Management of the Thrombosed Filter-Bearing Inferior Vena Cava

Abstract

Inferior vena cava (IVC) filter thrombosis is a complex problem. Thrombus within an IVC filter may range from an asymptomatic small thrombus to critical IVC occlusion that affects both lower extremities. The published experience of IVC thrombosis management in relation to filters is either anecdotal or limited to a small group of patients; however, endovascular treatment methods appear to be safe and effective in patients with IVC thrombosis. This review focuses on filter-related IVC thrombosis and its endovascular management.

Keywords

vena cava filters - vena cava inferior - venous thrombosis/therapy - thrombectomy/methods

• References

• 1 Vedantham S, Vesely TM, Parti N , et al. Endovascular recanalization of the thrombosed filter-bearing inferior vena cava. J Vasc Interv Radiol 2003; 14 (7) 893-903
• 2 Angle JF, Matsumoto AH, Al Shammari M, Hagspiel KD, Spinosa DJ, Humphries JE. Transcatheter regional urokinase therapy in the management of inferior vena cava thrombosis. J Vasc Interv Radiol 1998; 9 (6) 917-925
• 3 Mobin-Uddin K, Pleasant R, Mobin-Uddin O, Ahmad KA. Evolution of a new device for the prevention of pulmonary embolism. Am J Surg 1994; 168 (4) 330-334
• 4 Greenfield LJ, McCurdy JR, Brown PP, Elkins RC. A new intracaval filter permitting continued flow and resolution of emboli. Surgery 1973; 73 (4) 599-606
• 5 Ahmad I, Yeddula K, Wicky S, Kalva SP. Clinical sequelae of thrombus in an inferior vena cava filter. Cardiovasc Intervent Radiol 2010; 33 (2) 285-289
• 6 Ray Jr CE, Prochazka AV. The need for anticoagulation following inferior vena cava filter placement: systematic review. Cardiovasc Intervent Radiol 2008; 31 (2) 316-324
• 7 Habito CR, Kalva SP. Inferior vena cava filter thrombosis: a review of current concepts, evidence, and approach to management. Hosp Pract (Minneap) 2011; 39 (3) 79-86
• 8 Decousus H, Leizorovicz A, Parent F , et al. A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. . Prévention du Risque d'Embolie Pulmonaire par Interruption Cave Study Group. N Engl J Med 1998; 338 (7) 409-415
• 9 Ryu RK, Durham JD, Kumpe DA. Transcatheter venous thrombolysis—pitfalls and pratfalls: a case discussion of indications, technique, and alternatives. J Vasc Interv Radiol 1997; 8 (6) 1005-1010
• 10 Tarry WC, Makhoul RG, Tisnado J, Posner MP, Sobel M, Lee HM. Catheter-directed thrombolysis following vena cava filtration for severe deep venous thrombosis. Ann Vasc Surg 1994; 8 (6) 583-590
• 11 Semba CP, Dake MD. Catheter-directed thrombolysis for iliofemoral venous thrombosis. Semin Vasc Surg 1996; 9 (1) 26-33
• 12 Bjarnason H, Kruse JR, Asinger DA , et al. Iliofemoral deep venous thrombosis: safety and efficacy outcome during 5 years of catheter-directed thrombolytic therapy. J Vasc Interv Radiol 1997; 8 (3) 405-418
• 13 Hansen ME, Miller III GL, Starks KC. Pulse-spray thrombolysis of inferior vena cava thrombosis complicating filter placement. Cardiovasc Intervent Radiol 1994; 17 (1) 38-40
• 14 Arslan B, Turba UC, Matsumoto AH. Acute renal failure associated with percutaneous mechanical thrombectomy for iliocaval venous thrombosis. Semin Intervent Radiol 2007; 24 (3) 288-295
• 15 Entwisle KG, Watkinson AF, Hibbert J, Adam A. The use of the Wallstent endovascular prosthesis in the treatment of malignant inferior vena cava obstruction. Clin Radiol 1995; 50 (5) 310-313
• 16 Razavi MK, Hansch EC, Kee ST, Sze DY, Semba CP, Dake MD. Chronically occluded inferior venae cavae: endovascular treatment. Radiology 2000; 214 (1) 133-138
• 17 Golarz SR, Grimsley B. Use of Wallstent to exclude a thrombosed inferior vena cava filter. Ann Vasc Surg 2010; 24 (5) 690-, e5–e7
• 18 Neglén P, Oglesbee M, Olivier J, Raju S. Stenting of chronically obstructed inferior vena cava filters. J Vasc Surg 2011; 54 (1) 153-161
• 19 Turba UC, Arslan B, Meuse M , et al. Günter tulip filter retrieval experience: predictors of successful retrieval. Cardiovasc Intervent Radiol 2010; 33 (4) 732-738
• 20 Jost CJ, Gloviczki P, Cherry Jr KJ , et al. Surgical reconstruction of iliofemoral veins and the inferior vena cava for nonmalignant occlusive disease. J Vasc Surg 2001; 33 (2) 320-327; discussion 327–328
• 21 Davenport DL, Xenos ES. Early outcomes and risk factors in venous thrombectomy: an analysis of the American College of Surgeons NSQIP dataset. Vasc Endovascular Surg 2011; 45 (4) 325-328
• 22 Minocha J, Idakoji I, Riaz A , et al. Improving inferior vena cava filter retrieval rates: impact of a dedicated inferior vena cava filter clinic. J Vasc Interv Radiol 2010; 21 (12) 1847-1851