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

Authors

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

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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