Double vena cava filter insertion in congenital duplicated inferior vena cava: a case report and literature review.

The complex embryogenesis of the inferior vena cava (IVC) may result in several anomalies, often presenting as an incidental radiological finding. In addition to the differential diagnosis with pathological lesions, recognizing IVC defects is crucial for invasive procedures. This report describes a patient with a right femoral vein thrombosis who could not be given anticoagulant therapy due to a concomitant acute cerebral hemorrhage. He was found to have an asymptomatic duplicated IVC with interiliac communication. A filter had to be inserted in each vena cava to prevent pulmonary embolism. A review of the literature dealing with the few reported cases of filter insertion in congenital duplicated IVC is presented Congenital anomalies of the inferior vena cava (IVC) and its tributaries originate from a defective embryogenesis of three paired embryonic veins and occur in about 3% of population. They can be identified by iv. contrastenhanced radiological exams or magnetic resonance imaging, and have been encountered more frequently since the introduction of cross-sectional imaging.1 Ultrasound might also have a diagnostic role. In most cases, the congenital anomaly is an incidental finding in asymptomatic patients, but in rare instances, the IVC anomaly is associated with congenital cardiac disorders, as described in a patient with polysplenia and dextrocardia, or with right renal aplasia/hypoplasia.2 A few anomalies may be symptomatic, as observed in the retrocaval ureter variant, causing ureteral obstruction and/or urinary infections, and in the absent infrarenal inferior vena cava abnormality, which predisposes patients to recurrent venous thrombosis of the lower limbs.3 A radiological diagnosis of IVC anomalies is needed before attempting any invasive procedures. We describe a case of congenital duplicated IVC requiring the insertion of two vena cava filters to prevent pulmonary embolism. A review of the literature dealing with the rare cases of filter insertion in congenital duplicated IVC is also provided.