VPB0436 - Clinical and etiological features of vena cava thrombosis: 69 cases study

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: Virtual

Presenting Author(s)

Alaeddine Mabrouk

Medical resident
Faculty of Medicine of Tunis, Manar University
Ben Arous, Ben Arous, Tunisia

Co-Author(s)

BJ

Bilel Jemmali

Doctor
Internal Medicine department
Tunis, Tunis, Tunisia
TB

Tayssir Ben Achour

Doctor
Internal Medicine department
Tunis, Tunis, Tunisia
MJ

Maysam JRIDI

Resident
Faculty of medicine of Tunis
Tunis, Tunis, Tunisia
MK

Monia Khanfir

Pr
Faculty of Medicine of Tunis, Manar University
Tunis, Tunis, Tunisia
IB

Imed Ben Ghorbel

Pr
Faculty of Medicine of Tunis, Manar University
Tunis, Tunis, Tunisia
ML

Mounir Lamloum

Professor
Internal Medicine department
Tunis, Tunis, Tunisia
FS

Fatma Saïd

Pr
Faculty of Medicine of Tunis, Manar University
Tunis, Tunis, Tunisia
MH

Mohamed Habib Houman

Professor
Internal Medicine department
Tunis, Tunis, Tunisia

Background: Vena cava thromboses (VCT) are rare and remains under-recognized.

Aims: The aim of this study was to describe clinical and etiological features and outcomes of vena cava thromboses.

Methods: We conducted a retrospective study of patients with vena cava thromboses diagnosed in an internal medicine department over a period time of 20 years.

Results: Sixty nine patients with vena cava thrombosis were enrolled. The mean age was 44 years. Sex-ratio M/F was 2.45. Forty five patients had inferior vena cava thrombosis (IVCT) and 26 patients had superior vena cava thrombosis (SVCT); 2 patients had both superior and inferior vena cava thrombosis. Eighteen patients had personal history of deep venous thrombosis. IVCT was discovered incidentally in 67% of cases, otherwise it was revealed by bilateral lower limbs edema. Patients presented with lower limbs edema (57%), and collateral venous circulation (17%). Concomitant thromboses were found in 75% of patients: lower extremities (n=32), atypical locations (n=4), pulmonary embolism (n=7) and superficial thrombophlebitis (n=2). Six patients had Behcet’s disease and 7 had malignancy. Inherited thrombophilia was noted in 2 cases.
SVCT was discovered incidentally in 5 cases and revealed by a superior vena cava syndrome in 58% of cases. Collateral circulation (62%), bilateral upper extremities edema (30%), and dyspnea (23%) were other signs of SVCT. SVCT was associated to other locations in 84.6% of cases: upper extremities (n=12), cerebral (n=2), lower extremities (n=2), sub clavicular (n=2) and retinal (n=1). Pulmonary embolism was diagnosed in 3 cases. Behcet’s disease (n=13) and malignancy (n=6) were the main causes of SVCT.
Association of IVCT and SVCT were noted in patient with Behçet’s disease(n=1) and hyperhomocysteinemia(n=1).

Conclusion(s): In our series Vena cava thrombosis seems to be often associated with other concomitant deep vein thrombosis. Behcet’s disease and malignancies are the major causes of vena cava thrombosis.