Avoiding renal vein entry when implanting the Mobin-Uddin vena cava umbrella filter

Area of Science:

• Vascular Surgery
• Interventional Radiology

Background:

• Transvenous vena cava interruption is crucial for high-risk patients unable to undergo laparotomy.
• Mobin-Uddin vena cava umbrella filters offer a safe and effective method for this procedure.
• Aberrant renal vein anatomy can complicate filter device passage during transvenous insertion.

Purpose of the Study:

• To describe a technique to manage aberrant renal vein passage during transvenous Mobin-Uddin filter placement.
• To ensure successful vena cava interruption in challenging anatomical situations.

Main Methods:

• Utilized a venous thrombectomy catheter to temporarily occlude aberrant renal vein orifices.
• Employed patient repositioning maneuvers to correct device trajectory.
• Described the management of filter insertion device misplacement into renal veins.

Main Results:

• The described technique successfully prevented incorrect filter placement into aberrant renal veins.
• This method facilitated the completion of transvenous vena cava interruption.
• It avoided the need to abandon the transvenous approach.

Conclusions:

• Temporary occlusion of aberrant renal veins with a thrombectomy catheter is an effective strategy.
• This technique enhances the safety and success rate of transvenous vena cava filter placement.
• It provides a solution for complex anatomy encountered during the procedure.