Complete Superior and Inferior Vena Cava Obstruction Associated with Systemic-to-Pulmonary Venous Shunts in a Young Female with Heterozygous Prothrombin G20210A Gene Mutation

Abstract

Complete superior vena cava (SVC) and inferior vena cava (IVC) obstruction is not uncommon and most commonly associated with malignancy. The risk increases in patients with central lines and hypercoagulable states such as with malignancy, thrombophilia, or use of oral contraceptive pills. According to our knowledge, complete SVC and IVC obstruction associated with systemic-to-pulmonary venous shunts in patients with prothrombin G20210A gene mutation has not been reported in the literature. Here we report the case of a 34-year-old female with complete SVC and IVC obstruction presenting with oxygen desaturation and shortness of breath due to systemic-to-pulmonary venous shunts. The unusual collateral pathway was secondary to SVC obstruction. The patient was managed conservatively, and she remained stable.

Catheter-directed thrombectomy with the JETi8 in the treatment of acute superior vena cava syndrome

“…Hormone therapy is also a known risk factor for venous thromboembolism. 20 This patient combined several risk factors for acute SVCS. Considering these risk factors, despite successful SVC recanalization and PAC removal, there is an indication for life-long anticoagulation.…”

“Complete Venous Shutdown:” A Rare Case of Combined Superior Vena Cava (SVC) and Inferior Vena Cava (IVC) Occlusion

“…Concomitant superior vena cava (SVC) and inferior vena cava (IVC) occlusion most commonly occurs in the setting of malignancy but can also be seen in other hypercoagulable states or can be iatrogenic in the setting of central venous catheterization [1]. Depending on the site of occlusion, clot burden, and chronicity, SVC and IVC occlusion can present with a spectrum of symptoms.…”

“…Like SVC occlusion, the clinical presentation of ICVO depends on the clot burden and chronicity of occlusion with typical symptoms being lower extremity edema, pain, and venous insufficiency [3,4]. Management of SVC and ICVO includes angioplasty, stenting, thrombolytics, and vascular bypass [1,4]. Combined SVC and IVC obstruction is extremely rare with only case report data available, and thus, there is extremely limited information regarding its management.…”