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Transcatheter interventions across an inferior vena cava filter
John F Rhodes1, Stephen G Miller, Geoffrey K Lane
1The Cleveland Clinic Foundation, Cleveland, Ohio, USA. rhode028@mc.duke.edu
Summary
Transcatheter device closure effectively treats atrial communication in patients with inferior vena cava filters. This minimally invasive approach offers a new option for patients with concurrent embolic events and right-to-left shunting.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Inferior vena cava (IVC) filters are used to prevent pulmonary embolism in high-risk patients.
- Atrial communications, such as patent foramen ovale (PFO), can cause paradoxical emboli, especially in patients with IVC filters.
- Limited data exist on managing patients with both IVC filters and atrial communications.
Observation:
- This study presents four cases of patients with existing IVC filters who also had an atrial communication.
- These patients experienced embolic events necessitating IVC filter placement.
- The atrial communication allowed for right-to-left shunting of blood.
Findings:
- Transcatheter device closure was successfully performed in all four patients.
- The atrial communication was closed using a device across the IVC filter.
- No major complications were reported during or after the procedures.
Implications:
- Transcatheter closure of atrial communications is feasible and safe in patients with IVC filters.
- This technique provides a viable treatment option for preventing further embolic events in this complex patient group.
- Further research is warranted to evaluate long-term outcomes and expand indications.