Identification of Bleeding Sources During Removal of Inferior Vena Cava Tumor Thrombi: Multidetector Computed Tomography Study
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Date
2013-12
Authors
Shchukin, Dmytro
Altukhov, Oleksiy
Lisova, Ganna
Ilyukhin, Yuriy
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Abstract
Objectives: The purpose of this study was to investigate the sources of bleeding from the lumen of the
inferior vena cava (IVC) during removal of the tumor thrombus. We have studied the multidetector computed
tomography (MDCT) anatomy of the posterior tributaries of the IVC, including variant lumbar veins and lumbar
veins of the infrarenal IVC.
Materials and Methods: The retrospective study included 302 patients who underwent the bolus contrastenhanced
MDCT of the abdomen for various indications. We analyzed the anatomy of the variant lumbar veins
and infrarenal IVC lumbar veins.
Results: Variant lumbar veins were detected in 50% of patients (151 out of 302). The diameter of these vessels
ranged from 1 mm to 5 mm and averaged 2.5 mm. The distance from the upper edge of the right renal vein
mouth to the variant vein mouth varied from 0 mm to 51 mm and averaged 13.7 mm. In 71% of cases the variant
veins entered the subhepatic IVC. In 26.3% of cases it drained at the level of the upper edge of the renal vein
mouths (cavarenal segment) and only in 2% of cases—to the retrohepatic IVC. Lumbar veins entered the IVC
immediately next to the lower edge of the right renal vein mouth in 35 (11.6%) cases. Their average diameter
was 4.7 mm. On the left side of the "risk zone" the lumbar veins drained only in 2 (0.7%) patients at a distance
of 7 mm and 8 mm from the mouth of the left renal vein.
Conclusion: The variant lumbar veins rarely are the main source of bleeding during thrombectomy. From our
point of view, the right upper lumbar veins of the infrarenal IVC draining into the inferior vena cava in close
proximity to the mouths of the renal veins played the leading role in this matter.
Description
Keywords
inferior vena cava (IVC), variant lumbar veins, tumor trombus
Citation
Identification of Bleeding Sources During Removal of Inferior Vena Cava Tumor Thrombi: Multidetector Computed Tomography Study / D. V. Shchukin, O. O. Altukhov, G. V. Lisova, Yu. A. Ilyukhin // UroToday International Journal. – 2013. – Vol 6, Iss 6. – P.