The Filcard temporary, removable vena cava filter: use in local thrombolytic therapy

Femoral and iliac vein thrombosis with impending pulmonary embolism is a potentially life-threatening condition. The decision whether or not to implant a permanent caval filter always requires critical consideration of a number of factors. Improper positioning of the filter with resultant filtering inefficiency, thrombosis of the filter and of the cava, propagation of the thrombus through the filter, perforation by the filter of the vena cava with penetration of the aorta, the duodenum, the psoas muscle or the vertebral body, fragmentation of the filter and migration of the filter are well-documented complications of the currently available permanent filters. The danger of fatal pulmonary embolism has to be weighed against that of one or a combination of any of the above-mentioned possible complications associated with permanent caval filters which may affect the quality of later life. We present our initial observations with a temporary, removable inferior vena cava (IVC) filter in a young female patient with a floating thrombus in the left femoral and iliac vein who underwent successful local thrombolytic therapy.