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The incidence of traumatic inferior vena cava (IVC) injury is infrequent but is associated with high mortality. No clear and current society-based guidelines are available to dictate the role of endovascular therapy. In the present case report, we have described a unique clinical presentation of a patient in extremis after emergent exploratory laparotomy who had experienced an IVC injury that could not be controlled with open surgery. The IVC injury was treated with an endovascular approach with a Gore TAG endograft (W.L. Gore & Associates, Flagstaff, AZ). We have reported a technique for successful treatment of a complex IVC injury, with the aim of adding to the current body of literature supporting the use of endovascular approaches., (© 2022 Published by Elsevier Inc. on behalf of Society for Vascular Surgery.)

We present the case of a 66-year-old woman with severe aortoiliac occlusive disease (TASC-D) and an incidental finding of a left sided inferior vena cava, discovered on the preoperative computed tomography scan. This uncommon congenital finding can create intraoperative challenges to the vascular surgeon. In this case report, we have described this anatomic variant and elaborated on our surgical technique to suggest a few tips and tricks for addressing these cases., (© 2022 The Authors.)