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

Author:

Bikdeli Behnood,Sadeghipour Parham,Lou Junyang1,Bejjani Antoine,Khairani Candrika D.,Rashedi Sina2,Lookstein Robert3,Lansky Alexandra4,Vedantham Suresh5,Sobieszczyk Piotr1,Mena-Hurtado Carlos4,Aghayev Ayaz6,Henke Peter7,Mehdipoor Ghazaleh,Tufano Antonella8,Chatterjee Saurav9,Middeldorp Saskia10,Wasan Suman11,Bashir Riyaz12,Lang Irene M.13,Shishehbor Mehdi H.14,Gerhard-Herman Marie1,Giri Jay15,Menard Matthew T.16,Parikh Sahil A.,Mazzolai Lucia17,Moores Lisa18,Monreal Manuel19,Jimenez David,Goldhaber Samuel Z.,Krumholz Harlan M.,Piazza Gregory

Affiliation:

1. Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

2. Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran

3. Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York

4. Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut

5. Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, Missouri

6. Cardiovascular Imaging Program, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

7. Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan

8. Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy

9. Division of Cardiology, Department of Medicine, Zucker School of Medicine, New York, New York

10. Department of Internal Medicine, Radboud Institute of Health Sciences (RIHS), Radboud University Medical Center, Nijmegen, The Netherlands

11. University of North Carolina, Chapel Hill, North Carolina

12. Departement of Cardiovascular Diseases, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania

13. Department of Internal Medicine II, Cardiology and Center of Cardiovascular Medicine, Medical University of Vienna, Vienna, Austria

14. University Hospitals Heath System, Harrington Heart and Vascular Institute, Cleveland, Ohio

15. Penn Cardiovascular Outcomes, Quality, and Evaluative Research Center, Cardiovascular Division, University of Pennsylvania, Philadelphia, Pennsylvania

16. Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

17. Division of Angiology, Heart and Vessel Department, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland

18. Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, Maryland

19. Universidad Católica San Antonio de Murcia, Spain

Abstract

AbstractThe 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.

Publisher

Georg Thieme Verlag KG

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