Inferior vena cava calcification, a possible link with recurrent deep venous thrombosis and pulmonary embolism: a case study and review of literature.

Abstract

Inferior vena cava (IVC) anomalies have been reported to have an association with deep venous thrombosis of the lower limbs. It is, therefore, necessary to study the IVC in recurrent cases of unprovoked deep venous thrombosis (DVT) and/or pulmonary embolism (PE), where all other causes have been excluded. We report a case of a 65-year-old male, who had recurrent episodes of DVT in the past 5 years; some of which associated with PE of unknown cause. CT thorax abdomen and pelvis did not find an obvious cause for the DVT and/or PE, however, it did highlight a diffuse calcification of the IVC. Only a few cases of calcification of the IVC have been reported in literature, and a number of them have been associated with clot formation and PE. We speculate that, as in other anomalies of the IVC, calcification of the IVC might slow the blood flow, and thus predispose to DVT and/or PE. Our opinion is that in all cases of unexplained DVT and/or PE, a careful examination of the IVC should be performed. Furthermore, when this condition is present, other risk factors for hypercoagulability should be avoided and anticoagulant therapy should be considered.