Indian Journal of Radiology Indian Journal of Radiology  

   Login   | Users online: 767

Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size     

 

VASCULAR AND INTERVENTIONAL RADIOLOGY Table of Contents   
Year : 2015  |  Volume : 25  |  Issue : 3  |  Page : 233-238
Endovascular treatment of thrombosed inferior vena cava filters: Techniques and short-term outcomes


1 Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan, USA
2 Department of Vascular Surgery, University of Michigan Health System, Ann Arbor, Michigan, USA

Correspondence Address:
Dr. Mohammad Arabi
Department of Radiology, UH B2-A209, 1500 East Medical Center Drive, Ann Arbor, Michigan - 48109-5030
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-3026.161436

Rights and Permissions

Purpose: To present the techniques for endovascular treatment of thrombosed filter-bearing inferior vena cavae (IVCs), along with short-term clinical and imaging follow-up. Materials and Methods: A total of 45 consecutive patients (17 females and 28 males), aged 19-79 years (mean age of 49 years), who had IVC filter placement complicated by symptomatic acute or chronic iliocaval thrombosis and underwent endovascular therapy were studied. All patients presented with lower extremity swelling and/or pain. One patient also had bilateral lower extremity swelling and chronic gastrointestinal (GI) bleeding which was secondary to chronic systemic to portal venous collaterals. Patients underwent one or more of the following endovascular treatments depending on the chronicity and extent of thrombosis: (a) catheter-directed thrombolysis (CDT) (n = 25), (b) pharmacomechanical thrombolysis (PMT) (n = 15), (c) balloon angioplasty (n = 45), and/or (d) stent placement across the filter (n = 42). In addition, 16 patients underwent groin arteriovenous fistula (AVF) creation (36%) and 3 (7%) had femoral venous thrombectomy to improve flow in the recanalized iliac veins and IVCs. Results: Anatomical success was achieved in all patients. Follow-up was not available in 10 patients (lost to follow-up, n = 4; expired due to comorbidities, n = 2; lost to follow-up after re-intervention, n = 4). At a mean follow-up time of 13.3 months (range 1-48 months), clinical success was achieved in 27 patients (60%), i.e. in 21 patients without re-intervention and in 6 patients with re-intervention. Clinical success was not achieved despite re-intervention in eight patients. Higher clinical success was noted in patients who did not require repeat interventions (P = 0.03) and the time to re-intervention was significantly shorter in patients who had clinical failure (P = 0.01). AVF creation did not improve the clinical success rate (P = 1). There was no significant difference in clinical success between patients who had acute or subacute thrombosis compared to those who had chronically occluded filter-bearing IVCs (P = 1). Conclusion: This study suggests that endovascular therapy for thrombosed filter-bearing IVCs is safe and technically feasible.


[FULL TEXT] [PDF]*
Print this article     Email this article

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
  Citation Manager
 Access Statistics
  Reader Comments
  Email Alert *
  Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed2782    
    Printed60    
    Emailed0    
    PDF Downloaded223    
    Comments [Add]    

Recommend this journal