Extrinsic venous compression secondary to spine osteophytes

Abstract

Objective This study aims to report two cases of symptomatic extrinsic compression of the inferior vena cava and left iliac vein caused by vertebral osteophytes. Methods We present two case reports of extrinsic venous compression by vertebral osteophytes. Both cases were endovascularly treated, with a successful outcome. A review of the literature of this unusual condition is also presented. Results The first patient is an 80-year-old woman who presented to the vascular surgery clinic with bilateral lower extremity edema and pain. A computed-tomography angiography (CTA) revealed extrinsic compression of the inferior vena cava from enlarged osteophytes. Venography and intravascular ultrasound were performed, confirming the diagnosis. A self-expanding venous stent was successfully deployed in the inferior vena cava relieving the extrinsic compression. The edema resolved the following day and was discharged without complications. The second patient is a 61-year-old male that presented to the emergency department with a left iliofemoral deep venous thrombosis. CTA showed left iliac vein compression by a lumbar osteophyte. Percutaneous thrombectomy was successfully achieved and an expanding stent was deployed covering the entire lesion. One month after the procedure the patient died from COVID-19‐associated respiratory failure. Conclusion Osteophytes must be considered when dealing with extrinsic venous compression, especially in elderly people.

Acute left iliofemoral vein thrombosis: Comparison between simple and bony May-Thurner syndrome in CT venography

“…23 The anatomical characteristics of bony MTS and the effects ofdegenerative change of the lumbar spine on the LCIV have only been reported in a few studies. 12,20,24 According to CT findings, Ou-Yang et al classified MTS as simple MTS, degenerative MTS, and other-cause MTS. 20 Among them, degenerative MTS was caused by forward bulging discs, anterior vertebral spurs, and lumbar spondylolisthesis pressing into the iliac vein.…”

Utility of multimodal molecular imaging in the diagnosis and decision-making in arterial diseases

“…C) PET scan with an increased 18 F-FDG uptake (black arrow) Infective native aortic aneurysm (INAA), first described in 1885 by Osler as "mycotic aneurysm", is another entity in which 18 F-FDG has been used. Recently, the European Society for Vascular Surgery (ESVS) in a Delphi consensus proposed criteria for the diagnosis of this aetiology, as described in Table 1 [15,16]. One of the biomarkers expressed by monocytes/macrophages is the chemokine receptor type 2 (CCR2) that mediates the leukocyte traffic to the arterial wall lesion, which has been analysed in human AA tissue.…”