Persistence of the cardinal veins and thrombosis: CT demonstration

Area of Science:

• Vascular Surgery
• Radiology
• Medical Genetics

Background:

• Deep venous thrombosis (DVT) is a significant cause of morbidity and mortality.
• Recurrent DVT necessitates investigation into underlying causes, including congenital anomalies.
• The cardinal venous system and its variations are crucial in cardiovascular development.

Observation:

• A young male patient experienced recurrent, extensive bilateral lower extremity deep venous thrombosis over three years.
• Computed tomography (CT) imaging identified a persistent abdominal cardinal venous system.
• Azygous drainage of abdominal veins into a normal right superior vena cava was noted.

Findings:

• The patient's venous anomaly involved the persistence of embryonic venous structures.
• This anatomical variation may alter venous blood flow dynamics in the abdomen and lower extremities.
• A potential link between the venous anomaly and the recurrent peripheral thrombosis is hypothesized.

Implications:

• This case highlights the importance of considering rare venous anomalies in young patients with recurrent DVT.
• Understanding such anomalies can improve diagnostic accuracy and guide treatment strategies.
• Further research into the pathophysiology of thrombosis associated with venous malformations is warranted.