Superior vena caval placement of a temporary filter: a case report.

Placement of permanent filters in the superior vena cava (SVC) for preventing pulmonary embolism (PE) arising from thrombi superior to the right atrium has rarely been performed. The authors report the first case of temporary filter insertion in the SVC because of upper extremity thrombosis accompanied with PE. After thrombectomy, the temporary filter was successfully removed. It is recommended to use a temporary filter, especially in young patients with upper extremity thrombosis requiring temporary prophylaxis against PE.     

Entrapment of an exchange wire by an inferior vena caval filter: a technique for removal

The anesthesiology literature does not describe entrapment of a guidewire by an inferior vena caval filter. Because anesthesiologists are involved in central access in various perioperative and intraoperative settings, consideration of this complication is important. A case of guidewire entrapment by an inferior vena caval filter and a unique technique for removal of the entrapped wire is presented.     

Delayed retroperitoneal arterial hemorrhage after inferior vena cava (IVC) filter insertion: case report and literature review of caval perforations by IVC filters

Transvenous placement of inferior vena cava (IVC) filters has become commonplace in selected patients with deep venous thrombosis (DVT) and pulmonary embolism (PE). IVC filters have been shown to have excellent therapeutic efficacy and low complication rates. Penetration of the IVC by filter hooks or struts has been reported and commonly noted to be inconsequential. We report a laceration of a lumbar artery by a stainless steel Greenfield (SSG) filter strut that resulted in a near fatal hemorrhage, and review the world literature on caval perforation by IVC filters.     

Knotting of an epidural catheter: a case report.

Difficulty with removal of an epidural catheter is described due to formation of a knot near the end of the catheter. It is stressed that in the lumbar area an epidural catheter should never be inserted more than 5 cm into the epidural space, as curling with knot formation may occur. Removal may be attempted by pulling on the catheter if testing of a similar catheter indicates that it will withstand the tension. The patient and the spouse should be kept informed and involved in the decision-making for medico-legal reasons.     

Secondary migration of a central venous catheter. A case report

A case of central venous catheter (CVC) secondary migration in a patient with Hodgkin's lymphoma is reported. The catheter was inserted in the right internal jugular vein with anterior approach. The correct position of the catheter tip in the superior vena cava was confirmed by X-ray. Secondary migration to the right subclavian vein, without displacement at the point of insertion, was reported 8 days later by a chest X-ray performed for worsening of the respiratory condition. CVC was removed and reinserted with the same procedure. The correct position of the catheter tip was confirmed by thoracic radiography till 10 days later. Epidemiological data present in the literature and secondary migration predisposing factors are reported.     

Endovascular repair of an iatrogenic superior vena caval injury: a case report

We present the case of a patient with an iatrogenic injury to the superior vena cava during a central venous catheter placement. The vena cava was perforated when a left subclavian dialysis catheter was placed. The perforation in the right side of the vena cava occurred at the confluence of the innominate veins. This perforation was successfully repaired using a 10 mm Viabahn stent graft (W. L. Gore, Flagstaff, Ariz) delivered through a femoral approach. The stent graft was deployed as the dialysis catheter was removed. This case demonstrates the utility of stent graft repair of the superior vena cava in emergency situations.     

Bacterial endocarditis due to an infected peritoneal dialysis catheter. A case report

The diagnosis of infective endocarditis may be difficult in the patient with renal failure. The usual source of infection is a septic vascular access site. We present a case in which endocarditis developed from an infected peritoneal dialysis catheter.     

Entrapment of a cerebral embolic protection device--a case report

Cerebral protection devices have significantly reduced the incidence of embolic events in patients undergoing carotid stenting. With the increasing availability of such devices an awareness of the potential complications associated with their deployment is essential. Here we report a patient with entrapment of a filter device within a carotid stent that required surgical removal. The mechanisms underlying this complication and measures to prevent its occurrence are discussed.     

Entrapment neuropathy due to bilateral epitrochleoanconeus muscles: a case report.

A case of bilateral entrapment of the ulnar nerves due to accessory epitrochleoanconeus muscles was observed in a young athlete. Hypertrophy of this muscle may be one of the causes of cubital tunnel syndrome.     

Delayed subarachnoid migration of an epidural catheter: a case report

We often experience migration of an epidural catheter into an undesirable space. Migration of an epidural catheter into the subarachnoid space is a potentially lethal complication. Although almost all migrations of epidural catheters have been reported to occur at insertion of the catheter, we experienced a case of catheter migration into the subarachnoid space two days after its insertion. The symptoms caused by this migration were motor paralysis in the lower extremities and sensory disturbance of the trunk. Neurological and hemodynamic changes in a patient who is undergoing continuous epidural infusion of local anesthetics should be monitored carefully.     

Management of infected caval filter with simultaneous aortic pseudoaneurysm and retroperitoneal perforation: a case report and literature review

Inferior vena cava (IVC) filters have been reported to have complication rates up to 35%. Penetration of surrounding retroperitoneal structures is an uncommon, but potentially serious, complication, with several reports in the literature. We present a unique case of a 34-year-old intravenous drug user with infected IVC filter struts penetrating multiple structures simultaneously. Definitive operative management was necessary for removal of filter struts from the aorta, the second part of the duodenum and the iliopsoas muscle. Drainage and debridement of an associated iliopsoas abscess was performed, followed by aortic and caval reconstruction.