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Andreoli JM, Thornburg BG, Hickey RM. Inferior Vena Cava Filter-Related Thrombus/Deep Vein Thrombosis: Data and Management. Semin Intervent Radiol 2016; 33:101-4. [PMID: 27247478 DOI: 10.1055/s-0036-1581087] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Recurrent deep venous thrombosis and inferior vena cava (IVC) thrombosis are well-described complications following IVC filter placement. IVC thrombosis ranges in severity of clinical presentation, but can lead to significant morbidity and mortality with incidence rates depending on patient population and type of filter used. Endovascular therapies such as catheter-directed thrombolysis, mechanical thrombectomy, balloon venoplasty, and stenting are safe and effective in restoration of venous patency.
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Affiliation(s)
- Jessica M Andreoli
- Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, Illinois
| | - Bartley G Thornburg
- Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, Illinois
| | - Ryan M Hickey
- Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, Illinois
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Karageorgiou J, Fowler K, Vedantham S, Saad N. Endovascular intervention for deep venous thrombosis in patients with inferior vena cava filters. Vasc Med 2016; 21:459-466. [PMID: 27178760 DOI: 10.1177/1358863x16649678] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patients with inferior vena cava (IVC) filter-associated deep venous thrombosis (DVT) are a challenging subset of patients for endovascular intervention. Given the lack of available data pertaining to this clinical scenario, the purpose of this study was to evaluate the authors' experience with the use of endovascular treatment for DVT in patients with IVC filters. Primary aims included assessing the technical and clinical success, complications, and clinical patency in these patients. This was a retrospective single-center review of adult patients with IVC filters undergoing endovascular treatment of DVT between 1/2005 and 4/2014. Patient electronic medical records were reviewed for demographic data, anticoagulation status, symptoms, symptomatic extremities, extent of thrombosis, therapies received, technical and clinical success, and complications. Query yielded 82 patients (mean 53 years, range 18-96; 66% male), all of whom were included in our analysis. The majority of patients presented with lower extremity pain and swelling, with extensive clot burden despite the use of anticoagulant medication. Treatment elements utilized included pharmacologic lysis in 92%, mechanical thrombectomy in 77%, angioplasty in 63% and stent placement in 50% of patients. Interventions were technically successful in restoring flow in 87% of patients, and clinically successful in improving presenting symptoms in 79% of patients. By SIR criteria, 24% of patients experienced complications (categorized as 10% minor and 14% major). There were two deaths from intracranial hemorrhage. The probability of thrombosis-free survival at 1, 3, 6, 9 and 12 months was 0.85 (CI 0.74-0.93), 0.81 (CI 0.69-0.89), 0.74 (CI 0.62-0.83), 0.70 (CI 0.57-0.8) and 0.70 (CI 0.57-0.8), respectively. Endovascular interventions are usually effective in relieving symptoms in patients with DVT and pre-existing IVC filters. However, these outcomes are achieved with significant complication rates that may exceed those observed when endovascular therapy is provided for other DVT populations.
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Affiliation(s)
- John Karageorgiou
- Department of Radiology, Mallinckrodt Institute of Radiology, St Louis, MO, USA
| | - Kathryn Fowler
- Department of Radiology, Mallinckrodt Institute of Radiology, St Louis, MO, USA
| | - Suresh Vedantham
- Department of Radiology, Mallinckrodt Institute of Radiology, St Louis, MO, USA
| | - Nael Saad
- Department of Radiology, Mallinckrodt Institute of Radiology, St Louis, MO, USA
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Pharmacomechanical Thrombolysis in the Management of Acute Inferior Vena Cava Filter Occlusion Using the Trellis-8 Device. J Endovasc Ther 2015; 22:99-104. [DOI: 10.1177/1526602814564369] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: To evaluate the performance and safety of the Trellis-8 system, a pharmacomechanical thrombolysis infusion catheter, and adjunctive therapies in the treatment of symptomatic inferior vena cava (IVC) filter–related acute thrombotic occlusion. Methods: Eight consecutive patients (6 men; mean age 57.4 years, range 34–78 years) with acute thrombotic occlusion of the IVC in the presence of an IVC filter underwent percutaneous venous thrombectomy using the Trellis-8 thrombectomy system and adjunctive techniques between January 2009 and November 2013. Demographics, clinical data, procedures, and outcomes were retrospectively reviewed. All patients had clinical signs of lower extremity venous hypertension on presentation. The median time between IVC filter placement and occlusion was 25 months. Patients were followed for the development of thromboembolic complications to the last clinic visit or until they died. Results: The procedure was technically successful in 6 patients, whereas it could not be performed in 2 due to failure to cross the occlusion. The median follow-up period was 7.8 months, at which time all patients undergoing successful Trellis-8 thrombectomy had relief of symptoms without thromboembolic or bleeding complications. Conclusion: In this limited performance and safety evaluation, the Trellis-8 thrombectomy system combined with adjunctive therapies, such as mechanical thrombectomy and balloon angioplasty, was effective in 75% of patients with IVC filter–related acute caval occlusion.
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Sildiroglu O, Ozer H, Turba UC. Management of the thrombosed filter-bearing inferior vena cava. Semin Intervent Radiol 2012; 29:57-63. [PMID: 23449290 PMCID: PMC3348765 DOI: 10.1055/s-0032-1302453] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Inferior vena cava (IVC) filter thrombosis is a complex problem. Thrombus within an IVC filter may range from an asymptomatic small thrombus to critical IVC occlusion that affects both lower extremities. The published experience of IVC thrombosis management in relation to filters is either anecdotal or limited to a small group of patients; however, endovascular treatment methods appear to be safe and effective in patients with IVC thrombosis. This review focuses on filter-related IVC thrombosis and its endovascular management.
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Affiliation(s)
- Onur Sildiroglu
- University of Virginia Health System, Charlottesville, Virginia
| | - Harun Ozer
- University of Virginia Health System, Charlottesville, Virginia
| | - Ulku Cenk Turba
- University of Virginia Health System, Charlottesville, Virginia
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5
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Power-Pulse Thrombolysis and Stent Recanalization for Acute Post-Liver Transplant Iliocaval Venous Thrombosis. Cardiovasc Intervent Radiol 2008; 31 Suppl 2:S166-70. [DOI: 10.1007/s00270-007-9261-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2007] [Revised: 11/22/2007] [Accepted: 11/28/2007] [Indexed: 11/26/2022]
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Stecker MS, Chahin C. Transpopliteal removal of an OptEase inferior vena cava filter after treatment of symptomatic filter thrombosis. J Endovasc Ther 2007; 14:411-5. [PMID: 17723009 DOI: 10.1583/06-1999.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
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.
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Affiliation(s)
- Michael S Stecker
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
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Yamada N, Ishikura K, Ota S, Tsuji A, Nakamura M, Ito M, Isaka N, Nakano T. Pulse-spray Pharmacomechanical Thrombolysis for Proximal Deep Vein Thrombosis. Eur J Vasc Endovasc Surg 2006; 31:204-11. [PMID: 16169262 DOI: 10.1016/j.ejvs.2005.08.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2005] [Accepted: 08/14/2005] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the efficacy, safety, and feasibility of pulse-spray pharmacomechanical thrombolysis to treat proximal deep vein thrombosis (DVT) in conjunction with the placement of a non-permanent IVC filter. METHODS We studied 31 consecutive patients with acute proximal DVT defined as the inferior vena cava (IVC), iliac vein and/or femoral vein, who were diagnosed using duplex ultrasonography and/or contrast venography. All were treated with pulse-spray urokinase. Early success was assessed by comparing the pre- and post-treatment venographic severity score. Non-permanent IVC filters were used to reduce the risk of pulmonary thromboembolism. RESULTS The average total urokinase dose was 1.71 million IU (range: 0.72-3.6 million IU) and the average duration of therapy was 2.4 days. The average percentage of thrombus lysed was 85% (range: 22-100%). A large thrombus trapped by the filter was detected using cavography before extraction of the filter in one patient. There was no major treatment-related adverse event. CONCLUSION The combination of pulse-spray pharmacomechanical thrombolysis and the prophylactic use of a non-permanent IVC filter was a safe and effective approach for treating acute proximal DVT.
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Affiliation(s)
- N Yamada
- First Department (Cardiovascular Division) of Internal Medicine, Mie University School of Medicine, Tsu, Mie, Japan.
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Baldwin ZK, Comerota AJ, Schwartz LB. Catheter-directed thrombolysis for deep venous thrombosis. Vasc Endovascular Surg 2004; 38:1-9. [PMID: 14760472 DOI: 10.1177/153857440403800101] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Venous thromboembolism (VTE) represents a significant clinical problem, affecting patients of all age groups, nationalities, and socioeconomic strata. Despite its prevalence, the paradigms for care are largely centered around primary or secondary prophylaxis, with less emphasis on actual treatment of the thrombus. With the recent rapid development of advanced endovascular techniques, it is now feasible to dissolve many thrombi using catheter-directed thrombolysis (CDT), and favorable clinical experience has been reported in over 600 patients. If performed safely, the purported benefits of CDT for DVT include a decreased incidence of persistent phlebitic symptoms, improved quality of life and, possibly, a decreased incidence of recurrent thrombotic events.
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Affiliation(s)
- Zachary K Baldwin
- Section of Vascular Surgery, Department of Surgery University of Chicago, Chicago, IL, USA
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Vedantham S, Vesely TM, Parti N, Darcy MD, Pilgram TK, Sicard GA, Picus D. Endovascular recanalization of the thrombosed filter-bearing inferior vena cava. J Vasc Interv Radiol 2003; 14:893-903. [PMID: 12847197 DOI: 10.1097/01.rvi.0000083842.97061.c9] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To evaluate the authors' preliminary experience with use of endovascular methods to treat inferior vena cava (IVC) thrombosis in patients with IVC filters. MATERIALS AND METHODS Catheter-directed thrombolysis, balloon maceration, mechanical thrombectomy, and stent placement were used to treat 10 patients with thrombosis of filter-bearing IVCs causing symptoms in 18 limbs. Procedural challenges, technical and clinical success, complications, postprocedural filter status, and postprocedural pulmonary embolism (PE) prophylaxis were monitored. RESULTS Technical and clinical success were achieved in 15 of 18 (83%) and 14 of 18 symptomatic limbs (78%), respectively. Major bleeding (muscular hematoma) occurred in one patient (10%). Postprocedural PE prophylaxis included anticoagulation (n = 8) and placement of a new filter into a newly placed Wallstent (n = 1). During clinical follow-up, no clinically detectable PE was observed. Data pertaining to late limb status were available at a median of 19 months (range 1-46 months) follow-up in seven patients: three patients were asymptomatic, two patients had ambulatory edema only, one patient had constant mild edema, and one patient had constant severe edema. Postprocedural filter stability was radiographically documented at a median of 255 days (range, 4-1021 d) of follow-up. CONCLUSION Endovascular recanalization of the occluded IVC is feasible even in the presence of an IVC filter.
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Affiliation(s)
- Suresh Vedantham
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Box 8131, St. Louis, Missouri 63110, USA.
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Sharafuddin MJ, Sun S, Hoballah JJ, Youness FM, Sharp WJ, Roh BS. Endovascular management of venous thrombotic and occlusive diseases of the lower extremities. J Vasc Interv Radiol 2003; 14:405-23. [PMID: 12682198 DOI: 10.1097/01.rvi.0000064849.87207.4f] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Acute complications of deep vein thrombosis (DVT) of the lower extremities include pulmonary embolism and venous ischemia. Delayed complications include a spectrum of debilitating symptoms referred to as postthrombotic syndrome (PST). Anticoagulation therapy is recognized as the mainstay of therapy in acute DVT. However, there are few data to suggest any major beneficial effect on PTS, which is thought to be mediated by valve damage and/or occlusive chronic thrombus and venous scarring. Endovascular catheter-directed thrombolysis techniques with pharmacologic thrombolytic agents, used alone or in combination with mechanical thrombectomy devices, have been proven highly effective in clearing acute DVT, which may allow the preservation of venous valve function and prevention of subsequent venous occlusive disease. Definitive management of underlying anatomic occlusive abnormalities can also be undertaken.
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Affiliation(s)
- Melhem J Sharafuddin
- Department of Radiology, University of Iowa College of Medicine, 200 Hawkins Drive, Iowa City, Iowa 52242-1077, USA.
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Robinson A, Fellows KE, Bridges ND, Rome JJ. Effectiveness of pharmacomechanical thrombolysis in infants and children. Am J Cardiol 2001; 87:496-9, A8. [PMID: 11179547 DOI: 10.1016/s0002-9149(00)01416-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Between March 1995 and February 2000, 10 children with major thromboses were treated with local pharmacomechanical thrombolysis. Clinical improvement was found in 8 patients: follow-up angiography showed complete thrombus resolution in 5 patients and subtotal resolution in 4.
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Affiliation(s)
- A Robinson
- Cardiac Center at the Children's Hospital of Philadelphia, and the Department of Pediatrics, The University of Pennsylvania School of Medicine, USA
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Angle JF, Matsumoto AH, Al Shammari M, Hagspiel KD, Spinosa DJ, Humphries JE. Transcatheter regional urokinase therapy in the management of inferior vena cava thrombosis. J Vasc Interv Radiol 1998; 9:917-25. [PMID: 9840035 DOI: 10.1016/s1051-0443(98)70422-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To study the efficacy of local infusion of urokinase (UK) in the treatment of symptomatic inferior vena cava (IVC) thrombosis. MATERIALS AND METHODS Eight patients (five men and three women) who ranged in age from 19 years to 75 years (mean, 56 years) with symptomatic IVC thrombosis underwent local catheter-directed infusion of UK with use of up to three access sites. Infrarenal IVC thrombus and iliac vein thrombus was identified in all patients. Four patients had extension of thrombus proximal to the renal veins. Seven of eight patients had at least one risk factor for IVC thrombosis: hypercoagulable state (n = 3), IVC filter (n = 3), malignancy (n = 2), recent surgery (n = 2), and oral contraceptive use (n = 1). No serious procedure-related complications were encountered, although one patient died 5 days after UK therapy of pulmonary failure due to advanced lung cancer. UK was infused for an average of 79 hours (range, 24-140 hours) and a mean total dose of 7.4 million U of UK (range, 2.9-14.4 million U). Adjunctive balloon angioplasty was performed in three patients. No vascular stents were placed. Clinical and/or radiographic follow-up was obtained in all eight patients. RESULTS Thrombolysis was successful in seven of eight (88%) IVCs with no or minimal residual thrombus. The remaining seven patients had no lower extremity swelling 2-24 months (mean, 11 months) after the procedure. Three of seven patients had computed tomographic or venographic follow-up (mean, 9 months; range, 1.5-15 months), demonstrating unchanged or improved IVC patency. CONCLUSIONS Transcatheter regional infusion of UK for re-establishing venous patency in acute IVC thrombosis appears to be effective with good short-term and mid-term clinical benefit.
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Affiliation(s)
- J F Angle
- University of Virginia, Health Sciences Center, Charlottesville 22908, USA
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Hosaka J, Roy S, Kvernebo K, Enge I, Laerum F. In vitro function of an adjustable temporary venous spring filter: comparison with the temporary RF02 filter and the permanent Greenfield vena cava filter. Acad Radiol 1998; 5:620-5. [PMID: 9750891 DOI: 10.1016/s1076-6332(98)80298-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
RATIONALE AND OBJECTIVES The authors compared in vitro function of a temporary venous spring filter with that of a temporary RF02 filter and a permanent Greenfield filter. MATERIALS AND METHODS All three types of filters were placed in thin polyethylene tubes (diameters, 10.0-18.0 mm). Physiologic saline was substituted for flowing blood, and blood clots of three sizes (6 x 10 mm, 6 x 20 mm, 9 x 20 mm) were funneled to the filters. Clot-trapping ability of each filter and elevation of intraluminal pressure after clot trapping were assessed for each tube size. RESULTS No statistically significant elevation in intraluminal pressure was detected immediately after placement of any filter. The clot-trapping ability of the spring filter and of Greenfield filter were slightly lower than that of the RF02 filter, but the differences were not statistically significant. After filters had trapped large clots, a high pressure gradient was detected in the 10.0-mm tube for all filters. The spring filter was associated with a higher pressure than the other filters in the 12.0-mm tube (P < .05). CONCLUSION In vitro function of the spring filter was satisfactory in comparison with that of the RF02 filter and the Greenfield filter. For efficient filtering in the inferior vena cava, development of a larger version of the filter may be necessary.
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Affiliation(s)
- J Hosaka
- Section for Experimental Radiology, National Hospital, University of Oslo, Norway
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Sharafuddin MJ, Hicks ME. Current status of percutaneous mechanical thrombectomy. Part III. Present and future applications. J Vasc Interv Radiol 1998; 9:209-24. [PMID: 9540903 DOI: 10.1016/s1051-0443(98)70260-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- M J Sharafuddin
- Section of Vascular and Interventional Radiology, Mallinckrodt Institute of Radiology, Washington University Medical Center, St. Louis, MO 63110, USA
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Gu X, Sharafuddin MJ, Titus JL, Urness M, Cervera-Ceballos JJ, Ruth GD, Amplatz K. Acute and delayed outcomes of mechanical thrombectomy with use of the steerable Amplatz thrombectomy device in a model of subacute inferior vena cava thrombosis. J Vasc Interv Radiol 1997; 8:947-56. [PMID: 9399463 DOI: 10.1016/s1051-0443(97)70692-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To study the efficacy and delayed outcome of mechanical thrombectomy with the Amplatz thrombectomy device (ATD) in an experimental model of subacute inferior vena cava (IVC) thrombosis. MATERIALS AND METHODS Mechanical thrombectomy was performed in 23 dogs with subacute infrarenal IVC thrombosis (6-15 days old). Heparin was administered during thrombectomy in all procedures (activated clotting time > or = 300 sec). Thirteen animals were killed immediately after thrombectomy, and the remaining 10 were allowed to survive for up to 1 month with no anticoagulation therapy. RESULTS Venographic patency of the IVC was restored in all animals, although residual mural thrombus remained in nine dogs (< 20% narrowing in seven, 20%-30% narrowing in two). No histopathologic evidence of mechanical wall disruption attributed to mechanical thrombectomy was seen. However, foci of organizing residual thrombus with associated transmural phlebitic changes with round-cellular infiltration were present in all acute specimens, including those appearing clear at venography. Venography at 1 week or 1 month after thrombectomy showed IVC rethrombosis in eight dogs (80%) who were not receiving anticoagulants. During mechanical thrombectomy, a small increase in mean pulmonary artery pressure occurred, with a corresponding decrease in systemic arterial oxygen saturation. No acute emboli were noted on the post-thrombectomy pulmonary angiograms. However, histopathologic examination of acutely explanted lungs in 11 animals showed arteriolar microemboli (100-500 microm) in four. CONCLUSION Mechanical thrombectomy with use of the ATD can effectively clear subacute IVC thrombus. However, rethrombosis is common and may be due to the high prevalence of phlebitis and residual thrombus. Anticoagulation may need to be continued after successful thrombectomy to prevent progression of residual thrombus and allow mural phlebitic changes to subside.
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Affiliation(s)
- X Gu
- Department of Radiology, University of Minnesota Hospital and Clinic, Minneapolis, USA
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Hosaka J, Roy S, Kvernebo K, Enge I, Laerum F. Adjustable temporary venous spring filter: in vitro assessment. Acad Radiol 1997; 4:513-8. [PMID: 9232172 DOI: 10.1016/s1076-6332(97)80239-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
RATIONALE AND OBJECTIVES The authors performed an in vitro study to evaluate a temporary venous spring filter that can extend vessels of a wide range of diameters to a slit-shaped canal. MATERIALS AND METHODS Filters were placed in thin polyethylene tubes or in porcine inferior vena cava specimens (diameter, 10.0-16.0 mm). Physiologic saline was substituted for blood flow, and blood clots of three sizes (6 x 10, 6 x 20, and 9 x 20 mm) were funneled to the filter. Clot-trapping ability was assessed by the degree of luminal extension. RESULTS When the luminal extension was increased from 2.6r to 2.8r (where r is the original radius of the vein models), clot-trapping ability increased significantly (61.1%-87.5% in polyethylene tubes and 15.8%-77.5% in venous specimens, P < .001). When the luminal extension was increased to 3.0r, more than 90% of the clots were trapped in all tubes. After trapping the small, medium, and large clots, mean intraluminal pressure elevation was 1.0, 1.0, and 17.0 cm of saline, respectively. CONCLUSION Despite its simple design, the spring filter proved to be an efficient filtering device.
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Affiliation(s)
- J Hosaka
- Section for Experimental Radiology, National Hospital, Oslo, Norway
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