Successful thrombolysis, angioplasty, and stenting of delayed thrombosis in the vena cava following percutaneous vertebroplasty with polymethylmethacrylate.

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Successful thrombolysis, angioplasty, and stenting of delayed thrombosis in the vena cava following percutaneous vertebroplasty with polymethylmethacrylate cement Suh Min Kim, MD, Seung-Kee Min, MD, PhD, Hwan Jun Jae, MD, PhD, Sang-Il Min, MD, Jongwon Ha, MD, PhD, Sang Joon Kim, MD, PhD Journal of Vascular Surgery Volume 56, Issue 4, Pages 1119-1123 (October 2012) DOI: 10.1016/j.jvs.2012.02.039 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 Computed tomography (CT) angiography revealed (A) a segmental stenosis in infrarenal inferior vena cava (IVC) (arrow) and (B) thrombosis below the stenotic portion (arrow). C, Thrombosis was extended to both common iliac veins (arrows) and (D) the left common femoral vein (arrow). Journal of Vascular Surgery 2012 56, 1119-1123DOI: (10.1016/j.jvs.2012.02.039) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 A, Computed tomography (CT) angiography demonstrated high-density polymethylmethacrylate cement in the lumbar vein extended into the inferior vena cava (IVC) (arrow) and (B) inside the IVC (arrow). C, The coronal view of CT angiography demonstrated two longitudinal cement emboli inside the IVC (arrow). D, The axial chest CT scan shows a radio-opaque material at the subsegmental pulmonary artery in the left lower lobe (arrow). Journal of Vascular Surgery 2012 56, 1119-1123DOI: (10.1016/j.jvs.2012.02.039) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 3 A, Inferior vena cava (IVC) filter was inserted in the infrarenal IVC. B, Venography showed a segmental severe stenosis in infrarenal IVC. C, Catheter-directed thrombolysis with overnight urokinase infusion was performed. D, Balloon angioplasty for stenotic inferior vena cava was performed. E, A self-expandable stent (20 mm × 6 cm) was inserted to prevent the recurrence of thrombosis. Journal of Vascular Surgery 2012 56, 1119-1123DOI: (10.1016/j.jvs.2012.02.039) Copyright © 2012 Society for Vascular Surgery Terms and Conditions