A unique case of hypoplastic inferior vena cava leading to bilateral iliofemoral venous outflow obstruction and review of literature

Koudounas, Georgios; Giannopoulos, Stefanos; Volteas, Panagiotis; Virvilis, Dimitrios

doi:10.1016/j.jvscit.2022.10.010

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…7 Furthermore, venography has been shown to be less accurate compared to IVUS regarding the location of the iliac stenosis and the ilio-caval confluence, as well as the distal landing zone when planning for stent placement. 12,13 In contrast, IVUS can accurately determine the patency of the LCIV and identify MTS anatomy, and it is invaluable in determining the extent of thrombus occlusion in cases with DVT and the degree of vessel stenosis, assisting with stent sizing and appropriate stent apposition and deployment. 3,9,14…”

Section: Discussionmentioning

confidence: 99%

“…7 Furthermore, venography has been shown to be less accurate compared to IVUS regarding the location of the iliac stenosis and the iliocaval confluence, as well as the distal landing zone when planning for stent placement. 12,13 In contrast, IVUS can accurately determine the patency of the LCIV and identify MTS anatomy, and it is invaluable in determining the extent of thrombus occlusion in cases with DVT and the degree of vessel stenosis, assisting with stent sizing and appropriate stent apposition and deployment. 3,9,14 In contrast to patients with MTS without venous thrombosis those who present with acute iliofemoral DVT should receive therapeutic anticoagulation, while minimally invasive techniques for clot burden removal have been shown to be superior to anticoagulation alone regarding the risk of post-thrombotic syndrome in the future.…”

Section: Discussionmentioning

confidence: 99%

“…1,14 This can be accomplished with a combination of pharmaco-mechanical catheter-directed thrombolysis as in our second case, while cases of thrombolysis-free mechanical thrombectomy have also been described. 13,15,16 Although we placed an IVC filter in our second case, their use to prevent pulmonary embolism before or during pharmaco-mechanical thrombolysis/ thrombectomy and iliac vein stenting is not generally recommended due to the protective effect of venous stenosis from the MTS, unless there is extensive free-floating thrombus involving the IVC. 1 Anticoagulation should be continued for at least 3-6 months in cases of single DVT episode and venous stenting, or indefinitely in patients with prior history of DVT or thrombophilia.…”

Section: Discussionmentioning

confidence: 99%

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Intravascular Ultrasound in Treating Iliac Vein Compression With Endovascular Stenting: A Necessary Tool for Optimal Outcomes

Melian

Giannopoulos

Volteas

et al. 2022

Vasc Endovascular Surg

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Symptomatic compression of the left common iliac vein between the right common iliac artery and spinal vertebrae is referred to as May-Thurner Syndrome (MTS). Atypical cases of MTS including compression of the left external iliac vein, right iliac vein or the inferior vena cava can also coexist and cause double vein compression. Current literature suggests that endovascular treatment including thrombolysis, thrombectomy, venoplasty and stent placement to correct the mechanical obstruction together with anticoagulation therapy is safe and a reasonable management for patients with MTS. Intravascular ultrasound (IVUS) can aid in the diagnosis and the operative planning of MTS, especially regarding sizing and precise deployment of venous stents. Here we present 2 unique atypical cases of MTS with double left iliac vein compression treated endovascularly with stent placement along the common and external iliac vein with the assistance of IVUS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Intravascular Ultrasound in Treating Iliac Vein Compression With Endovascular Stenting: A Necessary Tool for Optimal Outcomes

Melian

Giannopoulos

Volteas

et al. 2022

Vasc Endovascular Surg

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A case of hypoplasia of the inferior vena cava with hypertrophic azygos/hemiazygos and collateral venous circles of the abdomen

Montatore,

Muscatella,

Masino

et al. 2024

Digital Diagnostics

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BACKGROUND AND AIM: Hypoplasia of the inferior vena cava (IVC) is a rare congenital vascular defect with many forms, making it difficult to identify a specific anatomical variant in literature; in some cases, the IVC may also be interrupted. METHODS: We present a unique example of an unknown sub-renal hypoplasia of IVC with azygos and hemiazygos hypertrophy and with the creation of several collateral circles especially in the anterior wall of the abdomen in an asymptomatic 75-year-old man. The goal of this case report is not only to describe this unusual instance, but also to quickly demonstrate the variations of the venous system in the abdomen especially on the right-side, as well as the IVC and the azygos system, and to explain the significance of imaging in recognizing the vascular anomaly. RESULTS: The case was investigated using Computed Tomography (CT) as an imaging modality, with a multiphase approach that accurately detected this intricate vascular abnormality. CONCLUSIONS: The patient has never had symptoms that can be linked to the same vascular anomaly, and the symptoms he had do not appear to be related, so only a follow-up was recommended.

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KILT Syndrome: A Systematic and Historical Review

2023

JMCCR

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Background: Kidney and IVC Abnormalities with Leg Thrombosis (KILT) is a rare condition that affects young individuals. It involves a clinical triad that consists of deep vein thrombosis of the legs, usually caused by a congenital abnormality of the inferior vena cava (IVC) that, in turns, leads to venous stasis, with the third component, also incidental, being the presence of unilateral renal agenesis. Aims: A systematic review is conducted of the literature to understand the syndrome’s current state from the following perspectives: a) clinical (presentation, diagnosis, and treatment), b) historical (before-and-after of the KILT acronym), and c) critical (evaluation of the syndrome’s three components). Methods: A systematic review using PRISMA methodology to identify the observational studies published in PubMed/Medline and Wiley/Cochrane Library that describe cases of KILT syndrome. The search concluded on December 15, 2023. Results: The search produced 620 potential publications. Following the removal of duplicates, non-relevant studies, and appropriate screening, the final sample consisted of 27 studies covering 29 cases of KILT (19 males, eight females, and four non-defined, aged 29.8 ± 2.7 years at the time of the diagnosis). A descriptive analysis of their characteristics is provided. Conclusions: KILT syndrome is an uncommon disorder, and the conclusions are based on a limited literature sample. Most of the cases share the symptoms of painful edema on the legs, the iliac location of the thrombosis, and the incidental diagnosis of full or partial agenesis of the IVC (with the appearance of collateral venous pathways) and renal hypoplasia with hypertrophy of the contralateral kidney. The diagnosis is based on imaging scans, and the long-term use of anticoagulants is the main form of treatment. The dearth of case studies limits a more precise understanding of recurrent thrombotic episodes and the post-thrombotic syndrome.

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A unique case of hypoplastic inferior vena cava leading to bilateral iliofemoral venous outflow obstruction and review of literature

Cited by 3 publications

References 27 publications

Intravascular Ultrasound in Treating Iliac Vein Compression With Endovascular Stenting: A Necessary Tool for Optimal Outcomes

Intravascular Ultrasound in Treating Iliac Vein Compression With Endovascular Stenting: A Necessary Tool for Optimal Outcomes

A case of hypoplasia of the inferior vena cava with hypertrophic azygos/hemiazygos and collateral venous circles of the abdomen

KILT Syndrome: A Systematic and Historical Review

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