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Endovascular recanalization of the thrombosed filter-bearing inferior vena cava

Suresh Vedantham1, Thomas M Vesely, Naveen Parti

  • 1Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Box 8131, St. Louis, Missouri 63110, USA. vedanthams@mir.wustl.edu

Journal of Vascular and Interventional Radiology : JVIR
|July 9, 2003
PubMed

Insights

Endovascular methods successfully treated inferior vena cava (IVC) thrombosis in patients with IVC filters, offering a feasible solution for venous occlusions. This approach demonstrated good clinical outcomes and manageable complications.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • Inferior vena cava (IVC) thrombosis is a serious complication, particularly in patients with IVC filters.
  • Treatment options for IVC thrombosis with filters are limited, posing significant clinical challenges.

Purpose of the Study:

  • To assess the preliminary experience and efficacy of endovascular techniques for treating IVC thrombosis in patients already possessing IVC filters.
  • To evaluate the feasibility and outcomes of minimally invasive procedures in this complex patient group.

Main Methods:

  • Ten patients with filter-bearing IVCs experiencing thrombosis and symptomatic limb issues underwent endovascular treatment.
  • Procedures included catheter-directed thrombolysis, balloon maceration, mechanical thrombectomy, and stent placement.
  • Outcomes monitored included technical and clinical success, complications, filter integrity, and pulmonary embolism (PE) prophylaxis.

Main Results:

  • Technical and clinical success rates were 83% and 78%, respectively, across 18 symptomatic limbs.
  • One patient (10%) experienced major bleeding (muscular hematoma); no clinically detectable PE occurred during follow-up.
  • At a median follow-up of 19 months, limb status varied, with most patients experiencing minimal to no edema.

Conclusions:

  • Endovascular recanalization is a feasible and effective treatment for occluded IVCs, even when an IVC filter is present.
  • These minimally invasive techniques offer a viable option for managing IVC thrombosis, improving limb symptoms and preventing further complications.
Abstract

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