Blood Clots and Abnormal Vessels of the Inferior Vena Cava. Ann Intern Med. 2002;136:S69. doi: 10.7326/0003-4819-136-1-200201010-00005
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Published: Ann Intern Med. 2002;136(1):S69.
Blood containing oxygen and vital nutrients is pumped to various parts of the body through blood vessels called arteries. After the body absorbs the oxygen and nutrients, blood returns to the heart and lungs through blood vessels called veins. Deep veins in the legs and pelvis join to form a large vein in the back of the abdomen (inferior vena cava), which carries blood from the lower part of the body to the heart. (The inferior vena cava is usually a single large vein that forms from many smaller veins in the early stages of development of a human embryo.) Sometimes adults get blood clots in their veins, a condition known as deep venous thrombosis. The blood clots usually form in the veins of the calves and the thighs, but they occasionally occur in the veins in the pelvis. Inferior vena cava vessels that developed abnormally might increase the risk for blood clots in the pelvic veins, but no one has any proof that this idea is correct.
The researchers wanted to see whether adults with clots in the deep veins of their legs and pelvis have abnormal inferior vena cava vessels.
The researchers studied 97 adults with blood clots in the deep veins of their legs.
The adults had special sound wave tests (duplex ultrasonography) to detect blood clots and abnormal blood flow in their veins. If ultrasonography showed clots in the veins of the pelvis, the patients had special x-ray dye tests (ascending venography) to examine their inferior vena cava vessels. If the venograms showed no blood flow through the inferior vena cava, the patients underwent a special computer-assisted imaging technique (magnetic resonance imaging [MRI]) to show detailed images of the anatomy of the inferior vena cava.
Thirty-one of the 97 patients with blood clots in their legs also had blood clots in their pelvic veins. The anatomy of the inferior vena cava vessel was abnormal in 5 of the 31 patients who had pelvic vein clots. The average age of the 5 adults with abnormal inferior vena cava vessels was 25 years. The average age of the other 92 people was 53 years. Two of the 5 people with abnormal inferior vena cava vessels had repeated episodes of blood clots in their legs or pelvis.
The study involved adults who were referred to radiology for special tests that look for blood clots. There may be people with abnormal inferior vena cava vessels who either do not develop blood clots or do not get tested for blood clots. Thus, this study cannot tell us how often abnormal inferior vena cava vessels are actually associated with blood clots.
Physicians should suspect abnormal inferior vena cava vessels when an adult younger than 30 years of age has blood clots in the veins of the pelvis. Such adults may have high risk for repeated episodes of blood clots.
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