Castro V Alende, Díaz-Peromingo Jose Antonio
Department of Internal Medicine, EOXI Pontevedra e Salnés, Spain.
Department of Internal Medicine, Complejo Hospitalario Universitario de Santiago de Compostela, Villagarcia, Spain.
Int J Angiol. 2021 Jul 30;31(2):88-91. doi: 10.1055/s-0041-1732434. eCollection 2022 Jun.
Congenital anomalies of the vena cava often go unnoticed, and their incidental finding is frequent in imaging tests performed for another cause in asymptomatic patients. However, an association with the development of thromboembolic disease has been described, mainly in young patients. We report the case of a young woman with deep vein thrombosis associated with vena cava atresia. We conducted a search of the PubMed/Medline database. The search identified 17 articles, of which 5 were selected for extraction and data analysis. Twelve studies were excluded because they failed to match the main criteria. We identified six new cases of deep vein thrombosis associated with vena cava abnormalities, with a mean age of 42.5 years; 83.3% were male. Regarding clinical manifestations, all patients presented as deep vein thrombosis, one case of recurrence, and another case associated with the kidney and inferior vena cava abnormalities with leg thrombosis syndrome. Only one patient had a target triggering factor (cholecystectomy postoperative). The thrombophilia study was negative in all cases and none of the patients died. Treatment included enoxaparin and vitamin K antagonists. This is the first study to report on a systematic review of vena cava atresia associated with deep vein thrombosis in Spain. It shows that in this region, the disease affects young population-even in the absence of risk factors-and is linked to a low mortality. The most frequent presentation form was deep vein thrombosis. Therefore, congenital abnormalities of the vena cava should be suspected in young patients with thromboembolic disease, due to their implications regarding to the duration of anticoagulant treatment, as well as their possible association with other prothrombotic factors.
腔静脉先天性异常常常未被发现，在为无症状患者因其他原因进行的影像学检查中，其偶然发现很常见。然而，已有报道称其与血栓栓塞性疾病的发生有关，主要见于年轻患者。我们报告了一例年轻女性，其深静脉血栓形成与腔静脉闭锁相关。我们检索了PubMed/Medline数据库。检索到17篇文章，其中5篇被选用于提取和数据分析。12项研究被排除，因为它们不符合主要标准。我们确定了6例与腔静脉异常相关的深静脉血栓形成新病例，平均年龄为42.5岁；83.3%为男性。关于临床表现，所有患者均表现为深静脉血栓形成，1例复发，另1例与肾脏及下腔静脉异常合并腿部血栓形成综合征相关。只有1例患者有明确的触发因素（胆囊切除术后）。所有病例的血栓形成倾向研究均为阴性，且无患者死亡。治疗包括依诺肝素和维生素K拮抗剂。这是西班牙第一项关于腔静脉闭锁与深静脉血栓形成的系统评价研究报告。研究表明，在该地区，这种疾病影响年轻人群——即使在没有危险因素的情况下——且死亡率较低。最常见的表现形式是深静脉血栓形成。因此，对于患有血栓栓塞性疾病的年轻患者，应怀疑其腔静脉先天性异常，因为这关系到抗凝治疗的持续时间，以及它们可能与其他促血栓形成因素的关联。
