Inferior Vena Cava (IVC) Wall Penetration by IVC Filter Detected Incidentally During Retroperitoneal Lymphadenectomy

The placement of an inferior vena cava (IVC) filter is a therapeutic method for selected patients with deep venous thrombosis and pulmonary embolism. However, insertion and placement of the filter may be associated with certain complications. For instance, retroperitoneal hematoma resulting from perforation of the wall by the filter is such a very rare but serious complication. We report the case of a 64-year-old woman with perforation of the IVC wall and consecutive hematoma caused by the filter who was treated surgically.

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A case report of pulmonary vein isolation with radiofrequency catheter using superior vena cava approach in patient with paroxysmal atrial fibrillation and inferior vena cava filter

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa562 ◽

2021 ◽

Vol 5 (2) ◽

Author(s):

Masatoshi Narikawa ◽

Masayoshi Kiyokuni ◽

Junya Hosoda ◽

Toshiyuki Ishikawa

Keyword(s):

Atrial Fibrillation ◽

Inferior Vena Cava ◽

Left Atrium ◽

Inferior Vena ◽

Superior Vena ◽

Vena Cava ◽

Ivc Filter ◽

Transseptal Puncture ◽

Mapping Catheter ◽

Steerable Sheath

Abstract Background Transseptal puncture and pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF) are generally performed via the inferior vena cava (IVC). However, in cases where the IVC is inaccessible, a specific strategy may be needed. Case summary An 86-year-old woman with paroxysmal AF and an IVC filter in situ was referred to our hospital for ablation therapy. An IVC filter for pulmonary embolism and deep venous thrombosis had been implanted 15 years prior, therefore we selected a transoesophageal echocardiography (TOE)-guided transseptal puncture using a superior vena cava (SVC) approach. After the single transseptal puncture, we performed fast anatomical mapping, voltage mapping by multipolar mapping catheter, and then PVI by contact force-guided radiofrequency catheter using a steerable sheath. Following the ablation, bidirectional conduction block between the four pulmonary veins and the left atrium was confirmed by both radiofrequency and mapping catheter. No complications occurred and no recurrence of AF was documented in the 12 months after the procedure. Discussion When performing a transseptal puncture during AF ablation, an SVC approach, via access through the right internal jugular vein, enables the sheath to directly approach the left atrium without angulation and improves operability of the ablation catheter. Combining the use of general anaesthesia, TOE, a steerable sheath, and contact force-guided ablation may contribute to achieving minimally invasive PVI with a single transseptal puncture via an SVC approach.

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Retroperitoneal Laparoscopic-Assisted Retrieval of Wall-Penetrating Inferior Vena Cava Filter After Endovascular Techniques Failed: An Initial Clinical Outcome

Vascular and Endovascular Surgery ◽

10.1177/15385744211022517 ◽

2021 ◽

pp. 153857442110225

Author(s):

Haidong Wang ◽

Zhenhua Liu ◽

Xiaofei Zhu ◽

Jianlong Liu ◽

Libo Man

Keyword(s):

Deep Vein Thrombosis ◽

Inferior Vena Cava ◽

Inferior Vena ◽

Vena Cava ◽

Ivc Filter ◽

Endovascular Techniques ◽

Vein Thrombosis ◽

Ivc Filters ◽

Laparoscopic Assisted ◽

Deep Vein

Background: Inferior vena cava (IVC) filters are commonly used in China to prevent pulmonary embolisms in patients with deep vein thrombosis. However, IVC filter removal is complicated when the filter has penetrated the IVC wall and endovascular techniques usually fail. The purpose of this study was to evaluate the effectiveness and safety of retroperitoneal laparoscopic-assisted retrieval of wall-penetrating IVC filters after endovascular techniques have failed. Patients and Methods: We retrospectively evaluated a series of 8 patients who underwent retroperitoneal laparoscopic-assisted retrieval of a wall-penetrating IVC filter between December 2017 and November 2019. All patients had experienced at least 1 failure with endovascular retrieval before the study. The filters were slanted and the proximal retrieval hooks penetrated the posterior lateral IVC wall in all patients on computed tomography. Demographic information, operation parameters, and complications were recorded and analyzed. All patients were followed up for at least 12 months. Results: The procedure was successful in all patients. The median surgery time was 53.6 ± 12.7 min and the average blood loss was 45.0 ± 13.5 ml. No serious complication occurred during the patients’ hospitalization, which was an average of 6.4 days. The median follow-up time was 15.1 months, and no patient had deep vein thrombosis recurrence. Conclusions: Retroperitoneal laparoscopic-assisted retrieval is a feasible and effective technique, particularly when proximal retrieval hooks penetrate the posterior lateral wall of the IVC after endovascular techniques have failed. To some extent, the development of this technique at our institution has increased the success rate of filter removal and improved patient satisfaction.

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Caval Penetration with Retroperitoneal Hemorrhage Following Placement of an Inferior Vena Cava (IVC) Filter

Seminars in Interventional Radiology ◽

10.1055/s-2007-985741 ◽

2007 ◽

Vol 24 (3) ◽

pp. 312-315 ◽

Cited By ~ 1

Author(s):

Andy Brown ◽

Michael Miller ◽

Tony Smith

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Vena Cava ◽

Ivc Filter ◽

Retroperitoneal Hemorrhage

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Practice patterns of retrievable inferior vena cava filters and predictors of filter retrieval in patients with pulmonary embolism

Vascular Medicine ◽

10.1177/1358863x17726596 ◽

2017 ◽

Vol 22 (6) ◽

pp. 512-517 ◽

Cited By ~ 2

Author(s):

Jieun Kang ◽

Heung-Kyu Ko ◽

Ji Hoon Shin ◽

Gi-Young Ko ◽

Kyung-Wook Jo ◽

...

Keyword(s):

Pulmonary Embolism ◽

Inferior Vena Cava ◽

Predictive Factors ◽

Inferior Vena ◽

Vena Cava ◽

Ivc Filter ◽

Retrieval Rate ◽

Filter Retrieval ◽

Ivc Filters ◽

Filter Insertion

Retrievable inferior vena cava (IVC) filters are increasingly used in patients with venous thromboembolism (VTE) who have contraindications to anticoagulant therapy. However, previous studies have shown that many retrievable filters are left permanently in patients. This study aimed to identify the common indications for IVC filter insertion, the filter retrieval rate, and the predictive factors for filter retrieval attempts. To this end, a retrospective cohort study was performed at a tertiary care center in South Korea between January 2010 and May 2016. Electronic medical charts were reviewed for patients with pulmonary embolism (PE) who underwent IVC filter insertion. A total of 439 cases were reviewed. The most common indication for filter insertion was a preoperative/procedural aim, followed by extensive iliofemoral deep vein thrombosis (DVT). Retrieval of the IVC filter was attempted in 44.9% of patients. The retrieval success rate was 93.9%. History of cerebral hemorrhage, malignancy, and admission to a nonsurgical department were the significant predictive factors of a lower retrieval attempt rate in multivariate analysis. With the increased use of IVC filters, more issues should be addressed before placing a filter and physicians should attempt to improve the filter retrieval rate.

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USE OF SUPRA RENAL RETRIEVABLE INFERIOR VENA CAVA (IVC) FILTER IN CONJUNCTION WITH EKOS FOR TREATMENT OF EXTENSIVE IVC THROMBOSIS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(18)32706-2 ◽

2018 ◽

Vol 71 (11) ◽

pp. A2165

Author(s):

Rahul Vasudev ◽

Sahitya Posimreddy ◽

Upamanyu Rampal ◽

Hiten Patel ◽

Razan Shamoon ◽

...

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Vena Cava ◽

Ivc Filter ◽

Ivc Thrombosis

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Retrospective analysis of outcomes following inferior vena cava (IVC) filter placement in a managed care population

Journal of Thrombosis and Thrombolysis ◽

10.1007/s11239-017-1507-z ◽

2017 ◽

Vol 44 (2) ◽

pp. 179-189 ◽

Cited By ~ 6

Author(s):

Damian Everhart ◽

Jamieson Vaccaro ◽

Karen Worley ◽

Teresa L. Rogstad ◽

Mitchel Seleznick

Keyword(s):

Managed Care ◽

Inferior Vena Cava ◽

Retrospective Analysis ◽

Inferior Vena ◽

Vena Cava ◽

Ivc Filter ◽

Filter Placement

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Duplication of the Inferior Vena Cava in a Patient Presenting for IVC Filter Placement

The Journal of Vascular Access ◽

10.1177/112972981001100215 ◽

2010 ◽

Vol 11 (2) ◽

pp. 162-164 ◽

Cited By ~ 5

Author(s):

Danny Cheng ◽

Steven M. Zangan

Keyword(s):

Inferior Vena Cava ◽

Protein C ◽

Inferior Vena ◽

Vena Cava ◽

Factor V Leiden ◽

Clinical Implications ◽

Factor V ◽

Ivc Filter ◽

Protein C Deficiency ◽

Filter Placement

Given the complex embryogenesis of the inferior vena cava (IVC), anatomic variations are commonly encountered. Duplication of the IVC occurs in up to 2.8% of the population. Though asymptomatic, a duplicated IVC has important clinical implications when attempting caval filtration. We present the case of a 45- year-old male with factor V leiden and protein C deficiency, who required cessation of warfarin anticoagulation in preparation for cervical laminectomy. The patient had a duplicated IVC and required placement of a caval filter in each IVC.

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