Management of Inferior Vena Cava Thrombosis: Guidance from the Italian Society for the Study of Haemostasis and Thrombosis

Résumé fourni par la source

Inferior vena cava thrombosis (IVCT) is an uncommon manifestation of venous thromboembolism characterized by heterogeneous clinical presentations and a paucity of disease-specific evidence. Consequently, diagnostic and therapeutic approaches are largely extrapolated from studies of proximal lower-extremity deep vein thrombosis (LE-DVT), resulting in considerable variability in clinical practice.This consensus-based guidance was developed by the Italian Society for the Study of Haemostasis and Thrombosis (SISET) through a narrative review of the available literature and expert consensus. Key clinical questions addressed included patient selection for IVCT investigation, optimal diagnostic imaging strategies, indications for thrombophilia testing, and pharmacological and interventional treatment approaches.The guidance identifies clinical scenarios warranting dedicated evaluation of the inferior vena cava, including bilateral LE-DVT, atypical abdominal or lumbar pain, and extensive venous obstruction. Diagnostic imaging should be tailored to the clinical presentation and the suspected extent of thrombosis. Anticoagulation is recommended as the cornerstone of treatment for most patients with IVCT. Endovascular or surgical interventions may be considered in selected cases, particularly in patients with acute extensive thrombosis or chronic symptomatic ilio-caval obstruction. Recommendations regarding thrombophilia testing and long-term management are provided to support individualized patient care.Owing to the limited availability of high-quality IVCT-specific evidence, management decisions should be individualized and guided by clinical presentation, thrombotic burden, and patient characteristics. These consensus recommendations provide a practical framework for the diagnosis and management of IVCT while highlighting the urgent need for prospective studies to strengthen the evidence base in this rare but clinically relevant condition.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.