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Transfemoral venous access through inferior vena cava filters for interventions requiring large sheaths

Michael Schoeffler1, Jeremy Ringewald, Eliot Schechter

  • 1University of Oklahoma Health Sciences Center and OU Medical Center, Oklahoma City, OK 73104, USA.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|December 2, 2006
PubMed

Insights

Performing interventional procedures across inferior vena cava (IVC) filters is feasible. This study details techniques for safely accessing the femoral vein in patients with IVC filters for necessary cardiac interventions.

Area of Science:

  • Cardiology
  • Interventional Radiology
  • Vascular Surgery

Background:

  • Inferior vena cava (IVC) filters are used to prevent pulmonary embolism from deep vein thrombosis.
  • Femoral venous catheterization is typically contraindicated in patients with IVC filters.
  • Some interventional procedures necessitate femoral access, even in patients with IVC filters.

Observation:

  • Two cases are presented where patients with IVC filters (Greenfield and Trapease) underwent complex interventional procedures.
  • One patient required balloon mitral valvuloplasty, and the other underwent atrial septostomy.
  • These procedures involved crossing the IVC filter via femoral venous access.

Findings:

  • Interventions across IVC filters are technically feasible and can be performed safely.
  • Detailed techniques were employed to navigate the IVC filter during catheterization.
  • Successful outcomes were achieved in both reported cases.

Implications:

  • This experience expands the interventional options for patients with IVC filters.
  • It suggests that femoral venous access is possible in select cases with IVC filters.
  • Further research into standardized techniques may benefit patients requiring interventions despite IVC filter placement.

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