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Chronic Inferior Vena Cava Filter Thrombosis: Endovascular Treatment and One-Year Follow-Up with Intravascular

Andrés Mesa1,2, Eliana Milazzo1,2, Oscar Rivera1,2

  • 1Department of Cardiology, Texas Heart Institute, Houston, Texas 77030.

Texas Heart Institute Journal
|July 1, 2020
PubMed

Insights

Inferior vena cava (IVC) filter thrombosis can be fatal. Pharmacomechanical thrombolysis with stenting successfully restored blood flow in a challenging case, showing long-term patency.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • Inferior vena cava (IVC) filter thrombosis is a critical complication with limited evidence-based treatment guidelines.
  • Management of IVC filter thrombosis poses significant challenges due to treatment uncertainties.

Observation:

  • A 72-year-old male with a history of deep vein thrombosis developed IVC filter thrombosis 7 years post-placement.
  • Previous recanalization attempts with oral anticoagulation were unsuccessful.

Findings:

  • Pharmacomechanical thrombolysis guided by intravascular ultrasonography was performed.
  • Simultaneous deployment of stents through the IVC filter and into the iliac veins achieved excellent results.
  • One-year follow-up demonstrated patent IVC filter and veins with symptom improvement and minimal neointimal hyperplasia.

Implications:

  • Balloon venoplasty and double-barrel stenting are effective in restoring blood flow in occluded IVCs.
  • Intravascular ultrasonography is valuable for guiding and assessing these complex interventions.
  • This case provides evidence for a successful treatment strategy for IVC filter thrombosis.

Keywords:
Endovascular procedures/instrumentationleg/blood supplystentsthrombectomy/methodsthrombolytic therapy/methodstreatment outcomeultrasonography, interventional/methodsvena cava filters/adverse effectsvena cava, inferior/diagnostic imagingvenous thrombosis/diagnosis/etiology/therapy

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