IVC

Infrarenal:
  • Duplicated IVC - typically drains to left renal vein (persistent bilateral supracardinal veins)
  • Left-sided IVC (persistent left supracardinal vein)
  • Mega cava (~ > 30 mm )
  • Persistent right posterior cardinal vein (retrocaval or circumcaval ureter)
  • Absent infrarenal IVC
Suprarenal:
  • IVC agenesis/hypoplasia
  • Azygos continuaiton
Renal:
  • Circumaortic left renal vein
  • Retroaortic left renal vein

Filter considerations

  • Duplicated IVC - can place two filters or a single suprarenal filter
  • Agenesis - don’t place
  • Azygos continuation - infrarenal should still work
  • Mega - can place bilateral iliac vein filters or a larger Bird’s Nest filter
  • Circumaortic renal - place inferior to the inferior moeity

SVC

  • SVC duplication - normal right SVC remains and embryonic left anterior cardinal vein fails to regress
    • Possible drainage to RA, coronary sinus, or left atrium
    • More common that isolated left sided SVC
  • Left sided SVC - persistent left anterior cardinal vein
    • Most common congenital venous anomaly in the chest
    • Drainage most often to coronary sinus (92% of time) but rarely can be to LA resulting in R-to-L shunting