Superior vena cava syndrome due to thrombotic occlusion in a thrombophilic renal transplant recipient: a case report.

Abstract

The case of a superior vena cava syndrome due to a central venous catheter thrombosis occurring in a second renal transplant patient is described. Imaging revealed thrombosis of the right internal jugular vein with extension along the confluence of the brachiocephalic veins and partial obstruction of the superior vena cava. Anticoagulant therapy with subcutaneous low-molecular-weight heparin was followed by warfarin administration. Despite adequate treatment, the symptomatology worsened because of thrombus organization. A workup revealed a complex prothrombotic underlying condition. Cardiothoracic surgeons were consulted, and an operative reconstruction of the superior vena cava using spiral vein bypass grafting was performed. In this report we describe the clinical presentation, diagnosis, and treatment of this case, with an emphasis on the role of thrombophilia.

• Authors: P Di Cocco, G Orlando, E Di Cesare, C Mazzotta, V Rizza, F Pisani, A Famulari, R Gregorini, A Mazzola, M Lapecorella
• Journal: Transplantation proceedings (Transplant Proc) Vol. 42 Issue 4 Pg. 1358-61 (May 2010) ISSN: 1873-2623 [Electronic] United States
• PMID: 20534301 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright (c) 2010 Elsevier Inc. All rights reserved.

Chemical References

• Anticoagulants
• Heparin, Low-Molecular-Weight
• Warfarin

Topics

• Anticoagulants (therapeutic use)
• Female
• Heparin, Low-Molecular-Weight (therapeutic use)
• Humans
• Jugular Veins (surgery)
• Kidney Failure, Chronic (complications, surgery)
• Kidney Transplantation (adverse effects)
• Middle Aged
• Postoperative Complications (diagnosis)
• Reoperation (adverse effects)
• Superior Vena Cava Syndrome (etiology, surgery)
• Thromboembolism (drug therapy, etiology)
• Warfarin (therapeutic use)