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

[Jack54]

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

[markw070707]

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.  

[Jack54]

"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

[markw070707]

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.