Real-time intravascular ultrasound-guided placement of a removable inferior vena cava filter.
BACKGROUND
Reports have demonstrated the benefit of prophylactic inferior vena cava filter (IVCF) placement to prevent pulmonary embolism. This series evaluates the potential for the bedside placement of a removable IVCF under "real-time" intravascular ultrasound (IVUS) guidance.


METHODS
Twenty trauma patients underwent intensive care unit placement of a removable IVCF with IVUS guidance. All patients had ultrasonography of the femoral veins after placement to rule out postprocedure femoral vein thrombosis and radiographs to identify filter location.


RESULTS
Nineteen of 20 IVCFs were placed at approximately the L2 level as verified by radiography. One patient had a large IVC (34 mm) and underwent bilateral common iliac IVCF placement under IVUS. Within 3 weeks of placement, 12 IVCFs were retrieved. Of the remaining eight patients, six had indications for permanent implantation, two had contralateral deep venous thrombosis, and one had ipsilateral deep venous thrombosis.


CONCLUSIONS
Bedside insertion of a removable IVCF with IVUS guidance and its removal are simple, safe, and accurate.
Department of Vascular Surgery, Atlanta Medical Center, Atlanta, Georgia 30312, USA. ewellons@hotmail.com
Eric D
ED
Wellons
David
D
Rosenthal
Frederick W
FW
Shuler
Adam B
AB
Levitt
John
J
Matsuura
Vernon J
VJ
Henderson
D003422:Critical Care / Q000379:methods; D005845:Georgia; D006801:Humans; D007362:Intensive Care Units; D019095:Point-of-Care Systems; D011655:Pulmonary Embolism / Q000517:prevention & control*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*; D014654:Vascular Patency; D016306:Vena Cava Filters; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging*; D014947:Wounds and Injuries / Q000628:therapy*