Membranstenose Vena cava inferior

Endovascular
treatment of an obstructive membrane between inferior vena cava and right atrium in an unrecognized Budd-Chiari syndrome. ECHO The first echo performed in a local hospital, indicated a possible tumour in the right atrium (arrow), what was the reason for referring the patient to our institution for further diagnostics and treatment
CVIRendovasc.springeropen.com • CC-by-4.0
Endovascular
treatment of an obstructive membrane between inferior vena cava and right atrium in an unrecognized Budd-Chiari syndrome. NMR: a IVC dilated (3,5–4,1 cm) separated from RA with a 3 mm thick membrane (arrow) obstructing the flow, b dilated hepatic veins
CVIRendovasc.springeropen.com • CC-by-4.0
Endovascular
treatment of an obstructive membrane between inferior vena cava and right atrium in an unrecognized Budd-Chiari syndrome. INTERVENTION a Angiography shows a complete obstruction of the blood flow between IVC and RA, b puncture with a Brockenbrough needle, c dilatation of the membrane with a 6/20 mm NC balloon. d dilatation with a 16/20 mm balloon. e final angiography of IVS, after withdrawn of a 30/40 balloon through the membrane, showing restoration of IVC to RA flow patency
CVIRendovasc.springeropen.com • CC-by-4.0
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Inferior vena cava (IVC) webs are an uncommon condition characterized by obstruction of the hepatic segment of the inferior vena cava by a membrane or fibrous band. This is often associated with occlusion of one or more of the hepatic veins.

Clinical presentation

If there is hepatic vein involvement, patients may present with Budd-Chiari syndrome.

Pathology

Etiology

It may be a congenital/developmental anomaly. More commonly they arise as fibrotic bands as post-thrombotic sequelae with the regressed thrombus replaced by a fibrous laminar structure. It can lead to hepatic outflow obstruc­tion.

Radiographic features

  • intrahepatic IVC may have a linear filling defect representing the web
  • features of hepatic vein obstruction may be present (also see: Budd-Chiari syndrome):
    • flow reversal on Doppler ultrasound
    • non-obstructed hepatic veins may be dilated
    • collateral pathways between obstructed hepatic veins
Siehe auch:
Assoziationen und Differentialdiagnosen zu Membranstenose Vena cava inferior:
Budd-Chiari-Syndrom
 
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