In Reply to: Re: Case 997_08 -- Filter placement in a patient with a large collateral vein posted by Scott Trerotola on September 18, 1997 at 14:14:57:
The accessory left renal vein does occasionally communicate with the main renal vein in the renal sinus, an example of which is shown in Figure 42-12 on page 949 of the third edition of Abrams Angiography. We have also noted 1 or 2 cases of this in the last few years, when we selectively injected the accessory renal vein to better characterize it prior to filter deployment. As mentioned already, the solution is to deploy the filter peripheral to the accessory left renal vein.