Successful percutaneous thrombectomy of an infected vena-caval thrombus due to a toothpick

Abstract

We report a case of a 25-year-old Caucasian female with a septic thrombosis in the inferior vena cava (IVC) which contained a toothpick. She was admitted with fever and abdominal pain for 2 weeks. Computed tomography scan showed thrombus with air density in the suprarenal IVC. However, there was no evidence of duodenocaval fistula. Because of the patient's reluctance for surgery, endovascular therapy was tried. A partially-deployed nitinol stent was used as a filter, and aspiration thrombectomy was performed. Unexpectedly, a toothpick was retrieved within the stent. Anticoagulants and antibiotics were administered. A follow-up computed tomography after 2 months showed total resolution of the residual thrombus.

Psoas abscess secondary to retroperitoneal distant metastases from squamous cell carcinoma of the cervix with thrombosis of the inferior vena cava and duodenal infiltration treated by Whipple procedure: A case report and review of the literature

“…The nearly complete thrombotic occlusion of the inferior vena cava is may be related to a compression of the vein by surrounding inflamed connective tissue that led to an abnormal blood flow. Data in the literature supports this assumption [ 21 , 22 ]. Proposed therapeutic regimens for such an inflammatory thrombus are anticoagulation and drainage of the adjacent abscess [ 22 ] or percutaneous thrombectomy with anticoagulation and antibiotic therapy [ 21 ].…”

“…Data in the literature supports this assumption [ 21 , 22 ]. Proposed therapeutic regimens for such an inflammatory thrombus are anticoagulation and drainage of the adjacent abscess [ 22 ] or percutaneous thrombectomy with anticoagulation and antibiotic therapy [ 21 ]. However, in the case of inflammatory thrombosis secondary to metastatic disease this therapeutic approach is ineffective as demonstrated in the presented case.…”

Percutaneous Thrombectomy with a Half-Deployed Stent for the Treatment of Acute Inferior Vena Cava Thrombosis

“…Wilner and Carrillo [ 16 ] reported a case of aspiration thrombectomy using the AngioVac suction cannula system (Angiodynamics, Latham, NY, USA) by inserting catheters into the internal jugular vein and femoral vein. Kim et al [ 17 ] published a case in which aspiration thrombectomy was performed through the right common femoral vein while using a half-deployed stent as a filter, which was inserted via the internal jugular vein. Truong et al [ 18 ] reported a case in which mechanical thrombectomy was performed with a combination of a rotatory fragmentation device and a large wire basket while using a half-deployed stent as a filter.…”

Trans-colonic foreign body penetration of the retro-hepatic vena cava. Report of a case and review of the literature

“…Cases of migration to the aorta, pericardium, coronary artery, lung, liver, portal vein, hepatoduodenal ligament, inferior vena cava, peritoneum, bladder, retroperitoneum, pancreas, kidney, ureter, perianal space, and hip have all been documented [14] . Although migration to other organs was previously described in the English literature direct penetration and impalement of the retro-hepatic vena cava was anecdotally described [15] , [16] , [17] , [18] , [19] , [20] , [21] .…”