There are no definitive evidence-based treatments for IVC atresia. Placement of an IVC filter for IVC-atresia-associated DVT is difficult, as the position of the filter must be below the origin of collateral veins to effectively prevent clot migration. A filter may be considered in the low infrarenal IVC, but if this position is not technically feasible, bilateral iliac vein filters may be warranted. In the setting of bilateral ileofemoral DVT, lumbar collateral thromboses, and IVC atresia, an IVC filter cannot be effectively placed to prevent clot migration. Placing several filters in the multiple collaterals would be unwieldy and, moreover, an IVC filter may further compromise blood return by exacerbating the low-flow state.