidity and mortality. This is especially true for hospitalized patients. Pulmonary embolism (PE) is the leading preventable cause of in-hospital mortality. The preferred method of both treatment and prophylaxis for VTE is anticoagulation. However, in a subset of patients, anticoagulation therapy is contraindicated or ineffective, and these patients often receive an inferior vena cava (IVC) filter. The sole purpose of an IVC filter is prevention of clinically significant PE. IVC filter usage has increased every year, most recently due to the availability of retrievable devices and a relaxation of thresholds for placement. Much of this recent growth has occurred in the trauma patient population given the high potential for VTE and frequent contraindication to anticoagulation. Retrievable filters, which strive to offer the benefits of permanent filters without time-sensitive complications, come with a new set of challenges including methods for filter follow-up and retrieval. PMID:23997414

Molvar, Christopher

2012-09-01

342

Inferior vena cava filters for primary prophylaxis: when are they indicated?  

PubMed

Over the past several years there has been a rapid increase in the number of inferior vena cava (IVC) filters placed for primary thromboprophylaxis. Increased use has occurred in settings where other methods of thromboprophylaxis are viewed to be inadequate, technically challenging, or that place patients at an unacceptably high bleeding risk. These clinical services include trauma, bariatric surgery, neurosurgery, cancer, intensive care unit populations, and patients with a relative contraindication to anticoagulation. We review the studies to date addressing filter placement for these indications. Although preliminary data are promising, the patient populations most likely to benefit from prophylactic IVC filter placement have not been well defined, and randomized studies demonstrating efficacy have not been conducted. Moving forward, it will be critical to accomplish these two tasks if IVC filters are to continue to have a role in primary thromboprophylaxis. PMID:23450194

Wehrenberg-Klee, Eric; Stavropoulos, S William

2012-03-01

343

Foam aptitude of trepat and monastrell red varieties in cava elaboration. 2. Second fermentation and aging.  

PubMed

The foam properties of sparkling wines (Cava) made from two red autochthonous grape varieties, Trepat and Monastrell, and coupages, including different percentages of them, were studied during second fermentation and aging. The effect of second fermentation on foam gave the highest decreases when the base wines had the highest foam values, while gave the lowest decreases or even increases for the base wines with the lowest foam characteristics. However, the greater the HM and Sigma of the base wine, the greater the foam values of the sparkling wine. Base wine determinations for quality control in cellars could provide information about future sparkling wine foaming. Acidity parameters, ethanol, sulfur, and polysaccharides contents were correlated to foam characteristics in the sparkling wines. In terms of color and foaming, wines made from the red varieties Trepat and Monastrell blended with white variety wines could be appropriate for elaborating "blanc de noirs" sparkling wines. PMID:12236684

Girbau-Solà, T; López-Barajas, M; López-Tamames, E; Buxaderas, S

2002-09-25

344

Diagnostic imaging and pacemaker implantation in a domestic goat with persistent left cranial vena cava.  

PubMed

Difficulty was encountered with the insertion of a right atrial pacing lead via the left jugular vein during lead and pacemaker implantation in a clinically normal goat as part of an ongoing rapid atrial pacing - induced atrial fibrillation research project. Fluoroscopic visualization of an abnormal lead advancement path prompted angiographic assessment which revealed a persistent left cranial vena cava (PLCVC) and prominent coronary sinus communicating with the right atrium. Angiography facilitated successful advancement and securing of the pacing lead into the right side of the interatrial septum. Cardiac magnetic resonance imaging/magnetic resonance angiography (MRI/MRA) allowed further characterization of this rare venous anomaly. Even though PLCVC has been reported once in a goat, to the authors' knowledge this is the first report to include MRI/MRA characterization of PLCVC and prominent coronary sinus with successful cardiac pacemaker implantation using the PLCVC. PMID:24480717

Ranjan, Ravi; Dosdall, Derek; Norlund, Layne; Higuchi, Koji; Silvernagel, Joshua M; Olsen, Aaron L; Davies, Christopher J; MacLeod, Rob; Marrouche, Nassir F

2014-03-01

345

[Leiomyosarcoma of the inferior vena cava: a case report and review].  

PubMed

A 37-year-old woman with an incidentally found abdominal mass was referred to our hospital. A fixed, non-tender mass was palpated in the right upper quadrum of her abdomen. There was no elevation of tumor markers. Computed tomography revealed a mass extending from the hepatic vein level to renal hilar level. The tumor completely obstructed the inferior vena cava (IVC). T1-weighted magnetic resonance imaging (MRI) showed that the mass was isointense with muscles. T2-weighted MRI image with contrast medium demonstrated collateral circulation. Upon diagnosis of the IVC tumor, we removed the right kidney and the tumor en bloc without reconstructing IVC. The tumor diameter was 11.6 × 5.5 × 4.7 cm. Pathological examination established a diagnosis of IVC leiomyosarcoma. She is alive without sign of recurrence after operation for seven months. There were 143 reports of IVC leiomyosarcoma in Japan. In 31% of them, IVC was not reconstructed. PMID:24759496

Yo, Toeki; Taoka, Rikiya; Hanasaki, Takeshi; Nakanishi, Yukako; Togo, Yoshikazu; Suzuki, Toru; Higuchi, Yoshihide; Zozumi, Masataka; Hirota, Seiichi; Kanematsu, Akihiro; Nojima, Michio; Yamamoto, Shingo

2014-03-01

346

Concomitant reconstruction of infrarenal aorta and inferior vena cava after en bloc resection of retroperitoneal rhabdomyosarcoma.  

PubMed

Adult paratesticular rhabdomyosarcoma (PRMS) with invasion of the retroperitoneum and involvement of the infrarenal aorta and inferior vena cava (IVC) is rare. We describe a 23-year-old male diagnosed with PRMS in 2008, previously treated with right orchiectomy, chemotherapy, and radiation, who presented with new onset of lower back pain. Computed tomography (CT) scan revealed a 4.8 × 4.2 cm mass involving both the infrarenal aorta and the IVC. We resected the tumor en bloc with in situ reconstruction of the aorta utilizing a Dacron graft and the IVC with a bovine pericardium roll graft. His postoperative period was uneventful, and he was discharged on postoperative day 6 in stable condition. At 2-month follow-up, the patient recovered well from the surgery, patent grafts on CT scan with no clinical signs of lower extremity ischemia or edema, and he continues to receive cycles of chemotherapy. PMID:21914678

Anaya-Ayala, Javier E; Cheema, Zulfiqar F; Davies, Mark G; Lumsden, Alan B; Reardon, Michael J

2011-11-01

347

Localized pleural mesothelioma causing cranial vena cava syndrome in a dog.  

PubMed

A 9-year-old female crossbred dog was presented to the Hospital Universitario Veterinario Rof Codina (Universidad de Santiago de Compostela, Lugo, Spain) for acute onset of severe, progressive swelling of the head, neck, and cranial trunk. Survey radiographs and ultrasonography revealed a large, heterogeneous mass in the cranial mediastinum, compressing or growing into a large blood vessel within the cranial mediastinum and displacing the heart dorsocaudally. At postmortem examination, the mass was diagnosed as a large, localized mesothelioma. Localized mesotheliomas are rare neoplasms in dogs but should be considered as a possible differential diagnosis for cranial vena cava syndrome. The anatomic distribution and clinical features of mesothelioma in the present report are similar to other cases in humans. PMID:20224100

Espino, Luciano; Vazquez, Sonia; Faílde, Daniel; Barreiro, Andres; Miño, Natalia; Goicoa, Ana

2010-03-01

348

Inferior vena cava duplication and deep venous thrombosis: case report and review of literature.  

PubMed

Duplications of the inferior vena cava (IVC) are seen with an incidence of 0.2% to 3.0%. Duplications causing symptoms are rare, with only six reported cases of IVC duplication associated with a deep venous thrombosis. We present a 78-year-old caucasian woman with an IVC duplication who developed a deep venous thrombosis. The etiologies of IVC duplication include failure of anastomosis between the primitive cardinal veins and failure of regression of the left supracardinal vein. When asymptomatic, treatment includes observation, placing filters in both systems, or coil-embolization of the duplicated segment plus placing a filter in the right IVC. For our patient, we chose to coil-embolize the communication to the duplicated segment as well as place a filter in the main right IVC system. PMID:16034513

Anne, Nirupama; Pallapothu, Ratnakishore; Holmes, Raymond; Johnson, Moses Degraft

2005-09-01

349

Radiographic features of intraluminal leiomyosarcoma of the inferior vena cava: an atypical case report.  

PubMed

We encountered a 74-year-old woman with a chief complaint of progressive right-sided back pain for more than 1 month. Physical examination and laboratory tests revealed no abnormalities. Multislice computed tomography (MSCT) showed dilatation of the inferior vena cava (IVC). An intraluminal mass of about 8.1 × 5.5 × 3.6 cm in size was found in the IVC, with big central necrosis and irregular peripheral enhancement. The tumor arose from the IVC just beneath the renal vein and reached the iliac bifurcation. Cavography demonstrated a filling defect with complete occlusion of the IVC and extensive collateral circulation. The patient underwent complete resection of tumor and vascular prosthetic graft. Pathological diagnosis was leiomyosarcoma. Because of its low incidences and atypical appearance, we highlight the significance of the imaging feature in its diagnosis in this article. PMID:21212948

Mu, Dan; Wang, Dongmei; Zhou, Kefeng; Zhu, Bin

2011-10-01

350

Massive venous thrombosis of inferior vena cava as primary manifestation of renal Ewing's sarcoma.  

PubMed

We report an extraordinarily rare case of a 17-year-old male with an extraskeletal Ewing's sarcoma (ESS) of the kidney and a massive thrombosis involving the inferior vena cava (IVC), from the iliac axis to the right atrium. This onset resembled renal cell carcinoma (RCC), although histological examination revealed it was an extraskeletal Ewing's sarcoma/peripheral neuro-ectodermal tumor (EES/PNET). EES/PNET should benefit from neoadjuvant chemotherapy to reduce the risk of metastasis and of recurrent disease due to delay in suitable treatment. Therefore, in the presence of a renal mass with tumor extension of IVC, it is reasonable to bear in mind that other tumors, apart from RCC, could occur. In such cases, a US or CT-scan guided biopsy could be useful. PMID:21612762

Rizzo, D; Barone, G; Ruggiero, A; Maurizi, P; Furfaro, I F; Castagneto, M; Riccardi, R

2011-06-01

351

Leiomyosarcoma of the inferior vena cava: radical surgery without vascular reconstruction.  

PubMed

Leiomyosarcoma of the inferior vena cava (IVC) is a rare tumor of mesenchymal origin, occurring most frequently in middle-aged women. Insidious complaints delay diagnosis, prognosis is poor, and the only curative modality remains an aggressive surgical resection yielding clear margins of disease. Commonly, radical tumor excision mandates caval repair or reconstruction, with significant related morbidity and mortality. We present a case of a 50-year-old woman with a leiomyosarcoma arising from the lower segment of the IVC, managed by surgical en-bloc resection of the tumor and IVC segment without further caval repair or reconstruction. During 14 months of follow-up the patient is well, had not had any complications, and is disease free. PMID:22983880

Drukker, Lior; Alberton, Joseph; Reissman, Petachia

2012-11-01

352

Retroperitoneal leiomyosarcoma of the inferior vena cava mimicking a liver tumor.  

PubMed

Leiomyosarcoma of the inferior vena cava (IVC) is a rare sarcoma, but it is the most common primary malignancy of the IVC. It has an extremely poor prognosis. We describe a 60-year-old white female complaining of abdominal fullness for 7 weeks before she sought medical assistance. Initial work-up including sonography, computed tomography, and magnetic resonance showed a tumor in the right upper quadrant of the abdominal cavity originating from the liver with compression of the IVC and displacement of the right kidney. The patient underwent surgical resection of the tumor with clear margins and reconstruction of the IVC using a Dacron tubular graft. Postoperatively, she was placed on Coumadin and adjuvant chemotherapy was started. Subsequently, the patient developed metastasis into the liver and peripancreatic nodes during the follow-up period. Considering the aggressiveness of this tumor, early radical en block resection with clear margins is still the only chance for long-term survival. PMID:18481503

Sokolich, Julio; Mejia, Alejandro; Cheng, Stephen; Dunn, Ernest

2008-05-01

353

Tube cavoplasty using autologous vein grafts for resected inferior vena cava reconstruction.  

PubMed

Reconstruction of inferior vena cava (IVC) defects after surgical resection of the IVC is associated with significant complications, such as venous thrombosis and graft infection. We herein report a new technique called "tube cavoplasty" that uses only autologous venous grafts to reconstruct IVC defects after resection of leiomyosarcomas of the IVC. The patient's own left internal jugular and left external iliac veins are procured independently and incised along their axes to create an independent venous patch that is approximated together to make a wider "tube" graft. The size and length of the "tube" graft perfectly matches the IVC defect. In this study, no complications associated with this new procedure were observed except for transient mild edema of the left leg. This new technique could be a valuable tool to reconstruct IVC defects, such as those that occur after resection of IVC tumors or IVC stenosis for Budd-Chiari syndrome. PMID:23188386

Soejima, Yuji; Matsumoto, Takuya; Shirabe, Ken; Maehara, Yoshihiko

2013-04-01

354

Leiomyosarcoma of inferior vena cava: a case series of four cases.  

PubMed

Vascular leiomyosarcomas are rare tumors, arising most frequently from inferior vena cava (IVC). They are mostly seen in sixth decade, with a female predominance. Their diagnosis is often challenging, as patients may present with non-specific complaints such as dyspnea, malaise, weight loss, abdominal pain, or back pain, preceding the diagnosis by several years. Leiomyosarcoma of the IVC most frequently occurs in the middle segment. The final diagnosis can be made by an ultrasound or computed tomography guided biopsy. Because of limited experience with this disease, optimal management of IVC leiomyosarcoma is unknown. Curative surgical resection remains the current treatment of choice for primary leiomyosarcoma of IVC. Neoadjuvant therapy may be given to downsize the tumor and increase resectability rates. Nonetheless, when complete resection is not possible, debulking combined with radiation therapy still provides good palliation. We, hereby, report four cases of this rare entity with emphasis on management. PMID:22499308

Yadav, Rajni; Kataria, Kamal; Mathur, Sandeep R; Seenu, V

2012-01-01

355

Sclerosing epithelioid fibrosarcoma of the liver infiltrating the inferior vena cava.  

PubMed

Sclerosing epithelioid fibrosarcoma (SEF) is a rare and distinct variant of fibrosarcoma, composed of epithelioid tumor cells arranged in strands, nests, cords, or sheets embedded within a sclerotic collagenous matrix. We report a 39-year-old man with SEF of the liver, which infiltrated the inferior vena cava (IVC). The SEF of the liver was successfully resected, and the infiltrated IVC was also removed together with the liver tumor. Histopathological examination of the tumor showed typical histopathology of SEF. Immunohistochemically, the tumor was positive for vimentin. Recurrence was noted 7 mo after surgery. After chemotherapy, the recurrent tumor was resected surgically, and histopathological examination showed similar findings to those of the primary tumor. To our knowledge, this is the first report of SEF of the liver with tumor invasion of the IVC. PMID:19725160

Tomimaru, Yoshito; Nagano, Hiroaki; Marubashi, Shigeru; Kobayashi, Shogo; Eguchi, Hidetoshi; Takeda, Yutaka; Tanemura, Masahiro; Kitagawa, Toru; Umeshita, Koji; Hashimoto, Nobuyuki; Yoshikawa, Hideki; Wakasa, Kenichi; Doki, Yuichiro; Mori, Masaki

2009-09-01

356

Long-Term Safety and Effectiveness of the 'OptEase' Vena Cava Filter  

SciTech Connect

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.

Kalva, Sanjeeva P., E-mail: skalva@partners.org [Massachusetts General Hospital, Department of Radiology (United States); Marentis, Theodore C. [Harvard Medical School Boston, Department of Radiology (United States); Yeddula, Kalpana; Somarouthu, Bhanusupriya; Wicky, Stephan [Massachusetts General Hospital, Department of Radiology (United States); Stecker, Michael S. [Brigham's Women's Hospital, Department of Radiology (United States)

2011-04-15

357

Longevity of Lake Superior lake trout  

USGS Publications Warehouse

The age structure of mature lake trout Salvelinus namaycush from the Wisconsin waters of Lake Superior increased following a population recovery that has taken place since the 1960s. As the population aged, it became apparent that scales were unreliable aging structures. Beginning in 1986, we examined both scale and sagittal otolith ages from tagged fish with a known period at liberty. We found large discrepancies in scale and sagittal otolith ages of mature fish, such that scale ages were biased low. We estimated lake trout living up to 42 years, which is greater than previously reported from Lake Superior. Investigators studying lake trout population dynamics in the Great Lakes should be aware that lake trout can live longer than previously thought.

Schram, Stephen T.; Fabrizio, Mary C.

1998-01-01

358

Complex Adaptive Special Operations (CASO).  

National Technical Information Service (NTIS)

Success in future war requires Special Operations Forces (SOF) to operate as a complex adaptive system. This paper offers a future operating concept called Complex Adaptive Special Operations (CASO), which incorporates the intrinsically unorthodox nature ...

P. R. Burns

2007-01-01

359

COSEE Great Lakes Lake Superior Exploration Workshop  

NSDL National Science Digital Library

Teachers of grades 4-10 or informal settings and scientists from universities, federal agencies, state agencies, and not-for-profit organizations are invited to take part in innovative and cutting edge science education. Participants will experience the Lake Superior ecosystem firsthand with experts through: field and classroom activities, classroom activity idea sharing, learning how to use cutting edge research, data, and technology with their students, and making peer connections.

360

Birds of Isle Royale in Lake Superior  

USGS Publications Warehouse

This report constitutes an annotated list of 197 species of birds reported from Isle Royale National Park, a 210-square-mile archipelago in northwestern Lake Superior including some 200 islets and rock outcrops. The island is 45 miles long and 8 miles wide at its widest point. Bird distribution and habitats are described, along with geography and vegetation; 62 species are known to have bred at least once, 26 are thought to be breeders, and the rest are migrants.

Krefting, L. W.; Lee, F. B.; Shelton, P. C.; Gilbert, K. T.

1966-01-01

361

[Aneurysm of the superior gluteal artery].  

PubMed

We report the case of an aneurysm of the superior gluteal artery that occurred more than ten years after a pelvic trauma. The diagnosis of this uncommon condition is sometimes difficult because of the predominant neurologic symptoms. Rupture can be life-threatening. The patient was treated by an embolization; thereafter a surgical procedure with control of the internal iliac artery and an endoaneurysmorrhaphy was performed. The main characteristics of this pathology are indicated. PMID:15529086

Blin, V; Picquet, J; Jousset, Y; Papon, X; Enon, B

2004-10-01

362

Gamma rays produce superior seedless citrus  

SciTech Connect

Using gamma radiation, seedless forms of some varieties of oranges and grapefruit are being produced. Since it has long been known that radiation causes mutations in plants and animals, experiments were conducted to determine if seediness could be altered by exposing seeds or budwood to higher than natural doses of gamma radiation. Orange and grapefruit seeds and cuttings exposed to gamma rays in the early 1970's have produced trees that bear fruit superior to that now on the market.

Pyrah, D.

1984-10-01

363

Reperfusion Hemorrhage Following Superior Mesenteric Artery Stenting  

Microsoft Academic Search

Percutaneous transluminal angioplasty and stent placement is now an established treatment option for chronic mesenteric ischemia\\u000a and is associated with low mortality and morbidity rates. We present a case of reperfusion hemorrhage complicating endovascular\\u000a repair of superior mesenteric artery stenosis. Although a recognized complication following repair of carotid stenosis, hemorrhage\\u000a has not previously been reported following mesenteric endovascular reperfusion. We

Michael Moore; Sean McSweeney; Gregory Fulton; John Buckley; Michael Maher; Michael Guiney

2008-01-01

364

Spontaneous Dissection of the Superior Mesenteric Artery  

Microsoft Academic Search

Spontaneous dissection of the superior mesenteric artery (SMA) is a rare occurrence, especially when not associated with aortic\\u000a dissection [1]. Currently, only 28 cases appear to have been reported. Due to the scarcity of cases in the literature, the\\u000a natural history of isolated, spontaneous SMA dissection is unclear. CT has been reported to be useful for the initial diagnosis\\u000a of

Patrick J. Sheldon; James B. Esther; Elana L. Sheldon; Steven R. Sparks; David P. Brophy; Steven B. Oglevie

2001-01-01

365

Spontaneous dissection of the superior mesenteric artery.  

PubMed

We describe a case of spontaneous dissection and thrombosis of the superior mesenteric artery in a 54-year-old man who presented with new onset of hypertension and epigastric pain. Initial unsuccessful treatment with catheter-directed thrombolysis was followed by surgical intervention. In cases in which an extensive intimectomy is performed, early institution of antiplatelet therapy or anticoagulation may be necessary to preserve vessel patency due to the presence of a prothrombotic surface and compromised outflow. PMID:20142003

Hwang, Christopher K; Wang, Jeffrey Y; Chaikof, Elliot L

2010-02-01

366

Superior mesenteric artery dissection: case report.  

PubMed

Spontaneous dissections of the superior mesenteric artery are exceptional events because only 26 reports have been published. We present a new case, revealed with an acute abdominal syndrome. Computed tomographic angiography and arteriography allowed a rapid diagnosis and urgent surgical intervention. Progress in imagery makes diagnosis and follow-up examination easier. Surgery is indicated for acute symptomatic forms with suspicion of mesenteric ischemia. In the other cases, a simple follow-up examination may be appropriate. PMID:12021719

Gouëffic, Yann; Costargent, Alain; Dupas, Benoît; Heymann, Marie-Françoise; Chaillou, Philippe; Patra, Philippe

2002-05-01

367

Superior Mesenteric Vein Thrombosis: A Case Report  

PubMed Central

Superior mesenteric vein thrombosis is an abdominal emergency that is rarely diagnosed early. Abdominal pain, vomiting, fever, and hematochezia are the characteristic presenting complaints. Tenderness, distension, and diminished intestinal sounds were the prominent abdominal physical findings in this case and were often associated with tachycardia and hypotension. This is a case that demonstrates all the nonspecifics, and one in which the patient survived beyond all others reported in the literature to date. ImagesFigure 1Figure 2Figure 3Figure 4

Nedd, Wilton O'R.; Siram, Suryanarayana M.; Bastien, Joseph A.; Leffall, LaSalle D.

1985-01-01

368

Laparoscopic Duodenojejunostomy for Superior Mesenteric Artery Syndrome  

PubMed Central

Background: Superior mesenteric artery (SMA) syndrome, also called Wilkie's syndrome, is a rare clinical phenomenon believed to be caused by compression of the third portion of the duodenum by the overlying superior mesenteric artery. We present the case of a 32-year-old female who presented with epigastric pain, weight loss, and vomiting. Methods: Her workup included a normal upper endoscopy as well as an abdominal CT scan and upper GI contrast study that confirmed the diagnosis of superior mesenteric artery syndrome. The patient was taken to the operating room and underwent successful treatment with laparoscopic duodenojejunostomy. Results: The patient achieved complete relief of her symptoms and is able to eat a regular diet without difficulty. SMA syndrome is a real anatomic clinical pathology resulting in chronic, consistent obstructive symptoms. An upper GI series and CT scan with contrast can confirm the diagnosis. Conclusion: Laparoscopic duodenojejunostomy should be considered the treatment of choice for these patients, because it offers a high likelihood of excellent outcome based on the current literature.

St. Peter, Shawn D.; Hughes, Jenevieve H.; Swain, James M.

2009-01-01

369

Chronic Budd-Chiari syndrome due to obstruction of the intrahepatic portion of the inferior vena cava  

PubMed Central

Clinical features of obstruction of the intrahepatic portion of the inferior vena cava were observed in five out of the 11 patients with the Budd-Chiari syndrome seen during the last four years. These patients apparently formed a distinct group from the remaining six and resembled in clinical course, biochemical features, haemodynamic findings, and radiological investigations the patients described as cases of membranous obliteration of the intrahepatic portion of the inferior vena cava. The present study reports five such patients diagnosed with the help of venous catheterization, percutaneous hepatography, and haemodynamic studies. The value of distinguishing these patients from those with obstruction due to hepatic vein occlusion is highlighted because of the difference in the prognosis and treatment. ImagesFig. 1Fig. 2Fig. 3Fig. 4

Datta, D. V.; Saha, S.; Singh, Samanta A. K.; Gupta, B. B.; Aikat, B. K.; Chugh, K. S.; Chhuttani, P. N.

1972-01-01

370

Novel Use of AngioVac System to Prevent Pulmonary Embolism during Radical Nephrectomy with Inferior Vena Cava Thrombectomy  

PubMed Central

Venous tumor thrombus occurs in 5-10% of patients with renal cell carcinoma. Surgical excision offers the best chance for survival, but is technically difficult. Risk of pulmonary embolism from venous thrombus or tumor thrombus is high, especially with tumors located higher in the inferior vena cava. Cardiopulmonary bypass may be used when a tumor extends above the diaphragm, but carries significant risk. We present an 86-year-old woman with a 7 cm renal mass extending into the inferior vena cava just below the confluence of the hepatic vessels. Prior to surgery she was found to have increasing pulmonary embolisms despite appropriate anticoagulation. Intraoperatively, the AngioVac aspiration system was utilized to prevent further pulmonary embolism. This is the first reported case of the use of this system during radical nephrectomy.

Brown, Robert J.; Uhlman, Matthew A.; Fernandez, Joss D.; Collins, Thomas; Brown, James A.

2013-01-01

371

Prophylactic Implantation of Inferior Vena Cava Filter during Endovascular Therapies for Deep Venous Thrombosis of the Lower Extremities  

PubMed Central

Patients with deep venous thrombosis (DVT) of the lower extremities have an increased risk of pulmonary emboli and post-thrombotic syndrome. Traditionally, they are treated medicinally, with anticoagulation therapy. Currently, endovascular therapies, with their higher efficiency, have replaced previously attempted systemic fibrinolytic therapies. There is a continuing controversy in the temporary use of filters in the inferior vena cava during these endovascular therapies, which may include catheter-directed thrombolysis, manual aspiration, mechanical thrombectomy, percutaneous transluminal angioplasty and placement of self-expandable metallic stents. Here, we present an overview of the literature and analysis on the application of prophylactic implantation of an inferior vena cava filter during endovascular therapy for DVT of the lower extremities.

Yamagami, Takuji; Nishimura, Tsunehiko

2011-01-01

372

The Operative Challenges of Advanced Renal Cell Carcinoma with Vena Cava Involvement: A Report of Three Cases  

PubMed Central

Surgical resection remains an important component in the care of advanced renal cell carcinoma (RCC). Some of the patients so managed had relief of symptoms and improved quality of life. However, palliative nephrectomies in late cases with vena cava involvement are not without challenges. An important factor to be considered for successful surgery is adequate vena cava management. We report in this paper three patients who had metastatic RCC. For over three decades now, researchers in Lagos had recorded the abysmal prognosis of advanced cases of RCC. Yet, late presentation and diagnosis still persisted in our environment. There is therefore the need to repackage our strategies aimed at early detection of this pathology and thus improved postoperative outcome.

Bioku, Muftau Jimoh; Saliu, Abdulwaid Niran; Ikuerowo, Stephen Odunayo; Omisanjo, Olufunmilade; Esho, Julius Olusanmi

2011-01-01

373

Antiphospholipid Antibody Syndrome Associated with Graves' Disease Presenting As Inferior Vena Cava Thrombosis with Bilateral Lower Limb DVT  

PubMed Central

We report a case of a 60-year-old lady who presented with bilateral lower limb swelling and a thyroid swelling with clinical features consistent with thyrotoxicosis. Investigations revealed the presence of a thrombus in bilateral external, internal iliac veins, and inferior vena cava extending up to its infrahepatic part. Hormone profile and radioiodine uptake scan confirmed the diagnosis of Graves’ disease. Further workup revealed the presence of antiphospholipid antibodies (confirmed after a repeat test at 12 weeks). The patient was treated with antithyroid drugs and anticoagulants. The patient improved with normalization of thyroid function and partial recanalization of the infrahepatic part of inferior vena cava. Hyperthyroidism has been implicated as a potential hypercoagulable state; however, the association of Graves’ disease with antiphospholipid antibody syndrome is limited to isolated case reports. This case highlights a new mechanism underlying hypercoagulability associated with Graves’ disease.

Jain, Ankur

2014-01-01

374

Antiphospholipid Antibody Syndrome Associated with Graves' Disease Presenting As Inferior Vena Cava Thrombosis with Bilateral Lower Limb DVT.  

PubMed

We report a case of a 60-year-old lady who presented with bilateral lower limb swelling and a thyroid swelling with clinical features consistent with thyrotoxicosis. Investigations revealed the presence of a thrombus in bilateral external, internal iliac veins, and inferior vena cava extending up to its infrahepatic part. Hormone profile and radioiodine uptake scan confirmed the diagnosis of Graves' disease. Further workup revealed the presence of antiphospholipid antibodies (confirmed after a repeat test at 12 weeks). The patient was treated with antithyroid drugs and anticoagulants. The patient improved with normalization of thyroid function and partial recanalization of the infrahepatic part of inferior vena cava. Hyperthyroidism has been implicated as a potential hypercoagulable state; however, the association of Graves' disease with antiphospholipid antibody syndrome is limited to isolated case reports. This case highlights a new mechanism underlying hypercoagulability associated with Graves' disease. PMID:24812529

Jain, Ankur

2014-01-01

375

Novel Use of AngioVac System to Prevent Pulmonary Embolism during Radical Nephrectomy with Inferior Vena Cava Thrombectomy.  

PubMed

Venous tumor thrombus occurs in 5-10% of patients with renal cell carcinoma. Surgical excision offers the best chance for survival, but is technically difficult. Risk of pulmonary embolism from venous thrombus or tumor thrombus is high, especially with tumors located higher in the inferior vena cava. Cardiopulmonary bypass may be used when a tumor extends above the diaphragm, but carries significant risk. We present an 86-year-old woman with a 7 cm renal mass extending into the inferior vena cava just below the confluence of the hepatic vessels. Prior to surgery she was found to have increasing pulmonary embolisms despite appropriate anticoagulation. Intraoperatively, the AngioVac aspiration system was utilized to prevent further pulmonary embolism. This is the first reported case of the use of this system during radical nephrectomy. PMID:24917754

Brown, Robert J; Uhlman, Matthew A; Fernandez, Joss D; Collins, Thomas; Brown, James A

2013-08-01

376

Protective effect of Ecklonia cava on UVB-induced oxidative stress: in vitro and in vivo zebrafish model  

Microsoft Academic Search

Chronic exposure of the skin to ultraviolet B (UVB) radiation induces oxidative stress, which plays a crucial role in the\\u000a induction of skin aging. In this study, potential protective effect of extracts of six species of brown seaweeds on UVB radiation-induced\\u000a cell damage was assessed via cell viability in HaCaT cells. The Ecklonia cava extract showed a profound protective effect

Seok-Chun Ko; Seon-Heui Cha; Soo-Jin Heo; Seung-Hong Lee; Sung-Myung Kang; You-Jin Jeon

377

Safety and efficacy of intravascular ultrasound-guided inferior vena cava filter in super obese bariatric patients  

Microsoft Academic Search

BackgroundThe morbidly obese (body mass index >40 kg\\/m2) are at significant risk of postoperative venous thromboembolism (VTE). Pulmonary embolism is the leading cause of death after Roux-en-Y gastric bypass, approximating .5%. Because of the technical limitations with fluoroscopy and table weight limits, it has been our practice at our university-based bariatric center to offer intravascular ultrasound (IVUS)-guided inferior vena cava

Clark M. Kardys; Michael C. Stoner; Mark L. Manwaring; Michael Barker; Kenneth G. MacDonald; John R. Pender; William H. Chapman III

2008-01-01

378

Posterior Nutcracker Syndrome Associated with Interrupted Left Inferior Vena Cava with Azygos Continuation and Retroaortic Right Renal Vein  

PubMed Central

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.

Luo, Xiao-Li; Qian, Gen-Nian; Xiao, Hui; Zhao, Chun-Lei

2012-01-01

379

Hemorrhagic Shock with Delayed Retroperitoneal Hemorrhage After Deployment of an Inferior Vena Cava Filter: Report of a Case  

Microsoft Academic Search

Although inferior vena cava (IVC) filter placement has demonstrated an excellent therapeutic efficacy in preventing pulmonary\\u000a embolism, several filter-related complications have been reported. Among them, retroperitoneal hemorrhage due to IVC perforation\\u000a is one of the most serious complications. We report herein a female patient who underwent TrapEase IVC filter placement with\\u000a anticoagulation and thrombolytic therapy for treatment of pulmonary embolism,

Kazunori Inuzuka; Naoki Unno; Naoto Yamamoto; Hiroshi Mitsuoka; Daisuke Sagara; Minoru Suzuki; Motohiro Nishiyama; Hiroyuki Konno

2007-01-01

380

Small Bowel Volvulus in a Quadriplegic: A Rare Complication of the Simon Nitinol Inferior Vena Cava Filter  

Microsoft Academic Search

\\u000a Abstract\\u000a   The advent and use of inferior vena cava (IVC) filters have reduced the overall incidence of pulmonary embolism in hospitalized\\u000a patients, but are not without potential complications. With the exponential increase in the utilization of IVC filters over\\u000a the past two decades, it is important to consider the use of retrievable filters, where indicated, in order to potentially\\u000a reduce

Nsikak J. Umoh; Christopher M. Alessi; David P. Franklin; Anthony O. Udekwu

2010-01-01

381

Persistent abdominal pain caused by an inferior vena cava filter protruding into the duodenum and the aortic wall.  

PubMed

Inferior vena cava (IVC) filter placement has increased dramatically over the past 2 decades. Symptomatic duodenal perforation by IVC filters with involvement of the aorta is a very rare, but challenging, complication. We report a case of persistent atypical right upper quadrant pain secondary to duodenal and aortic perforation by an IVC filter treated with cavotomy for filter removal, primary repair of the duodenum, and extraction of prongs from the aorta. PMID:22627053

Malgor, Rafael D; Hines, George L; Terrana, Lisa; Labropoulos, Nicos

2012-08-01

382

Blocking of the Hepatic Vein Outflow by Neointima Covering a Wallstent Across a Membranous Stenosis of the Inferior Vena Cava  

SciTech Connect

A 31-year-old man presented with idiopathic membranous obstruction of the suprahepatic inferior vena cava (IVC) and was treated by balloon dilation and placement of a Wallstent. The patient improved markedly. However, he developed obstruction of the hepatic vein outflow secondary to neointima formation over the stent that covered the hepatic vein ostia. The patient died of liver failure and septicemia. We believe that this is the first report of such a serious complication.

Dutta, Usha; Garg, Pramod K. [Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi 110029 (India); Agarwal, Rajeev [Department of Cardiology, All India Institute of Medical Sciences, New Delhi 110029 (India); Gupta, S. Dutta [Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029 (India); Prasad, G. A. [Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi 110029 (India); Kaul, Upendra [Department of Cardiology, All India Institute of Medical Sciences, New Delhi 110029 (India); Tandon, Rakesh K. [Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi 110029 (India)

1999-11-15

383

Capsular renal leiomyosarcoma with encasement of the inferior vena cava - Diagnosed by immunostaining and review of literature.  

PubMed

We report and describe the presentation, pathological diagnosis with immunostaining and management of a rare case of capsular renal leiomyosarcoma encasing the inferior vena cava (IVC). We have reviewed and tabulated other such similar cases. The present case was successfully managed by radical nephrectomy and adjuvant radio-chemotherapy. Immunostaining should be freely used to define the histological type of renal sarcoma in order to accurately counsel and deliver a prognosis for patients with renal leiomyosarcomas with a poor prognosis. PMID:20842257

Singh, Iqbal; Joshi, Mohit; Mishra, Kiran

2010-01-01

384

[Assessment of therapeutic efficacy in thromboses of the inferior vena cava by means of colour duplex scanning].  

PubMed

A total of two hundred and twenty-eight 18-to-83-year-old patients diagnosed with thrombotic occlusion of the lower-limb deep veins were examined in order to evaluate the possibilities of colour duplex angioscanning as a method aimed at monitoring both the course of and efficacy of treatment for acute venous thrombosis, as well as at preventing thromboembolic complications. Studied were the localization, incidence rate, and complications of the course of various types of venous thrombosis. It was demonstrated that an uncomplicated course the disease was observed in more than 80% of cases. At the same time, using dynamic ultrasonic monitoring made it possible to promptly detect progression of the pathological process in 3.5% of cases, and to introduce due amendments in the treatment policy being carried out. Also shown were the possibilities of the colour duplex scanning (CDS) technique in assessing the outcomes of the endovascular prevention of pulmonary thromboembolism (PTE) by means of implantation of the cava filter. The CDS turned out efficient in diagnosing the development of such complications as dislocation of the cava-filter and thrombus formation in the area of the cava filter. It was determined that the terms of fixation of the embolus-hazardous (floating) thrombus varied from 6 days to 6 months, which is of great importance in selecting the optimal period for temporary endovascular prevention of PTE. PMID:18382395

Shul'gina, L E; Karpenko, A A; Kulikov, V P; Subbotin, Iu G

2007-01-01

385

[Computerized three-dimensional reconstruction of the retrohepatic segment of inferior vena cava of a 20 mm human embryo].  

PubMed

The subdiaphragmatic venous drainage of the embryo is provided by the two caudal cardinal veins to which is added the subcardinal vein system, draining the mesonephros, the perispinal supracardinal veins and the umbilical and vitelline venous system. The anastomosis of certain segments of the embryonic venous structures and the disappearance of others are at the origin of the inferior vena cava. Since the 19th century, three-dimensional reconstruction of solid models from histological sections were developed. At present, the development of computerized three-dimensional reconstruction techniques allowed to operate a multitude of techniques of image processing and modeling in space. Three-dimensional reconstruction is a tool for teaching and research very useful in embryological studies because of the obvious difficulty of dissection and the necessity of introducing time as the fourth dimension in the study of organogenesis. This method represents a promising alternative compared to previous three-dimensional reconstruction techniques including Born technique. The aim of our work was to create a three-dimensional computer reconstruction of the retrohepatic segment of the inferior vena cava of a 20mm embryo from the embryo collection of Saints-Pères institute of anatomy (Paris Descartes university, Paris, France) to specify the path relative to the liver and initiate a series of computerized three-dimensional reconstruction that will follow the evolution of this segment of the inferior vena cava and this in a pedagogical and morphological research introducing the time as the fourth dimension. PMID:23756024

Abid, B; Douard, R; Hentati, N; Ghorbel, A; Delmas, V; Uhl, J-F; Chevallier, J-M

2013-06-01

386

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

PubMed

The purpose of this study was to demonstrate feasibility of percutaneous transluminal aortic stenting and cava filter placement under magnetic resonance imaging (MRI) guidance exclusively using a polyetheretherketone (PEEK)-based MRI-compatible guidewire. Percutaneous transluminal aortic stenting and cava filter placement were performed in 3 domestic swine. Procedures were performed under MRI-guidance in an open-bore 1.5-T scanner. The applied 0.035-inch guidewire has a PEEK core reinforced by fibres, floppy tip, hydrophilic coating, and paramagnetic markings for passive visualization. Through an 11F sheath, the guidewire was advanced into the abdominal (swine 1) or thoracic aorta (swine 2), and the stents were deployed. The guidewire was advanced into the inferior vena cava (swine 3), and the cava filter was deployed. Postmortem autopsy was performed. Procedural success, guidewire visibility, pushability, and stent support were qualitatively assessed by consensus. Procedure times were documented. Guidewire guidance into the abdominal and thoracic aortas and the inferior vena cava was successful. Stent deployments were successful in the abdominal (swine 1) and thoracic (swine 2) segments of the descending aorta. Cava filter positioning and deployment was successful. Autopsy documented good stent and filter positioning. Guidewire visibility through applied markers was rated acceptable for aortic stenting and good for venous filter placement. Steerability, pushability, and device support were good. The PEEK-based guidewire allows either percutaneous MRI-guided aortic stenting in the thoracic and abdominal segments of the descending aorta and filter placement in the inferior vena cava with acceptable to good device visibility and offers good steerability, pushability, and device support. PMID:19115070

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

2009-05-01

387

Spontaneous Dissection of the Superior Mesenteric Artery  

SciTech Connect

Spontaneous dissection of the superior mesenteric artery (SMA) is a rare occurrence, especially when not associated with aortic dissection [1]. Currently, only 28 cases appear to have been reported. Due to the scarcity of cases in the literature, the natural history of isolated, spontaneous SMA dissection is unclear. CT has been reported to be useful for the initial diagnosis of SMA dissection [2-5]. We present two recent cases of spontaneous SMA dissection in which enhanced spiral CT was instrumental in following the disease process and guiding clinical decision making.

Sheldon, Patrick J. [Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103 (United States); Esther, James B. [Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, West Campus, CC308E, One Deaconess Road, Boston, MA 02215 (United States); Sheldon, Elana L. [Department of Medicine, University of California San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103 (United States); Sparks, Steven R. [Department of Surgery, University of California San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103 (United States); Brophy, David P. [Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, West Campus, CC308E, One Deaconess Road, Boston, MA 02215 (United States); Oglevie, Steven B. [Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103 (United States)

2001-09-15

388

Spontaneous dissection of the superior mesenteric artery.  

PubMed

Spontaneous dissection of the superior mesenteric artery (SMA) is a rare occurrence, especially when not associated with aortic dissection [1]. Currently, only 28 cases appear to have been reported. Due to the scarcity of cases in the literature, the natural history of isolated, spontaneous SMA dissection is unclear. CT has been reported to be useful for the initial diagnosis of SMA dissection [2-5]. We present two recent cases of spontaneous SMA dissection in which enhanced spiral CT was instrumental in following the disease process and guiding clinical decision making. PMID:11815839

Sheldon, P J; Esther, J B; Sheldon, E L; Sparks, S R; Brophy, D P; Oglevie, S B

2001-01-01

389

Anterior approach to the superior mesenteric artery by using nerve plexus hanging maneuver for borderline resectable pancreatic head carcinoma.  

PubMed

To achieve R0 resection for pancreatic ductal adenocarcinoma (PDAC) of the pancreatic head, complete resection of the retropancreatic nerve plexus around the superior mesenteric artery (SMA) is thought to be required. Twenty-five patients with borderline resectable right-sided PDAC were divided into two groups after neoadjuvant chemoradiotherapy: those with portal vein (PV) invasion alone (n?=?12), and those with invasion of both PV and SMA (n?=?13). A tape for guidance was passed in a space ventral to the SMA and behind the pancreatic parenchyma, followed by resection of the pancreatic parenchyma with the splenic vein. Another tape was passed behind the nerve plexus lateral to the hepatic artery and the SMA ventral to the inferior vena cava and the nerve plexus was dissected, resulting in complete resection of the nerve plexus around the SMA. Pathological findings revealed that the rates of R0, R01 (a margin less than 1 mm) and R1 were 58.3 %, 41.7 % and 0 % in PV group, and 53.8 %, 30.8 % and 15.4 % in PV/A group, respectively. The median survival time was 23.3 and 22.8 months in PV and PV/A groups, respectively. The plexus hanging maneuver for PDAC of the pancreatic head achieved complete resection of the retropancreatic nerve plexus around the SMA, helping to secure a negative surgical margin. PMID:24664421

Mizuno, Shugo; Isaji, Shuji; Tanemura, Akihiro; Kishiwada, Masashi; Murata, Yasuhiro; Azumi, Yoshinori; Kuriyama, Naohisa; Usui, Masanobu; Sakurai, Hiroyuki; Tabata, Masami

2014-06-01

390

[Two particular cases of superior semicircular canal dehiscence related to a procidence of the superior petrous sinus].  

PubMed

We report two cases of superior semicircular canal dehiscence related to a dehiscence of the superior petrous sinus that creates a localized notch of the most superior part of the superior semicircular canal. This vascular dehiscence was suspected at CT and was confirmed by MR imaging with identification of the superior petrous sinus in touch with the intralabyrinthine fluid at this level. This not well-known etiology of the superior semicircular canal dehiscence syndrome has to be searched and described by radiologists, allowing an optimal surgical approach. PMID:19394696

Dubrulle, F; Kohler, R; Vincent, C; Casselman, J

2009-10-01

391

Laparoscopic Duodenojejunostomy for Superior Mesenteric Artery Syndrome  

PubMed Central

Background: Superior mesenteric artery (Wilkie's) syndrome is a rare condition. Only 400 cases have been reported so far. The symptoms may be acute or chronic, the chronic form being more common. Vomiting is the most common symptom. About 15 causal factors have been found. Conservative management is the rule for acute cases. Surgery is indicated for chronic cases and failure of conservative management. Laparoscopy has been used in only 8 cases so far. Case Report: We report the ninth case of superior mesenteric artery syndrome managed by laparoscopic duodenojejunostomy. The patient was a 14-year-old boy with chronic symptoms since childhood. The procedure was relatively straightforward. The case is being reported for its rarity and the possibility of laparoscopic management. Discussion: Laparoscopic severing of Treitz's ligament is another surgical option, though gastrojejunostomy is of no use. Conservative management is useful only in acute cases. Conclusion: Duodenojejunostomy is the procedure of choice and is effective in 90% of patients. We conclude that it is very effective in this condition, especially laparoscopically.

Palanivelu, Chinnusamy; Senthilkumar, Rangaswamy; Parthasarathi, Ramakrishnan; Jani, Kalpesh

2006-01-01

392

15. Stress Sheet, Truss number 2, span number 6, Superior ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

15. Stress Sheet, Truss number 2, span number 6, Superior Avenue viaduct. Drawing courtesy Engineering Dept., City of Cleveland. - Superior Avenue Viaduct, Cleveland East & West side, Cuyahoga Valley Vicinity, Cleveland, Cuyahoga County, OH

393

Is the unconscious, if it exists, a superior decision maker?  

PubMed

Newell & Shanks (N&S) show that there is no convincing evidence that processes assumed to be unconscious and superior are indeed unconscious. We take their argument one step further by showing that there is also no convincing evidence that these processes are superior. We review alternative paradigms that may provide more convincing tests of the superiority of (presumed) unconscious processes. PMID:24461083

Huizenga, Hilde M; van Duijvenvoorde, Anna C K; van Ravenzwaaij, Don; Wetzels, Ruud; Jansen, Brenda R J

2014-02-01

394

An antioxidative and antiinflammatory agent for potential treatment of osteoarthritis from Ecklonia cava.  

PubMed

Osteoarthritis is thought to be induced by the ageing-related loss of homeostatic balance between degeneration and repair mechanism around cartilage tissue in which inflammatory mediators such as reactive oxygen species, cytokines and prostaglandins are prone to over-production under undesirable physiological conditions. Phlorotannins are unique polyphenolic compounds bearing dibenzo-1,4-dioxin skeleton which are not found in terrestrial plants but found only in some brown algal species such as Ecklonia and Eisenia families. Phlorotannin-rich extracts of Ecklonia cava including LAD103 showed significant antioxidant activities such as DPPH radical scavenging, ferric ion reduction, peroxynitrite scavenging, and inhibition of LDL oxidation, indicating their possible antioxidative interference both in onset and downstream consequences of osteoarthritis. LAD103 also showed significant down regulation of PGE2 generation in LPS-treated RAW 246.7 cells, and significant inhibition of human recombinant interleukin-1alpha-induced proteoglycan degradation, indicating its beneficial involvement in pathophysiological consequences of osteoarthritis, the mechanism of which needs further investigation. Since LAD103 showed strong therapeutic potentials in arthritic treatment through several in vitro experiments, it is highly encouraged to perform further mechanistic and efficacy studies. PMID:16526282

Shin, Hyeon-Cheol; Hwang, Hye Jeong; Kang, Kee Jung; Lee, Bong Ho

2006-02-01

395

Placement of vena cava filter via percutaneous puncture of the great saphenous vein  

PubMed Central

The aim of this study was to investigate the feasibility and safety of vena cava filter (VCF) placement via percutaneous puncture of the great saphenous vein (GSV) in the prevention of pulmonary embolisms. Using ultrasound positioning, VCF placement via percutaneous puncture of the GSV was performed on 12 patients with deep vein thrombosis (DVT) in the lower extremities. Transcatheter thrombolysis was conducted simultaneously. The postoperative filter position, puncture wound recovery and fluency of the GSV were observed. All filters were successfully released, with accurate positioning. No hematoma was observed at the puncture point during the perioperative period. In certain patients, local petechiae appeared around the puncture point during the thrombolysis period, which did not require special treatment. Re-examination using ultrasound revealed unobstructed blood flow in the GSV. VCF placement via percutaneous puncture of the GSV is a new filter placement method. The feasibility and safety of this method for the prevention of pulmonary embolisms has been demonstrated in a small number of sample cases.

JIN, YIQI; ZHOU, DAYONG; CHEN, LEI; HUANG, XIANCHEN; XU, GUOXIONG; HUANG, JIAN; SHEN, LIMING

2013-01-01

396

Percutaneous balloon angioplasty of inferior vena cava in Budd-Chiari syndrome-R1.  

PubMed

This study was to evaluate the clinical effects of percutaneous balloon angioplasty of Budd-Chiari syndrome (BCS) caused by inferior vena cava (IVC) obstruction. Between 1993 and 1999, 28 men and 14 women with mean age of 44+/-12 years underwent percutaneous balloon angioplasty for primary BCS. Color Doppler ultrasound and venography showed membranous and segmental obstruction of IVC in 29 and 13 patients, respectively. Fourteen patients also had left- and/or mid-hepatic vein obstruction. Angioplasty of IVC was successful in 41 patients (97.6%), resulting in a reduction of pressure gradient between IVC and the right atrium from 15.0+/-2.5 to 5.5+/-0.8 mmHg (P<0.01). A stent was placed in the site of obstruction in the patient with unsuccessful balloon angioplasty. Patients with successful angioplasty or stent placement had significant improvement in clinical symptoms indicated by a reduction in hepatomegaly and the degree of ascites. No specific attempt was made to treat the occluded left- and/or mid-hepatic vein due to the presence of potent right hepatic vein. Over the follow-up period of 32+/-12 months, restenosis of IVC occurred in only one patient (2.4%), which was redilated successfully. Percutaneous balloon angioplasty is a safe and effective therapy for Budd-Chiari syndrome caused by IVC obstruction, therefore should be the first choice of treatment for this condition. PMID:12007692

Wu, Tongguo; Wang, Lexin; Xiao, Qiang; Wang, Bosong; Li, Shanying; Li, Xiurong; Zhang, Jinying

2002-05-01

397

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

PubMed

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. PMID:24099038

Wang, Stephen L; Lloyd, Allen J

2013-11-01

398

Improving the tracking and removal of retrievable inferior vena cava filters.  

PubMed

Therapeutic and prophylactic inferior vena cava (IVC) filters should be placed based on currently accepted indications to prevent a fatal pulmonary embolism (PE). The protective effect of filters is offset by the potential for lower extremity deep venous thrombosis (DVT), caval thrombosis, and possible otherwise unnecessary life-long anticoagulation (AC). The duration of treatment for most DVTs or PEs is 3 to 6 months of AC/filter. Filters should be retrieved when duration of treatment for a DVT/PE has been met, the risk of a PE is no longer high, and/or there is no longer a contraindication to AC. An effective system that leads to improving the retrieval rate of filters must include education of the patient, a tracking system to minimize patient lost to follow-up, and dedicated personnel to oversee the process. If these goals are accomplished, interventionalists can help decrease the incidence of a fatal PE during the high-risk period, and also decrease the risk of a DVT or the use of otherwise unnecessary life-long AC in subsequent years. Currently, there is much room for improvement in the frequency that IVCF patients are systematically followed and filters are retrieved. The principles discussed in this report will be helpful in this process. PMID:22379282

Goei, Anthony D; Josephs, Shellie C; Kinney, Thomas B; Ray, Charles E; Sacks, David

2011-03-01

399

Inferior vena cava filters in children: our experience and suggested guidelines.  

PubMed

Although use of inferior vena cava (IVC) filters for prophylaxis against pulmonary embolism (PE) is well reported in adults, long-term studies in children are lacking. We performed retrospective review of imaging and clinical database of IVC filters for the last 12 years. Thirty-five patients (mean age: 15.5 y) underwent filter placement and/or retrieval. Indications for placement were contraindication to anticoagulation with known deep venous thrombosis (DVT) (18) or high risk of venous thromboembolism (5), recurrent DVT despite anticoagulation (1), and prophylaxis before endovascular thrombolysis (8). All filter placements were technically successful without any complications. Filter retrieval was successful in 15 of 19 attempted (79%) at a mean of 42 days. Two complications occurred during retrieval: IVC stenosis successfully treated with angioplasty and contained IVC perforation. Endothelialization of filter prevented retrieval in 4 patients. Mean follow-up was 29.3 months. No patients had IVC thrombosis, breakthrough pulmonary embolism, filter fracture, or embolism. Two patients had recurrent DVT. Our results indicate that IVC filters can be successfully placed and retrieved in children with minimal procedural complications; follow-up demonstrates acceptable complication rate owing to presence of filters. Prophylactic IVC filter placement may be considered before endovascular thrombolysis for lower extremity DVT. Retrievable filters should be used in children for appropriate indications. PMID:21602720

Kukreja, Kamlesh U; Gollamudi, Jay; Patel, Manish N; Johnson, Neil D; Racadio, John M

2011-07-01

400

Histology of Tissue Adherent to OptEase Inferior Vena Cava Filters Regarding Indwelling Time  

SciTech Connect

The purpose of this paper is to report on the histology of tissues found on retrieved filters with regard to indwelling time. Between February 2006 and January 2007, 28 Optease inferior vena cava filters (Cordis Europa, Roden, The Netherlands) were retrieved from 27 patients. Twenty-two filters were inserted prophylactically for trauma patients and six for patients with venous thromboembolism. Cavography was performed both before and after filter removal to evaluate the presence of thrombi or wall damage. Filters were retrieved with the snare and sheath method. All material adherents to the filters were examined histologically.The mean indwelling time of the filters was 24.9 days (range, 6-69 days). Red tissue fragments were seen on all the filters, consistent microscopically with clots and fibrin. On five filters (18%; mean indwelling time, 45.4 days) white tissue consistent with vascular intima was found. All postprocedure cavographies were normal. We conclude that most material adherent to the retrieved filters is thrombi, while vascular intima can be found in the minority of filters with a longer indwelling time.

Rimon, Uri, E-mail: rimonu@sheba.health.gov.il; Volkov, Alexander; Garniek, Alexander; Golan, Gil; Bensaid, Paul; Khaitovich, Boris; Abu-Salah, Kamel; Zissin, Rivka; Simon, Daniel; Konen, Eli [Tel-Aviv University, Sackler School of Medicine (Israel)

2009-01-15

401

Surgical Treatment of Inferior Vena Cava Tumor Thrombus in Patients with Renal Cell Carcinoma  

PubMed Central

Radical nephrectomy with inferior vena cava (IVC) thrombectomy remains the most effective therapeutic option in patients with renal cell carcinoma and IVC tumor thrombus. Cephalic extension of the thrombus is closely related to perioperative morbidity. We purposed to design a safe and successful surgical strategy through a review of our surgical experience and treatment results in 35 patients (male:female=28:7, mean age=56 yr [32-77]) who underwent IVC thrombectomy with radical nephrectomy between January 1997 and December 2006. The limit of tumor extension was level I in 10 patients (28.6%), level II in 17 (48.6%), and level III and IV in 4 patients each (11.4%). Liver mobilization with hepatic vascular exclusion was performed in 12 patients and cardiopulmonary bypass in 7. Thirty-two primary closures, 2 patch closures, and 1 graft interposition were performed. One patient underwent simultaneous pulmonary embolectomy because of an operative pulmonary embolism. There was no operative mortality, and the overall survival at 5-yr was 50.8%. Complete thrombus removal without tumor fragmentation under long venotomy on fully exposed involved IVC is recommended for successful result in a bloodless operative field. The applicability of liver mobilization, hepatic vascular exclusion, and cardiopulmonary bypass, can be determined by the level of thrombus.

Kim, Hyangkyoung; Moon, Ki-Myung; Cho, Yong-Pil; Song, Cheryn; Kim, Chung-Soo; Ahn, Hanjong

2010-01-01

402

Double inferior vena cava with interiliac vein: a case report and literature review.  

PubMed

The duplication of the inferior vena cava (IVC) is a rare, but well-recognized anomaly. Duplicated IVC has a significant relevance for retroperitoneal surgery and venous interventional radiology. We report a case of duplicated IVC, which was observed during routine dissection of an 84-year-old Japanese female cadaver. The interiliac vein between the duplicated IVC ran obliquely upwards from left to right. We performed systematic literature review of published reports based on Pubmed and Medline from 1967 to 2011. Of 109 cases with IVC anomalies identified by the literature search, 22 cases (20.2%) displayed no interiliac anastomosis. The interiliac vein connecting duplicated IVC existed in 74 cases (67.9%). According to the running direction of the interiliac vein, we found that the vein ran from left to right in 42 cases, coursed from right to left in 19 cases, and ran horizontally in 13 cases. Thirteen left IVC displayed symmetrical-to-normal connection with the bilateral common iliac veins. Awareness of these venous variations is necessary to reduce surgical risk and to determine strategy in interventional radiology. PMID:22645906

Chen, Huayue; Emura, Shoichi; Nagasaki, Sachio; Kubo, Kin-ya

2012-02-01

403

Leiomyosarcoma of the inferior vena cava: case report and treatment of recurrence with repeat surgery.  

PubMed

Leiomyosarcoma of the inferior vena cava (IVC) is an extremely rare malignancy with poor prognosis due to late diagnosis. Surgical resection currently remains the best treatment; however, recurrence frequently occurs and the 5-year survival rate is only 31%. The aim of this study is to report a case of IVC leiomyosarcoma and treatment of recurrence with repeat surgery. A 36-year-old woman with a high-grade leiomyosarcoma originating from the infrahepatic IVC underwent an en bloc excision of the tumor. Eleven months after the initial operation, two metastases to the omentum were observed. Since the patient showed no response to adjuvant chemotherapy (i.e., a combination of 5-fluorouracil and gemcitabine), repeat operations were used as the main treatment modality for recurrence. The median time to recurrence was 15 months (range 8-27). The middle and upper IVC segments were involved in the local recurrence, and metastatic lesions occurred in multiple sites including the stomach, omentum, mesentery, left liver, and pelvic cavity. Repeat operations to remove the recurrent and metastatic tumors led to a long-term (at least 7 years) survival, and the patient is still alive. Postoperative recoveries were uneventful. Neither complication related to the venous blood flow in the IVC nor renal impairment was noted. Our results suggest that in the setting of chemotherapy-refractory IVC leiomyosarcoma repeat surgery may be an alternative treatment for recurrence and improve survival time. PMID:20036495

Zhang, Hongyi; Kong, Yalin; Zhang, Hui; He, Xiaojun; Zhang, Hong-yi; Liu, Chengli; Xiao, Mei; Xu, Xinbao

2010-04-01

404

Venous reconstruction of the inferior vena cava bifurcation for retroperitoneal rhabdomyosarcoma in a child. Case report.  

PubMed

Retroperitoneal tumors, as well as traumatic lesions and occlusions of the bifurcation of the inferior vena cava (IVC) and the common iliac veins may require venous vascular reconstruction. We present a method for inferior vena caval bifurcation reconstruction which employs the advantages of a large size straight expanded polytetrafluorethylene (ePTFE) graft in this position after a new IVC bifurcation has been created by uniting the stumps of both common iliac veins, and construction of an arteriovenous (A-V) fistula with controlled flow to decrease the rethrombosis rate of the graft, and still not cause heart failure. This method was used in a case of recurrent rhabdomyosarcoma in an 8 year old child encroaching upon the bifurcation of the IVC as well as on both common iliac veins. The situation was managed by radical resection of the tumor and by creating a new caval bifurcation of the common iliac veins, followed by interposition of a straight ePTFE graft. An A-V fistula was created between the left femoral vein and left femoral artery using the left greater saphenous vein in controlled fashion. The arterial defect of the right common iliac artery was reconstructed by interposition of a PTFE graft end-to-end. PMID:15758877

Chervenkoff, V; Kirilova, K; Tschirkov, A L

2005-02-01

405

Primary leiomyosarcoma of the inferior vena cava: reports of infrarenal and suprahepatic caval involvement.  

PubMed

We report two cases of primary inferior vena cava (IVC) leiomyosarcoma. The first patient was a 60-year-old female who presented with abdominal pain. The patient was initially diagnosed with a retroperitoneal sarcoma that may have involved the right renal vessels and the IVC. The Vascular Surgery Service was consulted intra-operatively when it became evident that the IVC was primarily involved. The patient was treated with total en-bloc excision of the infrarenal IVC tumor with concomitant interposition polytetrafluoroethylene (PTFE) graft caval replacement. The second patient was a 58-year-old female who presented with general malaise and anemia. This tumor began in the distal infrarenal IVC and extended cephalad to the suprahepatic IVC, ending approximately 2 cm below the right atrium. Intrapericardial IVC clamping was required for cephalad control in this patient, who was then treated with excision of the tumor and concomitant interposition PTFE graft caval replacement with reimplantation of the right renal vein. A review of this rare tumor is presented. PMID:19782508

Tameo, Michael N; Calligaro, Keith D; Antin, Leah; Dougherty, Matthew J

2010-01-01

406

Technical considerations for radical resection of a primary leiomyosarcoma of the vena cava  

PubMed Central

Background Radical resection provides the best hope for cure in leiomyosarcoma of the inferior vena cava (IVC). Multi-visceral resection is often indicated by extensive tumour involvement. This report describes the technical challenges encountered during resection of a retrohepatic IVC leiomyosarcoma. Methods Computed tomography showed an IVC leiomyosarcoma measuring 7.8 × 10.0 × 19.3 cm in a 41-year-old patient. The tumour reached the confluence of the hepatic veins, displacing the caudate lobe anteriorly and extending towards the IVC bifurcation inferiorly. En bloc resection of the IVC tumour with a right hepatic and caudate lobectomy, and a right nephrectomy was performed. Results Subsequent to a Cattel manoeuvre, the operative procedures carried out can be broadly categorized in four major steps: (i) mobilization of the infrahepatic IVC and tumour; (ii) mobilization of the suprahepatic IVC from diaphragmatic attachments; (iii) right hepatectomy with complete caudate lobe resection, and (iv) en bloc resection of the IVC tumour. This approach allowed the entire length of tumour-bearing IVC to be freed from the retroperitoneum and avoided the risk for iatrogenic tumour rupture during dissection at the retrohepatic IVC. Reconstruction of the IVC was not performed in the presence of venous collaterals. Conclusions Experience in liver resection and transplantation, and appreciation of the hepatocaval anatomy facilitate the safe and radical resection of retrohepatic IVC leiomyosarcoma.

Chan, Albert C Y; Chan, See Ching; Yiu, Ming Kwong; Ho, Kwan Lun; Wong, Edmond M H; Lo, Chung Mau

2012-01-01

407

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

SciTech Connect

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.

Vos, Louwerens D.; Tielbeek, Alexander V. [Catharina Hospital, Department of Radiology (Netherlands); Bom, Ernst P. [Sophia Hospital, Department of Radiology (Netherlands); Gooszen, Harm C. [Catharina Hospital, Department of Pulmonology (Netherlands); Vroegindeweij, Dammis [Catharina Hospital, Department of Radiology (Netherlands)

1997-03-15

408

A computational method for predicting inferior vena cava filter performance on a patient-specific basis.  

PubMed

A computational methodology for simulating virtual inferior vena cava (IVC) filter placement and IVC hemodynamics was developed and demonstrated in two patient-specific IVC geometries: a left-sided IVC and an IVC with a retroaortic left renal vein. An inverse analysis was performed to obtain the approximate in vivo stress state for each patient vein using nonlinear finite element analysis (FEA). Contact modeling was then used to simulate IVC filter placement. Contact area, contact normal force, and maximum vein displacements were higher in the retroaortic IVC than in the left-sided IVC (144 mm2, 0.47?N, and 1.49?mm versus 68 mm2, 0.22?N, and 1.01?mm, respectively). Hemodynamics were simulated using computational fluid dynamics (CFD), with four cases for each patient-specific vein: (1) IVC only, (2) IVC with a placed filter, (3) IVC with a placed filter and model embolus, all at resting flow conditions, and (4) IVC with a placed filter and model embolus at exercise flow conditions. Significant hemodynamic differences were observed between the two patient IVCs, with the development of a right-sided jet, larger flow recirculation regions, and lower maximum flow velocities in the left-sided IVC. These results support further investigation of IVC filter placement and hemodynamics on a patient-specific basis. PMID:24805200

Aycock, Kenneth I; Campbell, Robert L; Manning, Keefe B; Sastry, Shankar P; Shontz, Suzanne M; Lynch, Frank C; Craven, Brent A

2014-08-01

409

Feeling superior is a bipartisan issue: extremity (not direction) of political views predicts perceived belief superiority.  

PubMed

Accusations of entrenched political partisanship have been launched against both conservatives and liberals. But is feeling superior about one's beliefs a partisan issue? Two competing hypotheses exist: the rigidity-of-the-right hypothesis (i.e., conservatives are dogmatic) and the ideological-extremism hypothesis (i.e., extreme views on both sides predict dogmatism). We measured 527 Americans' attitudes about nine contentious political issues, the degree to which they thought their beliefs were superior to other people's, and their level of dogmatism. Dogmatism was higher for people endorsing conservative views than for people endorsing liberal views, which replicates the rigidity-of-the-right hypothesis. However, curvilinear effects of ideological attitude on belief superiority (i.e., belief that one's position is more correct than another's) supported the ideological-extremism hypothesis. Furthermore, responses reflecting the greatest belief superiority were obtained on conservative attitudes for three issues and liberal attitudes for another three issues. These findings capture nuances in the relationship between political beliefs and attitude entrenchment that have not been revealed previously. PMID:24096379

Toner, Kaitlin; Leary, Mark R; Asher, Michael W; Jongman-Sereno, Katrina P

2013-12-01

410

Arthroscopic stapling for detached superior glenoid labrum.  

PubMed

Superior labral tears of the shoulder involve the biceps tendon and labrum complex which may be detached, displaced inferiorly, and interposed between the glenoid and the humeral head. We have treated ten young athletes with painful shoulders due to this lesion by arthroscopic stapling. Arthroscopy at the time of staple removal, after three to six months, showed that all the lesions had been stabilised. Clinical review at over 24 months showed an excellent or good result in 80%. The two relative failures were due in one to residual subacromial bursitis, and the other to multidirectional shoulder instability. Arthroscopic stapling can restore the shoulder anatomy, and it is recommended for active adolescent athletes with this lesion. PMID:1894660

Yoneda, M; Hirooka, A; Saito, S; Yamamoto, T; Ochi, T; Shino, K

1991-09-01

411

Superior calcium homeostasis of extraocular muscles  

PubMed Central

Extraocular muscles (EOMs) are a unique group of skeletal muscles with unusual physiological properties such as being able to undergo rapid twitch contractions over extended periods and escape damage in the presence of excess intracellular calcium (Ca2+) in Duchenne’s muscular dystrophy (DMD). Enhanced Ca2+ buffering has been proposed as a contributory mechanism to explain these properties; however, the mechanisms are not well understood. We investigated mechanisms modulating Ca2+ levels in EOM and tibialis anterior (TA) limb muscles. Using Fura-2 based ratiometric Ca2+ imaging of primary myotubes we found that EOM myotubes reduced elevated Ca2+ ~2-fold faster than TA myotubes, demonstrating more efficient Ca2+ buffering. Quantitative PCR (qPCR) and western blotting revealed higher expression of key components of the Ca2+ regulation system in EOM, such as the cardiac/slow isoforms sarcoplasmic Ca2+-ATPase 2 (Serca2) and calsequestrin 2 (Casq2). Interestingly EOM expressed monomeric rather than multimeric forms of phospholamban (Pln), which was phosphorylated at threonine 17 (Thr17) but not at the serine 16 (Ser16) residue. EOM Pln remained monomeric and unphosphorylated at Ser16 despite protein kinase A (PKA) treatment, suggesting differential signalling and modulation cascades involving Pln-mediated Ca2+ regulation in EOM. Increased expression of Ca2+/SR mRNA, proteins, differential post-translational modification of Pln and superior Ca2+ buffering is consistent with the improved ability of EOM to handle elevated intracellular Ca2+ levels. These characteristics provide mechanistic insight for the potential role of superior Ca2+ buffering in the unusual physiology of EOM and their sparing in DMD.

Zeiger, Ulrike; Mitchell, Claire H.; Khurana, Tejvir S.

2014-01-01

412

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

PubMed Central

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

2010-01-01

413

[Acute thrombosis of pelvic and leg veins in agenesis of the renal segment of the inferior vena cava].  

PubMed

A 19-year-old, otherwise asymptomatic man presented to the hospital of orthopaedic surgery with acute severe pain like lumbago. Symptomatic treatment was performed after extensive orthopaedic diagnostic procedures. On the third day after admission he showed clinical signs of deep vein thrombosis with painful swelling and livid discoloration of both legs. Colour duplex ultrasound revealed complete thrombosis of the leg and pelvic veins bilaterally, but the cranial extent was not clear. Contrast-enhanced helical computer tomography of the abdomen and the pelvis confirmed deep pelvic vein thrombosis and showed extension into the inferior vena cava. Moreover, the study revealed the agenesis of the renal segment of the inferior vena cava with collateral flow through dilated lumbar veins to enlarged azygous and hemiazygous, through vertebral and paravertebral venous plexus. The renals were drained via dilated capsular veins. The agenesis of renal vena cava is a very rare anomaly causing acute thrombosis of the deep leg and pelvic veins. Other risk factors of thromboembolic disease were not found. The patient was treated successfully with systemic thrombolysis. Therefore we used ultra-high streptokinase infusion (9 million units over 6 hours). Colour duplex ultrasound revealed good flow into deep leg and pelvic veins after three cycle of lysis. Magnetic resonance angiography of the abdomen and pelvis was performed to evaluate the successful fibrinolysis with complete recanalisation of the pelvic veins and to demonstrate the venous anatomy. Permanent oral anticoagulation with phenprocoumon is indicated to decrease the high rate of recurrent thrombosis. Compression stockings were prescribed. To prevent thrombosis, additional risk factors like smoking, immobilization and unusual physical activity should be strictly avoided. PMID:11220087

Körber, T; Petzsch, M; Placke, J; Ismer, B; Schulze, C

2001-01-01

414

Two Stage Complex Embolization of an Arteriovenous Fistula between the Right Common Iliac Artery and the Inferior Vena Cava.  

PubMed

We present an interesting case of a symptomatic high flow AV fistula between the right common iliac artery (CIA) and the inferior vena cava (IVC), successfully treated by endovascular coil embolization. The patient was found to have a right lower polar renal artery crossing the ipsilateral ureter arising from the CIA, causing pelvi-ureteric junction (PUJ) obstruction and recurrent pyelonephritis. It is hypothesized that this fistula arising from the lower polar renal artery and entering the IVC, may have occurred as a result of trauma during a previous pyeloplasty, or a pathologically induced process of angiogenesis stemming from recurrent pyelonephritis. PMID:22470611

Littlejohn, Marc Gingell; Allaf, Nile; Butterfield, Stephen

2009-01-01

415

Ectopic drainage from the inferior vena cava to the left atrium together with a partial anomalous pulmonary venous connection.  

PubMed

We report a case of a 44-year-old male patient with ectopic drainage from the inferior vena cava to the left atrium accompanied by partial anomalous pulmonary venous drainage. After the patient was hospitalized, his diagnosis was confirmed by Doppler echocardiography and angiography. A pericardial patch was used to divert the blood to the atrium. The surgical procedure was successful, and the patient began a rehabilitation program 8 days later. This type of ectopic drainage pattern is an unusual and infrequent clinical finding. The definitive diagnosis should be made by Doppler ultrasound combined with angiography. PMID:24333195

Wu, Yuan; Xu, Shuangyue; Guo, Hongwei; Yan, Guoliang; Qi, Zhongquan; Shan, Zhonggui

2014-07-01

416

Idiopathic thrombosis of the inferior vena cava and bilateral femoral veins in an otherwise healthy male soldier.  

PubMed

Thrombosis of the inferior vena cava is less common than deep venous thrombosis of the lower extremities, particularly in the absence of an obvious congenital caval abnormality or hypercoagulable state. We present a case of IVC thrombosis in an otherwise healthy and active 28-year-old male soldier secondary to dehydration and venous webbing. IVC thrombosis is an uncommon and underrecognized condition; in this case, the patient's caval thrombosis was initially mistaken for acute back strain. Prompt recognition is necessary to minimize long-term sequelae. PMID:24187556

Gordon, Sarah; Kerns, Tamie; Londeree, William; Ching, Brian

2013-01-01

417

Posterior nutcracker syndrome associated with interrupted left inferior vena cava with azygos continuation and retroaortic right renal vein.  

PubMed

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. PMID:22563273

Luo, Xiao-Li; Qian, Gen-Nian; Xiao, Hui; Zhao, Chun-Lei; Zhou, Xiao-Dong

2012-01-01

418

Acute abdominal pain after retrievable inferior vena cava filter insertion: case report of caval perforation by an option filter.  

PubMed

Symptomatic caval injury is rare after inferior vena cava (IVC) filter insertion. A 39-year-old woman developed acute abdominal pain after uneventful placement of a retrievable Option IVC Filter (Angiotech Pharmaceuticals, Vancouver, British Columbia, Canada). Two days after placement, computed tomography showed a right-sided retroperitoneal hematoma, and three-dimensional C-arm rotational venography confirmed limb penetration beyond the caval wall. This is the first report of this complication despite two recent studies highlighting the safety profile of this relatively new filter. PMID:21170529

Wang, Weiping; Spain, James; Tam, Matthew D B S

2011-08-01

419

Open surgical inferior vena cava filter retrieval for caval perforation and a novel technique for minimal cavotomy filter extraction.  

PubMed

Late complications of retrievable inferior vena cava (IVC) filters resulting from IVC perforation and erosion into adjacent structures is an increasingly frequent phenomena. We describe six cases of open filter explantation for IVC penetration and offer a novel technique for open filter removal without the need for an extensive cavotomy. All patients had radiographic evidence of filter erosion into pericaval structures requiring open surgical filter explant. Four of the six patients underwent minimal cavatomy filter extraction, eliminating the need for caval reconstruction. PMID:22503185

Connolly, Peter H; Balachandran, Vinod P; Trost, David; Bush, Harry L

2012-07-01

420

Diabetes alters vascular mechanotransduction: pressure-induced regulation of mitogen activated protein kinases in the rat inferior vena cava  

PubMed Central

Background Diabetes mellitus is an important risk factor for increased vein graft failure after bypass surgery. However, the cellular and molecular mechanism(s) underlying vessel attrition in this population remain largely unexplored. Recent reports have suggested that the pathological remodeling of vein grafts may be mediated by mechanically-induced activation of the mitogen activated protein kinase (MAPK) signaling pathways and the MAPK-related induction of caspase-3 activity. On the basis of these findings, we hypothesized that diabetes may be associated with alterations in how veins "sense" and "respond" to altered mechanical loading. Methods Inferior venae cavae (IVC) from the non-diabetic lean (LNZ) and the diabetic obese (OSXZ) Zucker rats were isolated and incubated ex vivo under basal or pressurized conditions (120 mmHg). Protein expression, basal activation and the ability of increased pressure to activate MAPK pathways and apoptosis-related signaling was evaluated by immunoblot analysis. Results Immunoblot analyses revealed differential expression and activation of extracellular signal-regulated kinase (ERK1/2), p38 and c-Jun NH2-terminal kinase (JNK) MAPKs in the IVCs of diabetic rats as compared to non-diabetic rats. In particular, the expression and basal phosphorylation of p38?- (52.3 ± 11.8%; 45.8 ± 18.2%), JNK 1- (21.5 ± 9.3%; 19.4 ± 11.6%) and JNK3-MAPK (16.8 ± 3.3%; 29.5 ± 17.6%) were significantly higher (P < 0.05) in the diabetic vena cava. An acute increase in IVC intraluminal pressure failed to increase the phosphorylation of ERK1-, JNK-2, or any of the p38-MAPKs in the diabetic obese Zucker rats. Also, IVC loading in the LNZ led to a 276.0 ± 36.0% and 85.8 ± 25.1% (P < 0.05) increase in the cleavage of caspase-3 and caspase-9, respectively, with no effect on these molecules in the OSXZ. No differences were found in the regulation of Bax and Bcl-2 between groups. However, basal expression levels of Akt, phospho-Akt, PTEN, phospho-PTEN and phospho-Bad were higher in the diabetic venae cavae (P < 0.05). Conclusion These data suggest that diabetes is associated with significant alteration in the ability of the vena cava to activate MAPK- and apoptosis-related signaling. Whether these changes are associated with the increased vein graft attrition seen in the diabetic population will require further investigation.

Rice, Kevin M; Desai, Devashish H; Kakarla, Sunil K; Katta, Anjaiah; Preston, Deborah L; Wehner, Paulette; Blough, Eric R

2006-01-01

421

Bedside placement of a retrievable inferior vena cava filter in a morbidly obese patient guided by modified IVUS approach.  

PubMed

Deep vein thrombosis and pulmonary embolism are major causes of morbidity and mortality in trauma patients. Anticoagulation therapy is often contraindicated in these patient populations. The retrievable inferior vena cava (IVC) filter provides a good option for preventing pulmonary embolism in the immediate injury and postoperative periods. Bedside IVC filter placement by guidance of intravascular ultrasound eliminates the risk of transportation; it is safe, efficient, and cost effective. We hereby present a case of bedside IVC filter placement in a morbidly obese patient with modified intravascular ultrasound approach. PMID:23220991

Patel, Nishit; Saucedo, Jorge

2012-12-01

422

Curative resection and reconstruction of the inferior vena cava after extensive infiltration with low-grade endometrial stromal sarcoma.  

PubMed

Endometrial stromal sarcoma (ESS) rarely infiltrates the great vessels. We report a successful surgical resection of the inferior vena cava (IVC) after extensive infiltration with metastatic low-grade ESS. A case of presumed recurrence of low-grade ESS demonstrated complete IVC occlusion from tumour thrombus with extensive local disease. Radical resection of the tumour and caval reconstruction was performed. The IVC graft was thrombosed at short-term follow-up. Curative resection of extensive caval infiltration with metastatic low-grade ESS can be achieved. Caval reconstructive procedures may be redundant in the presence of an adequate collateral circulation. PMID:22368192

Delaney, C L; Saleem, H; Karapetis, C; Spark, J I

2013-02-01

423

Primary leiomyosarcoma of the inferior vena cava invading the right atrium: a technique for intraluminal biopsy through a transvenous approach.  

PubMed

Leiomyosarcoma of inferior vena cava (IVC) is a very rare tumor constituting less than 1% of all malignant tumors. However, it is the most common malignant primary IVC tumor. We report a case of primary leiomyosarcoma involving the entire IVC and extending into the right atrium. We also describe a simple endovascular technique that can be used to biopsy IVC masses through a transvenous approach. Our technique can be used as an alternative to percutaneous biopsy which carries a risk of bleeding when transgressing the IVC wall with a biopsy needle. To our knowledge, the use of this technique to biopsy IVC masses has not been described in literature. PMID:21914679

Abdel-Aal, Ahmed Kamel; Gaddikeri, Santhosh; Saddekni, Souheil; Oser, Rachel F; Underwood, Edgar; Wei, Shi

2011-11-01

424

Internal jugular and common femoral venous access for the removal of a long-term embedded vena cava filter.  

PubMed

We describe an inferior vena cava filter retrieval technique requiring triple venous access performed in a 35-year-old male who was referred for filter removal 16 months after its insertion. The filter showed a right-sided tilt with endothelialization of the distal filter struts into the caval wall. Access was required via both internal jugular veins to straighten the filter using a snared-loop technique. Further 18 F right common femoral vein access was required to snare and remove the filter, which could not be completely collapsed distally due to endothelialized tissue, precluding normal removal via the jugular venous route. PMID:24509181

Salati, Umer; Govender, Pradeep; Torreggiani, William; Browne, Ronan

2014-01-01

425

Use of a Trellis Device for Endovascular Treatment of Venous Thrombosis Involving a Duplicated Inferior Vena Cava  

SciTech Connect

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.

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)] [University of Missouri, Kansas City, Department of Interventional Radiology, Saint Luke's Hospital (United States)

2013-12-15

426

Process based modeling of sedimentary basin properties - Peïra Cava Basin, SE France  

NASA Astrophysics Data System (ADS)

Session SSP 3.2/GMPV46 The Eocene-Oligocene Grès d'Annot Formation which crops-out in the Peïra Cava region of south-eastern France is a 1200 m thick succession of sandstones and mudstones deposited in a confined, synclinal sub-basin plunging to the north. The Peïra Cava turbidite system is dominated by interceded high- and low-concentration turbidity deposits with several marker beds that can be correlated throughout the basin fill, providing a robust stratigraphic framework for analysis (Amy et al, 2007). Using deterministic process based simulations it is possible to recreate the flow events that deposited the basin fill. The aim of the present study to utilize this methodology and investigate the role of the confinement, relief, and the size of the turbidity currents events required to reproduce the observed stratigraphy. MassFLOW-3D is a 3D Computational Fluid Dynamic (CFD) software for the numerical simulation of the physical equations describing fluid flow and sediment transport for turbidity currents. Flows are simulated on a structural restored, back-stripped and decompacted palaeo-bathymetry. The sedimentary infilling was the results of 18 major events (the marker units of Amy et al, 2007) and many thousands of minor ones. Each stratigraphic package includes a major flow and numerous minor ones having similar characteristics (flow entry point, sediment species and concentration, velocity inlet). The numerical modelling aimed to reproduce these 10 major units as the result of 10 major gravity flows. The different boundary conditions, such as the turbidity current inflow dimensions, inlet velocity, grain size and sand concentration used were based on outcrop observations and analysis found in the literature. Comparison of the depositional results to the outcrop can highlight topographic issues but also validate the choice of palaeobathymetry. Overall good match were found with correct areas of erosion, bypass and deposition regarding outcrop observations. The fill of this basin initiated with deposition that was ponded within topographic lows and the earliest units are less continuous than the subsequent, more sheet like deposits. There was a clear up-slope back-lap of the basin fill and the retrogradation of the base of slope caused a reduction in the degree of erosion by successive surges (flow events) at the slope to basin transition. Reflection and refraction effects can be observed numerically as it had been observed in the outcrop (Amy et al, 2007). The process based modelling was able to reproduce the distribution of deposits observed in the outcrop. This suggests that while non-uniqueness may be an issue, the assumptions made for flow size, flow velocity, sediment concentration, surge time and grain size were reasonable. Modelling the stratigraphy as 10 discrete surges rather than several thousand beds does not appear to have impacted the ability to reproduce the large scale stratigraphic architecture and mimic the fill of the basin. It does not capture however the distribution of bed scales heterogeneities. The modelling process is sensitive to the palaeo-bathymetric surface that is used.

Rouzairol, Romain; Basani, Riccardo; Hansen, Ernst; Aas, Tor Even; Howell, John

2013-04-01

427

The superior transverse scapular ligament in fetuses.  

PubMed

Introduction. The superior transverse scapular ligament (STSL) links the margins of the suprascapular notch and converts it into a foramen, through which, the suprascapular nerve and, on some rare occasions, the suprascapular vessels pass. This conversion often results from partial or complete ossification of the STSL and may produce compressive symptoms in the suprascapular nerve. Material and Method. Twenty shoulders from human fetuses were dissected without the aid of optical instruments and, using a digital pachymeter of precision 0.01 millimeters, length measurements and thickness measurements were made. The fetal age was from 21 to 33 weeks of gestation, with a mean of 27.6 ± 4.14 weeks. Results. There was no statistically significant difference in STSL length or any difference in the thicknesses at the medial and lateral extremities between the halves of the body (P ? 0.05). However, in the left half of the body, the medial extremity of the STSL was significantly thinner than the lateral extremity (P ? 0.05). Conclusion. Anatomical and morphometric details about the STSL were described in human fetuses. These findings, in fetuses, may encourage the pursuit of further studies to understand the morphofunctional role and meaning of this small ligament. PMID:24455269

Aragão, José Aderval; Teles, Luiza Neves de Santana; Chaves, Ana Bárbara de Jesus; Prado, Jéssica Cândida Oliveira; Pereira, Priscila Soares; Dantas, João Gabriel Lima; Reis, Francisco Prado

2013-01-01

428

Transmastoid Repair of Superior Semicircular Canal Dehiscence  

PubMed Central

Objective/Hypothesis?Superior semicircular canal (Sup SC) dehiscence syndrome is a rare condition, causing a variety of auditory and vestibular symptoms. The traditional surgical management is a middle cranial fossa, extradural approach to resurface the Sup SC. Recently, a transmastoid approach for plugging of the Sup SC has been developed. We present further data supporting the use of the transmastoid approach in preference to the middle fossa approach. Design?This is a retrospective multi-institutional case series. Method?We included 10 patients in this case series from two tertiary otology institutions. Sup SC dehiscence was confirmed by correlation of clinical symptoms with positive audiometric, vestibular evoked myogenic potential, and computed tomography findings. A transmastoid approach was used for plugging of the Sup SC. Either a single fenestration was created at the site of dehiscence or separate fenestrations sited ampullopetal and ampullofugal to the dehiscence. Results?All patients who underwent this procedure had good symptom control and hearing preservation postoperatively. Conclusion?In patients with adequate temporal bone pneumatization, the transmastoid approach provides a safe and effective alternative to the middle cranial fossa approach. This series has demonstrated excellent symptom control and preservation of hearing with the transmastoid approach.

Zhao, Yi Chen; Somers, Thomas; van Dinther, Joost; Vanspauwen, Robby; Husseman, Jacob; Briggs, Robert

2012-01-01

429

Transmastoid repair of superior semicircular canal dehiscence.  

PubMed

Objective/Hypothesis?Superior semicircular canal (Sup SC) dehiscence syndrome is a rare condition, causing a variety of auditory and vestibular symptoms. The traditional surgical management is a middle cranial fossa, extradural approach to resurface the Sup SC. Recently, a transmastoid approach for plugging of the Sup SC has been developed. We present further data supporting the use of the transmastoid approach in preference to the middle fossa approach. Design?This is a retrospective multi-institutional case series. Method?We included 10 patients in this case series from two tertiary otology institutions. Sup SC dehiscence was confirmed by correlation of clinical symptoms with positive audiometric, vestibular evoked myogenic potential, and computed tomography findings. A transmastoid approach was used for plugging of the Sup SC. Either a single fenestration was created at the site of dehiscence or separate fenestrations sited ampullopetal and ampullofugal to the dehiscence. Results?All patients who underwent this procedure had good symptom control and hearing preservation postoperatively. Conclusion?In patients with adequate temporal bone pneumatization, the transmastoid approach provides a safe and effective alternative to the middle cranial fossa approach. This series has demonstrated excellent symptom control and preservation of hearing with the transmastoid approach. PMID:23904997

Zhao, Yi Chen; Somers, Thomas; van Dinther, Joost; Vanspauwen, Robby; Husseman, Jacob; Briggs, Robert

2012-08-01

430

Lateral superior olive function in congenital deafness  

PubMed Central

The development of cochlear ilmplants for the treatment of patients with profound hearing loss has advanced considerably in the last few decades, particularly in the field of speech comprehension. However, attempts to provide not only sound decoding but also spatial hearing are limited by our understanding of circuit adaptations in the absence of auditory input. Here we investigate the lateral superior olive (LSO), a nucleus involved in interaural level difference (ILD) processing in the auditory brainstem using a mouse model of congenital deafness (the dn/dn mouse). An electrophysiological investigation of principal neurons of the LSO from the dn/dn mouse reveals a higher than normal proportion of single spiking (SS) neurons, and an increase in the hyperpolarisation-activated Ih current. However, inhibitory glycinergic input to the LSO appears to develop normally both pre and postsynaptically in dn/dn mice despite the absence of auditory nerve activity. In combination with previous electrophysiological findings from the dn/dn mouse, we also compile a simple Hodgkin and Huxley circuit model in order to investigate possible computational deficits in ILD processing resulting from congenital hearing loss. We find that the predominance of SS neurons in the dn/dn LSO may compensate for upstream modifications and help to maintain a functioning ILD circuit in the dn/dn mouse. This could have clinical repercussions on the development of stimulation paradigms for spatial hearing with cochlear implants.

Couchman, Kiri; Garrett, Andrew; Deardorff, Adam S.; Rattay, Frank; Resatz, Susanne; Fyffe, Robert; Walmsley, Bruce; Leao, Richardson N.

2011-01-01

431

Lateral superior olive function in congenital deafness.  

PubMed

The development of cochlear implants for the treatment of patients with profound hearing loss has advanced considerably in the last few decades, particularly in the field of speech comprehension. However, attempts to provide not only sound decoding but also spatial hearing are limited by our understanding of circuit adaptations in the absence of auditory input. Here we investigate the lateral superior olive (LSO), a nucleus involved in interaural level difference (ILD) processing in the auditory brainstem using a mouse model of congenital deafness (the dn/dn mouse). An electrophysiological investigation of principal neurons of the LSO from the dn/dn mouse reveals a higher than normal proportion of single spiking (SS) neurons, and an increase in the hyperpolarisation-activated I(h) current. However, inhibitory glycinergic input to the LSO appears to develop normally both pre and postsynaptically in dn/dn mice despite the absence of auditory nerve activity. In combination with previous electrophysiological findings from the dn/dn mouse, we also compile a simple Hodgkin and Huxley circuit model in order to investigate possible computational deficits in ILD processing resulting from congenital hearing loss. We find that the predominance of SS neurons in the dn/dn LSO may compensate for upstream modifications and help to maintain a functioning ILD circuit in the dn/dn mouse. This could have clinical repercussions on the development of stimulation paradigms for spatial hearing with cochlear implants. PMID:21276842

Couchman, Kiri; Garrett, Andrew; Deardorff, Adam S; Rattay, Frank; Resatz, Susanne; Fyffe, Robert; Walmsley, Bruce; Leão, Richardson N

2011-07-01

432

Superior temporal gyrus spectral abnormalities in schizophrenia  

PubMed Central

Considerable evidence indicates early auditory stimulus processing abnormalities in schizophrenia, but the mechanisms are unclear. The present study examined oscillatory phenomena during a paired-click paradigm in the superior temporal gyrus (STG) as a possible core problem. The primary question addressed is whether first click and/or second click group differences in the time-domain evoked response in patients with schizophrenia are due to (1) group differences in the magnitude of poststimulus oscillatory activity, (2) group differences in poststimulus phase-locking, and/or (3) group differences in the magnitude of ongoing background oscillatory activity. Dense-array magnetoencephalography from 45 controls and 45 patients with schizophrenia produced left- and right-hemisphere STG 50- and 100-ms time-frequency evoked, phase-locking, and total power measures. Whereas first click 100-ms evoked theta and alpha abnormalities were observed bilaterally, evoked low beta-band differences were specific to the left hemisphere. Compared to controls, patients with schizophrenia showed more low-frequency phase variability, and the decreased 100-ms S1 evoked response observed in patients was best predicted by the STG phase-locking measure.

EDGAR, J. CHRISTOPHER; HANLON, FAITH M.; HUANG, MING-XIONG; WEISEND, MICHAEL P.; THOMA, ROBERT J.; CARPENTER, BRUCE; HOECHSTETTER, KARSTEN; CANIVE, JOSE M.; MILLER, GREGORY A.

2009-01-01

433

The role of ultrasonography and inferior vena cava filter placement in high-risk trauma patients.  

PubMed

Undetected lower-extremity deep-vein thrombosis (LEDVT) in the trauma patient can lead to significant morbidity and mortality. The purpose of this study was to: 1) evaluate the role of ultrasonography in the early detection of LEDVT in high-risk trauma patients; 2) identify prognostic indicators that predict LEDVT; and 3) evaluate the efficacy of selected inferior vena cava (IVC) filter placement in the prevention of pulmonary emboli. From October 1993 through December 1994, all adult multiple-trauma patients admitted to the Trauma Service who required prolonged bed rest (>3 days) or sustained a lower-extremity, pelvic, or spinal fracture with paralysis were prospectively studied with serial physical examinations and lower-extremity venous ultrasounds within 72 hours of admission and then weekly until discharge. Two hundred twenty-eight patients were entered into the study. Thirty-nine patients (17%) developed ultrasound evidence of LEDVT; of these, only seven (18%) were evident on physical examination. This allowed 32 patients (82%) with unsuspected LEDVT to receive earlier definitive therapy. Multivariate logistic regression analysis of LEDVT with various predictors found age, hospital length of stay, and lower-extremity trauma to be significant predictors of LEDVT (P < 0.05). Twenty-nine patients (74%) had immediate IVC filter placement upon ultrasound identification of proximal LEDVT. None of these patients developed pulmonary emboli. Ten patients (26%) with a LEDVT were treated with systemic anticoagulation alone. One of these patients sustained a fatal pulmonary embolus. In a historic control group of 234 high-risk trauma patients admitted in the 14 months prior to implementing screening ultrasounds, six patients sustained pulmonary emboli (P < 0.05). Screening ultrasounds combined with selective placement of IVC filters play an important role in reducing the morbidity and mortality associated with LEDVT in high-risk trauma patients. PMID:8985062

Headrick, J R; Barker, D E; Pate, L M; Horne, K; Russell, W L; Burns, R P

1997-01-01

434

The relationship between inferior vena cava diameter measured by bedside ultrasonography and central venous pressure value  

PubMed Central

Objective: We aimed to present inferior vena cava (IVC) diameter as a guiding method for detection of relationship between IVC diameter measured noninvasively with the help of ultrasonography (USG) and central venous pressure (CVP) and evaluation of patient's intravascular volume status. Methods: Patients over the age of 18, to whom a central venous catheter was inserted to their subclavian vein or internal jugular vein were included in our study. IVC diameter measurements were recorded in millimeters following measurement by the same clinician with the help of USG both at the end-inspiratory and end-expiratory phase. CVP measurements were viewed on the monitor by means of piezoelectric transducer and recorded in mmHg. SPSS 18.0 package program was used for statistical analysis of data. Results: Forty five patients were included in the study. The patients had the diagnosis of malignancy (35.6%), sepsis (13.3%), pneumonia, asthma, chronic obstructive pulmonary disease (11.1%). 11 patients (24.4%) required mechanical ventilation while 34 (75.6%) patients had spontaneous respiration. In patients with spontaneous respiration, a significant relationship was found between IVC diameters measured by ultrasonography at the end of expiratory and inspiratory phases and measured CVP values at the same phases (for expiratory p = 0.002, for inspiratory p= 0.001). There was no statistically significant association between IVC diameters measured by ultrasonography at the end of expiration and inspiration and measured CVP values at the same phases in mechanically ventilated patients. Conclusions: IVC diameter measured by bedside ultrasonography can be used for determination of the intravascular volume status of the patients with spontaneous respiration.

Citilcioglu, Serenat; Sebe, Ahmet; Oguzhan Ay, Mehmet; Icme, Ferhat; Avci, Akkan; Gulen, Muge; Sahan, Mustafa; Satar, Salim

2014-01-01

435

Treatment of Budd-Chiari syndrome with inferior vena cava thrombosis  

PubMed Central

The aim of this study was to evaluate the initial results of 41 patients with Budd-Chiari syndrome (BCS) with inferior vena cava (IVC) thrombosis, with regard to the clinical safety and feasibility of the therapeutic approaches selected according to the classification of the condition. Forty-one patients with BCS and IVC thrombosis were admitted for retrospective analysis. All 41 patients were classified as having one of three types of BCS. Interventional therapy was used successfully in 28 patients (68.3%), 7 patients (17.1%) were given conservative treatment and 6 patients (14.6%) were treated with surgical shunts. The interventional approach was used in 29 patients in total and was successful in 28 patients (all those of types I and II, and 3 of the 4 patients of type III with acute thrombosis; 96.6%). None of these 28 patients had pulmonary embolism, pericardial tamponade or intra-abdominal bleeding. After 1–5 years, 4 patients (9.8%) had a second dilation of the IVC. In the 7 cases treated in a conservative manner, 2 cases succumbed to upper gastrointestinal bleeding and 1 case succumbed to liver and kidney failure. This study indicates that the classification of BCS patients with IVC thrombosis is helpful in selecting a therapeutic approach. Interventional therapy is the first therapeutic choice for BCS patients with IVC thrombosis of type I, type II or type III with acute thrombosis. For the patients of type III with an obsolete thrombus, surgical shunts or conservative treatment are the main therapeutic methods.

WANG, RUIHUA; MENG, QINGYI; QU, LIFENG; WU, XUEJUN; SUN, NIANFENG; JIN, XING

2013-01-01

436

Improved removal rates for retrievable inferior vena cava filters with the use of a 'filter registry'.  

PubMed

The American Association for the Surgery of Trauma challenged the trauma community to improve a 22 per cent average removal rate for retrievable inferior vena cava filters (r-IVCFs). Since 2006, we maintained a "filter registry" documenting all IVCFs placed in trauma patients. Our goal was to improve removal rates for r-IVCF. Patients receiving an IVCF before implementation of filter registry, 2003-2005, comprised the control group. Patients receiving an IVCF after implementation of filter registry, 2006-2009, comprised the study group. Data obtained included age, gender, Injury Severity Score (ISS), length of stay (LOS), mortality, filter inserted, placement indication, removal rates, and reasons why removal did not occur. Fisher exact test and chi square were used for nominal variables. Stepwise logistic regression analysis was used to define predictors of removing and not removing an IVCF. Three hundred seven patients received an IVCF, 142 preregistry and 165 postregistry. No significant difference existed between groups in age, gender, ISS, placement indication, or mortality. A significant difference existed between groups in LOS and presence of deep vein thrombosis (DVT) and pulmonary embolism. A total of 98.2 per cent of postregistry patients received a Günther Tulip filter and all retrievals were performed by Interventional Radiology. Retrieval rates improved, 15.5 to 31.5 per cent post registry (P < 0.001). No differences existed in lost to follow-up (LTF) between groups. Univariate analysis identified age, IVC clot, DVT, and LTF as predictors for not removing a filter. Stepwise logistic regression revealed the filter registry independently predicts the removal of an r-IVCF. A filter registry is effective in improving rates of removal for r-IVCFs. PMID:22273323

Kalina, Michael; Bartley, Marilyn; Cipolle, Mark; Tinkoff, Glen; Stevenson, Scott; Fulda, Gerard

2012-01-01

437

Transcatheter thrombolytic therapy for symptomatic thrombo-occlusion of inferior vena cava filter.  

PubMed

Thrombus within an inferior vena cava (IVC) filter reduces filter patency and venous return from the lower extremities, and may progress to complete IVC occlusion. The clinical experiences and outcomes of transcatheter thrombolytic therapy for symptomatic IVC thrombosis following filter implantation have not been widely reported. The aim of the current study was to evaluate the efficiency and safety of trans-catheter thrombolysis for the treatment of symptomatic IVC thrombosis in patients with implanted IVC filters. Transcatheter thrombolysis was used to treat 5 patients with thrombosis of the filter-bearing IVC causing symptoms in 10 limbs from October 2005 to September 2010. The patients were implanted with a second IVC filter through the right internal jugular vein, followed by recanalization of the occluded IVC and intravenous transcatheter thrombolysis. The IVC filters were retrieved through the femoral or right internal jugular vein after the thrombus had dissolved. Technical and clinical outcome, complications and postoperative pulmonary embolism were monitored. A total of 5 filters were implanted and 6 filters were retrieved later. Technically and clinically successful recanalization and thrombolysis were achieved in 5 of 5 patients and 10 of 10 symptomatic limbs. The median thrombolysis period was 13 days (range, 8-14 days). The median dwell time for the filters that were removed was 50.5 days (range, 14-73 days). No major bleeding occurred during the current study. During clinical follow-up, no clinically detectable pulmonary embolism was observed. Endovascular recanalization and transcatheter thrombolysis of IVC thrombosis are efficient, feasible and safe in the presence of an IVC filter. PMID:23403505

Xiao, Liang; Shen, Jing; Tong, Jia-Jie; Zhang, Zhe; Mu, Xiao-Lin; Yi, Zheng-Jia; Bai, Shuo; Xu, Ke

2013-02-01

438

Effect of Different Suprahepatic Vena Cava Reconstruction Methods on the Hemodynamics of Rats after Liver Transplantation  

PubMed Central

Background There are few studies on the hemodynamic changes after orthotopic liver transplantation in rats. In this study, we aimed to evaluate the effect of different suprahepatic vena cava (SHVC) reconstruction methods on the hemodynamics of rats after liver transplantation. Materials and Methods Three rat liver transplantation groups were created according to the SHVC reconstruction method: Kamada’s two-cuff technique, a modified veno-lined stent technique, and Harihara’s three-cuff technique. Ten rats of similar weight were grouped as the control. Anatomical, ultrasonic, and hemodynamic parameters and the microcirculation of the liver were measured after transplantation. The detailed operation time, operative complications, and animal survival were recorded. Results All the recipients showed portal hypertension one month after transplantation. The portal hypertension in the group with the modified veno-lined stent technique was the most severe. The value measured with real-time elastography was significantly higher in the recipients using the modified veno-lined stent technique than in the other two groups (P<0.01). There was no difference in the graft microcirculation after reperfusion among the three groups. The survival rate of the three groups displayed no difference, but the modified veno-lined stent technique led to more venous complications than the other two techniques. Conclusions The hemodynamics after liver transplantation in rats is determined not only by the cuff used for portal vein reconstruction but also by the cuff or stent for the SHVC. Some SHVC reconstruction methods, such as the modified veno-lined stent technique, Miyata’s or Settaf’s three-cuff techniques, significantly affect the hemodynamics.

Wang, Hongdong; Li, Chonghui; Hu, Jianjun; Xu, Hongbin; Ji, Xu; Wang, Xiaofeng; Wang, Xuedong; Luo, Yukun; Li, Hailin; Xu, Kesen; Ye, Sheng; Zhang, Aiqun; Dong, Jiahong

2013-01-01

439

The bedside insertion of inferior vena cava filters using ultrasound guidance.  

PubMed

Since the introduction of inferior vena cava (IVC) filters more than 30 years ago, there has been a steady improvement in the design, ease, and safety of the delivery systems. Today, all of the commonly used filters can be placed via a peripheral vein by using standard percutaneous Seldinger technique. However, this typically requires fluoroscopy, intravenous contrast agents, radiation exposure, and transport of the patient to the interventional or operating suite. In the multiply injured trauma or critically-ill intensive care unit patient, often requiring inotropic and ventilator support, transport to these facilities can be hazardous. In addition, these patients frequently have a combination of neurospinal and long bone injuries, which require skeletal immobilization, thus further complicating transportation. Advancing technology with portable duplex ultrasound and improved deep abdominal duplex imaging has allowed for routine diagnostic evaluation of the IVC, renal veins, and surrounding visceral structures. This degree of accuracy has allowed numerous centers to gain experience with ultrasonic imaging of the IVC and insertion site after a filter has been placed. A logical progression has evolved to the point in which, today, duplex ultrasound can be used to guide the insertion of IVC filters. The following describes, in detail, a technique for the percutaneous placement of an IVC filter at the bedside using only duplex ultrasound guidance. The article also briefly compares and contrasts this technique with an alternate technique using intravascular ultrasound. Vena caval interruption can be safely performed under ultrasound guidance in a monitored, intensive care unit environment. In selected intensive care unit or multiply injured trauma patients, this will reduce the risk, complexity and cost of transport for these critically ill patients. Duplex-guided IVC filter placement also reduces procedural costs compared to an operating room or interventional suite, and eliminates intravenous contrast material exposure. PMID:17437987

Uppal, Baljeet; Flinn, William R; Benjamin, Marshall E

2007-03-01

440

Factors involved in gas embolism after laparoscopic injury to inferior vena cava.  

PubMed

This study evaluated the incidence and factors involved in the occurrence of gas embolism after laparoscopic injuries. A 5-MHz transesophageal echocardiographic (TEE) probe was placed in 11 anesthetized pigs and used to examine the right cardiac chambers and pulmonary artery. A calibrated carbon dioxide analyzer continuously measured end-tidal carbon dioxide (ETCO2). The ventilatory settings were adjusted to achieve a baseline ETCO2 between 25 and 28 mm Hg. A blinded dose-response curve for TEE and ETCO2 measurements were created by injecting 0.0007 to 1.5 mL/kg of CO2 gas intravenously. Venotomies (N = 22) were created laparoscopically in the inferior vena cava (IVC) of the study animals. All TEE images were videotaped and correlated with laparoscopic events. Embolic episodes were classified by comparison with images recorded during the bolus studies. A variety of methods for obtaining hemostasis and repairing the venotomies were evaluated and their effects on gas embolism were studied. No emboli were noted when the venotomies were bleeding freely, the hole was directly occluded, or the proximal IVC was compressed. Marked embolism was seen with distal IVC occlusion or when there had been significant blood loss. In this situation, manipulation of the hole and higher intraperitoneal pressures led to higher degrees of embolization. No emboli were seen in an open control group except after significant bleeding. The TEE is the most sensitive method of detecting gas emboli; however, the majority of episodes are not clinically significant. Embolism of CO2 occurs when central venous pressure is decreased by blood loss or distal compression. When significant venous bleeding occurs, intravascular volume should be maintained and the bleeding site should be directly occluded. PMID:9607442

O'Sullivan, D C; Micali, S; Averch, T D; Buffer, S; Reyerson, T; Schulam, P; Kavoussi, L R

1998-04-01

441

Leiomyosarcoma of the inferior vena cava: surgical management and clinical results.  

PubMed

Leiomyosarcoma of the inferior vena cava (IVC) is a rare lesion with less than 300 cases reported. Optimal management and long-term outcomes are not well described. From August 1984 to June 2004, eight patients with leiomyosarcoma of the IVC were treated at our institution. Clinical and pathologic data, surgical management, and outcomes were assessed. Eight cases were identified (4 males) with a median age of 52 (range 29-66). Presenting symptoms included abdominal pain (n = 5, 63%), lower extremity edema (n = 2, 25%), and palpable mass (n = 2, 25%). Tumor location was between the renal and iliac veins (low) (n = 4, 50%), between the hepatic and renal veins (middle) (n = 3, 38%), and above the hepatic veins with right atrial extension (high) (n = 1, 12%). Two patients with preoperative IVC occlusion were managed with tumor excision and IVC ligation. Three patients had primary repair of the IVC after tumor excision. A polytetrafluorothylene (PTFE) tube graft was used for IVC reconstruction in three cases. There was no postoperative mortality. Postoperative morbidity included deep venous thrombosis (DVT) (n = 1), lower extremity edema (mild n = 1; moderate n = 1), GI bleed (n = 1), and chronic renal insufficiency (n = 1). One patient is currently receiving adjuvant chemotherapy. Four patients received chemotherapy after recurrence, and one received palliative radiation therapy as well. Median survival to this point was 60 months with a median follow-up of 39 months. The 5-year overall survival and disease-free survival was 31 per cent for both (CI 0.1-1.0). The type of IVC reconstruction had no effect on survival (P = 0.22). Recurrence was discovered in four patients (50%) at a median time of 14 months. Resection of leiomyosarcoma of the IVC should be attempted whenever feasible. The management of the IVC can be managed with primary repair, ligation, or prosthetic graft. Long-term survival is possible if complete resection can be achieved. PMID:16044929

Dew, Jason; Hansen, Kimberly; Hammon, John; McCoy, Thomas; Levine, Edward A; Shen, Perry

2005-06-01

442

Leiomyosarcoma of the inferior vena cava: three case reports and review of the literature.  

PubMed

We describe 3 cases of leiomyosarcoma of the inferior vena cava (IVC) and review the literature describing clinicopathologic features of 211 cases and the outcome. Of these, 74% of the cases affected women with median age of 52 years. The most common symptoms were abdominal pain or mass (57%), Budd-Chiari syndrome (17%), and deep vein thrombosis (4%). The most frequent site of tumor origin is the middle segment of the IVC (33%). Tumor size ranged from 2 to 38 cm (mean, 12 cm). Of the tumors with an assigned grade, 46% were high grade, 17% were intermediate grade, and 36% were low grade. Of all patients, 47% underwent complete resection, 24% had complete resection with preoperative or postoperative chemotherapy and/or radiation, and 5% had palliative surgery. Tumor recurrence occurred in 40% of the patients (11% had local recurrence and 29% had metastasis). Perioperative mortality occurred in 4% of the cases. Of those patients who died, 42% died of the disease, 2% died of other causes, 26% were alive and free of the disease, 14% were alive with recurrent disease, and 11% were lost to follow-up. Tumors involving level 2 of the IVC have the best prognosis and tumors of level 1 have the worse prognosis. Although there is no standardized criteria for the grading of extrauterine leiomyosarcoma, we propose to grade based on mitotic activity as follows: high grade, 10 or more mitoses per 10 high-power field (HPF); intermediate grade, 5 to 9 mitoses per 10 HPF; and low grade, 1 to 4 mitoses per 10 HPF. PMID:16198953

Hilliard, Nicholaus J; Heslin, Martin J; Castro, Claudia Y

2005-10-01

443

Complex Adaptive System of Systems (CASoS) Engineering Applications. Version 1.0.  

SciTech Connect

Complex Adaptive Systems of Systems, or CASoS, are vastly complex eco-socio-economic-technical systems which we must understand to design a secure future for the nation and the world. Perturbations/disruptions in CASoS have the potential for far-reaching effects due to highly-saturated interdependencies and allied vulnerabilities to cascades in associated systems. The Phoenix initiative approaches this high-impact problem space as engineers, devising interventions (problem solutions) that influence CASoS to achieve specific aspirations. CASoS embody the world's biggest problems and greatest opportunities: applications to real world problems are the driving force of our effort. We are developing engineering theory and practice together to create a discipline that is grounded in reality, extends our understanding of how CASoS behave, and allows us to better control those behaviors. Through application to real-world problems, Phoenix is evolving CASoS Engineering principles while growing a community of practice and the CASoS engineers to populate it.

Linebarger, John Michael; Maffitt, S. Louise (New Mexico Institute of Mining and Technology, Albuquerque, NM); Glass, Robert John, Jr.; Beyeler, Walter Eugene; Brown, Theresa Jean; Ames, Arlo Leroy

2011-10-01

444

Phoenix : Complex Adaptive System of Systems (CASoS) engineering version 1.0.  

SciTech Connect

Complex Adaptive Systems of Systems, or CASoS, are vastly complex ecological, sociological, economic and/or technical systems which we must understand to design a secure future for the nation and the world. Perturbations/disruptions in CASoS have the potential for far-reaching effects due to pervasive interdependencies and attendant vulnerabilities to cascades in associated systems. Phoenix was initiated to address this high-impact problem space as engineers. Our overarching goals are maximizing security, maximizing health, and minimizing risk. We design interventions, or problem solutions, that influence CASoS to achieve specific aspirations. Through application to real-world problems, Phoenix is evolving the principles and discipline of CASoS Engineering while growing a community of practice and the CASoS engineers to populate it. Both grounded in reality and working to extend our understanding and control of that reality, Phoenix is at the same time a solution within a CASoS and a CASoS itself.

Moore, Thomas W.; Quach, Tu-Thach; Detry, Richard Joseph; Conrad, Stephen Hamilton; Kelic, Andjelka; Starks, Shirley J.; Beyeler, Walter Eugene; Brodsky, Nancy S.; Verzi, Stephen J.; Brown, Theresa Jean; Glass, Robert John, Jr.; Sunderland, Daniel J.; Mitchell, Michael David; Ames, Arlo Leroy; Maffitt, S. Louise; Finley, Patrick D.; Russell, Eric Dean; Zagonel, Aldo A.; Reedy, Geoffrey E.; Mitchell, Roger A.; Corbet, Thomas Frank, Jr.; Linebarger, John Michael

2011-08-01

445

The Quagga Mussel Invades the Lake Superior Basin  

Microsoft Academic Search

Prior studies recognized the presence of a single dreissenid species in Lake Superior—the zebra mussel Dreissena polymorpha. However, taxonomic keys based on traditional shell morphology are not always able to differentiate dreissenid species with confidence. We thus employed genetic and morphological analyses to identify dreissenids in a major river-embayment of Lake Superior—the lower St. Louis River\\/Duluth-Superior Harbor—during 2005–2006. Our results

Igor A. Grigorovich; John R. Kelly; John A. Darling; Corlis W. West

2008-01-01

446

Traumatic Rupture of the Superior Oblique Muscle Tendon  

PubMed Central

Traumatic rupture of the superior oblique muscle is rare. We report a case of a 54-year-old man injured by the metal hook of a hanger, resulting in a rupture of the superior oblique muscle tendon. He complained of torsional diplopia when in the primary position. The distal margin of the superior oblique muscle was reattached to sclera 5 and 9 mm apart from the medial insertion of the superior rectus muscle. One week after the operation, torsional diplopia disappeared. However, a 4-prism diopter ipsilateral hypertropia was observed. Three months later, hypertropia gradually increased to 20 prism dioptors and the second operation was done to correct vertical diplopia.

Chung, Hye Jin; Baek, Ji Won

2014-01-01

447

Traumatic rupture of the superior oblique muscle tendon.  

PubMed

Traumatic rupture of the superior oblique muscle is rare. We report a case of a 54-year-old man injured by the metal hook of a hanger, resulting in a rupture of the superior oblique muscle tendon. He complained of torsional diplopia when in the primary position. The distal margin of the superior oblique muscle was reattached to sclera 5 and 9 mm apart from the medial insertion of the superior rectus muscle. One week after the operation, torsional diplopia disappeared. However, a 4-prism diopter ipsilateral hypertropia was observed. Three months later, hypertropia gradually increased to 20 prism dioptors and the second operation was done to correct vertical diplopia. PMID:24882961

Chung, Hye Jin; Baek, Ji Won; Lee, Young Chun

2014-06-01

448

Biaxial mechanical properties of the inferior vena cava in C57BL/6 and CB-17 SCID/bg mice.  

PubMed

Multiple murine models have proven useful in studying the natural history of neovessel development in the tissue engineering of vascular grafts. Nevertheless, to better understand longitudinal changes in the biomechanics of such neovessels, we must first quantify native tissue structure and properties. In this paper, we present the first biaxial mechanical data for, and nonlinear constitutive modeling of, &QJ;the inferior vena cava from two models used in tissue engineering: wild-type C57BL/6 and immunodeficient CB-17 SCID/bg mice. Results show that inferior vena cava from the latter are significantly stiffer in the circumferential direction, both materially (as assessed by a stored energy function) and structurally (as assessed by the compliance), despite a lower intramural content of fibrillar collagen and similar wall thickness. Quantifying the natural history of neovessel development in different hosts could lead to increased insight into the mechanisms by which cells fashion and maintain extracellular matrix in order to match best the host stiffness while ensuring sufficient vascular integrity. PMID:23859752

Lee, Y U; Naito, Y; Kurobe, H; Breuer, C K; Humphrey, J D

2013-09-01

449

An abdominal aortic aneurysm (AAA) in combination with duplication of the inferior vena cava (IVC), the right renal artery (RRA) and the right renal vein (RRV)  

Microsoft Academic Search

Summary Intra-abdominal abnormality of vessels may sometimes lead to complications. A case of the rare combination of an abdominal aortic aneurysm (AAA) at the origin of the inferior mesenteric a. with duplications of the inferior vena cava (IVC), the right renal a. (RRA) and the right renal v. (RRV) as well as absence of the left common iliac v. is

C. Khaledpour; P. Matanovic; J. Rienäcker; J. Grönniger

1990-01-01

450

A critical evaluation of ultrasound measurement of inferior vena cava diameter in assessing dry weight in normotensive and hypertensive hemodialysis patients  

Microsoft Academic Search

The utility of measurement of the inferior vena cava diameter (IVCD) with ultrasound for the assessment of fluid status and posthemodialysis dry weight was studied in 35 hemodialysis (HD) patients, 17 with and 18 without hypertension. In 17 patients (group A), IVCD was measured before and 35 to 40 minutes after HD, pre-HD blood volume (BV) was measured with radiolabeled

Krassimir S. Katzarski; Jonas Nisell; Ivar Randmaa; Anders Danielsson; Ulla Freyschuss; Jonas Bergström

1997-01-01

451

The use of inferior vena cava filter as a treatment modality for massive pulmonary embolism. A case series and review of pathophysiology  

Microsoft Academic Search

The use of inferior vena cava (IVC) filter for massive pulmonary emboli (PE) with cardiopulmonary instability has not been clinically studied. We present a case series of six such patients who received an IVC filter with anticoagulation rather than thrombolysis because of high risk of bleeding. Acute pulmonary embolectomy was considered, but was not possible for a variety of individual

K. S. DESHPANDE; C. HATEM; M. KARWA; H. ULRICH; T. K. ALDRICH; V. KVETAN

2002-01-01

452

Comparison of Bedside Transabdominal Duplex Ultrasound versus Contrast Venography for Inferior Vena Cava Filter Placement: What Is the Best Imaging Modality?  

Microsoft Academic Search

While contrast venography is considered the gold standard for imaging prior to inferior vena cava (IVC) filter insertion, bedside placement via transabdominal duplex ultrasound (DUS) has been recognized as a safe and effective alternative. To date, there has been no direct comparison of the efficacy of both imaging modalities for IVC filter placement. A concurrent cohort of patients who underwent

Matthew A. Corriere; Marc A. Passman; Raul J. Guzman; Jeffery B. Dattilo; Thomas C. Naslund

2005-01-01

453

A confusing case: pulmonary lesions including cavities, isolated left heart endocarditis and inferior vena cava thrombosis in a patient with perforated diverticulitis.  

PubMed

There are numerous causes of pulmonary cavitary lesions as infection (bacterial, parasitic and invasive fungal), Wegener granulomatosis (WG) and other vasculitis, sarcoidosis, malignancy, septic thromboembolism, airways disease (cystic bronchiectasis and bullae), pneumatoceles and traumatic parenchymal laceration. Herein, we present a case with perforated diverticulitis causing pulmonary cavitary lesions and a septic thrombus in the neighboring inferior vena cava. PMID:22453530

I?ik, Metin; Çinar, Esat; Cemal Kizilarslano?lu, M; Özbek, Emre; Etgül, Sezgin; Kiraz, Sedat

2013-08-01

454

Placement of a caudal vena cava stent for treatment of Budd-Chiari-like syndrome in a 4-month-old Ragdoll cat.  

PubMed

Case Description-A 16-week-old 1.5-kg (3.3-lb) sexually intact male Ragdoll kitten that had a 9-week history of marked modified transudate ascites was evaluated. A membranous obstruction of the caudal vena cava at the cranial aspect of the liver was identified via CT angiography. Clinical Findings-Physical examination findings included a markedly distended abdomen and panting. Testing for circulating FIV antibody and FeLV antigen, a PCR assay for feline coronavirus performed on a sample of peritoneal fluid, and fecal flotation yielded negative results. A diagnosis of Budd-Chiari-like syndrome secondary to a membranous obstruction of the caudal vena cava was made. Treatment and Outcome-The cat was anesthetized, and the subhepatic portion of the caudal vena cava was identified and accessed via median celiotomy and direct venipuncture. A 6F 8 × 24-mm balloon-expandable nitinol biliary stent was placed across the stenotic area under fluoroscopic guidance. The patient remained free of clinical signs at the last follow-up 13 months following the procedure. Clinical Relevance-Budd-Chiari-like syndrome is a rare phenomenon in veterinary medicine, and congenital malformations should be considered in young feline patients with ascites. Computed tomography angiography proved to be a helpful adjunctive imaging technique to establish a diagnosis in this case. To the authors' knowledge, this is the first report of successful treatment of a congenital caudal vena cava obstruction by means of stent placement in a juvenile cat. PMID:25075825

Hoehne, Sabrina N; Milovancev, Milan; Hyde, Aleshia J; deMorais, Helio A; Scollan, Kate F; Nemanic, Sarah

2014-08-15

455

A comparison of the effect of bleeding site on haematological and plasma chemistry values of F344 rats: The inferior vena cava, abdominal aorta and orbital venous plexus  

Microsoft Academic Search

Of paramount importance to most toxicity studies in rats is the evaluation of haematological, coagulation and clinical chemistry parameters. In European and North American countries, the orbital venous plexus (OVP) is currently the most common route for obtaining blood, whereas in Japan the inferior vena cava (IVC) and abdominal aorta (AA) are the preferred routes. In order to compare clinical

T. Matsuzawa; H. Tabata; M. Sakazume; S. Yoshida; S. Nakamura

1994-01-01

456

Enhancement of Quality of Life with Adjustment of Dry Weight by Echocardiographic Measurement of Inferior Vena cava Diameter in Patients Undergoing Chronic Hemodialysis  

Microsoft Academic Search

Background\\/Aims: Ideal dry weight (DW) can serve as a marker of good quality of life (QOL) in patients receiving chronic hemodialysis. The size of the inferior vena cava (IVC) reflects the intravascular fluid status, and the diameter of IVC correlates indirectly with DW in these patients. Adjusting DW using echocardiographic measurement of the diameter of the IVC thus may be

Shih-Tai Chang; Chein-Lung Chen; Chien-Chung Chen; Fun-Chung Lin; Delon Wu

2004-01-01

457

Is blood cardioplegia superior to crystalloid cardioplegia?  

PubMed

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether blood cardioplegia is clinically superior to crystalloid cardioplegia for myocardial protection. Altogether 501 papers were identified. We selected 22 papers that represented the best evidence to answer the question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. This is a difficult topic to review, as the techniques studied in the many trials performed vary widely. Factors which may vary include warm or cold blood cardioplegia, antegrade and retrograde administration, systemic hypothermia or normothermia, topical heart cooling, high and low potassium solutions, 'hot shots', warm induction, volume of cardioplegia, patient factors and bypass times. However, three papers stand out. The meta-analysis of 34 randomised trials by Prof Fremes (2006) found a significantly lower incidence of low output syndrome (LOS) and CK-MB release with blood cardioplegia. He found no differences in myocardial infarction or mortality. This meta-analysis was confounded, however, by the fact that he was unable to extract data on LOS and CK-MB from the two largest trials which contributed over half the patients in his paper and are significantly larger than all other studies. The first paper by Ovrum (2006) randomised 1440 patients to antegrade cold blood or crystalloid and found no clinical differences, and the second paper by Martin (1994) of 1001 patients compared warm blood to cold crystalloid but the study had to be stopped due to a high incidence of neurological events in the warm blood group. We reviewed a further 18 randomised trials reporting over 50 patients. Of these, 10 reported some statistically significant clinical outcomes in favour of blood cardioplegia and five reported statistically significant differences in enzyme release in favour of blood cardioplegia. A recent survey of UK practice found that 56% of surgeons use cold blood cardioplegia, 14% use warm blood cardioplegia, 14% use crystalloid cardioplegia, 21% use retrograde infusion and 16% do not use any cardioplegia. The papers presented in our review support most of these practices! PMID:18339688

Jacob, Samuel; Kallikourdis, Antonios; Sellke, Frank; Dunning, Joel

2008-05-01

458

Food of lake trout in Lake Superior  

USGS Publications Warehouse

Stomachs were examined from 1,492 lake trout and 83 siscowets collected from Lake Superior. Data are given on the food of lake trout of legal size (17 inches or longer) by year, season, and depth of water, and on the relation between food and size among smaller lake trout. Fish contributed 96.7 to 99.9 per cent of the total volume of food in the annual samples. Ciscoes (Coregonus spp.) were most common (52.2 to 87.5 per cent of the volume) in 1950 to 1953 and American smelt ranked first (65.6 per cent of the volume) in 1963. Cottids were in 8.9 to 12.3 per cent of the stomachs in 1950 to 1953 but in only 4.3 per cent in 1963. Insects ranked second to fish in occurrence (9.6 per cent for the combined samples) and crustaceans followed at 3.9 per cent. The greatest seasonal changes in the food of lake trout were among fish caught at 35 fathoms and shallower. The occurrence of Coregonus increased from 34.6 per cent in February-March to 71.1 per cent in October-December. Smelt were in 76.9 per cent of the stomachs in February-March but in only 2.2 per cent in October-December. Cottids, Mysis relicta, and insects were most common in the July-September collections. Lake trout taken at depths greater than 35 fathoms had eaten a higher percentage of Cottidae and Coregonus than had those captured in shallower water. Smelt, ninespine sticklebacks, Mysis, and insects were more frequent in stomachs of lake trout from less than 35 fathoms. Crustaceans comprised more than 70 per cent of the total volume of food for 4.0- to 7.9-inch lake trout but their importance decreased as the lake trout grew larger. Pontoporeia affinis was the most common in the stomachs of 4.0- to 6.9-inch lake trout and Mysis held first rank at 7.0 to 12.9 inches. Ostracods were important only to 4.0- to 4.9-inch lake trout. As the lake trout became larger, the importance of fish grew from 4.4-per cent occurrence at 5.0 to 5.9 inches to 93.9 per cent at 16.0 to 16.9 inches. Smelt were most commonly eaten by undersize (less than 17 inches) lake trout.

Dryer, William R.; Erkkila, Leo F.; Tetzloff, Clifford L.

1965-01-01

459

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

SciTech Connect

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 pote