Combined pharmacomechanical thrombectomy for acute inferior vena cava filter thrombosis

Inferior vena cava (IVC) filter thrombosis has been reported to occur in up to 30% of cases and is associated with significant morbidity. The optimal treatment of IVC thrombosis has not been established to date. We report a case of IVC filter thrombosis with associated vena caval obstruction successfully treated with catheter-directed thrombolysis and adjunctive mechanical thrombectomy.     

Successful MitraClip® implantation after angioplasty of a chronic inferior vena cava filter thrombosis

The MitraClip® has increasing use for severe, high surgical risk mitral regurgitation (MR). The MitraClip® is implanted percutaneously across the interatrial septum. Given the large diameter of the device delivery system, the femoral vein is the best option for central venous access. This is the first reported case of successful MitraClip® implantation through a chronically occluded IVC filter. © 2015 Wiley Periodicals, Inc.     

Trauma-induced thrombosis of the inferior vena cava

A 25 year old foreign patient, in his native country had a blunt polytrauma of the abdomen and of the thigh. The consequence was a complete thrombosis of the vena cava inferior in a distal position to the junction with the liver veins. The diagnosis was realized with phlebography, angiography and computertomography. The diaphragmatic part of the vena cava inferior and the liver veins were not affected by the thrombosis. The increasing edemas of the shank and a stasis ulcer which were the reason for the patients admission to the hospital could be treated successfully by Furosemid and Phenprocoumon within a period of 4 weeks.     

Transpopliteal removal of an OptEase inferior vena cava filter after treatment of symptomatic filter thrombosis.

PURPOSE: To describe a case of transpopliteal retrieval of an inferior vena cava (IVC) filter. CASE REPORT: A paraplegic patient had an IVC filter placed for deep venous thrombosis (DVT) after anticoagulant therapy was stopped. Two weeks later, he developed massive scrotal and bilateral lower extremity swelling due to iliocaval thrombosis, which was treated by power pulse-spray thrombectomy and catheter-directed thrombolytic infusion via bilateral popliteal approaches. Following successful thrombus removal, the filter was uniquely retrieved via the right popliteal access; the patient was discharged on warfarin anticoagulation. CONCLUSION: Transpopliteal IVC filter retrieval is feasible and may be a useful alternative technique in selected instances.     

Perforation of inferior vena cava during filter placement

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.     

下腔静脉滤器在深静脉血栓介入治疗中的应用

目的 探讨下腔静脉滤器在深静脉血栓介入治疗中预防肺栓塞的应用价值。方法 35例下肢及盆腔静脉血栓病变患，分别经股静脉（32例）和锁骨下静脉（3例）放置血栓病变患，分别经股静脉（32例）和锁骨下静脉（3例）放置下腔静脉滤器，每例1枚，位置均为肾静脉开口下方，再行积极的介入治疗。结果 35枚滤器均放置成功，随访1-36个月，均未发生肺栓塞，亦未见滤器移位或倾斜，腔静脉阻塞等并发症；全部病人症状，体征明显改善。结论 在深静脉血栓介入治疗中，放置下腔静脉滤器是预防肺栓塞有效。安全的方法。     

Surgical management of a penetrated greenfield inferior vena cava filter

This is a case report of an IVC filter penetration identified during lymph-node dissection for endometrial carcinoma. Although the spread strut put the adjacent abdominal aorta in danger of penetration, surgical removal of the filter could not be performed because there was still an increased risk of pulmonary embolism. Instead of IVC interruption, we used a wrapping technique as a prophylaxis against major bleeding complication due to IVC filter dislocation and recurrent pulmonary embolism.     

Leiomyosarcoma of the inferior vena cava presenting as Budd-Chiari syndrome

A case of a 72-year-old male with a leiomyosarcoma of the inferior vena cava causing Budd-Chiari syndrome is described. Percutaneous decompression of the portal system was attempted but with no success. At autopsy, a large tumor arising from and completely obstructing the inferior vena cava was found, histologically proven to be a leiomyosarcoma. Over 50 cases of leiomyosarcoma of the inferior vena cava have been reported in the literature, the majority of which occurred in women and 1/3 of which were associated with the Budd-Chiari syndrome. Histologically up to two mitotic figures per 10 high power fields have been scored. This case indicates the unreliability of a low mitotic index as an indicator of benign behavior of smooth muscle neoplasms of the venous system.     

Ultrasonic diagnosis of thrombosis of the inferior vena cava

Ultrasonic scanning was used in 115 patients with suspected occlusion of vena cava inferior. Details of ultrasonic diagnosis of non-occlusive and occlusive thrombosis of vena cava inferior and vena cava compression from the outside, monitoring of the thrombosed vena cava and the antiembolic cava filter are discussed.     

Heparin-induced thrombocytopenia complicated with massive thrombosis of the inferior vena cava after filter placement.

A 45-year-old man presented with deep vein thrombosis of the right leg and bilateral pulmonary embolism. Heparin was administered on the initial one and a half days. On the 3rd day, an inferior vena cava (IVC) filter was placed with a heparin flush, after which massive IVC thrombosis developed. The platelet count was 221000/mm3, decreased 42% from the initial level, but remained within the normal range. Heparin was replaced by argatroban on the 13th day. The platelet count increased to 355000/mm3 on the 15th day. The patient was positive for antibody against complexes of heparin and platelet factor 4, and was diagnosed as heparin-induced thrombocytopenia with thrombosis syndrome (HITTS). When thrombosis develops during heparin treatment, it is important to suspect HITTs and to assay for the associated antibodies, regardless of the actual platelet count.     

下腔静脉滤器的应用现状与进展

静脉血栓栓塞症是一种常见病、多发病,部分患者可发生致命性肺梗死。下腔静脉滤器是一种预防肺动脉栓塞发生的滤过装置,其发展经历了较为漫长的历史。随着滤器应用的逐渐广泛,效果好、并发症少的可回收型滤器成为发展方向。文章就各种滤器的应用和优缺点进行简要综述。     

下腔静脉滤器的临床应用及进展

深静脉血栓形成是导致肺栓塞的最主要原因,预防血栓脱落至肺动脉尤为重要.近年来,下腔静脉滤器广泛应用于临床,可以有效预防深静脉血栓形成所致肺栓塞.本文就下腔静脉滤器的发展史、适应证、并发症、临床效果评价及新型下腔静脉滤器等方面展开讨论.