Vena caval thromboses

Background: Patients with vena caval (VC) thrombosis have been reported with a variety of clinical presentations, which may create a diagnostic challenge for physicians. Objective: The objective of the study was to evaluate the clinical characteristics of patients with VC thrombosis. Patients and Methods: Files and all imaging methods of consecutive patients with superior or inferior VC thrombosis with or without pulmonary embolism (PE) between January 26, 2001, and May 12, 2006, were retrospectively studied in detail. Results: In our series, VC thromboses within the inferior and superior VC were detected in 28 patients, mostly by combined computed tomographic venography and spiral computed tomographic pulmonary angiography. Nine of these 28 patients (32.1%) had VC thromboses without PE (7 patients with isolated and 2 patients with nonisolated VC thrombosis). Key symptoms and findings in the 9 patients without PE were unexplained dyspnea and tachypnea, respectively. Conclusions: Many patients with VC thrombosis do not have peripheral vein thrombosis. Moreover, nearly one third of patients with VC thrombosis have negative pulmonary angiograms but do have dyspnea and tachypnea. (C) 2010 Elsevier Inc. All rights reserved.