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Related Experiment Videos

Duplex-directed vena caval filter placement: report of initial experience

D F Neuzil1, C L Garrard, R A Berkman

  • 1Division of Vascular Surgery, Vanderbilt University Medical Center, Nashville, Tenn. 37232-2735, USA.

Surgery
|April 29, 1998
PubMed
Summary

Duplex ultrasonography enables feasible placement of vena caval filters, simplifying the procedure by reducing fluoroscopy needs and patient transport. This method is limited only by rare visualization issues, offering a cost-effective alternative.

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Area of Science:

  • Vascular Surgery
  • Medical Imaging
  • Interventional Radiology

Background:

  • Fluoroscopy, patient transport, and costs present challenges in vena caval filter placement.
  • Duplex ultrasonography is documented for post-placement filter visualization and caval patency assessment.
  • Bedside or vascular lab filter placement using duplex ultrasonography may simplify the procedure.

Purpose of the Study:

  • To determine the feasibility of vena caval filter placement using duplex ultrasonography.
  • To assess the potential for duplex ultrasonography to simplify filter placement procedures.

Main Methods:

  • Patients undergoing vena caval interruption were evaluated for inferior vena cava and renal vein visualization.
  • Filter placement was performed at the bedside or in the vascular laboratory if visualization was adequate.

Related Experiment Videos

  • Duplex ultrasonography assessed filter migration, thrombus, and caval patency; completion roentgenography was used selectively.

    • Main Results:

    • Twenty-five of twenty-nine vena caval filters were placed successfully using duplex ultrasonography.
    • Inadequate visualization occurred in four obese patients, necessitating fluoroscopic placement.
    • One filter tilt required fluoroscopic repositioning; one case of caval thrombosis and no major filter migration were noted via ultrasonography.

    Conclusions:

    • Vena caval filter placement is feasible with duplex ultrasonography, with visualization being the only rare limitation.
    • This technique reduces reliance on fluoroscopy, lowers costs, and avoids transporting critically ill patients.
    • Intravascular ultrasonography can potentially eliminate the need for fluoroscopic filter placement in selected patients.