Mechanical Thrombectomy Complicated by Vascular Mass Extraction: A Case of Inferior Vena Cava Arteriovenous Hemangioma

TL;DR

A rare vascular tumor was mistakenly treated as a blood clot during a medical procedure, highlighting the need to consider unusual diagnoses.

Contribution

This case report highlights the diagnostic and procedural challenges of managing thrombosis complicated by an arteriovenous hemangioma.

Findings

A 57-year-old patient was found to have an IVC thrombus, later identified as an arteriovenous hemangioma.

Mechanical thrombectomy was complicated by a stuck catheter and retrieval of a vascular lesion.

Histopathology confirmed the lesion as an arteriovenous hemangioma, a rare vascular anomaly.

Abstract

We present a case of a 57-year-old female admitted for non-ST elevation myocardial infarction (NSTEMI), who was incidentally found to have a suspected inferior vena cava (IVC) thrombus. Transthoracic echocardiogram (TTE) demonstrated a right atrial lesion with suspected IVC involvement. Echocardiography incidentally reported a mass extending to the right atrium, and CT imaging reported possible IVC thrombus involvement. Abdominal ultrasound confirmed a suprarenal IVC thrombus. Interventional radiology (IR) performed mechanical thrombectomy and catheter-directed thrombolysis, which was complicated by a stuck catheter and unexpected retrieval of a vascular lesion. Histopathological analysis revealed the lesion to be an arteriovenous hemangioma (AVH). This case underscores the importance of considering rare vascular anomalies, such as AVH, in the differential diagnosis of IVC thrombus and highlights the diagnostic and procedural challenges in managing venous thromboembolism complicated by underlying vascular malformations.

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