Venous anomalies and thromboembolism

Caroline Dix; Warren Clements; Harry Gibbs; Joanne So; Huyen A Tran; James D McFadyen

doi:10.1186/s12959-023-00484-5

Venous anomalies and thromboembolism

Thromb J. 2023 Apr 20;21(1):45. doi: 10.1186/s12959-023-00484-5.

Authors

Caroline Dix¹, Warren Clements², Harry Gibbs³, Joanne So⁴, Huyen A Tran^{4

5}, James D McFadyen^{4

5

6

7}

Affiliations

¹ Department of Clinical Haematology, The Alfred Hospital, Melbourne, VIC, 3004, Australia. caroline_dix@hotmail.com.
² Department of Radiology, The Alfred Hospital, Melbourne, VIC, 3004, Australia.
³ Department of General Medicine, Alfred Health, Melbourne, VIC, 3004, Australia.
⁴ Department of Clinical Haematology, The Alfred Hospital, Melbourne, VIC, 3004, Australia.
⁵ Australian Centre for Blood Diseases, Central Clinical School, Monash University, Melbourne, Australia.
⁶ Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, 3004, Australia.
⁷ Baker Department of Cardiometabolic Health, University of Melbourne, Melbourne, Australia.

Abstract

Patients with venous anomalies are at increased risk of developing venous thromboembolism (VTE) and subsequent complications, but they are often under-recognised. While unprovoked VTE may trigger testing for inherited thrombophilias and malignancy screening, anatomic variants are considered less often. Venous anomalies increase the risk due to venous flow disturbance, resulting in hypertension, reduced flow velocity and turbulence. Recognition is important as endovascular or surgical intervention may be appropriate, these patients have a high rate of VTE recurrence if anticoagulation is ceased, and the anomalies can predispose to extensive VTE and severe post-thrombotic syndrome (PTS). In this case series, we present representative cases and radiological images of May-Thurner syndrome (MTS), inferior vena cava (IVC) variants and venous aneurysms, and review the available literature regarding optimal diagnosis and management in each condition.

Keywords: Anatomic variant; Aneurysm; Anticoagulation; Endovascular; IVC agenesis; May-Thurner syndrome; Venous thromboembolism.

Publication types

Review