Inferior vena cava hypoplasia: treatment patient with bilateral venous thrombosis

In the treatment of bilateral venous thrombosis in patient with hypoplasia of IVC, congenital anomalies of inferior vena cava (IVC) development are a rather rare pathology; however, in many cases, it is accompanied by complications in the form of bilateral venous thrombosis. To date, there are no consensus and recommendations for the treatment of this category of patients, so the analysis of treatment results will better understand the pathophysiology of the disease and form an optimal treatment strategy. The patient was a 26-year-old male. In November 2010, the patient appeared to the clinic with symptoms of pain, cyanosis, and edema of the lower extremities, which bothered the patient for 14 days. The patient had trauma of the lumbar region in anamnesis. Clinical diagnostics showed edema of the lower extremities, cyanosis of the lower extremities, and pain after palpation of the lower extremities. There was peripheral arterial pulsation in this patient. During duplex ultrasound, hyperechogenic thrombosis of iliofemoral venous segments of lower extremities and hypoplasia and thrombosis of the infrarenal part of the IVC were diagnosed. CT scan of the abdomen with intravenous contrast showed hyperechogenic thrombosis of the iliofemoral venous segments of the lower extremities and hypoplasia and thrombosis of the infrarenal part of the IVC. The patient was treated with LMWH, venotonics, oral anticoagulants, and elastic compression stockings. The patient’s condition improved, and the pain, cyanosis, and edema of the lower extremities regressed. Duplex ultrasound during the two weeks after treatment showed beginning of recanalization of the infrarenal part of the IVC and iliofemoral venous segments of the lower extremities. The patient was treated with long-term oral anticoagulants and elastic compression stockings. Thus, the results of treatment of patient with venous thromboembolism and hypoplasia of IVC suggest that the use of anticoagulant therapy in this category of patients allows to obtain positive results of treatment with regression of clinical symptoms and no thromboembolic complications in the near and long term.