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Image Acquisition Method for the Sonographic Assessment of the Inferior Vena Cava
Published on: January 13, 2023
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Inferior vena cava reconstruction to alleviate back pain
Angel Hsu1, Michael S Segal2, Michael Addis2
1Department of General Surgery, Rutgers New Jersey Medical School, Newark, NJ.
Journal of Vascular Surgery Cases and Innovative Techniques
|March 21, 2024
Summary
End-stage renal disease patients on hemodialysis can experience severe back pain due to inferior vena cava occlusion. Stenting the inferior vena cava relieved lumbar vein engorgement and significantly reduced pain.
Area of Science:
- Nephrology
- Vascular Surgery
- Interventional Radiology
Background:
- End-stage renal disease (ESRD) necessitates hemodialysis, often requiring vascular access.
- Femoral loop grafts are utilized for hemodialysis access in some ESRD patients.
- Inferior vena cava (IVC) occlusion is a potential complication impacting vascular access and venous return.
Observation:
- A 38-year-old male undergoing hemodialysis via a left femoral loop graft presented with severe back pain.
- A fistulogram revealed a completely occluded IVC and engorged lumbar veins.
- Lumbar vein engorgement can lead to significant patient discomfort and pain.
Findings:
- The patient underwent successful IVC reconstruction with stenting.
- Post-procedure venography demonstrated resolution of lumbar vein engorgement.
- The patient experienced a significant reduction in back pain following the intervention.
Implications:
- Inferior vena cava occlusion can manifest as debilitating back pain in hemodialysis patients.
- IVC stenting is an effective treatment for IVC occlusion and associated lumbar vein engorgement.
- Addressing venous outflow obstruction can improve quality of life for ESRD patients with vascular access complications.
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