一篇关于接受溶栓治疗的下腔静脉缺如的深静脉血栓形成患者的文献综述及病例系列报道
A Literature Review and Case Series of DVT Patients with Absent IVC Treated with Thrombolysis.
作者信息
Tarazi Munir, Bashir Ammani, Khan Kamran, Kakani Nirmal, Murray David, Serracino-Inglott Ferdinand
机构信息
Department of Vascular Surgery, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK.
Department of Vascular Surgery, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK.
出版信息
Ann Vasc Surg. 2020 Aug;67:521-531. doi: 10.1016/j.avsg.2020.03.021. Epub 2020 Mar 28.
BACKGROUND
Congenital absence of the inferior vena cava is related to deep venous thrombosis (DVT) in 5% of cases with no other risk factors. DVT is normally diagnosed by Duplex, whereas computerized tomography or magnetic resonance imaging is required to visualize this absence, and so, it is often missed but ought to be considered in young patients. There are many existing cases in the literature illustrating this link, but these patients were often managed conservatively with anticoagulation.
CASE SERIES
We report five cases presenting with a DVT who were found to have an absent inferior vena cava after imaging and were treated successfully with thrombolysis and consequently managed with lifelong anticoagulation, between January 2014 and January 2019.
CONCLUSIONS
Anomalies of the inferior vena cava can cause unprovoked DVT. These anomalies are often incidental findings after CT but could change the management plan in these patients. Treatment can be with anticoagulants only, thrombolysis, thrombectomy, balloon angioplasty or stents, and long-term or lifelong anticoagulation to prevent DVT recurrence.
背景
在无其他危险因素的病例中，5%的先天性下腔静脉缺如与深静脉血栓形成（DVT）有关。DVT通常通过双功超声诊断，而需要计算机断层扫描或磁共振成像来显示这种缺如情况，因此，这种情况常被漏诊，但在年轻患者中应予以考虑。文献中有许多现有病例说明了这种关联，但这些患者通常采用抗凝保守治疗。
病例系列
我们报告了2014年1月至2019年1月期间的5例DVT患者，经影像学检查发现存在下腔静脉缺如，经溶栓治疗成功，并因此接受终身抗凝治疗。
结论
下腔静脉异常可导致不明原因的DVT。这些异常在CT检查后常为偶然发现，但可能会改变这些患者的治疗方案。治疗方法可以是仅使用抗凝剂、溶栓、血栓切除术、球囊血管成形术或支架置入，以及长期或终身抗凝以预防DVT复发。
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