Thrombus was seen extending into left external iliac vein
, however IVC appeared unremarkable as seen in Figures-1 A CT scan was also performed which showed dilatation in the left external and common iliac veins
, with evidence of a filling defect indicating presence of thrombus.
The most medial among the five was larger than other veins (3 mm in diameter) and it continued as lower right testicular vein and opened into the right edge of the inferior vena cava, 1 cm above the union of the common iliac veins
Ferumoxytol contrast-enhanced magnetic resonance venography (MRV) (2), demonstrated a large infrahepatic caval thrombus extending from the IVC filter down into the bilateral common, external and internal iliac veins
and nonocclusive thrombus within the transplant renal vein (Fig.
Common iliac vein
: This starts from the conjunction point of the internal and external iliac veins
and forms the inferior vena cava with its counterpart.
We observed by using CT that, after the creation of IVC by both common iliac veins
, IVC have been took a position on the left of the aorta (Figure 4).
An ultrasound examination of the lower extremities to evaluate for an embolic source revealed occlusive thrombus within the inferior vena cava extending into the right common and external iliac veins
Dr Al Kowatli performed Sylvester's nearly 5-hour surgery, under general anesthesia, by inserting a small, narrow, hollow tube (catheter) into a blood vessel in the groin area, advancing through the iliac veins
, the large vena cava veins then into the heart.
As mentioned before, Doppler ultrasound can miss abnormalities in iliac veins
and is hence not the ideal imaging modality for the diagnosis of MTS.
Noncontrast opacification of the IVC as well as the iliac veins
indicated arterial and venous thrombosis (Figures 2(a), 2(b), 2(c), and 2(d)).
The occurrence of congenital adhesion in the common iliac veins
and their relation to thrombosis of the femoral and iliac vein
[4,5] Comparable areas in the lower-extremity venous system include both (but especially the left) common iliac veins
where they are crossed by the right common iliac artery (Fig.
Injury to the common iliac veins
(CIVs) during S1 screw insertion is not a common complication, but it is serious and may be fatal [9, 10].