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Extensive Inferior Vena Cava Thrombosis in Trauma when IVC Filter Placement Is Not Feasible Managed Using ClotTriever
Karthigesu Aimanan1, Muhammad Aizat Tamlikha Ismail1, Michael Arvind1
1Department of Surgery, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
Summary
Mechanical thrombectomy using ClotTriever and FlowTriever systems effectively treated extensive iliocaval thrombosis in a trauma patient unsuitable for inferior vena cava (IVC) filter placement. This approach restored venous patency and resolved symptoms, offering a viable alternative when filters are suboptimal.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Trauma Management
Background:
- Managing extensive inferior vena cava (IVC) thrombosis post-trauma is complex, especially with contraindications to IVC filter placement.
- Concomitant injuries requiring surgery complicate anticoagulation and pulmonary embolism prevention strategies.
Purpose of the Study:
- To evaluate the efficacy of percutaneous mechanical thrombectomy for extensive traumatic iliocaval thrombosis in a patient unsuitable for IVC filter placement.
- To present a case study of successful intervention using combined ClotTriever and FlowTriever systems.
Main Methods:
- A patient with extensive iliocaval thrombosis post-trauma, deemed unsuitable for IVC filter placement, underwent percutaneous mechanical thrombectomy.
- The procedure utilized a combined ClotTriever BOLD and FlowTriever system, with a FlowTriever disc for embolic protection.
Main Results:
- Successful thrombus extraction restored caval patency without complications.
- Patient's lower limb swelling resolved within three days, enabling subsequent surgical reconstructions.
- The patient completed anticoagulation therapy without recurrence.
Conclusions:
- Combined ClotTriever and FlowTriever mechanical thrombectomy is a potentially effective treatment for extensive traumatic iliocaval thrombosis.
- This technique offers a viable alternative when inferior vena cava filter placement is not feasible or suboptimal.
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