Coexistence of left-sided inferior vena cava, deep vein thrombosis of the upper and lower extremities and prothrombotic polymorphisms in a young patient: a case report

Şırlak, Mustafa; Çakıcı, Mehmet; İnan, Mustafa; Eryilmaz, Sadık; Üstüner, Evren; Atasoy, Çetin; Kaya, Bülent; Özyurda, Ümit

doi:10.1097/mbc.0b013e3282f9ae35

Cited by 7 publications

(9 citation statements)

References 18 publications

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“…IVC congenital malformations have been reported in 16.2% of young patients with iliac vein thrombosis 29. When these malformations are associated with inherited genetic defects leading to thrombophilia, the risks of venous thrombosis are increased several times 30–33. The three reported patients with IVC anomalies (two left-sided and one agenesis) in this study were young males, complaining of iliac venous thrombosis and were carriers for prothrombotic genetic mutations.…”

Section: Discussionmentioning

confidence: 58%

Lower extremity venous thrombosis in patients younger than 50 years of age

Kreidy¹,

Salameh²,

Waked³

2012

VHRM

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AimLower extremity deep venous thrombosis in the young adult is uncommon and has not been well studied in the literature. The aim of this study is to define risk factors for deep venous thrombosis among patients younger than 50 years of age, to compare them with a control group, and to suggest recommendations for the management and treatment of venous thrombosis in this particular group of patients.MethodsFrom January 2003 to January 2011, 66 consecutive Lebanese patients (29 males and 37 females) younger than 50 years, diagnosed in an academic tertiary-care center with lower extremity deep venous thrombosis by color flow duplex scan, were retrospectively reviewed. Their age varied between 21 and 50 years (mean 38.7 years). The control group included 217 patients (86 males and 131 females) older than 50 years (range: 50–96 years; mean 72.9 years).ResultsThe most commonly reported risk factors in the younger age group were inherited thrombophilia (46.9% compared with 13.8% in the control group; P < 0.001), pregnancy (18.2% compared with 0.5%; P < 0.001), treatment with estrogen drugs (13.6% compared with 2.3%; P = 0.001), and family history of venous thromboembolism (9.1% compared with 3.8%; P = 0.084).ConclusionInherited thrombophilia is the most commonly observed risk factor among patients younger than 50 years, with a prevalence of three times more than the control group. Young adults should be screened for thrombophilia even in the presence of transient acquired risk factors. Pregnancy and treatment with estrogen drugs essentially when associated with inherited thrombophilia represent a frequent cause of venous thrombosis among young female patients. Inferior vena cava abnormalities should be excluded in young patients with spontaneous proximal venous thrombosis especially when recurrent venous thrombosis or resistance to anticoagulation are observed.

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Section: Discussionmentioning

confidence: 58%

Lower extremity venous thrombosis in patients younger than 50 years of age

Kreidy¹,

Salameh²,

Waked³

2012

VHRM

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“…Radiologists, surgeons, and other clinical practitioners must be aware of these IVC abnormalities as to avoid misdiagnosis as lymphadenopathy or tumors on US (ultrasound) or CT (computed tomography) (Pilcher and Padhani, ; Evans et al, ; Castillo et al, ; Ang et al, ). Hospitalists need to be aware of the increased risk of deep vein thrombosis with aberrations in IVC anatomy (Spivak et al, ; Sirlak et al, ; Ang et al, ). Surgeons, especially those who work in the retroperitoneal space, must be aware of the common IVC abnormalities which may be encountered during surgery (Ito et al, ; Kumar et al, ; Ang et al, ).…”

Section: Embryologymentioning

confidence: 99%

The clinical anatomy of the inferior vena cava: A review of common congenital anomalies and considerations for clinicians

et al. 2014

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Anomalies in the course and drainage of the Inferior Vena Cava (IVC) may complicate normal functioning, correct diagnosis, and therapeutic interventions within the abdomen. Development of the IVC occurs during the 4th to 8th week of gestation, and due to its developmental complexity, there are many opportunities for malformations to occur. Although most IVC anomalies are clinically silent and are usually discovered incidentally on abdominal imaging, aberrations may be responsible for formation of thrombosis, back pain, and anomalous circulation of blood to the heart. In this review, we will discuss the most common variations and abnormalities of the IVC, which include the posterior cardinal veins, the subcardinal veins, the supracardinal veins, persistent left IVC, IVC duplication, situs inversus, left retroaortic renal vein, left circumaortic renal collar, scimitar syndrome, and IVC agenesis. For each abnormality outlined above, we aim to discuss relevant embryology and potential clinical significance with regards to presentation, diagnosis, and treatment as is important for radiologists, surgeons, and clinicians in current clinical practice.

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“…Left‐sided and duplicate IVC may predispose to thromboembolism because of changes in blood flow induced by the anomalous IVC or compression of the vessel or its major tributaries. Considering the multifactorial etiology of DVT (Rosendaal, ), patients with a left‐sided or duplicate IVC are particularly likely to develop thromboembolism in the presence of additional predisposing factors such as congenital or acquired thrombophilia or endothelial trauma (Spivack et al, ; Taniguchi et al, ; Milani et al, ; Sirlak et al, ; Cheng and Zangan, ; Daher et al, ). These anomalies can also complicate the management of venous thrombobembolism, particularly in relation to insertion of an inferior vena caval filter.…”

Section: Discussionmentioning

confidence: 99%

Left‐sided and duplicate inferior vena cava: A case series and review

2012

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Left-sided and duplicate inferior vena cava (IVC) are two major anatomical variants within the spectrum of IVC malformations, both of which are developmental abnormalities of the supracardinal veins. Four clinical cases are described to highlight the computed tomographic appearances of these vascular malformations and provide novel data on venous dimensions. A systematic review of the recent literature (2000-2011) was conducted focusing on the anatomy, demographics, and associated pathology (congenital and acquired) of isolated left-sided and duplicate IVC. A total of 73 relevant articles were retrieved, consisting of case reports and small case series. The prevalence of left-sided IVC is about 0.1-0.4% and that for duplicate IVC about 0.3-0.4%; both anomalies show a slight male preponderance. In each condition, there are documented variations in the course and tributaries of the IVC. The clinical importance of these anomalies lies in three principal areas: the potential for misdiagnosis on imaging; technical difficulties during retroperitoneal surgery (particularly abdominal aortic aneurysm repair and live donor nephrectomy); and their significance in relation to the etiology and management of venous thromboembolism.

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Coexistence of left-sided inferior vena cava, deep vein thrombosis of the upper and lower extremities and prothrombotic polymorphisms in a young patient: a case report

Cited by 7 publications

References 18 publications

Lower extremity venous thrombosis in patients younger than 50 years of age

Lower extremity venous thrombosis in patients younger than 50 years of age

The clinical anatomy of the inferior vena cava: A review of common congenital anomalies and considerations for clinicians

Left‐sided and duplicate inferior vena cava: A case series and review

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