Absence of the right iliac vein and an unusual connection between both common femoral veins

The aim of the study is to report a case of a rare congenital anomaly of the venous system and to emphasize its clinical importance. We describe a case of aplasia of the right common and external iliac veins in a healthy seven-year-old boy who was referred for Doppler ultrasound examination for further evaluation of an abnormal varicosity in the suprapubic region. Colour Doppler ultrasound revealed a dilated, arch-shaped vein. Contrast-enhanced magnetic resonance angiography showed the absence of the right common iliac vein and external iliac vein. It also clearly demonstrated the aberrant venous structure, originating from the right common femoral vein and draining to the left common femoral vein. In conclusion, in our case, the patient's life was threatened because the aberrant venous connection crossing within subcutaneous fatty tissue was not protected from external trauma and possible abdominal surgical interventions. Additional attention should be given to avoid such injuries, which can cause significant haemorrhage.

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Endovascular correction of venogenic erectile dysfunction in May–Thurner syndrome (clinical case)

Andrology and Genital Surgery ◽

10.17650/2070-9781-2019-20-4-45-51 ◽

2019 ◽

Vol 20 (4) ◽

pp. 45-51

Author(s):

E. A. Povelitsa ◽

A. V. Bystrenkov ◽

A. M. Shesternya ◽

O. V. Parkhomenko

Keyword(s):

Erectile Dysfunction ◽

Clinical Case ◽

Femoral Vein ◽

Iliac Vein ◽

Common Iliac Vein ◽

Venous Plexus ◽

Common Femoral Vein ◽

Left Common Iliac Vein ◽

The Right ◽

Deep Vein

Introduction. Secondary varicose small pelvic veins with the development of chronic venous insufficiency due to obstruction of the magistral venous vessels, in particular, the left common iliac vein and the right common iliac artery (May–Thurner syndrome), occupy a special place in the structure of the causes of venogenic erectile dysfunction (ED).The study objective is to present the clinical case of arteriovenous conflict (May–Thurner syndrome), leading to the development of secondary varicose small pelvic veins in men and venogenic ED, as well as modern methods of its verification and endovascular surgical repair.Clinical case. A clinical case of successful endovascular correction of venogenic ED is presented. The patient is diagnosed with: May– Thurner syndrome. Pelvic varicose disease С3 (according to CEAP Classification). Condition after endovascular balloon angioplasty and stenting of the left common iliac vein. Bilateral varicocele. Condition after bilateral varicocelectomy in 2018. Severe venogenic ED (pathological venous drainage, proximal type, International Index of Erectile Function (v. 5) – 12 points; Er3 according to the Unem Scale) in accordance with the Comprehensive Classification System for Chronic Venous Disorders. On July 24, 2019 endovascular occlusion of the Santorini’s plexus veins was performed with the installation of occlusion spirals in their lumen according to Gianturco. In order to provide visualization of the veins in the Santorini’s plexus, given the impossibility of cannulation of the deep vein of the penis, bilateral symmetrical cannulation of the cavernous bodies of the penis was carried out to perform cavernosophlebography. The left common iliac vein was catheterized according to the Crossover technique. Under phlebography control we ensured that the stent in the common iliac vein passed without signs of loss of its lumen. The internal pudental vein on the left was selectively catheterized. Hydrophilic guidewire was introduced through the veins of the periprostatic plexus into the right internal pudental vein. Selective catheterization of the periprostatic venous plexus was not possible due to pronounced tortuosity, valve flaps of the veins and small diameter of the catheterized veins. It was decided to pass the guidewire further through the right iliac vein system with access to the inferior vena cava. Further, the guidewire was again transferred to the left common iliac vein (double crossover). The left common femoral vein was punctured followed by the placement of 5 Fr introducer sheath according to Seldinger. The guidewire tip was fixed by the loop in the left common iliac vein, then captured and brought out through the introducer in the left common femoral vein. A catheter Сobra15 Fr was inserted through a crossover guide from the left common femoral vein into the right internal iliac vein and further into the periostatic venous plexus. Gradually veins of the Santorini’s plexus were selectively catheterized followed by Gianturco coils embolization.Conclusion. The first choice surgery for verified proximal type ED is endovascular occlusion of the veins in the Santorini’s plexus through the deep vein of the penis, which allows to change the hemodynamics in the penis and provide sufficient erection without resorting to endofalloprosthesis of the penis. Single or double-sided transfemoral access is suggested for patients when access through the deep vein of the penis is rather challenging or absent.

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Flipping the Filter: Forceps Retrieval of a Left Common Iliac Vein Denali Filter through the Left Common Femoral Vein

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2016.04.009 ◽

2016 ◽

Vol 27 (12) ◽

pp. 1870-1871

Author(s):

Aaron Bos ◽

Marc Alonzo ◽

Hector Ferral

Keyword(s):

Femoral Vein ◽

Iliac Vein ◽

Common Iliac Vein ◽

Common Femoral Vein ◽

Left Common Iliac Vein

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Extensive venous thrombosis and hind-limb edema associated with adrenocortical carcinoma in a dog

Journal of the American Animal Hospital Association ◽

10.5326/15473317-35-4-306 ◽

1999 ◽

Vol 35 (4) ◽

pp. 306-310 ◽

Cited By ~ 8

Author(s):

MH Jaffe ◽

AM Grooters ◽

BP Partington ◽

AC Camus ◽

G Hosgood

Keyword(s):

Venous Thrombosis ◽

Adrenocortical Carcinoma ◽

Femoral Vein ◽

Vena Cava ◽

Iliac Vein ◽

Common Iliac Vein ◽

Abdominal Ultrasonography ◽

Mixed Breed ◽

Limb Edema ◽

The Right

A 10-year-old, spayed female, mixed-breed dog was referred for evaluation of bilateral hindlimb edema and weakness. Abdominal ultrasonography showed increased echogenicity of the lumen of the caudal vena cava from the level of the urinary bladder to the level of the cranial pole of the right kidney. Bilateral saphenous venograms displayed numerous filling defects in the caudal vena cava, right external iliac vein, right femoral vein, and the right common iliac vein. Extensive venous thrombosis was diagnosed, and the animal was euthanized. Necropsy confirmed the presence of venous thrombosis and revealed a right adrenocortical carcinoma that had invaded the caudal vena cava.

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May-Thurner syndrome – Are we aware enough?

VASA ◽

10.1024/0301-1526/a000775 ◽

2019 ◽

Vol 48 (5) ◽

pp. 381-388 ◽

Cited By ~ 6

Author(s):

Katalin Mako ◽

Attila Puskas

Keyword(s):

Contraceptive Use ◽

Iliac Vein ◽

Common Iliac Vein ◽

Vein Thrombosis ◽

Compression Syndrome ◽

Threatening Condition ◽

Life Threatening ◽

Iliac Vein Compression ◽

Iliac Vein Compression Syndrome ◽

The Right

Summary. Iliac vein compression syndrome (May-Thurner syndrome – MTS) is an anatomically variable clinical condition in which the left common iliac vein is compressed between the right common iliac artery and the underlying spine. This anatomic variant results in an increased incidence of left iliac or iliofemoral vein thrombosis. It predominantly affects young women in the second or third decades of life with preponderance during pregnancy or oral contraceptive use. Although MTS is rare, its true prevalence is underestimated but it can be a life-threatening condition due to development of pulmonary embolism (PE). In this case based review the authors present three cases of MTS. All patients had been previously confirmed with PE, but despite they were admitted to hospital, diagnosed and correctly treated for PE and investigated for thrombophilia, the iliac vein compression syndrome was not suspected or investigated. With this presentation the authors would like to emphasize that MTS is mostly underdiagnosed, and it needs to be ruled out in left iliofemoral vein thrombosis in young individuals.

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Considerations on the caliber of the internal iliac vein

ARS Medica Tomitana ◽

10.1515/arsm-2015-0013 ◽

2015 ◽

Vol 21 (1) ◽

pp. 12-16 ◽

Cited By ~ 1

Author(s):

Oana Popa ◽

P. Bordei ◽

C. Ionescu ◽

D.M. Iliescu

Keyword(s):

Iliac Vein ◽

Statistical Distribution ◽

Common Iliac Vein ◽

Internal Iliac Vein ◽

Distribution Of Values ◽

Internal Iliac ◽

The Common ◽

The Right

Abstract The diameter at the origin of the internal iliac vein was found between 4.7 to 9.9 mm; for the right internal iliac vein between 4.7 to 9.7 mm; the statistical distribution groups value in ascending order being as follows: 4.7 to 5.5 mm: 4 cases (22.22% of cases); 6.9 to 7.8 mm: 6 cases (33.33% of cases); 8.4-8.8 mm: 4 cases (22.22% of cases); 9.1 to 9.7 mm: 4 cases (22.22% of cases). The diameter at the origin of the left internal iliac vein was between 4.8 to 9.9 mm, while the distribution statistics on groups of values, in ascending order, being as follows: 4.8-5.2 mm: 4 cases (22.22 % of cases); 6.8-7.1 mm: 8 cases (44.44% of cases); 8.3 to 9.9 mm: 6 cases (33.33% of cases). The diameter at the end of the internal iliac vein was between 5.9 to 10.2 mm; the diameter at the end of the right internal iliac vein was between 6.1 to 10.2 mm, the statistical distribution of values groups in ascending order being follows: 6.1 to 7.5 mm: 6 cases (33.33% of cases); 8.4 to 8.7 mm: 8 cases (44.44% of cases); 9.3 to 10.2 mm: 4 cases (22.22% of cases). The diameter at the end of the left internal iliac vein was between 5.9 to 9.9 mm, while the distribution statistics on groups of values in ascending order being as follows: 5.9 to 6.2 mm: 4 cases (22.22 % of cases); 7 to 7.6 mm: 3 cases (16.67% of cases); 8.3-8.4 mm: 5 cases (27.28% of cases); 9.1 to 9.9 mm: 6 cases (33.33% of cases). Comparing the common iliac vein caliber of the two, right and left, we found that in 10 cases (55.56% of cases), the right internal iliac vein has a greater diameter than the left one by 0.3 mm. In 8 cases (44.44% of cases), the left internal iliac vein has a larger diameter than the right one with 0.1-0.6 mm; between the two values there is a difference of 0.5 mm

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Absence of the Right Common Iliac Vein with the Right Internal Iliac Vein Arising from the Left Common Iliac Vein: Case Report

Cureus ◽

10.7759/cureus.4575 ◽

2019 ◽

Cited By ~ 1

Author(s):

Karishma Mehta ◽

Joe Iwanaga ◽

R. Shane Tubbs

Keyword(s):

Case Report ◽

Iliac Vein ◽

Common Iliac Vein ◽

Left Common Iliac Vein ◽

Internal Iliac Vein ◽

Internal Iliac ◽

The Right

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Iliocaval Compression Syndrome

Phlebology The Journal of Venous Disease ◽

10.1177/026835558700200310 ◽

1987 ◽

Vol 2 (3) ◽

pp. 173-179 ◽

Cited By ~ 5

Author(s):

Syde A. Taheri ◽

Paul Nowakowski ◽

David Pendergast ◽

Julie Cullen ◽

Steve Pisano ◽

...

Keyword(s):

Iliac Artery ◽

Common Iliac Artery ◽

Vena Cava ◽

Signs And Symptoms ◽

Iliac Vein ◽

Venous Hypertension ◽

Common Iliac Vein ◽

Compression Syndrome ◽

Extrinsic Compression ◽

The Right

The iliocaval compression syndrome is a disorder, frequently found in young women, in which extrinsic compression of the left iliocaval junction produces signs and symptoms of lower extremity venous insufficiency. The anatomic variant which gives rise to this syndrome consists of compression of the left common iliac vein by the overlying right common iliac artery, near its junction with the vena cava. Additional reduction of outflow results from intraluminal venous webs and tight adhesions between the iliac artery and vein. Pain, swelling, pigmentation, and venous claudication characterize this syndrome, which affects predominantly the left leg. The syndrome may progress to iliofemoral thrombosis, phlegmasia cerulea dolens, and venous gangrene. Longstanding iliocaval stenosis may produce valvular incompetence. Exercise plethysmography is a non-invasive test useful in screening patients for iliocaval compression. The definitive diagnosis is made by venography, both ascending and descending, to determine the degree of outflow stenosis. Iliocaval patch angioplasty with retrocaval positioning of the right iliac artery, decreases venous hypertension and leads to improvement in the clinical condition. To date, we have performed iliocaval angioplasty, with retrocaval repositioning of the right common iliac artery, on 18 patients. Of these, 83% have had good results as determined by hemodynamic and clinical assessment.

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Morphological and Histological Study of an ‘Iliac Venous Ladder’ Associated with Very Short Common Iliac Arteries

Journal of Morphological Sciences ◽

10.1055/s-0039-1697009 ◽

2019 ◽

Vol 36 (04) ◽

pp. 255-260

Author(s):

Satheesha B. Nayak ◽

Sudarshan Surendran ◽

Venu Madhav Nelluri ◽

Prakashchandra Shetty

Keyword(s):

Developmental Process ◽

Present Report ◽

Histological Study ◽

Vena Cava ◽

Iliac Vein ◽

Histological Structure ◽

Common Iliac Vein ◽

Structural Variations ◽

Surgical Interventions ◽

The Common

Abstract Introduction Communications between iliac veins in the pelvis are reported to be rare occurrences, which are mostly due to developmental abnormalities. The common iliac vein is formed by the joining of the internal and external iliac veins. Here, we present a detailed morphological and histological study of a rare communication found between the internal and external iliac veins, which would prove to be of substantial value to the knowledge of vessels in the pelvis, both for clinicians and surgeons. Materials and Methods In the present study, we came across a rare communication in the form of a ladder, between the left internal and external iliac veins in a 70-year-old male cadaver. There were two communications (named upper and lower communications) between the external and internal iliac veins, before they joined to form the common iliac vein. On naked eye observation, the lumen of the right common iliac vein appeared to be wider than on the left side. The lengths of these communications and the distance between each of their attachments have been measured and tabulated. The walls of these veins, their microscopic sections and their communication involved in the case were taken. The possible causes for these variations were congenital, owing to the complicated nature of the developmental process involved in the formation of the inferior vena cava and the venous system of the lower limb. Results The structure of all the veins involved in this case and the communications were seen to be normal. The thickness of these walls were measured and tabulated for uniformity around the circumference of the wall of these veins. All the measurements from the structural variations and from the histological observations are tabulated in our results. Conclusion The complicated development sequence of these veins could have possibly led to the persistence of these communications. Such a developmental variation does not seem to pose any threat until unless encountered under clinical or surgical interventions, as the histological structure of the walls of the communications as well as the major channels connected appeared to be normal and well-developed. The detailed morphological and histological features of these structures involved in the variation along with the possible complications have been presented in the present report. Knowledge of these variations and complications due to injury plays a key role in a clinical setup.

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