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Fukasawa H, Kameyama A, Tsukada M, Imamura H. Infected aortic pseudoaneurysm caused by an inferior vena cava filter. Acute Med Surg 2022; 9:e767. [PMID: 35959097 PMCID: PMC9360758 DOI: 10.1002/ams2.767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/28/2022] [Indexed: 12/02/2022] Open
Abstract
Background Inferior vena cava filters are widely used to prevent pulmonary embolism, but they can cause serious complications. Case Presentation A 45‐year‐old man with multiple abscesses was transferred to the emergency department from another hospital. Computed tomography revealed bilateral subscapular abscesses, septic pulmonary embolism, and an abdominal aortic pseudoaneurysm with an abscess at the site of the inferior vena cava filter limb inserted 12 years before. After admission to our hospital, surgical drainage of the bilateral subscapular and right wrist joint abscesses was performed; subsequent treatment with ampicillin improved the patient's condition. Inflammation resolved on the 19th hospitalization day, and abdominal aortic replacement surgery was performed. The patient's postoperative course was uneventful. He returned to the previous hospital for rehabilitation after 40 days of hospitalization. Conclusion Inferior vena cava filters could cause serious complications.
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Affiliation(s)
- Hiroaki Fukasawa
- Department of Emergency and Critical Care Medicine Shinshu University School of Medicine Matsumoto Japan
| | - Akiko Kameyama
- Department of Emergency and Critical Care Medicine Shinshu University School of Medicine Matsumoto Japan
| | - Megumi Tsukada
- Department of Emergency and Critical Care Medicine Shinshu University School of Medicine Matsumoto Japan
| | - Hiroshi Imamura
- Department of Emergency and Critical Care Medicine Shinshu University School of Medicine Matsumoto Japan
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2
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Inferior Vena Cava (IVC) Wall Penetration by IVC Filter Detected Incidentally During Retroperitoneal Lymphadenectomy. Indian J Surg Oncol 2021; 12:362-364. [DOI: 10.1007/s13193-021-01372-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 06/09/2021] [Indexed: 10/20/2022] Open
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3
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Lee J, Roche-Nagle G. Permanent IVC filter strut penetration into an abdominal aortic aneurysm. BMJ Case Rep 2021; 14:14/6/e241962. [PMID: 34099449 DOI: 10.1136/bcr-2021-241962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
An 85-year-old man with a known history of abdominal aortic aneurysm (AAA) presented to a vascular surgery clinic with a severely swollen, tender and erythematous left leg. An urgent CT angiogram demonstrated a left-sided, proximal deep vein thrombosis, and a permanent, Bird's Nest inferior vena cava (IVC) filter (Cook, Inc., Bloomington, Ind.) penetrating his AAA. The patient was treated with a course of apixaban 5 mg two times per day and the decision was made to closely observe his IVC filter and AAA, given his numerous comorbidities and age. This case highlights the unique considerations associated with an approach to permanent IVC filter complications among patients with AAAs.
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Affiliation(s)
- Juehea Lee
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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4
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Robinson E, Jordano L, Mirza AK, Eisenmenger L, Skeik N, Manunga J. Management of a contained ruptured infrarenal abdominal aortic pseudoaneurysm caused by inferior vena cava struts injury: A case report and literature review. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2021; 7:438-442. [PMID: 34278079 PMCID: PMC8263528 DOI: 10.1016/j.jvscit.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/04/2021] [Indexed: 11/20/2022]
Abstract
Aortic pseudoaneurysms are rare entities caused by infection, trauma, atherosclerotic plaque rupture, or aortic instrumentation. Their natural course remains unknown; however, repair is invariably recommended. We present a case of a 71-year-old man with a history of recurrent deep venous thrombosis and pulmonary embolisms who underwent an inferior vena cava filter placement 8 years prior and was found to have a 3.6-cm contained ruptured infrarenal aortic pseudoaneurysm on imaging performed for abdominal pain. His pseudoaneurysm was excluded using a Gore Excluder Endoprosthesis. We further reviewed literature on the subject to highlight the various surgical approaches to this lethal condition.
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Affiliation(s)
- Emilie Robinson
- Section of vascular & Endovascular Surgery, Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minn
| | - Lia Jordano
- Section of vascular & Endovascular Surgery, Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minn
| | - Aleem K. Mirza
- Section of vascular & Endovascular Surgery, Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minn
| | - Laura Eisenmenger
- Division of Neuroradiology, Department of Radiology, University of Wisconsin at Madison, Madison, Wisc
| | - Nedaa Skeik
- Section of vascular & Endovascular Surgery, Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minn
| | - Jesse Manunga
- Section of vascular & Endovascular Surgery, Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minn
- Correspondence: Jesse Manunga, MD, FACS, Section of Vascular and Endovascular Surgery, Minneapolis Heart Institute @ Abbott Northwestern Hospital, 920 E 28th St, Ste 300, Minneapolis, MN 55407
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5
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Capasso K, Awad NA, Alvarez N, Deutsch ER, Zaki R, Choudry RG. Urinary excretion after transcaval renal penetration of a fragmented Bird's Nest filter. J Vasc Surg Venous Lymphat Disord 2020; 9:254-257. [PMID: 32305584 DOI: 10.1016/j.jvsv.2020.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/28/2020] [Indexed: 10/24/2022]
Abstract
Permanent inferior vena cava (IVC) filters are used to prevent venous thromboembolic events in select populations of patients. The Bird's Nest filter (BNF; Cook Medical, Bloomington, Ind) is an IVC filter that has been associated with various complications including filter strut fractures, migration, caval wall perforation, visceral perforation, and vascular injury. We report a case of a BNF that eroded transmurally through the IVC into the right kidney parenchyma. The patient underwent operative intervention with removal of the BNF with an uncomplicated postoperative course. In patients with symptoms and local filter perforations, we advocate for safe filter removal when possible to avoid long-term damage.
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Affiliation(s)
- Kathryn Capasso
- Department of Surgery, Albert Einstein Medical Center, Philadelphia, Pa.
| | - Nadia A Awad
- Division of Vascular Surgery, Albert Einstein Medical Center, Philadelphia, Pa
| | - Nkosi Alvarez
- Department of Surgery, Albert Einstein Medical Center, Philadelphia, Pa
| | - Evan R Deutsch
- Division of Vascular Surgery, Albert Einstein Medical Center, Philadelphia, Pa
| | - Radi Zaki
- Department of Transplantation, Albert Einstein Medical Center, Philadelphia, Pa
| | - Rashad G Choudry
- Division of Vascular Surgery, Albert Einstein Medical Center, Philadelphia, Pa
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6
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Song C, Yu G, Dong J, Feng X, Jing Z. Abdominal aortic pseudoaneurysm eroding lumbar vertebra. J Vasc Surg 2018; 68:885-886. [DOI: 10.1016/j.jvs.2017.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 09/10/2017] [Indexed: 11/27/2022]
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7
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Duncan C, Trerotola SO, Stavropoulos SW. Endovascular Removal of Inferior Vena Cava Filters with Arterial Penetration. J Vasc Interv Radiol 2018; 29:486-490. [PMID: 29477624 DOI: 10.1016/j.jvir.2017.12.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 12/08/2017] [Accepted: 12/15/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To evaluate the safety and outcomes of endovascular percutaneous removal of inferior vena cava filters (IVCFs) with elements penetrating an artery. MATERIALS AND METHODS From an IVCF retrieval database, computerized tomographic scans of patients who underwent IVCF retrieval from 2011 to 2017 were reviewed for IVCF elements penetrating through the caval wall and into an adjacent arterial wall (AW) or penetrating into an adjacent arterial lumen (AL). Forty-two patients were identified, including 20 with elements penetrating into an AW and 22 with elements penetrating into an AL; 30 of these IVCFs were tip embedded. RESULTS All of the filters in both groups were removed. Of the arterial-interacting filters, 9 were removed with the use of standard techniques and 33 with the use of endobronchial forceps. Arterial access was obtained before removal in 3 patients (7%) with post-removal arteriography revealing no abnormalities, such as extravasation, pseudoaneurysm, or new fractured components. There was no significant difference between groups in tip embedding, retrieval technique, or fluoroscopy time. CONCLUSIONS Endovascular removal of IVCFs with elements that have penetrated into adjacent arterial walls or lumens can be performed safely in the majority of patients.
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Affiliation(s)
- Christopher Duncan
- Department of Radiology, Division of Interventional Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, 1 Silverstein 3400 Spruce Street, Philadelphia, PA 19104
| | - Scott O Trerotola
- Department of Radiology, Division of Interventional Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, 1 Silverstein 3400 Spruce Street, Philadelphia, PA 19104.
| | - S William Stavropoulos
- Department of Radiology, Division of Interventional Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, 1 Silverstein 3400 Spruce Street, Philadelphia, PA 19104
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8
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Abstract
Inferior vena cava (IVC) filter placement is a relatively low risk alternative for prophylaxis against pulmonary embolism in patients with pelvic or lower extremity deep venous thrombosis who are not suitable for anticoagulation. There is an increasing trend in the number of IVC filter implantation procedures performed every year. There are many device types in the market and in the early 2000s, the introduction of retrievable filters brought an additional subset of complications to consider. Modern filter designs have led to decreased morbidity and mortality, however, a thorough understanding of the limitations and complications of IVC filters is necessary to weight the risks and benefits of placing IVC filters. In this review, the complications associated with IVC filters are divided into procedure related, post-procedure, and retrieval complications. Differences amongst the device types and retrievable filters are described, though this is limited by a significant lack of prospective studies. Additionally, the clinical presentation as well as prevention and treatment strategies are outlined with each complication type.
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Affiliation(s)
- Simer Grewal
- Department of Radiology, Division of Interventional Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Murthy R Chamarthy
- Department of Radiology, Division of Interventional Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sanjeeva P Kalva
- Department of Radiology, Division of Interventional Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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9
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Shiraev TP, Kwok TM, Rajendran S, Gan JP, Qasabian RA. Pseudoaneurysm of the thoracic aorta following botulinum toxin injection to the esophagus. J Vasc Surg Cases Innov Tech 2016; 2:126-129. [PMID: 38827205 PMCID: PMC11140365 DOI: 10.1016/j.jvscit.2016.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 04/30/2016] [Indexed: 11/19/2022] Open
Abstract
Aortic pseudoaneurysms are uncommon and are usually secondary to penetrating trauma. We describe the presentation and management of an elderly woman who suffered a pseudoaneurysm of the descending thoracic aorta several days after receiving botulinum toxin injection to the esophagus. Urgent thoracic endovascular aortic repair was performed, and long-term antibiotic therapy was commenced. Despite a slow initial clinical recovery, she returned to an independent lifestyle, with radiographic resolution of the pseudoaneurysm seen at follow-up. This case illustrates that endovascular aortic repair is a suitable and safe treatment option for this unusual presentation.
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Affiliation(s)
- Timothy P. Shiraev
- Department of Vascular Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Trevor M.Y. Kwok
- Department of Vascular Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Saissan Rajendran
- Department of Vascular Surgery, Port Macquarie Base Hospital, Port Macquarie, New South Wales, Australia
| | - John P. Gan
- Department of Vascular Surgery, Port Macquarie Base Hospital, Port Macquarie, New South Wales, Australia
| | - Raffi A. Qasabian
- Department of Vascular Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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10
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Chauhan Y, Al Jabbari O, Abu Saleh WK, Loh T, Ali I, Lumsden A. Open Removal of Penetrating Inferior Vena Cava Filter with Repair of Secondary Aortic Dissection: Case Report. Ann Vasc Surg 2016; 32:130.e9-12. [DOI: 10.1016/j.avsg.2015.10.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 10/17/2015] [Accepted: 10/25/2015] [Indexed: 11/15/2022]
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11
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Jia Z, Wu A, Tam M, Spain J, McKinney JM, Wang W. Caval Penetration by Inferior Vena Cava Filters. Circulation 2015; 132:944-52. [DOI: 10.1161/circulationaha.115.016468] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 07/06/2015] [Indexed: 12/18/2022]
Abstract
Background—
Limited penetration into the caval wall is an important securing mechanism for inferior vena cava (IVC) filters; however, caval penetration can also cause unintentional complications. The aim of this study was to assess the incidence, severity, clinical consequences, and management of filter penetration across a range of commercially available IVC filters.
Methods and Results—
The MEDLINE database was searched for all studies (1970–2014) related to IVC filters. A total of 88 clinical studies and 112 case reports qualified for analysis; these studies included 9002 patients and 15 types of IVC filters. Overall, penetration was reported in 19% of patients (1699 of 9002), and 19% of those penetrations (322 of 1699) showed evidence of organ/structure involvement. Among patients with penetration, 8% were symptomatic, 45% were asymptomatic, and 47% had unknown symptomatology. The most frequently reported symptom was pain (77%, 108 of 140). Major complications were reported in 83 patients (5%). These complications required interventions including surgical removal of the IVC filter (n=63), endovascular stent placement or embolization (n=11), endovascular retrieval of the permanent filter (n=4), and percutaneous nephrostomy or ureteral stent placement (n=3). Complications led to death in 2 patients. A total of 87% of patients (127 of 146) underwent premature filter retrieval or interventions for underlying symptoms or penetration-related complications.
Conclusions—
Caval penetration is a frequent but clinically underrecognized complication of IVC filter placement. Symptomatic patients accounted for nearly 1/10th of all penetrations; most of these cases had organ/structure involvement. Interventions with endovascular retrieval and surgery were required in most of these symptomatic patients.
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Affiliation(s)
- Zhongzhi Jia
- From Department of Interventional Radiology, No. 2 People’s Hospital of Changzhou, Nanjing Medical University, Chang Zhou, China (Z.J.); Imaging Institute, Section of Interventional Radiology, Cleveland Clinic, OH (A.W.); Department of Radiology, Southend University Hospital, Essex, UK (M.T.); Department of Radiology, Wexner Medical Center at The Ohio State University, Columbus (J.S.); and Department of Radiology, Mayo Clinic, Jacksonville, FL (J.M.M., W.W.)
| | - Alex Wu
- From Department of Interventional Radiology, No. 2 People’s Hospital of Changzhou, Nanjing Medical University, Chang Zhou, China (Z.J.); Imaging Institute, Section of Interventional Radiology, Cleveland Clinic, OH (A.W.); Department of Radiology, Southend University Hospital, Essex, UK (M.T.); Department of Radiology, Wexner Medical Center at The Ohio State University, Columbus (J.S.); and Department of Radiology, Mayo Clinic, Jacksonville, FL (J.M.M., W.W.)
| | - Mathew Tam
- From Department of Interventional Radiology, No. 2 People’s Hospital of Changzhou, Nanjing Medical University, Chang Zhou, China (Z.J.); Imaging Institute, Section of Interventional Radiology, Cleveland Clinic, OH (A.W.); Department of Radiology, Southend University Hospital, Essex, UK (M.T.); Department of Radiology, Wexner Medical Center at The Ohio State University, Columbus (J.S.); and Department of Radiology, Mayo Clinic, Jacksonville, FL (J.M.M., W.W.)
| | - James Spain
- From Department of Interventional Radiology, No. 2 People’s Hospital of Changzhou, Nanjing Medical University, Chang Zhou, China (Z.J.); Imaging Institute, Section of Interventional Radiology, Cleveland Clinic, OH (A.W.); Department of Radiology, Southend University Hospital, Essex, UK (M.T.); Department of Radiology, Wexner Medical Center at The Ohio State University, Columbus (J.S.); and Department of Radiology, Mayo Clinic, Jacksonville, FL (J.M.M., W.W.)
| | - J. Mark McKinney
- From Department of Interventional Radiology, No. 2 People’s Hospital of Changzhou, Nanjing Medical University, Chang Zhou, China (Z.J.); Imaging Institute, Section of Interventional Radiology, Cleveland Clinic, OH (A.W.); Department of Radiology, Southend University Hospital, Essex, UK (M.T.); Department of Radiology, Wexner Medical Center at The Ohio State University, Columbus (J.S.); and Department of Radiology, Mayo Clinic, Jacksonville, FL (J.M.M., W.W.)
| | - Weiping Wang
- From Department of Interventional Radiology, No. 2 People’s Hospital of Changzhou, Nanjing Medical University, Chang Zhou, China (Z.J.); Imaging Institute, Section of Interventional Radiology, Cleveland Clinic, OH (A.W.); Department of Radiology, Southend University Hospital, Essex, UK (M.T.); Department of Radiology, Wexner Medical Center at The Ohio State University, Columbus (J.S.); and Department of Radiology, Mayo Clinic, Jacksonville, FL (J.M.M., W.W.)
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12
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Pham JD, Huang SY, Sabir SH, Huynh T, Wallace MJ. Celect Filter Penetration of Aorta and Lumbar Artery. J Vasc Interv Radiol 2014; 25:487-90. [DOI: 10.1016/j.jvir.2013.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 11/10/2013] [Accepted: 11/11/2013] [Indexed: 11/17/2022] Open
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13
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Assifi MM, Bagameri G, Dimuzio PJ, Eisenberg JA. Management of infected caval filter with simultaneous aortic pseudoaneurysm and retroperitoneal perforation: a case report and literature review. Vascular 2012; 20:225-8. [PMID: 22688925 DOI: 10.1258/vasc.2011.cr0310] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
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.
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Affiliation(s)
- M Mura Assifi
- Department of Surgery, Division of Vascular and Endovascular Surgery, Thomas Jefferson University, 111 South 11th Street, Philadelphia, PA 19107, USA
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14
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Caceres M, Braud R, Weiman D. Aortic Penetration by Temporary Inferior Vena Cava Filters: Report of an Interesting Case and Review of the Literature. Vasc Endovascular Surg 2012; 46:181-6. [DOI: 10.1177/1538574411432160] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We report a patient who received a retrievable G2 filter and developed inferior vena cava perforations in multiple locations, including penetration of one of the prongs inside the aortic lumen. Furthermore, we conducted an extensive literature review of similar cases to describe the clinical presentation, aortic pathology, radiologic findings, treatment, and outcomes related to this complication.
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15
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Advanced Techniques for Removal of Retrievable Inferior Vena Cava Filters. Cardiovasc Intervent Radiol 2011; 35:741-50. [DOI: 10.1007/s00270-011-0205-z] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Accepted: 05/22/2011] [Indexed: 10/18/2022]
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16
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Shang EK, Nathan DP, Carpenter JP, Fairman RM, Jackson BM. Delayed Complications of Inferior Vena Cava Filters: Case Report and Literature Review. Vasc Endovascular Surg 2011; 45:290-4. [DOI: 10.1177/1538574410395038] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Inferior vena cava (IVC) filters are frequently placed to prevent pulmonary embolism in patients in whom anticoagulation is contraindicated or ineffective. Delayed erosion of the filter into adjacent vital structures is a rare complication. We report 3 complications of IVC filters managed with both surgical and endovascular therapies. A review of the available literature addresses incidence of delayed IVC filter complications, the approach to these problems, and the role of retrievable IVC filters.
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Affiliation(s)
- Eric K. Shang
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Derek P. Nathan
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Une complication rare d’un filtre cave : la pénétration aortique et vertébrale. ACTA ACUST UNITED AC 2010; 91:231-2. [DOI: 10.1016/s0221-0363(10)70029-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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18
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Aortic and Vertebral Penetration by a G2 Inferior Vena Cava Filter: Report of a Case. J Vasc Interv Radiol 2009; 20:829-32. [DOI: 10.1016/j.jvir.2009.02.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Revised: 02/03/2009] [Accepted: 02/08/2009] [Indexed: 11/23/2022] Open
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19
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Veroux M, Tallarita T, Pennisi M, Veroux P. Late complication from a retrievable inferior vena cava filter with associated caval, aortic, and duodenal perforation: A case report. J Vasc Surg 2008; 48:223-5. [DOI: 10.1016/j.jvs.2008.02.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2007] [Revised: 01/31/2008] [Accepted: 02/01/2008] [Indexed: 11/15/2022]
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20
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Surgical removal of a tilted temporary inferior vena cava filter incorporated with a large thrombus: report of a case. Surg Today 2008; 38:258-60. [PMID: 18307002 DOI: 10.1007/s00595-007-3607-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2006] [Accepted: 07/09/2007] [Indexed: 10/22/2022]
Abstract
A 68-year-old woman was referred to our hospital with left leg edema and dull pain. Magnetic resonance imaging and enhanced computed tomography (CT) revealed a huge myoma uteri compressing the left common iliac vein, thus resulting in iliofemoral venous thrombosis. A total hysterectomy was uneventfully performed under the placement of a temporary inferior vena cava (IVC) filter. The postoperative enhanced CT-scan and cavography revealed the 90 degrees -tilted filter incorporated with a large thrombus. As an increased dose of heparin that was administered during the following week resulted in no reduction of the thrombus, a surgical removal was indicated. The infrarenal IVC was clamped proximal and distal to the filter, and the tilted filter with the large thrombus was removed through a longitudinal cavotomy. The postoperative course was uneventful, and she had no recurrence or residual symptoms for 6 months following the surgery.
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Abstract
The most common imaging modality used for diagnosis of aortic disease is CT, followed by transesophageal echocardiography, MRI, and aortography. If multiple imaging is performed, the initial imaging technique most frequently employed is computerized tomography. During the past decade, computed tomographic angiography (CTA) has become a standard non-invasive imaging modality for the depiction of vascular anatomy and pathology. The quality and speed of CTA examinations have increased dramatically as CT technology has evolved from-channel spiral CT systems to multichannel (4-, 8-, 10- and 16-slice) spiral CT system. The quality and speed of CTA is superior to other imaging modalities, and it is also cheaper and less invasive. CTA of the aorta has proven to be superior in diagnostic accuracy to conventional arteriography in several applications.
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Affiliation(s)
- Tongfu Yu
- Radiological Department of the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
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