How is inferior vena cava thrombosis (IVCT) treated?

Updated: Jun 12, 2018
  • Author: Luis G Fernandez, MD, FACS, FASAS, FCCP, FCCM, FICS, KHS, KCOEG; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Once the diagnosis has been confirmed, the clinician must choose an appropriate treatment regimen for inferior vena cava (IVC) thrombosis (IVCT) on the basis of the underlying pathophysiology. Both surgical and medical options are available. Medical professionals are encouraged to investigate the most recent research to keep apprised of the latest information relating to the various risks and benefits of treatment modalities.

In the broadest sense, surgical therapy of IVCT encompasses caval interruption and thrombectomy. Currently, both of these modalities are being used less frequently.

There is very little evidence available on the surgical correction or the treatment of a complete absence of the IVC. A case report, in which there was a complete absence of the IVC but patent iliac veins and nonhealing pretibial ulceration, described successful treatment with a prosthetic graft from the iliac vein to the intrathoracic azygos vein. [24] Authors of another case report concluded, on the basis of their review of the available literature, that surgical options in this patient population are limited. [37]

Go to Deep Venous Thrombosis for more complete information on this topic.

The goals of therapy center on managing the primary impact of the deep vein thrombosis (DVT) and the impact of embolization. Medical management can include anticoagulation therapy and thrombolytic agents (see Medication).

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