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Image Acquisition Method for the Sonographic Assessment of the Inferior Vena Cava
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Double Inferior Vena Cava With Mega Cava: A Case Report
Michael J Sinnott1, David Kosoy2, Albert Xing3
1Medicine, Florida International University (FIU) Herbert Wertheim College of Medicine, Tampa, USA.
Cureus
|May 21, 2025
Summary
Dual inferior vena cava (IVC) filters effectively managed a patient with a rare double IVC and mega cava, preventing pulmonary embolism when a single filter was not feasible.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Medical Imaging
Background:
- Deep venous thrombosis (DVT) poses a significant thromboembolic risk.
- Anticoagulation is contraindicated in patients with high fall risk due to ataxia.
- Inferior vena cava (IVC) filter placement is an alternative for thromboembolic event prevention.
Observation:
- A 68-year-old male with DVT and contraindication to anticoagulation presented for IVC filter placement.
- Pre-procedural imaging revealed a rare double IVC variant with a mega cava configuration.
- A single IVC filter was deemed infeasible due to anatomical constraints.
Findings:
- Dual IVC filters were successfully placed, one in each venous channel, to ensure thromboembolic protection.
- This approach provided effective coverage of both IVC lumens in a mega cava configuration.
- Dual filters offered retrievability, unlike permanent alternatives like the Bird's Nest filter.
Implications:
- Dual IVC filter placement is a viable strategy for patients with double IVC and mega cava variants.
- Recognizing and managing rare anatomical variations is crucial for successful endovascular interventions.
- Pre-procedural imaging and strategic planning optimize thromboembolic protection in complex cases.
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