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Thrombus embolization into IVC filters during catheter-directed thrombolysis for proximal deep venous thrombosis

Tilo Kölbel1, Alaa Alhadad, Stefan Acosta

  • 1Vascular Centre Malmö-Lund, Malmö University Hospital UMAS, Malmö, Sweden. tilo.kolbel@skane.se

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
|October 9, 2008
PubMed

Insights

Thrombus embolization into inferior vena cava (IVC) filters is common during catheter-directed thrombolysis for deep venous thrombosis (DVT). IVC filters help prevent pulmonary embolism in these patients.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • Acute iliocaval deep venous thrombosis (DVT) poses a risk of pulmonary embolism.
  • Catheter-directed thrombolysis (CDT) is a treatment option for proximal DVT.
  • Inferior vena cava (IVC) filters are used to prevent pulmonary embolism.

Purpose of the Study:

  • To determine the frequency of emboli in retrievable IVC filters during CDT for acute iliocaval DVT.
  • To identify predictors of embolization into IVC filters.

Main Methods:

  • Retrospective analysis of serial phlebograms from 40 patients treated with CDT for DVT.
  • Evaluation for visible emboli in IVC filters.
  • Analysis of clinical and procedural data to find predictors of embolization.

Main Results:

  • Visible emboli were found in 45% of patients.
  • Embolization to the IVC filter was less frequent in patients with hypercoagulable disorders (31% vs. 69%).
  • No symptomatic pulmonary embolism or filter-related complications occurred.

Conclusions:

  • Thrombus embolization is frequent during CDT for proximal DVT.
  • Retrievable IVC filters can prevent silent and symptomatic pulmonary embolism.
  • IVC filters are effective in managing DVT patients undergoing thrombolysis.
Abstract

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