Inferior vena cava agenesis: Clinical presentation, imaging characteristics, and midterm outcomes with a proposed diagnostic algorithm
Phlebology, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1177/02683555261486520
- Dergi Adı: Phlebology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Anahtar Kelimeler: computed tomography, deep vein thrombosis, diagnostic algorithm, inferior vena cava agenesis, venous anomaly
- Kocaeli Üniversitesi Adresli: Evet
Özet
Objective: Inferior vena cava agenesis (IVCA) is a rare developmental venous anomaly associated with proximal deep vein thrombosis (DVT) in young patients. Evidence guiding diagnostic and therapeutic strategies remains limited. We evaluated clinical presentation, imaging characteristics, management approaches, and midterm outcomes of patients with IVCA. Methods: We performed a retrospective review of patients diagnosed with IVCA between January 2020 and January 2025 at a tertiary referral center. Demographics, thrombotic events, imaging findings, associated anomalies, treatment strategies, and follow-up outcomes were analyzed descriptively. Results: Eight patients were identified (87.5% male; mean age 35.8 ± 13.1 years). Six (75%) were symptomatic, most commonly with lower-extremity swelling (50%) and pain (37.5%). Iliofemoral DVT occurred in two patients (25%); superficial thrombophlebitis occurred in one (12.5%). Pulmonary embolism was not observed. Diagnosis was established primarily by computed tomography (87.5%). Anatomical subtypes included infrarenal (50%), complete (37.5%), and suprarenal agenesis (12.5%). One patient had thrombophilia with associated cardiac and renal anomalies. Over a mean follow-up of 3.5 ± 2.33 years, no recurrent DVT or new venous insufficiency occurred. Conclusions: IVCA should be suspected in young patients presenting with unexplained proximal DVT. Cross-sectional imaging is essential for definitive diagnosis. Individualized, risk-adapted management appears safe in the midterm; however, standardized therapeutic guidelines are lacking.