Deng Yuqing, Yan Yuanyuan, Li Wenrui, Feng Hai, Jin Lei, Liu Zhao, Xu Bodong, Zhang Zhiwen
Department of Vascular surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Department of Radiology, Beijing Friendship Hospital, Capital medical university, Beijing, China.
Ann Vasc Surg. 2025 Jan;110(Pt A):47-54. doi: 10.1016/j.avsg.2024.07.123. Epub 2024 Sep 27.
The primary goal of this research is to delve into the clinical and pathological facets of the left-sided inferior vena cava (IVC), and to catalog and condense its radiological and clinical attributes, thereby furnishing valuable references for pertinent clinical diagnosis and therapeutic procedures.
We collated and scrutinized the general clinical features, radiological characteristics, and diagnostic and therapeutic strategies of 30 patients diagnosed with left-sided IVC (LIVC) in our hospital from July 2014 through February 2024.
A majority of patients were asymptomatic and were only identified during diagnostic procedures for other ailments. CT scans revealed anomalies in the anatomical configuration of the LIVC. The radiological presentations primarily showcased the right common iliac vein traversing the lumbar vertebrae to amalgamate with the left common iliac vein, forming the IVC. The IVC ascended on the left side of the abdominal aorta, accepted the left renal vein, and then transitioned to the right side of the abdominal aorta. In 3 instances, the IVC was witnessed ascending on the left side of the abdominal aorta, permeating through the diaphragm, converging with the azygos vein and abdominal aorta, and making its way into the right atrium. In these cases, the hepatic segment of the IVC was missing, and there was an absence of the IVC inferior to the hepatic vein, a condition we refer to as complete LIVC.
LIVC is predominantly asymptomatic but carries significant anatomical implications during abdominal, retroperitoneal surgeries, and vascular interventions. Precise identification and management of this anomaly can mitigate surgical risks and enhance patient prognosis.
本研究的主要目的是深入探讨左侧下腔静脉(IVC)的临床和病理方面,并梳理和总结其影像学和临床特征,从而为相关临床诊断和治疗程序提供有价值的参考。
我们整理并分析了2014年7月至2024年2月期间在我院确诊为左侧IVC(LIVC)的30例患者的一般临床特征、影像学特征以及诊断和治疗策略。
大多数患者无症状,仅在其他疾病的诊断过程中被发现。CT扫描显示LIVC的解剖结构异常。影像学表现主要显示右髂总静脉穿过腰椎与左髂总静脉汇合形成IVC。IVC在腹主动脉左侧上升,接受左肾静脉,然后过渡到腹主动脉右侧。在3例病例中,IVC在腹主动脉左侧上升,穿过膈肌,与奇静脉和腹主动脉汇合,进入右心房。在这些病例中,IVC的肝段缺失,肝静脉下方没有IVC,我们将这种情况称为完全性LIVC。
LIVC主要无症状,但在腹部、腹膜后手术和血管介入治疗中具有重要的解剖学意义。准确识别和处理这种异常可以降低手术风险,提高患者预后。