|
1
|
Tadayon N, Najari D, Refaei M, Sheikhzadeh M, Babaei M, Mirhosseini MM. Unveiling absent inferor vena cava in young patients: Case reports and clinical insights. Int J Surg Case Rep 2024; 123:110258. [PMID: 39276403 PMCID: PMC11417193 DOI: 10.1016/j.ijscr.2024.110258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 08/30/2024] [Accepted: 09/05/2024] [Indexed: 09/17/2024] Open
Abstract
INTRODUCTION Inferior vena cava agenesis (IVCA), a rare congenital anomaly, contributes to approximately 5 % of deep venous thrombosis (DVT) cases lacking other risk factors. It can lead to chronic venous insufficiency and DVT when collateral circulation is insufficient, presenting diagnostic challenges due to its rarity. CASE PRESENTATION We present two cases of Absent IVC (AIVC) in young males. Case 1: a 22-year-old developed bilateral lower limb DVT post-appendectomy. Imaging revealed AIVC with azygos continuation. Treatment included Heparin and Rivaroxaban, achieving symptom resolution. Case 2: a 41-year-old with recurrent DVT and chronic venous insufficiency was diagnosed with AIVC via venography. Managed with warfarin and compression therapy, his symptoms stabilized. CLINICAL DISCUSSION These cases underscore the importance of recognizing AIVC in young patients presenting with unexplained DVT. Diagnosis often requires advanced imaging techniques like CT venography. Management typically involves long-term anticoagulation and compression therapy to mitigate the risk of recurrence and chronic venous complications. CONCLUSION Early identification of AIVC in young adults presenting with recurrent DVT is essential for appropriate management and prevention of long-term complications.
Collapse
Affiliation(s)
- Niki Tadayon
- Division of Vascular and Endovascular Surgery, Department of Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Dorsa Najari
- Division of Vascular and Endovascular Surgery, Department of Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Meisam Refaei
- Division of Vascular and Endovascular Surgery, Department of Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Sheikhzadeh
- Division of Vascular and Endovascular Surgery, Department of Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Babaei
- Division of Vascular and Endovascular Surgery, Department of Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Moein Mirhosseini
- Division of Vascular and Endovascular Surgery, Department of Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
|
2
|
Yeh YT, Tsai SE, Chen YC, Yang SF, Yeh HW, Wang BY, Yeh LT, Shih NC, Wang YH, Chen YY, Yeh CB. Deep Venous Thrombosis and Risk of Consequent Sepsis Event: A Retrospective Nationwide Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157879. [PMID: 34360172 PMCID: PMC8345651 DOI: 10.3390/ijerph18157879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 12/21/2022]
Abstract
Deep vein thrombosis causes several acute and chronic vessel complications and puts patients at risk of subsequent sepsis development. This unique study aimed to estimate the risk of sepsis development in DVT patients compared with non-DVT patients. This population-based cohort study used records of a longitudinal health insurance database containing two million patients defined in Taiwan's National Health Insurance Research Database (NHIRD). Our study included patients aged over 20 years with a new diagnosis of DVT with at least two outpatient department visits or an admission between 2001 and 2014. Patients with a diagnosis of sepsis before the index date were excluded. Propensity score matching (PSM) was used to homogenize the baseline characteristics between the two groups. To define the independent risk of the DVT group, a multivariate Cox proportional hazard model was used to estimate the hazard ratios. After PSM, the DVT group (n = 5753) exhibited a higher risk of sepsis (adjusted hazard ratio, aHR, 1.74; 95% CI, 1.59-1.90) compared with non-DVT group (n = 5753). Patients with an increased risk of sepsis were associated with being elderly aged, male, having diabetes, chronic kidney disease, chronic obstructive pulmonary disease, stroke, malignancy, and use of antibiotics. In conclusion, this population-based cohort study demonstrated an increased risk of sepsis in DVT patients compared with non-DVT patients. Thus, early prevention and adequate treatment of DVT is necessary in clinical practice.
Collapse
Affiliation(s)
- Ying-Tung Yeh
- Graduate School of Dentistry, School of Dentistry, Chung Shan Medical University, Taichung 40201, Taiwan;
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Sheng-En Tsai
- Department of Anesthesiology, Changhua Christian Hospital, Changhua 50006, Taiwan; (S.-E.T.); (L.-T.Y.)
| | - Ying-Cheng Chen
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (Y.-C.C.); (S.-F.Y.); (B.-Y.W.)
- Department of Surgery, Changhua Christian Hospital, Changhua 50006, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (Y.-C.C.); (S.-F.Y.); (B.-Y.W.)
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan;
| | - Han-Wei Yeh
- School of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan;
- Chang Gung Memorial Hospital, Linkou, Taoyuan City 33302, Taiwan
| | - Bo-Yuan Wang
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (Y.-C.C.); (S.-F.Y.); (B.-Y.W.)
- Department of Emergency Medicine, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Liang-Tsai Yeh
- Department of Anesthesiology, Changhua Christian Hospital, Changhua 50006, Taiwan; (S.-E.T.); (L.-T.Y.)
| | - Nai-Chen Shih
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan;
| | - Yin-Yang Chen
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (Y.-C.C.); (S.-F.Y.); (B.-Y.W.)
- Department of Surgery, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
- Correspondence: (Y.-Y.C.); (C.-B.Y.)
| | - Chao-Bin Yeh
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (Y.-C.C.); (S.-F.Y.); (B.-Y.W.)
- Department of Emergency Medicine, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
- Correspondence: (Y.-Y.C.); (C.-B.Y.)
| |
Collapse
|
|
3
|
Tomidokoro D, Hayama H, Bekki N, Hara H, Hiroi Y. Venous Thromboembolism in a Young Man With Fused Renal Ectopia. JACC Case Rep 2020; 2:2479-2483. [PMID: 34317198 PMCID: PMC8305092 DOI: 10.1016/j.jaccas.2020.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/16/2020] [Indexed: 11/29/2022]
Abstract
A 19-year-old man presented with chest pain after a trans-Pacific flight. Venous thromboembolism was diagnosed and treated with catheter-directed thrombolysis. Genetic testing revealed factor V Leiden mutation. In addition to the flight history and genetic hypercoagulability, a renal abnormality causing an external compression over the inferior vena cava was suspected to be a contributing factor. (Level of Difficulty: Intermediate.)
Collapse
Affiliation(s)
- Daiki Tomidokoro
- Address for correspondence: Dr. Daiki Tomidokoro, Department of Cardiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
| | | | | | | | | |
Collapse
|
|
4
|
Wu H, Cao H, Song Z, Xu X, Tang M, Yang S, Liu Y, Qin L. Rivaroxaban treatment for young patients with pulmonary embolism (Review). Exp Ther Med 2020; 20:694-704. [PMID: 32742315 PMCID: PMC7388139 DOI: 10.3892/etm.2020.8791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 04/17/2020] [Indexed: 12/16/2022] Open
Abstract
Pulmonary embolism (PE) is a serious, life-threatening condition that affects young populations (>18 and <50 years old, according to most literature reviews) with improved recognition of its clinical manifestations and the widespread use of sensitive imaging techniques, PE is increasingly diagnosed in younger patients. At present, there is limited understanding of the clinical features and adequate anticoagulant treatment options for this population. Most studies to date have yet to demonstrate significant differences in PE pathophysiology or symptoms between young and elderly patients. Although the overall incidence of PE is lower in young populations compared with elderly patients, important risk factors also apply for young patients. Hereditary thrombophilia is common and is a major cause of PE in younger patients. Immobilization, trauma, obesity, smoking and infection are also becoming increasingly frequent in young patients with PE. Among female patients, oral contraceptive use, pregnancy and postpartum status are predominant risk factors underlying PE. Rivaroxaban is a direct oral anticoagulant with a rapid onset of action that is associated with less drug-drug interactions compared with other therapies. Because the drug is administered at fixed doses with no requirement for routine coagulation monitoring, it is becoming an attractive option for anticoagulation treatment in young patients with PE. Therefore, the present literature review focuses on the clinical characteristics of PE and rivaroxaban therapy in younger patients.
Collapse
Affiliation(s)
- Haidi Wu
- Department of Cardiology, The First Hospital of Jilin University, Changchun, Jilin 130000, P.R. China
| | - Hongyan Cao
- Department of Cardiology, The First Hospital of Jilin University, Changchun, Jilin 130000, P.R. China
| | - Zikai Song
- Department of Cardiology, The First Hospital of Jilin University, Changchun, Jilin 130000, P.R. China
| | - Xiaoyan Xu
- Department of Cardiology, The First Hospital of Jilin University, Changchun, Jilin 130000, P.R. China
| | - Minglong Tang
- Department of Cardiology, The First Hospital of Jilin University, Changchun, Jilin 130000, P.R. China
| | - Shuo Yang
- Department of Cardiology, The First Hospital of Jilin University, Changchun, Jilin 130000, P.R. China
| | - Yang Liu
- Department of Cardiology, The First Hospital of Jilin University, Changchun, Jilin 130000, P.R. China
| | - Ling Qin
- Department of Cardiology, The First Hospital of Jilin University, Changchun, Jilin 130000, P.R. China
| |
Collapse
|
|
5
|
Sakr M, Abdelhakam SM, Elsayed SA, Allam EH, Farid AM, Abdelmoaty W, Hassan AM, Shaker M, El-Gharib M, Eldorry A. Validation of prognostic indices in Egyptian Budd-Chiari syndrome patients: A single-center study. World J Gastroenterol 2017; 23:629-637. [PMID: 28216969 PMCID: PMC5292336 DOI: 10.3748/wjg.v23.i4.629] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/09/2016] [Accepted: 12/21/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To compare predictive ability of Budd-Chiari syndrome (BCS) prognostic indices (PIs) for one-year survival and Transjugular intrahepatic portosystemic shunt (TIPS) patency.
METHODS This retrospective study enrolled 194 Egyptian patients with primary BCS who presented to the Budd-Chiari Study Group of Ain Shams University Hospital. Calculation of the available PIs was performed using Child-Pugh and model for end-stage liver disease scores, BCS-specific PIs (Clichy, New Clichy and Rotterdam) for all patients, and BCS-TIPS PI only for patients who underwent TIPS. The overall one-year survival rate and the one-year shunt patency rate for TIPS were reported.
RESULTS The overall one-year survival rate was 69.6%, and the New Clichy PI revealed the best validity for its prediction at a cut-off value of 3.75, with sensitivity and specificity of 78% and 73.3%, respectively [area under receiver operating characteristic curve (AUC) = 0.806]. The one-year survival rate post-TIPS was 89.7%, and the BCS-TIPS score demonstrated validity for its prediction at a cut-off value of 3.92 (sensitivity and specificity were 71.4% and 64.5%, respectively) (AUC = 0.715). Logistic regression analysis revealed that the New Clichy PI (P = 0.030), high serum total bilirubin (P = 0.047) and low albumin (P < 0.001) were independent factors for predicting mortality within one year. The one-year shunt patency rate in TIPS was 80.2%, and none of the PIs exhibited significant validity for its prediction.
CONCLUSION The New Clichy score could independently predict the one-year survival in Egyptian BCS patients.
Collapse
|
|
6
|
Roupie AL, Dossier A, Goulenok T, Perozziello A, Papo T, Sacre K. First venous thromboembolism in admitted patients younger than 50years old. Eur J Intern Med 2016; 34:e18-e20. [PMID: 27230786 DOI: 10.1016/j.ejim.2016.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 05/11/2016] [Indexed: 11/22/2022]
Affiliation(s)
- Anne-Laure Roupie
- Département de Médecine Interne, Hôpital Bichat, Université Paris Diderot, PRES Sorbonne Paris Cité, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Antoine Dossier
- Département de Médecine Interne, Hôpital Bichat, Université Paris Diderot, PRES Sorbonne Paris Cité, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Tiphaine Goulenok
- Département de Médecine Interne, Hôpital Bichat, Université Paris Diderot, PRES Sorbonne Paris Cité, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Anne Perozziello
- Département d'Epidémiologie, Biostatistiques et Recherche Clinique, Hôpital Bichat, Université Paris Diderot, PRES Sorbonne Paris Cité, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Thomas Papo
- Département de Médecine Interne, Hôpital Bichat, Université Paris Diderot, PRES Sorbonne Paris Cité, Assistance Publique Hôpitaux de Paris, Paris, France; INSERM U1149, Paris, France; Département Hospitalo-Universitaire FIRE (Fibrosis, Inflammation and Remodelling in Renal and Respiratory Diseases), Paris, France
| | - Karim Sacre
- Département de Médecine Interne, Hôpital Bichat, Université Paris Diderot, PRES Sorbonne Paris Cité, Assistance Publique Hôpitaux de Paris, Paris, France; INSERM U1149, Paris, France; Département Hospitalo-Universitaire FIRE (Fibrosis, Inflammation and Remodelling in Renal and Respiratory Diseases), Paris, France.
| |
Collapse
|
|
7
|
Zhang C, Fu Q, Zhao Y, Mu S, Liu L. Short-Term Anticoagulant Therapy and Thrombus Location Are Independent Risk Factors for Delayed Recanalization of Deep Vein Thrombosis. Med Sci Monit 2016; 22:219-25. [PMID: 26790571 PMCID: PMC4727491 DOI: 10.12659/msm.895228] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background Prompt recanalization of the vein containing the thrombus is an important goal during the initial treatment of DVT, and risk factors for delayed recanalization in patients with deep vein thrombosis (DVT) in the lower extremities need to be determined. Material/Methods A total of 174 patients with DVT in lower extremities were recruited from June 2014 to March 2015 at our hospital. Duplex ultrasound scanning was conducted for all patients at 1 and 6 months after baseline evaluation. We divided the patients into recanalization and non-recanalization groups and analyzed risk factors for delayed recanalization. Results The univariate analysis revealed that an oral anticoagulant time of less than 3 months and venous thrombus location were risk factors for delayed recanalization (P<0.01). However, age, gender, hypertension, diabetes, pulmonary embolism, incidence factors, the use of catheter-directed thrombolytic (CDT) drugs, and inferior vena cava filter (IVCF) implantation had no influence on the incidence of delayed recanalization in patients with DVT (P>0.05). The multivariate analysis showed that patients with an anticoagulant time of less than 3 months had a lower incidence of recanalization than those with an anticoagulant time of more than 3 months (OR=2.358, P<0.05). The risk of delayed recanalization in patients with proximal DVT was 7 times higher than that in patients with distal DVT. Conclusions Duration of anticoagulant treatment of less than 3 months and venous thrombus location are independent risk factors for delayed recanalization of DVT in the lower extremities.
Collapse
Affiliation(s)
- Chuanlin Zhang
- School of Nursing, Chongqing Medical University, Chongqing, China (mainland)
| | - Qining Fu
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Yu Zhao
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Shaoyu Mu
- School of Nursing, Chongqing Medical University, Chongqing, China (mainland)
| | - Liping Liu
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| |
Collapse
|
|
8
|
Malatino L, Cardella AM, Puccia G, Cilia C, Terranova V, Cataudella E, Buonacera A, Tripepi G, Di Marca S, Mastrosimone G, Pisano M, Giordano M, Stancanelli B. Testing Clinical Scores to Diagnose Incident Deep Vein Thrombosis in Patients Hospitalized in a Department of Medicine: Can Biomarkers Improve Accuracy? Angiology 2015; 67:245-51. [PMID: 25991607 DOI: 10.1177/0003319715586289] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Shifting the context from the emergency department to the department of medicine, we compared different scores to diagnose deep vein thrombosis (DVT) in patients with several comorbidities, hospitalized in a department of internal medicine. We prospectively recruited 178 consecutive hospitalized patients in whom clinical suspicion of DVT was assessed by Wells modified score for DVT, Hamilton, Kahn, and St Andrè Hospital scores. Deep vein thrombosis was confirmed in 85 (48%) patients by both echocolor Doppler and angiocomputed tomography scan. The use of risk scores based on symptoms and clinical signs was weakly useful (area under the curve [AUC]: 0.69, positive predictive value: 59%, and negative predictive value: 74%). Patients with DVT had significantly (P < .0001) lower serum albumin and protein S levels compared to those without DVT. Moreover, serum protein S (AUC: 0.82) and albumin in percentage (AUC: 0.80) showed a better accuracy than clinical scores (P < .001) in assessing the diagnosis of DVT. Therefore, serum albumin and protein S improved the accuracy of clinical scores for the diagnosis of incident DVT in patients hospitalized in a department of medicine.
Collapse
Affiliation(s)
- Lorenzo Malatino
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | - Antonella M Cardella
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | - Giuseppe Puccia
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | - Chiara Cilia
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | - Valentina Terranova
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | - Emanuela Cataudella
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | - Agata Buonacera
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | | | - Salvatore Di Marca
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | - Gianluca Mastrosimone
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | - Marcella Pisano
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | - Mauro Giordano
- Department of Medical, Surgical, Neurologic, Metabolic and Geriatric Sciences, Second University of Naples, Naples, Italy
| | - Benedetta Stancanelli
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| |
Collapse
|
|
9
|
Deep Venous Thrombosis of the Leg, Associated with Agenesis of the Infrarenal Inferior Vena Cava and Hypoplastic Left Kidney (KILT Syndrome) in a 14-Year-Old Child. Case Rep Pediatr 2015; 2015:864047. [PMID: 25685585 PMCID: PMC4313679 DOI: 10.1155/2015/864047] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 12/16/2014] [Indexed: 11/17/2022] Open
Abstract
Agenesis of the inferior vena cava (IVC) is a rare anomaly which can be identified as incidental finding or can be associated with iliofemoral vein thrombosis. IVC agenesis has a known association with renal anomalies which are mainly confined to the right kidney. We describe a case of a 14-year-old male who presented with left leg swelling and pain. Ultrasonography confirmed the presence of left leg deep vein thrombosis (DVT). No underlying hematologic risk factors were identified. A CT scan was obtained which demonstrated absent infrarenal IVC and extensive thrombosis in the left deep venous system and development of collateral venous flow into the azygous/hemiazygous system, with extension of thrombus into paraspinal collaterals. An additional finding in the patient was an atrophic left kidney and stenosis of an accessory left renal artery. Agenesis of the IVC should be considered in a young patient presenting with lower extremity DVT, especially in patients with no risk factors for thrombosis. As agenesis of the IVC cannot be corrected, one should be aware that there is a lifelong risk of lower extremity DVT.
Collapse
|
|
10
|
Influence of acquired and genetic risk factors on the prevention, management, and treatment of thromboembolic disease. Int J Vasc Med 2014; 2014:859726. [PMID: 25057415 PMCID: PMC4099036 DOI: 10.1155/2014/859726] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Accepted: 06/11/2014] [Indexed: 11/29/2022] Open
Abstract
Prevention, management, and treatment of venous thromboembolism requires understanding
of the epidemiology and associated risk factors, particularly in recognizing populations warranting
prophylaxis, in evaluating patients with high risk situations, and in determining the duration of
anticoagulation required to minimize recurrent thrombosis and to avoid postthrombotic
syndrome. The present paper reviews recent advances concerning acquired and genetic risk factors for
venous thrombosis, analyses individual risks related to age, and focuses on thrombotic genetic risk
factors and the synergistic gene-environment and gene-gene interactions and their importance in
the management and treatment of venous thromboembolic disease.
Collapse
|
|
11
|
Chen F, Xiong JX, Zhou WM. Differences in limb, age and sex of Chinese deep vein thrombosis patients. Phlebology 2014; 30:242-8. [PMID: 24531804 DOI: 10.1177/0268355514524192] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Recently, the differences in age or sex of deep vein thrombosis (DVT) patients have been widely debated. However, close analyses of the differences in limb, age and sex of Chinese DVT patients have been scarcely reported. The purpose of this research is to study the differences in limb, age and sex of DVT patients. METHODS A total of 783 consecutive DVT patients were retrospectively reviewed. Patients with an acute presentation of DVT were diagnosed by means of compression ultrasonography or venography. Clinical characteristics and provoked risk factors were analyzed. RESULTS There were three frequency peaks including two smaller peaks at age 20-24 and 70-74 years, and the largest peak at age 45-59 years. The most significant risk factors affecting different age groups were as follows: pregnancy/puerperium for age ≤ 39; fracture and hysterectomy for age 40-64; fracture and malignancy for age ≥ 65. DVT frequency rate provoked by malignancy was higher in right DVT than left DVT (15.8% vs. 4.6%; p < 0.001). Left DVT was more common than right DVT (582 vs. 158). Left DVT tended to occur in females (male:female, 40.5%:59.5%), and right DVT in males (male:female, 74.7%:25.3%). DVT provoked by pregnancy/puerperium (56/63, 88.9%) or hysterectomy (27/30, 90.0%) was mostly located in left limb. CONCLUSION It is necessary to pay more attention to thromboprophylaxis for patients with the risk factors of pregnancy/puerperium, hysterectomy, fracture and malignancy, especially those over the age of 65. And further research into the cause of limb, age and sex differences in DVT occurrence is needed.
Collapse
Affiliation(s)
- Feng Chen
- Department of Vascular Surgery, the second affiliated Hospital, Nanchang University, Nanchang, People's Republic of China
| | - Ji Xin Xiong
- Department of Vascular Surgery, the second affiliated Hospital, Nanchang University, Nanchang, People's Republic of China
| | - Wei Min Zhou
- Department of Vascular Surgery, the second affiliated Hospital, Nanchang University, Nanchang, People's Republic of China
| |
Collapse
|
|
12
|
Hickey BA, Ahuja S. Acute lumbar radiculopathy with weak legs. J Emerg Med 2014; 46:479-81. [PMID: 24495938 DOI: 10.1016/j.jemermed.2013.09.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 09/18/2013] [Accepted: 09/26/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Inferior vena cava thrombosis is a rare but important cause of acute low back pain and lumbar radiculopathy. Failure to diagnose and treat this condition could result in propagation of the thrombosis, resulting in fatal pulmonary embolism. CASE REPORT We report the first known case of inferior vena cava thrombosis in a postpartum woman presenting with acute lumbar radiculopathy and weak legs. She was successfully treated with i.v. heparin and oral anticoagulation. CONCLUSIONS Inferior vena cava thrombosis is a rare cause of acute lumbar radiculopathy, but is in the differential diagnosis to consider, especially in those patients at increased risk of thrombosis.
Collapse
Affiliation(s)
- Benjamin A Hickey
- Department of Spinal Surgery, University Hospital of Wales, Cardiff, Wales
| | - Sashin Ahuja
- Department of Spinal Surgery, University Hospital of Wales, Cardiff, Wales
| |
Collapse
|
|
13
|
Trombosis venosa de repetición de etiología no habitual en el paciente joven. ANGIOLOGIA 2013. [DOI: 10.1016/s0003-3170(13)70091-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
|
14
|
Copy number variations of the F8 gene are associated with venous thromboembolism. Blood Cells Mol Dis 2013; 50:259-62. [DOI: 10.1016/j.bcmd.2013.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 12/24/2012] [Indexed: 11/21/2022]
|
|
15
|
Signorelli SS, Fiore V, Puccia G, Mastrosimone G, Anzaldi M. Thrombophilia in Patients With Lower Limb Deep Veins Thrombosis (LDVT) Results of a Monocentric Survey on 103 Consecutive Outpatients. Clin Appl Thromb Hemost 2013; 20:589-93. [DOI: 10.1177/1076029612474716] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
A debate concerns the utility of large screening for acquired or inherited thrombophilia. The study concerns relationship between inherited thrombophilic status and lower limb deep vein thrombosis (LDVT) and highlights the possible use of extensive thrombophilia screening to determine an emerging risk of LDVT. From January 2010 to January 2012, 103 consecutive patients with LDVT were considered. In all, 57 (55.3%) patients with LDVT showed inherited thrombophilia. The most frequent trombophilic alterations were deficiency of protein S (33 patients, 32.0%), methylentethrafolate reductase (MTHFR) gene C677T variant (22 patients, 21.4%), protrombin gene G20210A alteration (50, 14.6%), and deficiency of protein C (12, 11.6%). Age and MTHFR variant were found related to LDVT and thrombophilia was related to distal LDVT. A high frequency of thrombophylic factor was found in patients with LDVT, but we believe that a generic genetic screening should not be suggested for these patients.
Collapse
Affiliation(s)
- Salvatore Santo Signorelli
- Department of Medical and Pediatric Science, University of Catania, Medical Angiology Unit Hospital Garibaldi, Catania, Italy
| | - Valerio Fiore
- Department of Medical and Pediatric Science, University of Catania, Medical Angiology Unit Hospital Garibaldi, Catania, Italy
| | - Giuseppe Puccia
- Department of Medical and Pediatric Science, University of Catania, Medical Angiology Unit Hospital Garibaldi, Catania, Italy
| | - Gianluca Mastrosimone
- Department of Medical and Pediatric Science, University of Catania, Medical Angiology Unit Hospital Garibaldi, Catania, Italy
| | - Massimiliano Anzaldi
- Department of Medical and Pediatric Science, University of Catania, Medical Angiology Unit Hospital Garibaldi, Catania, Italy
| |
Collapse
|