Venous thromboembolism in the setting of IVC calcification managed with pharmacomechanical thrombectomy and anticoagulation: A case report

Abel A Belay; Japnit Singh; Sandeep Laroia

doi:10.1016/j.radcr.2021.06.077

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Venous thromboembolism in the setting of IVC calcification managed with pharmacomechanical thrombectomy and anticoagulation: A case report

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Venous thromboembolism in the setting of IVC calcification managed with pharmacomechanical thrombectomy and anticoagulation: A case report

Abel A Belay, Japnit Singh and Sandeep Laroia

Radiology case reports, Vol.16(9), pp.2757-2762

09/2021

DOI: 10.1016/j.radcr.2021.06.077

PMCID: PMC8326595

PMID: 34367390

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Abstract

In this paper, we describe a case of an otherwise healthy 51 year old Caucasian male who presented with extensive venous thrombosis and a large retroperitoneal hepatoma without active bleeding. On imaging he was found to have focal calciifcation in the juxtarenal IVC and extensive thrombosis of the iliofemoral and femoropoliteal veins as well as the infrarenal IVC. Despite treating the patient with pharmacomechanical thrombectomy and anticoaguation, he passed away likely due to a new pulmonary embolism. According to the literature available to us, IVC calcification is a rare finding in adults and has been associated with an increased incidence of recurrent deep vein thrombosis and pulmonary embolism. While long term anticoagulation has been recommended for patients with recurrent venous thromboembolism (VTE), there is no expert consensus or societal guidelines for the treatment VTE in the setting of IVC calcification, specifically, regarding pharmacomechanical Vs. surgical thrombectomy [1]. Furthermore, no recommendations currently exist regarding whether expectant management Vs. prophylactic anticoagulation is appropriate. In conclusion, disease specific management guidelines by professional medical societies may be needed regarding the utility and appropriateness of pharmacomechanical thrombectomy Vs. surgical thrombectomy for symptomatic cases as well as expectant management Vs. prophylactic anticoagulation for asymptomatic cases in the setting of IVC calcification.

IVC calcification

Pharmacomechanical thrombectomy

Pulmonary embolism

Recurrent deep vein thrombosis

Details

Title: Subtitle: Venous thromboembolism in the setting of IVC calcification managed with pharmacomechanical thrombectomy and anticoagulation: A case report
Creators: Abel A Belay - University of Iowa Hospitals and Clinics
Japnit Singh - University of Iowa
Sandeep Laroia - University of Iowa
Resource Type: Journal article
Publication Details: Radiology case reports, Vol.16(9), pp.2757-2762
DOI: 10.1016/j.radcr.2021.06.077
PMID: 34367390
PMCID: PMC8326595
NLM abbreviation: Radiol Case Rep
ISSN: 1930-0433
eISSN: 1930-0433
Publisher: Elsevier Inc
Language: English
Date published: 09/2021
Academic Unit: Radiology; Internal Medicine
Record Identifier: 9984318722802771

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