Inferior vena cava

Last revised by Yoshi Yu on 7 Apr 2023

The inferior vena cava (IVC) (plural: inferior venae cavae) is one of the great vessels that drains venous blood from the lower limbs, pelvis and abdomen into the right atrium of the heart.

The inferior vena cava is formed by the confluence of the two common iliac veins at the L5 vertebral level. The IVC has a retroperitoneal course within the abdominal cavity. It runs along the right side of the vertebral column with the aorta lying laterally on the left. Various other veins drain into the IVC along its course before it passes through the diaphragm at the caval hiatus at the T8 level. Its intrathoracic course is very short before draining into the right atrium at the inferior cavoatrial junction

Since the IVC is not a midline structure, there is a degree of asymmetry of drainage, e.g. the gonadal and suprarenal veins drain into the IVC on the right side, but into the left renal vein on the left.

The normal IVC has a complex embryological development with many embryological veins contributing to many different parts:

  • right vitelline vein: forms suprahepatic and hepatic segments of IVC

  • right subcardinal vein: forms suprarenal segment

  • right subsupracardinal anastomosis: forms renal segment

  • right supracardinal vein: forms infrarenal segment

  • right posterior cardinal vein: forms distal most IVC and its bifurcation into common iliac veins

Inferior caval abnormalities are typically the result of abnormal embryologic development involving the vitelline, posterior cardinal, subcardinal and supracardinal veins 3:

Rarely a Eustachian valve at the inferior cavoatrial junction may be present. 

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Cases and figures

  • Figure 1
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  • Figure 2: caval variants
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  • Figure 3: mediastinum (Gray's illustration)
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  • Figure 4: venous development (Gray's illustrations)
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