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Surgical Management of Deep Venous Insufficiency Caused by Congenital Absence of the Infrarenal Inferior Vena Cava

Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran, arash_mtofigh{at}yahoo.com

Raphaël Coscas, MD

Service de Chirurgie Vasculaire, CHU Pitie-Salpêtrière, Paris, France

Fabien Koskas, MD

Service de Chirurgie Vasculaire, CHU Pitie-Salpêtrière, Paris, France

Edouard Kieffer, MD

Service de Chirurgie Vasculaire, CHU Pitie-Salpêtrière, Paris, France

Congenital absence of the inferior vena cava (CAIVC) is a rare vascular defect, commonly reported as a fortuitous finding because patients are typically asymptomatic of the condition itself but are symptomatic of associated conditions such as congenital heart disease, polysplenia, asplenia, and inversion of bowel viscera. The presence of CAIVC is probably underestimated because CAIVC may not be detected by compression B-mode ultrasonography. By use of computed tomography, we diagnosed a case of CAIVC in a young athletic patient with disabling venous stasis symptoms of the lower limbs. Venous prosthetic reconstruction of the infrarenal vena cava provided with early subsiding of edema and healing of stasis ulcers. An intracaval web was found as potentially responsible for the condition. We present and propose our surgical method for this rare disabling condition.

Key Words: inferior vena cava • congenital absence • venous insufficiency • surgical management • intracaval web

Vascular and Endovascular Surgery, Vol. 42, No. 1, 58-61 (2008)
DOI: 10.1177/1538574407306791


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