title: Successful surgical management of pelvic congestion and lower extremity swelling owing to absence of infrarenal inferior vena cava.
abstract: Absence of isolated infrarenal inferior vena cava (IVC) is a rare condition documented in only a few published cases and typically treated with anticoagulation. We herein describe successful surgical management of the isolated infrarenal IVC absence in a healthy 35-year-old woman who presented with disabling pelvic congestion. An ascending venogram showed the absence of infrarenal IVC with a large left ovarian vein draining pelvic collateral vessels to the normal left renal vein and suprarenal IVC. The patient was successfully treated with a common femoral vein to the suprarenal IVC bypass using a bifurcated polytetrafluoroethylene graft, with rapid symptom resolution, and remained symptom free 6 months later. This is the first reported case describing a surgical strategy for isolated infrarenal IVC absence in a symptomatic patient.
authors.affiliation: Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA. wzhou1@bcm.tmc.edu
authors.forename: Wei
authors.initials: W
authors.lastname: Zhou
authors.forename: Wade
authors.initials: W
authors.lastname: Rosenberg
authors.forename: Alan
authors.initials: A
authors.lastname: Lumsden
authors.forename: James
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D004487:Edema / Q000209:etiology; D005260:Female; D005268:Femoral Vein / Q000601:surgery; D006801:Humans; D007866:Leg; D010388:Pelvis / Q000098:blood supply*; D011859:Radiography; D014682:Vena Cava, Inferior / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery