Intravascular endoscopy can directly visualize the proximal end-site of inferior vena cava obstruction, revealing anatomical abnormalities that may predispose to extensive thrombosis.
May aid visualization of rare IVC anomalies in thrombosis; hypothesis-generating and should not yet alter practice.
A 28-year-old, previously healthy man was referred to our hospital three months after the appearance of lumbago, leg pains and fever. Routine examinations were normal. Phlebography demonstrated occlusion of the common femoral veins by thrombosis. Inferior vena cavography and magnetic resonance image showed that the inferior vena cava (IVC) became gradually narrower from the level of 11th thoracic vertebra. An intravascular endoscopic study gave the same morphological findings; the endothelial surface was found to be intact. We concluded that the stenosis of the IVC was the primary lesion and was the essential pathological condition. The massive thrombosis appeared to have occurred secondarily.
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Arao et al. (1993) studied this question.
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