A Case of Inferior Vena Cava Thrombosis Induced by Left Iliac Vein Stents

Wei, Wei; Jiang, Xuemei; Xu, Bo; Chen, Yikuan

doi:10.1055/s-0038-1672212

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…Some patients will benefit from placement of an IVC filter to decrease the risk of thromboembolism. Invasive surgical interventions with successful endovascular thrombectomy, stenting, and prosthetic replacement of the inferior vena cava have also been reported, even though the procedures are not without risk (Gwozdz et al, 2018;Wei et al, 2018;Che et al, 2019;Mityul et al, 2019;Wagenhäuser et al, 2019;Yang et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Thrombosis of portal, superior mesenteric, and splenic veins: a case report

Soghomonyan,

Khachatryan,

Soghomonyan

et al. 2023

Front. Pharmacol.

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Patients with venous thrombosis of splanchnic circulation represent a group of high risk with significant morbidity and mortality, if treatment is delayed. We present a patient with thrombosis of portal vein and its tributaries combined with deep venous thrombosis (DVT) of the lower extremities who was successfully treated with conservative management. This patient case highlights the importance of early empiric anti-inflammatory therapy along with systemic anticoagulation to reduce the intestinal inflammation and enteritis and break the vicious circuit resulting in secondary progressive thrombosis of the splanchnic veins, fluid shifts, and functional ileus. Case presentation: A previously healthy 61-years-old female patient with no significant medical history was admitted with progressive upper abdominal pain, nausea and vomiting, low-grade fever, mild signs of ileus, and malaise. Imaging studies revealed portal venous dilation reaching ∼20 mm with near-total obliteration of the lumen by a thrombus. In addition, thrombosis of superior mesenteric and splenic veins with thrombophlebitis was found. Imaging studies also confirmed the presence of DVT of lower extremities including thrombus propagation into the iliac veins. An immediate therapy was started with parenteral antibiotics, anti-inflammatory medications, systemic anticoagulants, and intravenous fluid infusions to restore the circulating volume deficit and treat electrolyte disbalance. With such therapy, the patient’s symptoms resolved within a month, and she was discharged from the hospital with full recovery. Heparin infusion was started to reach systemic anticoagulation. With resolution of symptoms, anticoagulation was continued with warfarin. We used non-steroidal anti-inflammatory drugs (NSAIDs) as a component in management of intestinal and systemic inflammation and multifocal thrombosis when the antiphospholipid syndrome was also on the list of differential diagnoses. Conclusion: We present a previously asymptomatic patient with progressive portal venous thrombosis and ascending DVT. Early establishment of diagnosis and initiation of therapy with systemic anticoagulants, anti-inflammatory and antibacterial drugs helped to stop thrombus progression, prevent irreversible intestinal ischemia, and allow for re-canalization of the occluded veins. This case highlights the importance of early interventions to improve the treatment outcome.

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Section: Discussionmentioning

confidence: 99%

Thrombosis of portal, superior mesenteric, and splenic veins: a case report

Soghomonyan,

Khachatryan,

Soghomonyan

et al. 2023

Front. Pharmacol.

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Diagnosis and treatment of chronic venous obstruction: consensus statement of the Russian experts (part 1)

Lobastov

Bondarchuk²,

Борсук³

et al. 2020

Hirurg (Surgeon)

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This consensus statement of Russian experts is based on a review of the relevant literature on the prevalence, diagnosis, and treatment of non-thrombotic and post-thrombotic venous obstruction, as well as management of patients after venous stenting. In the Part 1 we discussed the clinical manifestations of venous obstruction, the role of duplex ultrasound scan, CT venography, MR venography, direct venography, and intravascular ultrasound scan, as well as typical findings obtained by using these methods. The authors mentioned the functional assessment of venous outflow in healthy subjects and in those with obstruction and changes in them after the intervention. In conclusion, the authors formulated the suggestions for clinical recommendations on the diagnosis of chronic venous obstruction.

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A Case of Inferior Vena Cava Thrombosis Induced by Left Iliac Vein Stents

Cited by 2 publications

References 7 publications

Thrombosis of portal, superior mesenteric, and splenic veins: a case report

Thrombosis of portal, superior mesenteric, and splenic veins: a case report

Diagnosis and treatment of chronic venous obstruction: consensus statement of the Russian experts (part 1)

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