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

Behnood Bikdeli; Parham Sadeghipour; Junyang Lou; Antoine Bejjani; Candrika D. Khairani; Sina Rashedi; Robert Lookstein; Alexandra Lansky; Suresh Vedantham; Piotr Sobieszczyk; Carlos Mena-Hurtado; Ayaz Aghayev; Peter Henke; Ghazaleh Mehdipoor; Antonella Tufano; Saurav Chatterjee; Saskia Middeldorp; Suman Wasan; Riyaz Bashir; Irene M. Lang; Mehdi H. Shishehbor; Marie Gerhard-Herman; Jay Giri; Matthew T. Menard; Sahil A. Parikh; Lucia Mazzolai; Lisa Moores; Manuel Monreal; David Jimenez; Samuel Z. Goldhaber; Harlan M. Krumholz; Gregory Piazza

doi:10.1055/s-0043-1777991

Seminars in Thrombosis and Hemostasis, Table of Contents

Semin Thromb Hemost 2024; 50(06): 851-865
DOI: 10.1055/s-0043-1777991

Review Article

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

Behnood Bikdeli^*

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

²Thrombosis Research Group, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

³YNHH/Yale Center for Outcomes Research and Evaluation (CORE), New Haven, Connecticut

⁴Cardiovascular Research Foundation (CRF), New York, New York

,

Parham Sadeghipour^*

⁵Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran

⁶Clinical Trial Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran

,

Junyang Lou

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

,

Antoine Bejjani

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

²Thrombosis Research Group, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

,

Candrika D. Khairani

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

²Thrombosis Research Group, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

,

Sina Rashedi

⁵Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran

,

Robert Lookstein

⁷Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York

,

Alexandra Lansky

⁸Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut

,

Suresh Vedantham

⁹Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, Missouri

,

Piotr Sobieszczyk

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

,

Carlos Mena-Hurtado

⁸Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut

,

Ayaz Aghayev

¹⁰Cardiovascular Imaging Program, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

,

Peter Henke

¹¹Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan

,

Ghazaleh Mehdipoor

⁴Cardiovascular Research Foundation (CRF), New York, New York

¹²Center for Evidence-based Imaging, Brigham and Women's Hospital, Boston, Massachusetts

,

Antonella Tufano

¹³Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy

,

Saurav Chatterjee

¹⁴Division of Cardiology, Department of Medicine, Zucker School of Medicine, New York, New York

,

Saskia Middeldorp

¹⁵Department of Internal Medicine, Radboud Institute of Health Sciences (RIHS), Radboud University Medical Center, Nijmegen, The Netherlands

,

Suman Wasan

¹⁶University of North Carolina, Chapel Hill, North Carolina

,

Riyaz Bashir

¹⁷Departement of Cardiovascular Diseases, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania

,

Irene M. Lang

¹⁸Department of Internal Medicine II, Cardiology and Center of Cardiovascular Medicine, Medical University of Vienna, Vienna, Austria

,

Mehdi H. Shishehbor

¹⁹University Hospitals Heath System, Harrington Heart and Vascular Institute, Cleveland, Ohio

,

Marie Gerhard-Herman

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

,

Jay Giri

²⁰Penn Cardiovascular Outcomes, Quality, and Evaluative Research Center, Cardiovascular Division, University of Pennsylvania, Philadelphia, Pennsylvania

,

Matthew T. Menard

²¹Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

,

Sahil A. Parikh

⁴Cardiovascular Research Foundation (CRF), New York, New York

²²Division of Cardiology, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York

,

Lucia Mazzolai

²³Division of Angiology, Heart and Vessel Department, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland

,

Lisa Moores

²⁴Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, Maryland

,

Manuel Monreal

²⁵Universidad Católica San Antonio de Murcia, Spain

,

David Jimenez

²⁶Respiratory Department, Hospital Ramón y Cajal (IRYCIS), Madrid, Spain

²⁷Medicine Department, Universidad de Alcalá (IRYCIS), Madrid, Spain

²⁸CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain

,

Samuel Z. Goldhaber

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

²Thrombosis Research Group, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

,

Harlan M. Krumholz

³YNHH/Yale Center for Outcomes Research and Evaluation (CORE), New Haven, Connecticut

⁸Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut

²⁹Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut

,

Gregory Piazza

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

²Thrombosis Research Group, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

› Author Affiliations

Abstract

The 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.

Keywords

venous thromboembolism - deep vein thrombosis - pulmonary embolism - IVC agenesis - vena cava filters - IVC ligation

Full Text

References

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Supplementary Material

Supplementary Material