The clinical anatomy of the inferior vena cava: A review of common congenital anomalies and considerations for clinicians

Abstract

Anomalies in the course and drainage of the Inferior Vena Cava (IVC) may complicate normal functioning, correct diagnosis, and therapeutic interventions within the abdomen. Development of the IVC occurs during the 4th to 8th week of gestation, and due to its developmental complexity, there are many opportunities for malformations to occur. Although most IVC anomalies are clinically silent and are usually discovered incidentally on abdominal imaging, aberrations may be responsible for formation of thrombosis, back pain, and anomalous circulation of blood to the heart. In this review, we will discuss the most common variations and abnormalities of the IVC, which include the posterior cardinal veins, the subcardinal veins, the supracardinal veins, persistent left IVC, IVC duplication, situs inversus, left retroaortic renal vein, left circumaortic renal collar, scimitar syndrome, and IVC agenesis. For each abnormality outlined above, we aim to discuss relevant embryology and potential clinical significance with regards to presentation, diagnosis, and treatment as is important for radiologists, surgeons, and clinicians in current clinical practice.

Deep Venous Thrombosis Associated With Inferior Vena Cava Abnormalities And Hypoplastic Kidney In Siblings

“…The normal IVC consists of four segments: hepatic, suprarenal, renal, and infrarenal. The most common anomalies of IVC are duplication of IVC, left sided IVC, IVC continued with intrathoracic azygos vein, IVC agenesis, retro aortic left renal vein [6].There are controversies in the literature about the etiology of IVC abnormalities. Some authors suggest that thrombosis on the IVC during intrauterine or the perinatal period with obliteration and subsequent resorbtion is the origin of its disappearance, hence no embryologic abnormalities are seen [2,[6][7][8].…”

Co-existence of the double inferior vena cava with complex interiliac venous communication and aberrant common hepatic artery arising from superior mesenteric artery: a case report

“…It results from the persistence of the caudal portion of the left supracardinal vein [16]. Double IVC may associate with various anomalies including cloacal extrophy, unilateral renal agenesis and right retrocaval ureter, hemiazygos continuation of IVC, retroaortic right renal vein, situs inversus and congenital heart disease [4,10,30,34]. Although double IVC is usually asymptomatic and diagnosed incidentally on abdominal imaging, it is important to recognise.…”

Double inferior vena cava with three shunts: a rare anomaly with important implications for surgeons

“…The IVC is formed by regression, anastomosis and replacement of the foetal venous blood system during 4 th -8 th week of gestation [8,19,21]. Initially, there were composed of the three sets of paired veins; the posterior cardinal veins, the subcardinal veins, and the supra cardinal veins, which are formed at the retroperitoneal region.…”

“…When attempting cava filtration, DIVC patient may require placement of a caval filter into each vessel in order to avoid the embolism [5]. DIVC is also a risk factor for formation of thrombosis back pain and anomalous circulation of blood to the heart as a consequence of changes in blood flow [21]. In addition, the DIVC can increase a risk of vascular injury during retroperitoneal procedures leading to life-threatening [6,9].…”