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

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.