Percutaneous insertion of the Kimray-Greenfield filter: technical considerations and problems

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Medical Device Technology

Background:

• Percutaneous insertion of Kimray-Greenfield filters into the inferior vena cava (IVC) is a common procedure.
• Assessing the feasibility and safety of different venous access routes is critical for successful filter placement.
• Inferior vena cavography plays a vital role in pre-procedural planning and risk assessment.

Purpose of the Study:

• To evaluate the safety and efficacy of percutaneous Kimray-Greenfield filter insertion.
• To assess the outcomes associated with different venous access routes (femoral and internal jugular).
• To identify potential complications and technical challenges during filter placement.

Main Methods:

• Retrospective analysis of 57 patients undergoing percutaneous IVC filter insertion.
• Filters were placed via right femoral vein (36), left femoral vein (14), and right internal jugular vein (7).
• Inferior vena cavography was performed prior to all filter insertions to assess anatomical suitability and identify potential risks.

Main Results:

• No deaths or major complications were reported; six minor complications occurred.
• The femoral approach was preferred due to its feasibility.
• A modified guide wire was used to mitigate issues with wire entanglement during filter deployment.

Conclusions:

• Percutaneous Kimray-Greenfield filter insertion is a safe procedure with a low complication rate.
• Inferior vena cavography is essential for successful filter placement and risk stratification.
• While the femoral approach is preferred, potential for femoral vein thrombosis requires ongoing monitoring.