Long-term anticoagulant treatment in patients with inferior vena cava agenesis and deep vein thrombosis

Oblitas, Crhistian-Mario; García‐García, Alejandra; Galeano‐Valle, Francisco; Palacios-Bermejo, Andrea; Ojeda-García, Raquel; Echenagusía-Boyra, Mikel; Álvarez-Luque, Arturo; Del-Toro-Cervera, Jorge; Demelo‐Rodríguez, Pablo

doi:10.1016/j.thromres.2020.09.009

Cited by 6 publications

(14 citation statements)

References 9 publications

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“…Previous experiences with DOACs were successful in these patients 6,18,21 . Esteves Cruz et al 24 reported that they switched from warfarin to rivaroxaban and after a 3‐year follow‐up, no thrombotic event occurred.…”

Section: Discussionmentioning

confidence: 90%

“…Current guidelines of the American Society of Hematology 20 recommends indefinite use of direct oral anticoagulants (DOAC) over vitamin K antagonists (VKA) in patients with unprovoked DVTs but states that DOACs are non‐superior to each other. Although the majority of patients were put on indefinite anticoagulation, mostly warfarin, only nine patients were taking DOACs with no adverse effects reported 6,18,21 . Although multiple reports showed DVT recurrence in patients who discontinued indefinite anticoagulation or were non‐complaint, 21,22 a recent study demonstrates that the risk of VTE recurrence or leg ulcers has not changed after anticoagulation withdrawal in patients with AIVC 23 .…”

Section: Discussionmentioning

confidence: 99%

“…Although the majority of patients were put on indefinite anticoagulation, mostly warfarin, only nine patients were taking DOACs with no adverse effects reported. 6 , 18 , 21 Although multiple reports showed DVT recurrence in patients who discontinued indefinite anticoagulation or were non‐complaint, 21 , 22 a recent study demonstrates that the risk of VTE recurrence or leg ulcers has not changed after anticoagulation withdrawal in patients with AIVC. 23 With these controversial data, the authors suggest a more conservative approach.…”

Section: Discussionmentioning

confidence: 99%

“…Previous experiences with DOACs were successful in these patients. 6 , 18 , 21 Esteves Cruz et al 24 reported that they switched from warfarin to rivaroxaban and after a 3‐year follow‐up, no thrombotic event occurred. In another study, the treatment with rivaroxaban was started but after 1 month, the symptoms persisted.…”

Section: Discussionmentioning

confidence: 99%

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Bilateral proximal deep vein thrombosis and COVID‐19 in a patient with absence of inferior vena cava: A case report and review of literature

Jenab

Ghafouri

Hosseini

et al. 2022

Clinical Case Reports

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Bilateral proximal deep vein thrombosis (DVT) in the lower extremities of young patients should raise suspicion over pro-thrombotic conditions and venous anatomical abnormalities, even in the presence of other precipitating factors, such as viral infection. The authors present a 33-year-old man with bilateral DVT and absence of inferior vena cava (AIVC), who also had concurrent COVID-19, and discuss the management of this patient. K E Y W O R D Sabsence of inferior vena cava, anticoagulants, deep vein thrombosis, inferior vena cava agenesis, inferior vena cava atresia

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Bilateral proximal deep vein thrombosis and COVID‐19 in a patient with absence of inferior vena cava: A case report and review of literature

Jenab

Ghafouri

Hosseini

et al. 2022

Clinical Case Reports

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“…A recent article confirms the importance of long-term anticoagulation. Briefly, in a series of 9 patients with AIVC, only two patients experienced DVT re-occurrence during a mean follow-up of nearly 78 months, in which the anticoagulation regimen was withdrawn in these two patients ( 7 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Inferior Vena Cava Agenesia in a Young Male Patient Presenting With Bilateral Iliac Veins Thrombosis

Pasqui

Donato

Camarri³

et al. 2022

Front. Surg.

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IntroductionAnomalies in inferior vena cava represent an uncommon finding with a prevalence of 0. 3 to 0.5% among healthy patients. Specifically, the condition characterized by the agenesis of the inferior vena cava (IVC; AIVC) has been observed among the 0.0005 to 1% of the general population. AIVC is strongly related to deep vein thrombosis (DVT) of the lower limb and pelvic district, especially in young patients. The rarity of the presented condition could relate to an underestimation of its impact on a particular clinical setting leading to a delayed diagnosis and inaccurate early- and long-term management.ReportWe presented a case of this anomaly regarding a 31-year-old man presenting with bilateral symptomatic proximal DVT. Duplex vascular ultrasound and subsequent CT-angiography revealed the complete occlusion of the right external and common iliac vein, as well as partial occlusion of the contralateral external iliac vein, in the patient. The exam also revealed the interruption of IVC in its infrarenal part. At the level of renal veins coalescence, IVC appeared again in its usual position. A dilatated portal system, hepatic veins, and azygos and hemiazygos systems were also highlighted. Anticoagulation was promptly started with the administration of Fondaparinux (7.5 mg/die). In addition, compression stocking was initiated within 24 h from diagnosis. After 3 weeks, the anticoagulation regimen was shifted toward the administration of a direct oral anticoagulant (Apixaban; 5 mg two times a day). At 1-month follow-up, a vascular duplex ultrasound revealed a complete resolution of the iliac veins' thrombosis.ConclusionIt is important to consider the eventuality of IVC anomalies in a young adult presenting with unexplained, extensive, or bilateral DVT. Accurate diagnostic evaluation is necessary to fully identify this condition that could represent a real challenge.

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Developmental or Procedural Vena Cava Interruption and Venous Thromboembolism: A Review

Bikdeli,

Sadeghipour,

Lou

et al. 2024

Semin Thromb Hemost

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The inferior vena cava (IVC) and superior vena cava are the main conduits of the systemic venous circulation into the right atrium. Developmental or procedural interruptions of vena cava might predispose to stasis and deep vein thrombosis (DVT) distal to the anomaly and may impact the subsequent rate of pulmonary embolism (PE). This study aimed to review the various etiologies of developmental or procedural vena cava interruption and their impact on venous thromboembolism. A systematic search was performed in PubMed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines per each clinical question. For management questions with no high-quality evidence and no mutual agreements between authors, Delphi methods were used. IVC agenesis is the most common form of congenital vena cava interruption, is associated with an increased risk of DVT, and should be suspected in young patients with unexpected extensive bilateral DVT. Surgical techniques for vena cava interruption (ligation, clipping, and plication) to prevent PE have been largely abandoned due to short-term procedural risks and long-term complications, although survivors of prior procedures are occasionally encountered. Vena cava filters are now the most commonly used method of procedural interruption, frequently placed in the infrarenal IVC. The most agreed-upon indication for vena cava filters is for patients with acute venous thromboembolism and coexisting contraindications to anticoagulation. Familiarity with different forms of vena cava interruption and their local and systemic adverse effects is important to minimize complications and thrombotic events.

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Long-term anticoagulant treatment in patients with inferior vena cava agenesis and deep vein thrombosis

Cited by 6 publications

References 9 publications

Bilateral proximal deep vein thrombosis and COVID‐19 in a patient with absence of inferior vena cava: A case report and review of literature

Bilateral proximal deep vein thrombosis and COVID‐19 in a patient with absence of inferior vena cava: A case report and review of literature

Case Report: Inferior Vena Cava Agenesia in a Young Male Patient Presenting With Bilateral Iliac Veins Thrombosis

Developmental or Procedural Vena Cava Interruption and Venous Thromboembolism: A Review

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