The inferior vena cava: anatomical variants and acquired pathologies

Abstract

The inferior vena cava (IVC) is the largest vein in the body, draining blood from the abdomen, pelvis and lower extremities. This pictorial review summarises normal anatomy and embryological development of the IVC. In addition, we highlight a wide range of anatomical variants, acquired pathologies and a common pitfall in imaging of the IVC. This information is essential for clinical decision making and to reduce misdiagnosis.

Embryological Aspects and Anatomical Variations of the Inferior Vena Cava – Its Importance in Gynecologic Oncology Surgery

“…The IVC forms during the sixth to tenth gestation week through a complex process of subsequent regression and extensive anastomotic development of channels among the vitelline, posterior cardinal (PCVs), subcardinal (SUVs), and supracardinal veins (SUPVs) [4,5]. These veins develop in a sequence [6].…”

“…As later the umbilical veins regress, the superior part of the VIVs forms the paired hepatocardiac channels. The left hepatocardiac channel regresses, whereas the right persists and forms the hepatic compartment of the IVC [4,5,7]. The SUVs are paired veins, which emerge in the seventh week of gestations.…”

“…Concurrent anomalies of the renal veins are often encountered -retroaortic left renal vein or circum-aortic renal vein known as a 'venous collar' [20][21][22][23][24][25][26]. Moreover, in some cases, anastomoses between right and left CIVs at the caudal origin of the BDIVC could be noticed [5,21]. Worldwide, many case reports describe the association of the BDIVC with venous thrombosis, recurrence of pulmonary thromboembolism, retrocaval ureters, and kidney anomalies [22][23][24][25][26][27][28].…”

Thrombosen der Vena cava inferior – Ursachen und therapeutische Implikationen

“…Im Zusammenhang mit Thrombosen der VCI und/oder der Beckenvenen ist die infrarenale Aplasie bzw. Hypoplasie der VCI die häufigste in der Literatur beschriebene Anomalie [9]. Dabei lässt sich allerdings nicht immer genau feststellen, ob es sich um eine primäre Fehlanlage handelt.…”

“…Eine gedoppelte VCI lässt sich älteren Literaturangaben zufolge in 0,2-3,0 % der Fälle nachweisen [9]. Dabei setzt sich die Vena iliaca communis in jeweils eine gleichseitige VCI fort.…”