From the Research
Congenital absence of the left common iliac vein is an extremely rare vascular anomaly, with significant clinical implications for patients, particularly in terms of increased risk of deep vein thrombosis and post-thrombotic syndrome, as highlighted in a recent study 1. This condition occurs when the left common iliac vein fails to develop properly during embryonic development. The clinical implications are generally minimal in most individuals, as the body typically develops collateral venous drainage pathways to compensate for the missing vessel. However, some patients may experience symptoms such as left leg swelling, pain, or venous insufficiency due to inadequate collateral circulation.
Key Considerations
- The condition becomes clinically significant when patients require procedures involving the iliac veins, such as inferior vena cava filter placement, venous sampling, or catheterization, as standard approaches may be impossible, as noted in a case report 2.
- Diagnostic imaging with CT venography or MR venography is essential when this anomaly is suspected, as it can help identify the absence of the left common iliac vein and guide further management.
- Management is typically conservative unless symptoms are severe, in which case endovascular interventions to improve venous return may be considered, as discussed in a review of contemporary management of deep venous thrombosis 3.
- Healthcare providers should be aware of this rare anomaly when evaluating patients with asymmetric lower extremity swelling or when planning procedures involving the iliac venous system, as anatomical variations can significantly impact procedural success and patient outcomes, as emphasized in a study on prevention and management of post-thrombotic syndrome 4.
Clinical Implications
- Patients with congenital absence of the left common iliac vein may be at increased risk of developing post-thrombotic syndrome, which can have significant clinical and economic consequences, as highlighted in a narrative review 1.
- Anticoagulation therapy may be effective in preventing post-thrombotic syndrome in these patients, particularly with the use of low molecular weight heparins or direct oral anticoagulants, as suggested by recent studies 1.