What are the important findings here? • Xray of the Week
Duplication of the inferior vena cava (IVC) is a rare congenital anomaly, seen in up to 1.5% of the population. The left IVC is visualized as a continuation of the left common iliac vein, then flows into the left renal vein. It is asymptomatic and no treatment is required. However, this variant must be kept in mind when inserting an IVC filter. In order to prevent emboli from both lower extremities, the filter should be placed above the renal veins  as in this case. Alternatively, two IVC filters  can be inserted, with one in each of the two inferior venacavas.
Fig. 1 Coronal CT image demonstrating the two inferior vena cavas.
Fig. 2 Axial CT image demonstrating the two inferior vena cavas.
Fig. 3 Inferior vena cavagram via the left common femoral vein. Note the left IVC draining into the left renal vein. The right IVC is not opacified. Retrograde filling of the lumbar veins is prominent.
Fig. 4 IVC filter is placed in the suprarenal IVC.
1. MalgorI RD, SobreiraII ML, BoaventuraII PN, et al. Filter placement in duplicated inferior vena cava: case report and review of the literature. J Vasc Bras. 2008;7(2):167-170. http://www.scielo.br/pdf/jvb/v7n2/en_v7n2a13.pdf
2. Sartori MT1, Zampieri P, Andres AL, Prandoni P, Motta R, Miotto D. Double vena cava filter insertion in congenital duplicated inferior vena cava: a case report and literature review. Haematologica. 2006 Jun;91(6 Suppl):ECR30. http://www.haematologica.org/content/91/6_Suppl/ECR30.long
Kevin M. Rice, MD is the president of Global Radiology CME
Dr. Rice serves as the Chair of the Radiology Department of Valley Presbyterian Hospital and is a radiologist with Renaissance Imaging in Los Angeles, California. Dr. Rice has made several media appearances as part of his ongoing commitment to public education. Dr. Rice's passion for state of the art radiology and teaching includes acting as a guest lecturer at UCLA. In 2015 Dr. Rice founded Global Radiology CME to provide innovative radiology education at exciting international destinations, with the world's foremost authorities in their field.
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