Congenital absence of the inferior vena cava with bilateral iliofemoral acute deep venous thrombosis

Iliofemoral acute deep venous thrombosis (DVT) poses increased risk for post-thrombotic syndrome. Absent inferior vena cava (IVC) syndrome is a rare vascular anomaly that can be associated with idiopathic DVT in the young patient. It remains unclear whether endovenous thrombolytic intervention for DVT in patients with absent IVC can be successful, given the impaired venous outflow. This case report describes revascularization of bilateral iliofemoral and femoropopliteal DVT using endovascular pharmacomechanical thrombolysis and thrombectomy in a patient with underlying absent IVC syndrome to prevent post-thrombotic morbidity.