Al Hatmi Asma, Al Hajriy Mahmood
Radiology Residency Program, Oman Medical Specialty Board, Muscat, Oman.
Department of Radiology, Royal Hospital, Muscat, Oman.
Oman Med J. 2021 Mar 31;36(2):e244. doi: 10.5001/omj.2021.29. eCollection 2021 Mar.
Inferior vena cava (IVC) duplication is a well-known anatomic variation that is important when relevant procedures are being planned. Duplication of IVC is a relatively rare to detect especially vascular anomaly with a prevalence of 1.5% (range 0.2-3.0%). Knowing this anatomical variation is very important in cases of IVC filter placement. Filter placement in duplicated IVC cases has many options like placing it in both vena cavae, suprarenal filter placement, or coil embolization of the intervenous segment plus placing a filter in the right IVC. We report a case of a patient with newly diagnosed bladder cancer who had a high risk of thrombosis and a recent massive pulmonary embolism. The patient was planned for transurethral resection of the bladder tumor. As a prophylactic measure, an IVC filter placement was requested to prevent further pulmonary emboli that might occur during or after surgery. Cavography showed a duplicated IVC, and the filter placement was performed in the suprarenal portion and was proved to be an adequate and safe procedure. No procedure-related complications were reported. There are few worldwide reported cases of filter placement in a duplicated vena cava, and to our best knowledge, this is the first case reported in Oman.
下腔静脉（IVC）重复是一种已知的解剖变异，在规划相关手术时很重要。IVC重复是一种相对罕见的尤其是血管方面的异常，患病率为1.5%（范围0.2 - 3.0%）。了解这种解剖变异在IVC滤器置入病例中非常重要。在IVC重复病例中，滤器置入有多种选择，如在两个腔静脉中置入、肾上极滤器置入，或对静脉段进行线圈栓塞并在右侧IVC中置入滤器。我们报告一例新诊断为膀胱癌的患者，该患者有血栓形成的高风险且近期发生了大面积肺栓塞。该患者计划行经尿道膀胱肿瘤切除术。作为预防措施，要求置入IVC滤器以防止手术期间或术后可能发生的进一步肺栓塞。腔静脉造影显示IVC重复，滤器置入在肾上极部分，且被证明是一种充分且安全的操作。未报告与手术相关的并发症。全球范围内报道的在重复腔静脉中置入滤器的病例很少，据我们所知，这是阿曼报道的首例。
