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Occluded IVC
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Occluded IVC

Hello

I have a long term occluded IVC (inferior vena cava) which is supported by collateral vessels. Coagulopathy and anticoagulation issues aside, I have the following queries and would really appreciate a second opinion. Thank you very much.

For background, I am 32 years old, male, DVT 15 years ago which is when the IVC occluded. Only found out about occluded IVC recently though, secondary to further thrombosis (gonad vein and a collateral) in March this year.

1. My blood pressure has always been borderline high - could this be due to the occluded IVC?

2. I can easily get my heart rate over 220 during exercise. I don't get pain or anything (other than awareness of fast beating) but again, wondered if this could be attributable to blocked IVC.

3. In terms of life expectancy, is it reasonable to expect that provided i keep the coagulation in check, the occluded IVC should have no impact on my mortality?

4. Is this likely to put extra strain on my heart or other organs in anyway, and is there something I can be doing to mitigate risk?

Thank you very much. I have a haematologist on my case, but getting specific answers to these questions has been difficult.

Thanks
Mark
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214864_tn?1229718839
I just did a search on totally occluded inferior vena cava. It appears that they are having success stenting these blockages nowadays. You always need an opening through the IVC in case of the need for right heart catheterization. I do not know if any of your collaterals would be large enough.

Below is an excerpt from the first url. Good info at both. Welcome to the board.

Jack

Endoluminal recanalization and stent placement in chronically occluded IVCs has a good intermediate-term outcome and should be considered in patients who have symptoms and who often do not have adequate alternative therapy.

http://content.onlinejacc.org/cgi/content/full/37/1/251

http://radiology.rsnajnls.org/cgi/content/full/214/1/133
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Avatar_n_tn
Thanks Jack

I'm really looking for comments related to if the occluded IVC will damage my heart though, as in the questions i posted.  

Any insight much appreciated.  I can get my heart rate off the scale easilly under exercise.  
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214864_tn?1229718839
"copy'paste "

Chronic obstructions of the inferior vena cava (IVC) are associated with many odd features. Even total occlusions may remain entirely silent or present late with acute symptoms. Renal dysfunction is rare. Many have chronic symptoms, but often only one limb is affected.

In the asymptomatic group, 10 patients with total occlusions had transient or no occlusive symptoms. In the acute symptom group, four patients with chronic IVC occlusions presented with acute onset of deep venous thrombosis distal to the occlusion but became asymptomatic when the clot was lysed. In the chronic symptom group, 97 patients (99 limbs) had symptoms of chronic venous disease of variable distribution and intensity. In two-thirds, limb symptoms were unilateral. Pathology was total occlusion in 14%, and the rest were stenoses.

http://www.jvascsurg.org/article/PIIS0741521406010172/abstract
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Avatar_n_tn
Thanks again Jack

I'm really looking for comments related to if the occluded IVC will damage my heart though long term, as in the questions i posted.  
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Avatar_f_tn
I am going through similar situations. The doctors do not seem to be on the same page. I am told my heart is healthy, but the ivc occlusion was discovered after going to the er for atrial fibrillation. I have been told my situation is congenital, as I have never had a blood clot.  But, on the clip side, the collateral arteries are within my esophogas, stomach, uterus and liver.  My bottom number of my bp is boderline high while the top number is low. They are wanting to do surgery because the risk of a bleed is so high. They cannot explain why I went into a fib or how to prevent it. I cannot take aspirin, acemetophine, I Ibuprofen or naproxen because of the bleeding risk from the collateral arteries. I am a 30 year old female that had no symptoms other than a vericosity on my abdomen that appeared after I gave birth to my daughter. Getting info on this topic has been more than difficult. The docs are also not on the same page. I am currently seeing a vascular surgeon and heart surgeon. They sAy my heart is fine, but why would I go into a fib if thAt is the case? Hope this helps a little. Good Luck
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Avatar_f_tn
I have a blocked ivc due to blocked stent after removal of a filter, and have right sided heart failure, enlarged liver, and currently kidney failure stag 3, the doctors have told me they cannot do anything for me, i have been nursing for 18 years, swelling feet and abdomin (abdomen) is very uncomfortable, i am glad i am not the only one out there. What are they doing for you?
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