An Unusual Case of Inferior Vena Cava Thrombosis in a Healthy Male Bodybuilder

Abstract

Inferior vena cava (IVC) thrombosis is very rare, particularly in the absence of an apparent congenital caval abnormality or hypercoagulable state. We herein report an unusual case of a healthy and active 62-year-old male bodybuilder with a mass-like IVC thrombus. We placed an IVC filter and began treatment with rivaroxaban. The patient recovered successfully, and the IVC thrombus completely disappeared three months later. This case suggested that extrinsic compression of IVC by a tightened weightlifting belt around the abdomen is a triggering factor of IVC thrombosis, and rivaroxaban, a new oral anticoagulant, may be a useful option for treatment.

Direct oral anticoagulants versus warfarin for the treatment of inferior vena cava thrombus

“…This is also the first study to include patients receiving apixaban, as rivaroxaban was the only DOAC described in prior studies. [10][11][12][13] Similarly to the aforementioned studies, [10][11][12][13] we observed the majority of patients receiving standard VTE treatment doses of rivaroxaban and apixaban. While Kido et al 10 and Imanishi et al 11 described successful treatment of IVC thrombus with 3 months of rivaroxaban, the majority of the population in the study by Du et al received 6 months of therapy.…”

“…The current body of evidence evaluating the efficacy and safety of DOACs in the treatment of IVC thrombus is limited to case reports and one retrospective study. [10][11][12][13] The first case reported by Kido et al describes a 52-year-old male who required surgical intervention to address multiple injuries sustained in a motorcycle accident. During his inpatient rehabilitation course, the patient developed an IVC thrombus with no evidence of concurrent PE or DVT.…”

“…Repeat imaging performed at the patient's 1-month follow-up demonstrated a significant reduction in thrombus size, and by the patient's 3-month follow-up, complete thrombus resolution was observed. 11 The final case reported by Sakatani et al described a 68-year-old male with a history of an IVC filter who presented with an IVC filter thrombus and concurrent PE. A second temporary IVC filter was placed, and the patient was initiated on intravenous unfractionated heparin.…”

“…[6][7][8][9] Furthermore, the limited amount of data regarding the use of DOACs for the treatment of IVC thrombus is currently limited to case reports and one single-arm retrospective cohort study. [10][11][12][13] Therefore, the aim of this study was to evaluate the safety and efficacy of DOACs compared to traditional therapy for the treatment of IVC thrombus.…”

Delayed presentation of blunt inferior vena cava injury following high-speed motor vehicle collision

“…1 Although the potential mechanisms of IVC thrombosis secondary to acute trauma, particularly abdominal, are multiple, fewer than 20 cases of post-traumatic IVC thrombosis have been reported in the literature. [2][3][4] Amongst these cases, the most common cause is blunt abdominal trauma following MVC. 2 Severe trauma creates a prothrombotic state, and deep vein thrombosis is a well-known complication.…”