The CD94/NKG2A inhibitory receptor educates uterine NK cells to optimize pregnancy outcomes in humans and mice

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Bilateral inferior vena cava filter insertion in a patient with duplication of the infrarenal vena cava

Background

Inferior vena cava (IVC) filter insertion is a commonly performed procedure for indications such as recurrent pulmonary emboli or contraindication to anticoagulation. Symptomatic duplication of the IVC is exceedingly rare with only a handful of cases being described in the literature.

Aim

We report an unusual case of a patient with symptomatic duplication of the IVC.

Result

A 53-year-old woman presented at our hospital for resection of a cerebral metastasis from a non-small cell lung cancer following a recent diagnosis of bilateral lower limb deep venous thrombosis. This required perioperative reversal of anticoagulation and IVC filter insertion. Conventional venography performed during filter insertion documented the existence of a duplicated IVC.

Conclusion

We present a case of a symptomatic duplication of the IVC requiring filter insertion. We review the developmental anatomy of the IVC along with the diagnostic findings and management strategies available.     

Proximal femoral anatomy in total hip arthroplasty. A tri-planar computed tomographic assessment

The relationship between the tip of the Greater Trochanter (GT) and the centre of the Femoral Head (FH) is commonly used as reference point to align the femoral component during hip arthroplasty. We performed tri-planar computed tomography analysis of the proximal femoral anatomy in a series of 150 patients (n = 150) to accurately delineate this relationship. The mean location for the centre of the FH was 8.64 mm (95% confidence interval, 9.44-7.83) distal to the tip of the GT. The centre of the FH was found to be distal to the tip of the GT in 90.6% of cases. Hence we would suggest caution in using the tip of the GT as a reference point during total hip arthroplasty as it could be associated with an inadvertent intraoperative leg lengthening.