Surgical removal of an inferior vena cava thrombus

Neglén, Peter; Nazzal, Munier; al-Hassan, H K; Christenson, Jan T.; Eklöf, B

doi:10.1016/s0950-821x(05)80099-4

Cited by 29 publications

(15 citation statements)

References 12 publications

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“…7 Surgical interventions including thrombectomy, bypass, reconstruction/replacement and interruption/ligation are used infrequently owing to inherent morbidity and mortality. [84][85][86] Thrombectomy may be indicated for acute or septic IVC thrombosis and PCD but these procedures are less commonly performed because of high rates of re-thrombosis. 7 Such procedures are typically completed in conjunction with a distal arteriovenous (AV) fistula to maintain high flow.…”

Section: Acute Ivc Thrombosis Treatmentmentioning

confidence: 99%

Inferior vena cava thrombosis: A review of current practice

et al. 2013

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Inferior vena cava (IVC) thrombosis remains under-recognised as it is often not pursued as a primary diagnosis. The aetiology of IVC thrombosis can be divided into congenital versus acquired, with all aetiological factors found among Virchow's triad of stasis, injury and hypercoagulability. Signs and symptoms are related to aetiology and range from no symptoms to cardiovascular collapse. Painful lower limb swelling combined with lower back pain, pyrexia, dilatation of cutaneous abdominal wall veins and a concurrent rise in inflammatory markers are suggestive of IVC thrombosis. Following initial lower limb venous duplex, magnetic resonance imaging (MRI) is the optimal non-invasive imaging tool. Aetiology directs treatment, which ranges from anticoagulation and lower limb compression to open surgery, with endovascular therapies increasingly favoured. The objective of this review is to assess current literature on the aetiology, presentation, investigation, treatment, prognosis and other factors pertaining to IVC thrombosis.

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Section: Acute Ivc Thrombosis Treatmentmentioning

confidence: 99%

Inferior vena cava thrombosis: A review of current practice

et al. 2013

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“…15 Standard surgical therapy for IVC thrombosis/occlusion involves surgical thrombectomy, often with adjunctive temporary distal arteriovenous fistula creation. 16,17 Endovascular therapy offers significantly less morbidity and mortality than surgery. In the largest reported series of endovascular therapy for IVC occlusion, 82% of the lesions in a cohort of 120 patients were infrarenal, with suprarenal involvement in 18% of cases.…”

Section: Ivc Obstructionmentioning

confidence: 99%

Venous Interventions

O'Dea

Schainfeld

2014

Circ: Cardiovascular Interventions

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These studies indicate that CDT for DVT achieves more rapid lysis, reduces the incidence of long-term sequelae of DVT, improves quality of life, preserves valvular competence and more completely restores vessel patency as compared with standard anticoagulation or systemic thrombolytic therapy, although at the expense of a higher rate of hemorrhagic complications (see Table 1 summary of CDT trials).

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“…Lediglich 2 retrospektive Arbeiten befassen sich mit der transabdominellen Thrombektomie (Neglen 1992, Kniemeyer 1997). Prospektiv-randomisierte Studien liegen nicht vor.…”

Section: Diskussionunclassified

“…Die verfu Ègbaren Daten u Èber konservativ behandelte Kavathrombosen sind nicht zufriedenstellend, mit veno Èsen Ulzera bei 42 % nach 8 Jahren [7]. Das Risiko und die Mortalita Èt von Lungenembolien bei Kavathrombose werden nicht einheitlich beurteilt, scheinen jedoch mit der Ausdehnung nach proximal zuzunehmen [12]. Unter alleiniger Antikoagulation traten innerhalb eines Monates bei 18 % der Patienten Lungenembolien unterschiedlichen klinischen Schweregrades bei Vena cava inferior Thrombose auf [14].…”

Section: Diskussionunclassified

“…Die transperitoneale Thrombektomie der Vena cava inferior zusammen mit der transfemoralen veno Èsen Thrombektomie ist eine effektive und sichere Therapieoption in der Behandlung der akuten Thrombose der unteren Hohlvene. Schwere postthrombotische Folgescha Èden, insbesondere bei jungen Frauen, ko Ènnen vermieden werden.Eine Teilthrombose oder ein thrombotischer Verschluss der unteren Hohlvene sind vermutlich sehr seltene Ereignisse, die genaue Inzidenz ist aber letzlich unbekannt[9,12]. Kommt es zur Gerinnselbildung in einer 20 mm weiten Vene, die zudem durch ausgepra Ègte Atemmodulation rhythmisch hohe Flussgeschwindigkeiten aufweist, liegt in der Regel eine erho Èhte Thrombogenita Èt in Kombination mit anderen auslo Èsenden Faktoren vor.…”

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Früh- und Spätergebnisse nach transperitonealer Thrombektomie bei Thrombose der Vena cava inferior*

Wack

Wölfle²,

Loeprecht³

2001

Zentralbl Chir

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Acute inferior vena cava thrombosis is a rare clinical feature with unknown incidence. A clear evidence about the best treatment does not exist. Especially the indications for surgical therapy and their clinical results are published only in a few reports. So the aim of this study was to take a look to our experience and make an evaluation of the combined transcaval and transfemoral venous thrombectomy. In a retrospective study of the past 12 years 19 patients with a mean age of 28.5 years, 15 women and 4 men, showing ascension of a iliofemoral clot to the vena cava were treated by transperitoneal and transfemoral thrombectomy. The mean thrombus age was 7 days, 2 patients had bilateral iliofemoral thrombosis. Simultaneously a transfemoral thrombectomy and transcaval thrombectomy were performed after exposure of the vena cava inferior via transabdominal approach. In all cases a venous patency could be achieved, 3 times a re-thrombectomy within 1 week was necessary. One intraabdominal hematoma was revised surgically. One patient died on the first postoperative day because of a fulminant lung embolism. After a mean follow-up of 6 years 3 patients did not have any symptoms of post-thrombotic sequelae, 13 had mild and only one patient moderate post-thrombotic syndrome. The combined transperitoneal and transfemoral venous thrombectomy of the vena cava inferior represents a safe and effective treatment of the acute thrombosis of the vena cava inferior. Severe post-thrombotic sequelae especially in young women may be avoided.

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Surgical removal of an inferior vena cava thrombus

Cited by 29 publications

References 12 publications

Inferior vena cava thrombosis: A review of current practice

Inferior vena cava thrombosis: A review of current practice

Venous Interventions

Früh- und Spätergebnisse nach transperitonealer Thrombektomie bei Thrombose der Vena cava inferior*

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