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May 24-25, 2018
London, UK
Vascular Surgery 2018
3
rd
Edition of World Congress & Exhibition on
Vascular Surgery
Journal of Vascular and Endovascular Therapy
ISSN: 2573-4482
Background:
Congenital absence of inferior vena cava (IVCA)
is an extremely rare anomaly with an estimated prevalence of
1%. It is recognised to be associated with deep vein thrombosis
(DVT) particularly in the young. There can be clues indicating the
presence of such an anomaly from a young age. Patients with IVC
anomalies usually develop compensatory circulation through the
collateral veins; despite the compensatory circulation, the venous
drainage of the lower limbs is often insufficient leading to venous
stasis and thrombosis. We present two cases of young adult
aged 17 and 28 years who presented with groin pain, swelling and
lower limb DVT respectively. The clinical features, diagnostic and
therapeutic options are discussed.
Discussion:
IVCA is an uncommon but well recognised anomaly.
Most of the patients with IVCA are asymptomatic and detected
incidentally during radiological procedures or abdominal surgery.
Common symptoms are lower extremity pain, swelling, ulcers,
and sometimes nonspecific pain in the lower back and abdomen.
The most reliable non-invasive methods for diagnosing IVC
anomalies are CT and MRI. There is no role of surgical correction
in the management of these patients. There is no consensus
regarding the duration of anti-coagulation but it would seem
sensible for them to remain on life-long anticoagulation given the
on-going risk of further DVT.
Conclusion:
All vascular surgeons should consider the possibility
of IVC anomalies in a young adult presenting with unexplained,
extensive, or bilateral DVT. The diagnosis can be challenging and
requires detailed imaging studies. Further diagnostic workup
and management should be considered for any coagulation
abnormalities and long-term anticoagulation.
Recent Publications
1. Sakellaris G, Tilemis S, Papakonstantinou O, Bitsori M,
Tsetis D and Charissis G (2005) Deep venous thrombosis
in a child associatedwith an abnormal inferior vena cava.
Acta Paediatrica 94:242-
244.
2. Gayer G, Luboshitz J, Hertz
M, Zissin R, et al. (2003)
Congenital
anomalies
of the inferior vena cava
revealed on CT in patients
with deep vein thrombosis.
AJR Am J Roentgenology
180: 729-732.
3. Iqbal J and Nagaraju E
(2008) Congenital absence of inferior vena cava and
thrombosis: a case report. Journal of Medical Case
Reports 2:46.
4. Koc Z and Oguzkurt (2007) Interuption or congenital
stenosis of the inferior vena cava: prevalence, imaging
and clinical findings. European Journal of Radiology 62:
257-266.
5. Koppisetty S, Smith A G and Dhillon R K (2015) Incidental
finding of inferior vena cava atresia presenting with DVT
following physical assertion. Case Reports in Emergency
Medicine 2015:146304.
Biography
Sanjay Singh has his expertise and passion in Vascular and Endovascu-
lar Surgery. He has done complex aortic endovascular fellowship and is a
Vascular Consultant working in United Kingdom. His open and contextual
surgical techniques are based on researched and practiced models which
helped to create new pathways for innovation. He has achieved this aptitude
after years of experience in research and teaching in university hospitals and
institutions. The ever-responsive and adapting field of Endovascular Surgery
has improved the survival rates of high risk patients.
dr_sanjaysingh@hotmail.comCongenital absence of inferior vena cava associated with
lower limb and pelvic venous thrombosis
Sanjay Singh, Asghar Butt, Muhammad Usman Cheema
and
Jayarama Mohan
United Lincolnshire Hospitals NHS Trust, UK
Sanjay Singh et al., J Vasc Endovasc Therapy 2018, Volume 3
DOI: 10.21767/2573-4482-C1-002