Duplication Of Inferior Vena Cava Research Articles

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

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

Duplication of the Inferior Vena Cava in a Patient Presenting for IVC Filter Placement

Given the complex embryogenesis of the inferior vena cava (IVC), anatomic variations are commonly encountered. Duplication of the IVC occurs in up to 2.8% of the population. Though asymptomatic, a duplicated IVC has important clinical implications when attempting caval filtration. We present the case of a 45- year-old male with factor V leiden and protein C deficiency, who required cessation of warfarin anticoagulation in preparation for cervical laminectomy. The patient had a duplicated IVC and required placement of a caval filter in each IVC.

Laparoscopic radical nephrectomy in the presence of a duplicated inferior vena cava

Laparoscopic radical nephrectomy in the presence of a duplicated inferior vena cava

Duplicated Inferior Vena Cava—Something to Consider in the Evaluation of a Living‐Donor Renal Transplant

AbstractCongenital anomalies of the inferior vena cava are rare and usually of no clinical significance. The presence of a duplicated inferior vena cava (D‐IVC) has an incidence rate ranging from 0.3% to 3% and is a result of an embryological misadventure. Typically, the primitive cardinal veins come together and, along with the regression of the left supracardinal vein, leave a solitary, right‐sided vena cava. Here we review the relevant anatomy and clinical significance of a D‐IVC and present a case of successful laparoscopic donor nephrectomy in a patient with this anomaly.

Congenital Single, Pelvic Iliac Artery: A Case Report

Congenital vascular anomalies of pelvis and lower limb arteries are rare. During embryologic development, the sciatic artery represents the dominant supplier of blood to the lower limb. The external iliac and femoral arteries appear later in the process and take over as the sciatic artery regresses. Failure of the sciatic artery to regress creates a persistent sciatic artery malformation. Failure of the external iliac artery to properly bud may lead to similar vascular malformations. The authors present a patient with atresia of the left external iliac artery with an associated atresia of the left common iliac vein, duplication of the infrarenal inferior vena cava, and absence of the left S1 bony arch. The left-sided single iliac artery supplies both pelvic structures and the lower limb. The "pelvic" external iliac artery may result from embryologic budding at a lower segmental level than the usual fifth lumbar segmental artery. This combination of anomalies suggests an abnormality of segmentation on left at the first sacral level.

Duplication of the inferior vena cava: anatomy, embryology and classification proposal

A case of a duplicated inferior vena cava (IVC) along with other anatomical vessel variations in a 72-year-old male cadaver is presented. The anomalous vessels involved, besides the IVC, were the left testicular vein and artery, the left suprarenal artery and a superior accessory left renal artery. Based on the gross appearance of the preaortic anastomotic trunk between the left and right IVC as well as on the underlying embryological features, a classification is proposed: incomplete bilateral duplication of the IVC and complete bilateral duplication of the IVC. The latter can be further divided into three types: major, minor and asymmetric.

The Prevalence of Incidental Findings on Abdominal Computed Tomography Scans of Trauma Patients

Abdominal computed tomography scanning (AbdCTS) is the standard of care in the evaluation of blunt trauma patients. The liberal use of AbdCTS coupled with advancing imaging technology often results in the detection of incidental findings. We sought to characterize the incidence and prevalence of such findings, describe the lesions most frequently seen on AbdCTS performed on patients admitted to a Level I trauma center, and develop a plan for follow-up through our performance improvement process. AbdCTS reports of all admissions to a Level I trauma center between January 2000 and December 2002 were reviewed. Incidental findings identified were classified into benign anatomic variants, benign pathologic lesions, and pathologic lesions requiring further work-up. A total of 3,113 patients were evaluated by AbdCTS during this time period. There were 1474 incidental findings in 1,103 patients. Seventy-five percent of patients with incidental lesions had no traumatic findings. Benign anatomic variants were present in 1.8%, benign pathologic findings in 27.5%, and pathologic findings requiring work-up in 6.1%. Congenital renal anomalies and duplicate inferior vena cava were the most common benign anatomical findings. Renal and hepatic cysts were the most frequent benign lesions and non-calcified pulmonary nodules and adrenal masses were the pathologic lesions most commonly seen. Incidental findings are seen in up to 35% of trauma AbdCTS. No concomitant traumatic injuries are present in up to 75% of these patients. Protocols for appropriate intervention or arrangements for follow-up care need to be incorporated into the care of the trauma patients.

Duplicated Inferior Vena Cava Recognized during Laparotomy

Duplicated inferior vena cava (IVC) is a congenital anomaly seen rarely in the general population. Patients with IVC variants usually do not present any symptoms and are found incidentally in many cases. However, physicians are urged to recognize the presence of such anomalies during diagnostic or invasive procedures as these variants of blood vessel systems can impose substantial implications in certain clinical situations. Subsequently, information about IVC variants may become critical if surgical injuries or predisposing conditions act as life-threatening risks to patients during medical procedures. We present a case of duplicated IVC in a 68˗year˗old female patient with rectal cancer where an IVC anomaly was found during surgical resection of her tumor. From our experience, we emphasize the importance of having the knowledge of IVC variations in patients undergoing invasive surgical procedures which may involve large vessels.

Left sided inferior vena cava duplication and venous thromboembolism: case report and review of literature

The etiology of venous thromboembolism in young patients is frequently associated with hereditary coagulation abnormalities, immunologic diseases, and neoplasia. The advent of radiological advances, namely Computed Tomography (CT) scans and venography has identified vena cava malformations as a new etiologic factor worthy of consideration. In this case report, we describe the unusual occurrence of venous thromboembolism in association with a duplicated inferior vena cava. Duplications of the inferior vena cava (IVC) are seen with an incidence of 0.2% to 3.0% in the general population. Embryogenesis of the IVC is a complex process involving the intricate formation and regression of numerous anastomoses, potentially leading to various anomalies. We present a 23-year-old Caucasian woman with IVC duplication who developed a deep venous thrombosis and multiple pulmonary emboli. Anomaly of the IVC is a rare example of a congenital condition that predisposes to thromboembolism, presumably by favoring venous stasis. This diagnosis should be considered in patients under the age of 30 with spontaneous occurrence of blood clots.

An Unusual Case of Leiomyosarcoma of the Inferior Vena Cava in a Patient With a Duplicated Inferior Vena Cava

Leiomyosarcoma of primary vascular origin is a rare primary soft tissue tumour, which arises mainly from the inferior vena cava (IVC). Clinical symptoms depend upon the size and location of the tumour and presents usually with abdominal pain, palpable mass and weight loss. Complete surgical resection with clear surgical margin plays a central therapeutic role. The effect of chemotherapy and radiation therapy remains to be evaluated. We report a 64 year old Chinese female who presented with abdominal mass and pain associated with weight loss and was subsequently diagnosed with inferior vena cava leiomyosarcoma. She underwent successful surgical resection but unfortunately developed recurrence of tumour 12 month post-operative. She was also found to have a duplicated inferior vena cave which allowed reconstitution of venous return from the lower limbs after surgical resection of the IVC tumour. We discuss the surgical treatment and results of leiomyosarcoma of the IVC.

Long-term efficacy of two vena cava filter implants for congenital duplicated inferior vena cava

Long-term efficacy of two vena cava filter implants for congenital duplicated inferior vena cava

Uterus didelphys with an obstructed unilateral vagina by a transverse vaginal septum associated with ipsilateral renal agenesis, duplication of inferior vena cava, high-riding aortic bifurcation, and intestinal malrotation: a case report

To present a case of müllerian defects associated with other anomalies, including ipsilateral renal agenesia, duplication of inferior vena cava, high-riding aortic bifurcation, and intestinal malrotation. Case study. Academic medical center. A 16-year-old woman with müllerian defects associated with vascular and intestinal anomalies. Excision of vaginal septum. Improvement of symptoms caused by obstructed müllerian defect. After an incision on the vaginal septum, a large amount of chocolate-colored fluid was drained, and the dimensions of the right uterus were diminished. Then the vaginal septum was excised completely; we saw a second distinct cervical portion. Uterus didelphys with obstructed hemivagina is almost always associated with renal agenesis ipsilateral to the obstruction. Inferior vena cava duplication associated with müllerian anomalies is an extremely rare condition. In addition, the presented case also had a high-riding aortic bifurcation and intestinal malrotation. To the best of our knowledge, this is the first case to include all of these anomalies.

Percutaneous Embolization of a Left-sided Varicocele in a Patient with a Duplicated Inferior Vena Cava

Anatomic variants of the inferior vena cava (IVC) can make selective catheterization of the spermatic vein difficult. In an attempt to embolize the left varicocele, the authors identified a duplicated IVC on an initial venogram through the right common femoral vein. However, it was not possible to cannulate the left spermatic vein with this conventional approach, necessitating an approach from the right internal jugular vein. The left varicocele was successfully embolized.

Inferior vena cava duplication and left renal aplasia: incidental findings?

A duplicated inferior vena cava and renal aplasia is rare and absence of one kidney has been considered to occur exclusively on the right side. We report an unusual case of a duplicated inferior vena cava and left renal aplasia and discuss the interrelationship between these developmental anomalies.

Management of infrarenal duplicated inferior vena cava during living related kidney transplantation

Congenital anomalies of the inferior vena cava (IVC) arerelatively rare pathologies, usually with an asymptomaticcourse.During open donor nephrectomy, we incidentallyfound two left infrarenal duplicated IVCs (Fig. 1):In the first case, left infrarenal IVC was sacrificed. Leftkidney was harvested with a normal length renal vein(Fig. 2a). The recipient had uneventful post-op course.Only mild edema was seen in his donor, around pelvisgirdle and proximal left thigh, persisting for 2 weeks.In second donor, we divided left renal vein more prox-imally with an acceptable short renal vein to preserve thecontinuity of left IVC (Fig. 2b). Both donor and recipienthad good renal function and no surgical complication onfollow-ups was seen.DiscussionCongenital anomalies of IVC are usually diagnosed bychance during surgery. From bioptic material their inci-dence has been estimated to be 2–3% [1]. The frequencyof accidental intraoperative finding in different series var-ies between 0.2% and 0.6%. Caval duplication and a leftpositioned vena cava are the most common incidentalanomalies [2]. They are known to be associated with var-ious urogenital tract anomalies such as horseshoe kidneysand circum-aortic renal collar [3,4].Nowadays, in many transplant centers, helical CT angi-ography and MR angiography have replaced conventionalangiography. They give a better view of the renal paren-chyma and the computer reconstruction shows the arter-ial anatomy as well. Ureteric and renal anomalies are alsoseen well with these methods; the accuracy is 95% andthey are quicker and cheaper [5].Up to now, few cases with complete duplication ofIVC have been reported to be found during live donornephrectomy (LDN) [6,7]. In previous literature, onlyone case with infrarenal duplicated IVC was found thatwas managed as the first case in this report [8]. They didnot mention any complication in post-op course. How-ever, as we mentioned earlier, due to ligation of left IVC,our first case suffered from edema. In complete duplica-ted IVC, usually each kidney drains to the ipsilateral IVCand nephrectomy has no effect on limb drainage. How-ever, infrarenal duplicated IVC is totally different, as ipsi-lateral limb drains partially or totally to renal vein andligation of this vein compromises drainage of limb, atleast early in post-op. So, it seems reasonable to take thesecond surgical technique.We advise to perform imaging technique in LDN. Ifthe donor has duplicated IVC, it is essential to carefullyconduct advance imaging techniques to investigate otherpossible anomalies and blood flow of the renal vein.Although it is preferred to use kidney with longer renalvein, the graft must be carefully selected so it is not dis-advantageous to the donor.Hamid Reza Davari, Seyed Ali Malek-Hosseini,Heshmatollah Salahi, Ali Bahador, Saman Nikeghbalian,

Bilateral retrocaval ureters with IVC duplication

We report a rare case of bilateral retrocaval ureters associated with duplicated inferior renal cava. A 69-year-old woman was sent to our emergency room for abdominal pain. Multidetector computed tomogram with multiplanar reconstruction revealed duplicated inferior renal cavae and the bilateral ureters were positioned behind the duplicated inferior vena cava. To our knowledge, coexistence of bilateral retrocaval ureters and duplicated inferior renal cavae has not been reported in the literature.

Inferior Vena Cava Duplication and Deep Venous Thrombosis: Case Report and Review of Literature

Duplications of the inferior vena cava (IVC) are seen with an incidence of 0.2% to 3.0%. Duplications causing symptoms are rare, with only six reported cases of IVC duplication associated with a deep venous thrombosis. We present a 78-year-old caucasian woman with an IVC duplication who developed a deep venous thrombosis. The etiologies of IVC duplication include failure of anastomosis between the primitive cardinal veins and failure of regression of the left supracardinal vein. When asymptomatic, treatment includes observation, placing filters in both systems, or coil-embolization of the duplicated segment plus placing a filter in the right IVC. For our patient, we chose to coil-embolize the communication to the duplicated segment as well as place a filter in the main right IVC system.

Ureteral obstruction caused by a duplicated anomaly of inferior vena cava

Developmental anomalies of inferior vena cava are a rare cause of ureteral obstruction. We report a case that presented with right upper ureteral obstruction that radiologically simulated a retrocaval ureter. An aberrant vessel, which caused obstruction of the right ureter was identified at operation and surgical relief of ureteral obstruction was performed. Inferior venocavography was performed postoperatively and disclosed an unusual incomplete duplication of inferior vena cava. Our findings suggested that ureteral obstruction by incompletely duplicated anomaly of the inferior vena cava should be included in the differential diagnosis of extrinsic ureteral obstruction.

Duplication droite de la veine cave inférieure

An infrarenal duplication of the inferior vena cava with both channels lying on the right side of the aorta was fortuitously found during an abdominal Computed Tomography performed on a 52 year-old woman. Only two same cases seem to be reported in the literature. This very uncommon abnormality probably results from persistence of the infra-renal part of the right subcardinal vein. Radiologists have to be aware of this right-sided ipsilateral duplication for it may be a trap in abdominal imaging as well as "classical" inferior vena cava duplication located on both sides of the abdominal aorta.

Repair of a thoracoabdominal aortic aneurysm in the presence of a left-sided inferior vena cava

Venous anomalies are not infrequently encountered during aortoiliac reconstruction, because of the complexity of development of the venous system. Retroaortic left renal veins, duplicate inferior vena cava (IVC), and left-sided IVC are occasionally found. Left-sided IVC has been reported with infrarenal aortic aneurysms. We report successful repair of a thoracoabdominal aneurysm in a patient with a left-sided IVC. The embryology and intraoperative management are discussed.