IMAGES IN IR

Marsupial Inferior Vena Cava Rajesh Singh, MBBS, and Kishore Sieunarine, FRACS A 76-year-old man underwent contrast computed tomographic (CT) angiography for preoperative assessment of abdominal aortic aneurysm (AAA). The scan showed a rare inferior vena cava (IVC) anomaly where it is situated anterior to the distal aorta and its bifurcation. Figure 1 shows the IVC in front of the aortic aneurysm. The IVC develops from a complex embryologic process between sixth and 10th weeks of gestation from the cardinal veins. Preaortic IVC occurs when the caval confluence lies anterior to the aortic bifurcation rather than its normal posterior position. Figure 2 shows the confluence of iliac veins anterior to the aortic bifurcation. The illustrated anomaly is thought to have resulted from persistence of the ventral portion of the embryologic circumaortic venous ring with regression of the normal dorsal portion of the ring. Because such an anterior position of the IVC is typical in most marsupials, it is also known as marsupial IVC.

Figure 1.

Figure 2.

From the Department of General Surgery (R.S.), Osborne Park Hospital; and Department of Vascular Surgery (K.S.), Royal Perth Hospital, Perth, Australia. Received September 5, 2013; final revision received and accepted October 2, 2013. Address correspondence to R.S., Department of General Surgery, Osborne Park Hospital, Osborne Place Sterling, Perth, WA 6021, Australia; E-mail: [email protected]

Neither of the authors have identified a conflict of interest. & SIR, 2014 J Vasc Interv Radiol 2014; 25:71 http://dx.doi.org/10.1016/j.jvir.2013.10.002

Marsupial inferior vena cava.

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