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Duplicated inferior vena cava filter placement

Case contributed by Adam Krajewski
Diagnosis certain

Presentation

Background of pancreatic cancer and deep vein thrombosis

Patient Data

Age: 75 years
Gender: Female

There is a duplicated inferior vena cava. The left-sided inferior vena cava drains into the left renal vein. The left internal iliac vein joins the right-sided IVC. The left external iliac vein drains directly into the duplicated left-sided IVC and into the left renal vein. 

There is soft tissue infiltration along the right hemipelvis with no evidence of pelvic DVT.

A posterior pancreatic head mass is noted.

The right femoral vein was accessed and a Denali filter was placed in the right-sided IVC in the infrarenal position. Subsequently, the left femoral vein was accessed and a Denali filter was placed in the left-sided IVC in the infrarenal position. 

Successful placement of bilateral retrievable inferior vena cava filters.

Bilateral inferior vena cava filters seen in the setting of duplicated IVC.

Case Discussion

The prevalence of duplication of the inferior vena cava is reported as 0.2 - 3% 1. In the setting of duplicated inferior vena cava, filters may be placed in both IVCs. Access can be performed via the right internal jugular vein or bilateral common femoral veins as in this case.

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