1
|
Borghesan AC, Barbosa RG, Cerqueira NF, Takahira RK, Vulcano LC, Alves ALG, Watanabe MJ, Alonso JM, Rollo HA, Hussni CA. Evaluation of Experimental Jugular Thrombophlebitis in Horses Treated With Heparin. J Equine Vet Sci 2018. [DOI: 10.1016/j.jevs.2018.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Saettele MR, Morelli JN, Chesis P, Wible BC. Use of a Trellis device for endovascular treatment of venous thrombosis involving a duplicated inferior vena cava. Cardiovasc Intervent Radiol 2013; 36:1699-1703. [PMID: 23370490 DOI: 10.1007/s00270-013-0559-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 12/17/2012] [Indexed: 11/29/2022]
Abstract
Congenital anomalies of the inferior vena cava (IVC) are increasingly recognized with CT and venography techniques. Although many patients with IVC anomalies are asymptomatic, recent studies have suggested an association with venous thromboembolism. We report the case of a 62-year-old woman with extensive venous clot involving the infrarenal segment of a duplicated left IVC who underwent pharmacomechanical thrombectomy and tissue plasminogen activator catheter-directed thrombolysis with complete deep venous thrombosis resolution. To our knowledge this is the first reported case in the English literature of the use of a Trellis thrombectomy catheter in the setting of duplicated IVC.
Collapse
Affiliation(s)
- Megan R Saettele
- Department of Radiology, Saint Luke's Hospital, University of Missouri, Kansas City, 4401 Wornall Road, Kansas City, MO, 64111, USA.
| | - John N Morelli
- Department of Radiology, Scott & White Clinic and Hospital, Texas A&M University Health Science Center, 2401 S 31st Street, Temple, TX, 76504, USA
| | - Paul Chesis
- Department of Interventional Radiology, Saint Luke's Hospital, University of Missouri, Kansas City, 4401 Wornall Road, Kansas City, MO, 64111, USA
| | - Brandt C Wible
- Department of Interventional Radiology, Saint Luke's Hospital, University of Missouri, Kansas City, 4401 Wornall Road, Kansas City, MO, 64111, USA
| |
Collapse
|
4
|
Abstract
Trauma patients are at exceedingly high risk of development of venous thromboembolism (VTE) including deep venous thrombosis and pulmonary embolism (PE). The epidemiology of VTE in trauma patients is reviewed. PE is thought to be the third major cause of death after trauma in those patients who survive longer than 24 hours after onset of injury. In fact, patients recovering from trauma have the highest rate of VTE among all subgroups of hospitalized patients. Various prophylactic and surveillance methods have been evaluated and found helpful in certain situations, but VTE complications can occur despite such measures. Therapeutic and prophylactic uses of inferior vena cava (IVC) filters in trauma patients are reviewed. Prophylactic IVC filter use is revealed to be a controversial subject with valid arguments on both sides of the issue. With the lack of prospective randomized trials of IVC filter use in trauma, it is impossible to make evidence-based recommendations. Unfortunately, two sets of guidelines are available for insertion of filters in trauma patients, with conflicting recommendations. The introduction of retrievable IVC filters seems to offer a unique solution for VTE protection in the trauma patient population, which often consists of younger members of our population. Lastly, current generations of FDA-approved retrieval filters are discussed.
Collapse
Affiliation(s)
- Hamed Aryafar
- UCSD Medical Center, Department of Radiology, San Diego, California
| | | |
Collapse
|
5
|
Malgor RD, Oropallo A, Wood E, Natan K, Labropoulos N. Filter Placement for Duplicated Cava. Vasc Endovascular Surg 2011; 45:269-73. [DOI: 10.1177/1538574410395041] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Anatomic variations of the inferior vena cava (IVC) are found in 3-5% of the population. IVC duplication is a well-known anatomic variation that is important when relevant procedures are being planed. Therefore, the identification of IVC anomalies should be checked prior to pertinent interventions. We report two cases of dual IVC filter placement for duplicated cava including a missing left inferior vena cava and subsequent pulmonary embolism. The rationale of one versus two filters and the current literature are discussed.
Collapse
Affiliation(s)
- Rafael D. Malgor
- Division of Vascular Surgery, Stony Brook Medical Center, NY, USA,
| | - Alisha Oropallo
- Division of Vascular Surgery, Winthrop University Hospital, NY, USA
| | - Emily Wood
- Division of General Surgery, Stony Brook Medical Center, NY, USA
| | - Kristina Natan
- School of Medicine, State University of New York at Stony Brook, Stony Brook and Mineola, NY, USA
| | | |
Collapse
|
6
|
Jaskolka JD, Kwok RPW, Gray SH, Mojibian HR. The value of preprocedure computed tomography for planning insertion of inferior vena cava filters. Can Assoc Radiol J 2010; 61:223-9. [PMID: 20083369 DOI: 10.1016/j.carj.2009.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2009] [Revised: 11/03/2009] [Accepted: 11/04/2009] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To determine if valuable information could be obtained from abdominal computed tomography (CT) performed before insertion of an inferior vena cava (IVC) filter. MATERIALS AND METHODS A retrospective review was performed on IVC filter insertions with a CT performed before the procedure. Cavagram and CT were compared for renal vein and IVC anatomy, the diameter of the IVC, and the prevalence of iliocaval thrombus. Correlations were assessed among 3 reference standards for measuring the IVC at cavography. RESULTS The mean IVC diameter was 23.0 mm on CT. On cavagram the mean IVC diameter was assessed by using 3 reference standards: 20.7 mm, with the catheter tip as a reference; 26.9 mm, with a radiopaque ruler; and 23.4 mm, by using a lumbar vertebral body. There was good correlation among the 3 measures of IVC diameter (Pearson's r = 0.75, P < .0001) but moderate correlation with CT (r = 0.36-0.56, P < .001). The sensitivity of cavagram for detecting retroaortic and circumaortic renal veins was 40% and 0%, respectively. Nineteen accessory renal veins (12.8%) were not seen by cavagram. Thirteen patients (8.8%) had iliocaval thrombus on cavagram, of which 12 (92.3%) were not previously detected by CT. CONCLUSIONS CT is more sensitive than cavagram for detection of renal vein variants and the level of the lowest renal vein. Therefore, if available, the CT should be reviewed before placement of an IVC filter to optimize positioning. Cavagram remains the criterion standard for detection of iliocaval thrombosis and is necessary before IVC filter insertion.
Collapse
|
7
|
Hussni CA, Dornbusch PT, Yoshida WB, Alves ALG, Nicoletti JLM, Mamprim MJ, Vulcano LC. Trombectomia com cateter de Fogarty no tratamento da tromboflebite jugular experimental em eqüinos. PESQUISA VETERINÁRIA BRASILEIRA 2009. [DOI: 10.1590/s0100-736x2009000100007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Trombose da veia jugular é problema freqüente na medicina eqüina, implicando muitas vezes em conseqüências fatais. O objetivo deste trabalho foi avaliar em eqüinos a aplicabilidade da trombectomia com cateter de Fogarty, técnica rotineiramente empregada pela medicina humana, no restabelecimento da perviedade vascular. Foram utilizados 10 eqüinos divididos em dois grupos de cinco animais, em que se induziu a trombose da veia jugular direita, através do acesso cirúrgico à veia e aplicação de sutura estenosante e injeção de glicose a 50%. No grupo controle avaliou-se a evolução da tromboflebite sem qualquer tipo de intervenção terapêutica. Os animais do grupo tratado foram submetidos à trombectomia com cateter de Fogarty. Foram avaliados os parâmetros clínicos gerais, regionais, ultra-sonográficos e angiográficos, nos momentos pré-indução (M-PRÉ), indução da trombose (MTI) e 10 dias de evolução da trombose (M10). A técnica empregada induziu a tromboflebite, que obstruiu completamente um segmento da veia jugular de todos os animais. Os animais do grupo controle mantiveram os trombos obstruindo totalmente o lume vascular até o final do período de avaliação, sendo que avaliações regionais mostraram principalmente o edema parotídeo e o ingurgitamento vascular, cranial à tromboflebite da veia jugular. O grupo tratado apresentou as veias jugulares pérvias ao final do experimento, confirmadas pelos exames ultra-sonográficos e angiográficos, com remissão total dos sinais clínicos. Concluiu-se que a técnica da trombectomia com cateter de Fogarty foi eficiente na desobstrução da veia jugular submetida à trombose experimental.
Collapse
|
8
|
Meissner MH, Moneta G, Burnand K, Gloviczki P, Lohr JM, Lurie F, Mattos MA, McLafferty RB, Mozes G, Rutherford RB, Padberg F, Sumner DS. The hemodynamics and diagnosis of venous disease. J Vasc Surg 2007; 46 Suppl S:4S-24S. [PMID: 18068561 DOI: 10.1016/j.jvs.2007.09.043] [Citation(s) in RCA: 192] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2006] [Accepted: 08/23/2007] [Indexed: 01/19/2023]
Affiliation(s)
- Mark H Meissner
- Department of Surgery, University of Washington School of Medicine, Seattle 98195, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Abstract
Venous thromboembolism is a major health problem that results in significant long-term complications and mortality. The management of venous thromboembolism is complex and can be particularly challenging when pharmacological therapy alone cannot be effectively utilized. Vena cava filters provide protection from pulmonary embolism for patients in whom therapeutic anticoagulation is contraindicated or inadequate. Recent innovations in caval interruption have included the use of alternative imaging modalities for filter insertion and the emergence of devices designed to allow temporary caval filtration. These developments have been accompanied by a controversial increase in the use of vena cava filters for prophylactic indications in the absence of venous thromboembolism. In addition to a brief historical perspective on caval filtration, this update reviews the indications for vena cava filter insertion, associated complications, methods of caval imaging and filter insertion and current FDA-approved devices.
Collapse
Affiliation(s)
- Matthew A Corriere
- Department of General Surgery, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - K Todd Piercy
- MidSouth Surgeons, 1220 Trotwood Avenue, Columbia, TN 38401, USA
| | - Matthew S Edwards
- Assistant Professor of Surgery and Public Health, Wake Forest University School of Medicine, Sciences, Department of General Surgery, Winston-Salem, NC 27157, USA
| |
Collapse
|
10
|
|
11
|
Abstract
Currently, there are more than 10 permanent and optional retrievable vena cava filters in use in North America and Europe. Indications for inferior vena cava (IVC) filter placement are intuitive and filters are used in patients who have deep venous thrombosis (DVT) and contraindications to anticoagulation, or in patients who hemorrhage while anticoagulated for DVT. Multiple studies have proposed broadening the use of IVC filters as primary venous thromboembolism (VTE) prophylaxis in certain patient populations. Many permanent IVC filters have been well studied and have superior performance characteristics. On the other hand, optional retrievable IVC filters are attractive in the patient with a well-defined, short-term risk for VTE and contraindications to anticoagulation. Filter retrieval after the patient can be anticoagulated would eliminate the long-term risk of DVT associated with permanent IVC filter placement. Unfortunately, most optional retrievable filters are relatively new and have little to no data on their long-term performance when used as permanent filters, and the percentage of retrievable filters actually removed is less than 50%. The spirited debate concerning which patient should get which filter is just beginning. More prospective, randomized trials evaluating optional retrievable filters are needed to answer these important questions.
Collapse
Affiliation(s)
- John E Rectenwald
- Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
| |
Collapse
|
12
|
D'Ayala M, Nguyen ET, Deitch JS, Degraft-Johnson JB, Wise L. Safety of Contrast Venography prior to Caval Interruption in Patients with Renal Insufficiency. Ann Vasc Surg 2005; 19:347-51. [PMID: 15818452 DOI: 10.1007/s10016-005-0009-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We undertook this study to determine whether the use of contrast venography would adversely affect renal function in patients with renal insufficiency requiring caval interruption. We conducted a retrospective review of all inferior vena cava (IVC) filters inserted at our institution over a 2-year period (January 2002 to January 2004). The indication for caval interruption, insertion technique, type of filter used, pre- and postintervention creatinine level, and the presence of diabetes and hypertension were analyzed. A total of 282 IVC filters were inserted, with 38 of them placed in patients with renal insufficiency as defined by a serum creatinine level of > 1.5 mg/dL. Contrast venography with 15 to 30 mL of iohexol (Omnipaque 300) was used in all cases, and no special measures other than proper hydration were used for renal protection. All filters were successfully deployed. The mean +/- SD preintervention creatinine level was 2.38 +/- 0.79 mg/dL. The mean +/- SD postintervention creatinine levels at 2 and 30 days were 2.26 +/- 0.45 mg/dL and 2.12 +/- 0.94 mg/dL, respectively. No patients required hemodialysis following caval interruption, and no adverse effect on renal function was noted. Contrast venography accurately delineates venous anatomy and facilitates proper caval filter placement with no apparent adverse effect on renal function. We believe contrast venography is safe even in the presence of renal insufficiency.
Collapse
Affiliation(s)
- Marcus D'Ayala
- Department of Surgery, New York Methodist Hospital, Brooklyn, NY 11215, USA.
| | | | | | | | | |
Collapse
|
13
|
Corriere MA, Passman MA, Guzman RJ, Dattilo JB, Naslund TC. Comparison of Bedside Transabdominal Duplex Ultrasound versus Contrast Venography for Inferior Vena Cava Filter Placement: What Is the Best Imaging Modality? Ann Vasc Surg 2005; 19:229-34. [PMID: 15782272 DOI: 10.1007/s10016-004-0163-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
While contrast venography is considered the gold standard for imaging prior to inferior vena cava (IVC) filter insertion, bedside placement via transabdominal duplex ultrasound (DUS) has been recognized as a safe and effective alternative. To date, there has been no direct comparison of the efficacy of both imaging modalities for IVC filter placement. A concurrent cohort of patients who underwent IVC filter placement at a single institution over a 7-year period with either contrast venography or transabdominal DUS performed at bedside was retrospectively reviewed. Patient demographics, venous thromboembolism risk factors, indications, technical success, and procedural complications were compared. Of 439 patients initially imaged with transabdominal DUS, IVC filter placement was determined to be technically feasible in 382 patients (87%). The procedural technical success rate for IVC filter placement using transabdominal DUS when IVC visualization was adequate was 97.4% (n = 382 patients), compared to 99.7% (n = 318 patients) for contrast venography (p = 0.018). Patients undergoing IVC filter placement with transabdominal DUS more commonly required IVC filter for venous thromboembolism prophylaxis (81.1% vs. 27.8%, p < 0.001), had increased incidence of multiple traumatic injuries (28% vs. 10%, p < 0.001), and had increased risk from immobilization (91.3% vs. 34.1%, p < 0.001). Overall complication rates were 0.6% for venography and 1.8% for transabdominal DUS (p = NS). When IVC visualization was adequate, contrast venography and transabdominal duplex ultrasound both had high rates of success and a low incidence of complications. A technical success advantage was observed for contrast venography; this difference in technical success must be weighed against the bedside insertion advantage offered by DUS, which may be especially important in the immobilized or critically ill patient. Transabdominal DUS remains our preferred technique when feasible, especially when bedside placement is desired.
Collapse
Affiliation(s)
- Matthew A Corriere
- Division of Vascular Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | | | | | | | | |
Collapse
|
14
|
Use of Vena Cava Filters. Tech Orthop 2004. [DOI: 10.1097/01.bto.0000145148.25878.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|