Inferior Vena Cava Atresia: Characterisation of Risk Factors, Treatment, and Outcomes
Purpose To characterise (1) the risk factors associated with inferior vena cava (IVC) atresia, (2) the radiographic and clinical presentations of deep vein thrombosis (DVT) in patients with IVC atresia, and (3) the treatment and outcome of DVT in patients with IVC atresia. Methods The electronic med...
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| Veröffentlicht in: | Cardiovascular and interventional radiology 2020, Vol.43 (1), p.37-45 |
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| creator | Mabud, Tarub S. Sailer, Anna M. Swee, Joshua K. Y. Tamboli, Mallika Arendt, Victoria A. Jeon, Gyeong-Sik An, Xiao Cohn, David M. Kuo, William T. Hofmann, Lawrence V. |
| description | Purpose
To characterise (1) the risk factors associated with inferior vena cava (IVC) atresia, (2) the radiographic and clinical presentations of deep vein thrombosis (DVT) in patients with IVC atresia, and (3) the treatment and outcome of DVT in patients with IVC atresia.
Methods
The electronic medical record was systematically reviewed for thrombotic risk factors in patients who presented with lower-extremity DVT (
n
= 409) at a single centre between 1996 and 2017. Patients with IVC atresia were identified based on imaging and chart review. Differences in demographics and thrombotic risk factors between patients with and without IVC atresia were statistically assessed. Extent and chronicity of DVT on imaging, clinical presentation, treatment, and outcomes were evaluated for all patients with IVC atresia.
Results
4.2% of DVT patients (17/409) were found to have IVC atresia; mean age at diagnosis was 25.5 ± 9.4 years. The rate of heritable thrombophilia was significantly higher in patients with IVC atresia compared to patients without IVC atresia (52.9% vs. 17.9%,
p
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| doi_str_mv | 10.1007/s00270-019-02353-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2309497634</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2309497634</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-a0af242624f690cdb07a171fec9a6a997466b170872a3f1deba84edfe855ff43</originalsourceid><addsrcrecordid>eNp9kEFLHTEQx0NR6vPpF-ihBLx4cO0k2SS73uShVhCE8irewrzdSbv6dqPJbqF-eqPPtuChp4GZ3_xn-DH2ScCxALBfEoC0UICoC5BKq-LpA5uJUskCKnO7xWYgbFkIrcUO203pDkDoSuqPbEcJo0GWcsa-Xw6eYhciv6EB-QJ_IT8dI6UOT_jiJ0ZsxjxPOHZh4MHzb1265-e5G2I64stIOPY0jEcch5ZfT2MTekp7bNvjOtH-W52z5fnZcvG1uLq-uFycXhWNsnosENDnL4wsvamhaVdgUVjhqanRYF3b0piVsFBZicqLllZYldR6qrT2vlRzdriJfYjhcaI0ur5LDa3XOFCYkpMK6rK2Rr2gB-_QuzDFIT-XKSUBjMkG50xuqCaGlCJ59xC7HuNvJ8C9OHcb5y47d6_O3VNe-vwWPa16av-u_JGcAbUBUh4NPyj-u_2f2GdSTIv1</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2332006635</pqid></control><display><type>article</type><title>Inferior Vena Cava Atresia: Characterisation of Risk Factors, Treatment, and Outcomes</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Mabud, Tarub S. ; Sailer, Anna M. ; Swee, Joshua K. Y. ; Tamboli, Mallika ; Arendt, Victoria A. ; Jeon, Gyeong-Sik ; An, Xiao ; Cohn, David M. ; Kuo, William T. ; Hofmann, Lawrence V.</creator><creatorcontrib>Mabud, Tarub S. ; Sailer, Anna M. ; Swee, Joshua K. Y. ; Tamboli, Mallika ; Arendt, Victoria A. ; Jeon, Gyeong-Sik ; An, Xiao ; Cohn, David M. ; Kuo, William T. ; Hofmann, Lawrence V.</creatorcontrib><description>Purpose
To characterise (1) the risk factors associated with inferior vena cava (IVC) atresia, (2) the radiographic and clinical presentations of deep vein thrombosis (DVT) in patients with IVC atresia, and (3) the treatment and outcome of DVT in patients with IVC atresia.
Methods
The electronic medical record was systematically reviewed for thrombotic risk factors in patients who presented with lower-extremity DVT (
n
= 409) at a single centre between 1996 and 2017. Patients with IVC atresia were identified based on imaging and chart review. Differences in demographics and thrombotic risk factors between patients with and without IVC atresia were statistically assessed. Extent and chronicity of DVT on imaging, clinical presentation, treatment, and outcomes were evaluated for all patients with IVC atresia.
Results
4.2% of DVT patients (17/409) were found to have IVC atresia; mean age at diagnosis was 25.5 ± 9.4 years. The rate of heritable thrombophilia was significantly higher in patients with IVC atresia compared to patients without IVC atresia (52.9% vs. 17.9%,
p
< 0.0001). There were bilateral DVT in 70.6% of IVC atresia patients; DVT was chronic in 41.2% and acute on chronic in 58.8%. Pre-intervention Villalta scores were 13.9 ± 9.8 in the left limb and 8.5 ± 7.0 in the right limb. DVT in IVC atresia patients was typically treated with catheter-directed thrombolysis followed by stent placement, achieving complete or partial symptom resolution in 78.6% of cases.
Conclusion
Thrombotic risk factors such as heritable thrombophilia are associated with IVC atresia. IVC atresia patients can experience high burdens of lower-extremity thrombotic disease at a young age which benefit from endovascular treatment.
Level of Evidence
Level 4.</description><identifier>ISSN: 0174-1551</identifier><identifier>EISSN: 1432-086X</identifier><identifier>DOI: 10.1007/s00270-019-02353-z</identifier><identifier>PMID: 31650242</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adolescent ; Adult ; Cardiology ; Cardiovascular system ; Catheters ; Clinical Investigation ; Computed Tomography Angiography ; Demographics ; Demography ; Electronic health records ; Electronic medical records ; Female ; Humans ; Imaging ; Implants ; Lower Extremity - blood supply ; Magnetic Resonance Angiography ; Male ; Medical imaging ; Medical instruments ; Medicine ; Medicine & Public Health ; Nuclear Medicine ; Patients ; Radiology ; Risk analysis ; Risk Factors ; Surgical implants ; Thromboembolism ; Thrombolysis ; Thrombolytic Therapy - methods ; Thrombophilia ; Thrombosis ; Treatment Outcome ; Ultrasound ; Vena Cava, Inferior - abnormalities ; Vena Cava, Inferior - diagnostic imaging ; Venous Interventions ; Venous Thrombosis - complications ; Venous Thrombosis - diagnostic imaging ; Venous Thrombosis - drug therapy ; Young Adult</subject><ispartof>Cardiovascular and interventional radiology, 2020, Vol.43 (1), p.37-45</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019</rights><rights>CardioVascular and Interventional Radiology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-a0af242624f690cdb07a171fec9a6a997466b170872a3f1deba84edfe855ff43</citedby><cites>FETCH-LOGICAL-c375t-a0af242624f690cdb07a171fec9a6a997466b170872a3f1deba84edfe855ff43</cites><orcidid>0000-0002-0192-2395</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00270-019-02353-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00270-019-02353-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31650242$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mabud, Tarub S.</creatorcontrib><creatorcontrib>Sailer, Anna M.</creatorcontrib><creatorcontrib>Swee, Joshua K. Y.</creatorcontrib><creatorcontrib>Tamboli, Mallika</creatorcontrib><creatorcontrib>Arendt, Victoria A.</creatorcontrib><creatorcontrib>Jeon, Gyeong-Sik</creatorcontrib><creatorcontrib>An, Xiao</creatorcontrib><creatorcontrib>Cohn, David M.</creatorcontrib><creatorcontrib>Kuo, William T.</creatorcontrib><creatorcontrib>Hofmann, Lawrence V.</creatorcontrib><title>Inferior Vena Cava Atresia: Characterisation of Risk Factors, Treatment, and Outcomes</title><title>Cardiovascular and interventional radiology</title><addtitle>Cardiovasc Intervent Radiol</addtitle><addtitle>Cardiovasc Intervent Radiol</addtitle><description>Purpose
To characterise (1) the risk factors associated with inferior vena cava (IVC) atresia, (2) the radiographic and clinical presentations of deep vein thrombosis (DVT) in patients with IVC atresia, and (3) the treatment and outcome of DVT in patients with IVC atresia.
Methods
The electronic medical record was systematically reviewed for thrombotic risk factors in patients who presented with lower-extremity DVT (
n
= 409) at a single centre between 1996 and 2017. Patients with IVC atresia were identified based on imaging and chart review. Differences in demographics and thrombotic risk factors between patients with and without IVC atresia were statistically assessed. Extent and chronicity of DVT on imaging, clinical presentation, treatment, and outcomes were evaluated for all patients with IVC atresia.
Results
4.2% of DVT patients (17/409) were found to have IVC atresia; mean age at diagnosis was 25.5 ± 9.4 years. The rate of heritable thrombophilia was significantly higher in patients with IVC atresia compared to patients without IVC atresia (52.9% vs. 17.9%,
p
< 0.0001). There were bilateral DVT in 70.6% of IVC atresia patients; DVT was chronic in 41.2% and acute on chronic in 58.8%. Pre-intervention Villalta scores were 13.9 ± 9.8 in the left limb and 8.5 ± 7.0 in the right limb. DVT in IVC atresia patients was typically treated with catheter-directed thrombolysis followed by stent placement, achieving complete or partial symptom resolution in 78.6% of cases.
Conclusion
Thrombotic risk factors such as heritable thrombophilia are associated with IVC atresia. IVC atresia patients can experience high burdens of lower-extremity thrombotic disease at a young age which benefit from endovascular treatment.
Level of Evidence
Level 4.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Cardiology</subject><subject>Cardiovascular system</subject><subject>Catheters</subject><subject>Clinical Investigation</subject><subject>Computed Tomography Angiography</subject><subject>Demographics</subject><subject>Demography</subject><subject>Electronic health records</subject><subject>Electronic medical records</subject><subject>Female</subject><subject>Humans</subject><subject>Imaging</subject><subject>Implants</subject><subject>Lower Extremity - blood supply</subject><subject>Magnetic Resonance Angiography</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical instruments</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nuclear Medicine</subject><subject>Patients</subject><subject>Radiology</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Surgical implants</subject><subject>Thromboembolism</subject><subject>Thrombolysis</subject><subject>Thrombolytic Therapy - methods</subject><subject>Thrombophilia</subject><subject>Thrombosis</subject><subject>Treatment Outcome</subject><subject>Ultrasound</subject><subject>Vena Cava, Inferior - abnormalities</subject><subject>Vena Cava, Inferior - diagnostic imaging</subject><subject>Venous Interventions</subject><subject>Venous Thrombosis - complications</subject><subject>Venous Thrombosis - diagnostic imaging</subject><subject>Venous Thrombosis - drug therapy</subject><subject>Young Adult</subject><issn>0174-1551</issn><issn>1432-086X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kEFLHTEQx0NR6vPpF-ihBLx4cO0k2SS73uShVhCE8irewrzdSbv6dqPJbqF-eqPPtuChp4GZ3_xn-DH2ScCxALBfEoC0UICoC5BKq-LpA5uJUskCKnO7xWYgbFkIrcUO203pDkDoSuqPbEcJo0GWcsa-Xw6eYhciv6EB-QJ_IT8dI6UOT_jiJ0ZsxjxPOHZh4MHzb1265-e5G2I64stIOPY0jEcch5ZfT2MTekp7bNvjOtH-W52z5fnZcvG1uLq-uFycXhWNsnosENDnL4wsvamhaVdgUVjhqanRYF3b0piVsFBZicqLllZYldR6qrT2vlRzdriJfYjhcaI0ur5LDa3XOFCYkpMK6rK2Rr2gB-_QuzDFIT-XKSUBjMkG50xuqCaGlCJ59xC7HuNvJ8C9OHcb5y47d6_O3VNe-vwWPa16av-u_JGcAbUBUh4NPyj-u_2f2GdSTIv1</recordid><startdate>2020</startdate><enddate>2020</enddate><creator>Mabud, Tarub S.</creator><creator>Sailer, Anna M.</creator><creator>Swee, Joshua K. Y.</creator><creator>Tamboli, Mallika</creator><creator>Arendt, Victoria A.</creator><creator>Jeon, Gyeong-Sik</creator><creator>An, Xiao</creator><creator>Cohn, David M.</creator><creator>Kuo, William T.</creator><creator>Hofmann, Lawrence V.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0192-2395</orcidid></search><sort><creationdate>2020</creationdate><title>Inferior Vena Cava Atresia: Characterisation of Risk Factors, Treatment, and Outcomes</title><author>Mabud, Tarub S. ; Sailer, Anna M. ; Swee, Joshua K. Y. ; Tamboli, Mallika ; Arendt, Victoria A. ; Jeon, Gyeong-Sik ; An, Xiao ; Cohn, David M. ; Kuo, William T. ; Hofmann, Lawrence V.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-a0af242624f690cdb07a171fec9a6a997466b170872a3f1deba84edfe855ff43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Cardiology</topic><topic>Cardiovascular system</topic><topic>Catheters</topic><topic>Clinical Investigation</topic><topic>Computed Tomography Angiography</topic><topic>Demographics</topic><topic>Demography</topic><topic>Electronic health records</topic><topic>Electronic medical records</topic><topic>Female</topic><topic>Humans</topic><topic>Imaging</topic><topic>Implants</topic><topic>Lower Extremity - blood supply</topic><topic>Magnetic Resonance Angiography</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical instruments</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nuclear Medicine</topic><topic>Patients</topic><topic>Radiology</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Surgical implants</topic><topic>Thromboembolism</topic><topic>Thrombolysis</topic><topic>Thrombolytic Therapy - methods</topic><topic>Thrombophilia</topic><topic>Thrombosis</topic><topic>Treatment Outcome</topic><topic>Ultrasound</topic><topic>Vena Cava, Inferior - abnormalities</topic><topic>Vena Cava, Inferior - diagnostic imaging</topic><topic>Venous Interventions</topic><topic>Venous Thrombosis - complications</topic><topic>Venous Thrombosis - diagnostic imaging</topic><topic>Venous Thrombosis - drug therapy</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mabud, Tarub S.</creatorcontrib><creatorcontrib>Sailer, Anna M.</creatorcontrib><creatorcontrib>Swee, Joshua K. Y.</creatorcontrib><creatorcontrib>Tamboli, Mallika</creatorcontrib><creatorcontrib>Arendt, Victoria A.</creatorcontrib><creatorcontrib>Jeon, Gyeong-Sik</creatorcontrib><creatorcontrib>An, Xiao</creatorcontrib><creatorcontrib>Cohn, David M.</creatorcontrib><creatorcontrib>Kuo, William T.</creatorcontrib><creatorcontrib>Hofmann, Lawrence V.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Cardiovascular and interventional radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mabud, Tarub S.</au><au>Sailer, Anna M.</au><au>Swee, Joshua K. Y.</au><au>Tamboli, Mallika</au><au>Arendt, Victoria A.</au><au>Jeon, Gyeong-Sik</au><au>An, Xiao</au><au>Cohn, David M.</au><au>Kuo, William T.</au><au>Hofmann, Lawrence V.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Inferior Vena Cava Atresia: Characterisation of Risk Factors, Treatment, and Outcomes</atitle><jtitle>Cardiovascular and interventional radiology</jtitle><stitle>Cardiovasc Intervent Radiol</stitle><addtitle>Cardiovasc Intervent Radiol</addtitle><date>2020</date><risdate>2020</risdate><volume>43</volume><issue>1</issue><spage>37</spage><epage>45</epage><pages>37-45</pages><issn>0174-1551</issn><eissn>1432-086X</eissn><abstract>Purpose
To characterise (1) the risk factors associated with inferior vena cava (IVC) atresia, (2) the radiographic and clinical presentations of deep vein thrombosis (DVT) in patients with IVC atresia, and (3) the treatment and outcome of DVT in patients with IVC atresia.
Methods
The electronic medical record was systematically reviewed for thrombotic risk factors in patients who presented with lower-extremity DVT (
n
= 409) at a single centre between 1996 and 2017. Patients with IVC atresia were identified based on imaging and chart review. Differences in demographics and thrombotic risk factors between patients with and without IVC atresia were statistically assessed. Extent and chronicity of DVT on imaging, clinical presentation, treatment, and outcomes were evaluated for all patients with IVC atresia.
Results
4.2% of DVT patients (17/409) were found to have IVC atresia; mean age at diagnosis was 25.5 ± 9.4 years. The rate of heritable thrombophilia was significantly higher in patients with IVC atresia compared to patients without IVC atresia (52.9% vs. 17.9%,
p
< 0.0001). There were bilateral DVT in 70.6% of IVC atresia patients; DVT was chronic in 41.2% and acute on chronic in 58.8%. Pre-intervention Villalta scores were 13.9 ± 9.8 in the left limb and 8.5 ± 7.0 in the right limb. DVT in IVC atresia patients was typically treated with catheter-directed thrombolysis followed by stent placement, achieving complete or partial symptom resolution in 78.6% of cases.
Conclusion
Thrombotic risk factors such as heritable thrombophilia are associated with IVC atresia. IVC atresia patients can experience high burdens of lower-extremity thrombotic disease at a young age which benefit from endovascular treatment.
Level of Evidence
Level 4.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31650242</pmid><doi>10.1007/s00270-019-02353-z</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-0192-2395</orcidid></addata></record> |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Adolescent Adult Cardiology Cardiovascular system Catheters Clinical Investigation Computed Tomography Angiography Demographics Demography Electronic health records Electronic medical records Female Humans Imaging Implants Lower Extremity - blood supply Magnetic Resonance Angiography Male Medical imaging Medical instruments Medicine Medicine & Public Health Nuclear Medicine Patients Radiology Risk analysis Risk Factors Surgical implants Thromboembolism Thrombolysis Thrombolytic Therapy - methods Thrombophilia Thrombosis Treatment Outcome Ultrasound Vena Cava, Inferior - abnormalities Vena Cava, Inferior - diagnostic imaging Venous Interventions Venous Thrombosis - complications Venous Thrombosis - diagnostic imaging Venous Thrombosis - drug therapy Young Adult |
| title | Inferior Vena Cava Atresia: Characterisation of Risk Factors, Treatment, and Outcomes |
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