State-of-the-Art Review
Inferior Vena Cava Thrombosis

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Abstract

Thrombosis of the inferior vena cava (IVC) is an under-recognized entity that is associated with significant short- and long-term morbidity and mortality. In absence of a congenital anomaly, the most common cause of IVC thrombosis is the presence of an unretrieved IVC filter. Due to the substantial increase in the number of IVC filters placed in the United States and the very low filter retrieval rates, clinicians are faced with a very large population of patients at risk for developing IVC thrombosis. Nevertheless, there is a paucity of data and societal guidelines with regards to the diagnosis and management of IVC thrombosis. This paper aims to enhance the awareness of this uncommon, but morbid, condition by providing a concise, yet comprehensive, review of the etiology, diagnostic approaches, and treatment strategies in patients with IVC thrombosis.

Key Words

catheter-directed thrombolysis
deep venous thrombosis
inferior vena cava
pharmacomechanical catheter-directed thrombolysis
post-thrombotic syndrome

Abbreviations and Acronyms

ACCP
American College of Chest Physicians
CDT
catheter-directed thrombolysis
CT
computed tomography
DVT
deep vein thrombosis
GCS
graduated compression stockings
IVC
inferior vena cava
MR
magnetic resonance
PE
pulmonary embolism
PMCT
pharmacomechanical catheter-directed thrombolysis
PTA
percutaneous transluminal angioplasty
PTS
post-thrombotic syndrome

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The authors have reported that they have no relationships relevant to the contents of this paper to disclose.