Transfemoral venous catheterization through inferior vena caval filters: results in seven cases

Use of the transfemoral route for venous catheterization has been considered contraindicated in patients with inferior vena caval (IVC) filters. The transjugular route has been used instead in such patients when subsequent diagnostic or therapeutic procedures are required. Many radiologists, however, are more accustomed to the transfemoral approach, and may not find the transjugular route a desirable alternative. We describe seven patients with previously placed IVC filters in whom the transfemoral route was used to perform pulmonary arteriography (five patients) or to place additional IVC filters (two patients). After venographic confirmation of caval patency, filters were catheterized under fluoroscopic control and the procedures were performed. All procedures were technically successful; no complications occurred. We believe the transfemoral route to be a safe and feasible approach for performing venous procedures in selected patients with IVC filters, obviating the less familiar and potentially more hazardous transjugular approach.