[A patient with pulmonary thromboembolism after cesarean section, inspite of having a temporary IVC filter inserted]

There are several reports on use of a temporary IVC filter (T-IVC-F) in patients with deep vein thrombosis. They conclude that the preoperative insertion of a T-IVC-F is useful to prevent intraoperative pulmonary thromboembolism (PTE). But there is no report on preoperative insertion of T-IVC-F not preventing PTE in perioperative period. We experienced a patient who had developed PTE perioperatively despite preoperative insertion of a T-IVC-F. There is a report that some thrombi are not trapped by T-IVC-F in vitro. This suggests that intraoperative PTE can occur. Then, even if T-IVC-F has been inserted preoperatively, it may cause minor thromboembolism, but not major. Therefore we have to observe the vital signs carefully on monitors, such as, pulmonary arterial pressure, end tidal CO2, and transesophageal echocardiograph.