Preaortic iliac vein and double inferior vena cava

A 64-year-old man was admitted to our hospital for surgery of an abdominal aortic aneurysm (AAA). Computed tomography showed the AAA, both common iliac arterial aneurysms, and anomalies of the retroperitoneal venous system. Three-dimensional volume-rendered reconstruction clearly demonstrated the preaortic iliac veins and the double inferior vena cava (A/Cover). The left common iliac vein (CIV) crossed over the right common iliac artery (CIA) and the right CIV was also located anterior to the right CIA. Both CIVs were parallel to the right side of the abdominal aorta, as the double inferior vena cava. The confluent position of both CIVs was superior to the right renal artery and, thereafter, the common inferior vena cava was formed. In addition, the left renal vein was positioned behind the abdominal aorta. The AAA was replaced by open surgery with a quadrifurcated prosthesis. The right limbs of the graft tunneled through the former the right CIA and were placed behind the right CIV (B). Postoperative computed tomography showed that all four branches of the graft were patent, and the venous drainage was satisfactory (C). The patient was discharged 10 days after the surgery without complications. The patient has consented to publication.