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Journal of Radiological Review 2020 November-December;7(6):494-9

DOI: 10.23736/S2723-9284.20.00065-1

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English, Italian

Inferior vena cava aplasia and bilateral iliac-femoral thrombosis

Irene GRAZZINI 1 , Matteo MAZZETTI 2, Ilaria BINDI 3, Silvia PARLAPIANO 2, Claudia NOCENTINI 3

1 Unit of Neuroradiology, Department of Radiology, San Donato Hospital, Arezzo, Italy; 2 Department of Internal Medicine, Santa Maria alla Gruccia Hospital, Montevarchi, Italy; 3 Department of Radiology, Santa Maria alla Gruccia Hospital, Montevarchi, Italy


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A congenitally absent inferior vena cava (IVC), also called IVC aplasia or agenesis, is a rare vascular anomaly. It is associated with high risk of idiopathic and recurrent deep venous thrombosis (DVT), particularly in young patients, due to a decreased flow velocity in the venous vessels, despite the compensatory circulation with prominent collaterals. Ultrasound (US) is usually the first imaging modality in the evaluation of young patients with DVT, but anomalies of the IVC may be missed on sonography. The most reliable non-invasive imaging methods for diagnosing IVC anomalies are computed tomography (CT) with intravenous contrast or Magnetic Resonance (MR) scan. Differentiating congenital pathology of the IVC from acquired diseases such as thrombosis or compression by a tumor is important in choosing a treatment method and further prognosis. A thorough investigation for thrombophilia markers may also be useful to complete the evaluation of these patients. We report a case of extensive and bilateral iliac-femoral DVT in a 32-year-old male, with incidental finding of congenital infrarenal IVC aplasia on contrast-enhanced CT. The patient was successfully treated with anticoagulation. When DVT develops in young patients with no apparent risk factors, the presence of congenital IVC anomalies should be carefully considered.


KEY WORDS: Vena cava, inferior; Congenital abnormalities; Venous thrombosis; Tomography, X-ray Computed

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