The inferior vena cava is the largest vein in the body, formed by the confluence of the two common iliac veins at the level of the fifth lumbar vertebra. It ascends on the right of the aorta, passing through the caval opening in the diaphragm at T8 to drain into the right atrium. It collects blood from the lower limbs, pelvis, and abdominal viscera including the kidneys and liver.
IVC filters are placed percutaneously to prevent pulmonary embolism in patients with lower extremity DVT who cannot receive anticoagulation. IVC thrombosis produces bilateral lower limb swelling and is associated with hypercoagulable states, IVC filters, and right-sided abdominal tumours, especially renal cell carcinoma with tumour thrombus extending into the IVC. The IVC and its relationship to major vessels is the primary anatomical consideration during retroperitoneal dissection and right hepatic lobe mobilisation.
Thrombotic occlusion of the inferior vena cava producing bilateral lower limb oedema and dilated abdominal wall collateral veins; causes include hypercoagulable states, IVC filter thrombosis, and tumour thrombus from renal cell carcinoma.
Venous tumour extension from renal cell carcinoma into the IVC, sometimes reaching the right atrium, requires complex surgical planning including possible cardiopulmonary bypass for suprarenal thrombus, with prognosis determined primarily by nodal and metastatic status rather than thrombus level.
