title: Transcatheter thrombolytic therapy for symptomatic thrombo-occlusion of inferior vena cava filter.
abstract: Thrombus within an inferior vena cava (IVC) filter reduces filter patency and venous return from the lower extremities, and may progress to complete IVC occlusion. The clinical experiences and outcomes of transcatheter thrombolytic therapy for symptomatic IVC thrombosis following filter implantation have not been widely reported. The aim of the current study was to evaluate the efficiency and safety of trans-catheter thrombolysis for the treatment of symptomatic IVC thrombosis in patients with implanted IVC filters. Transcatheter thrombolysis was used to treat 5 patients with thrombosis of the filter-bearing IVC causing symptoms in 10 limbs from October 2005 to September 2010. The patients were implanted with a second IVC filter through the right internal jugular vein, followed by recanalization of the occluded IVC and intravenous transcatheter thrombolysis. The IVC filters were retrieved through the femoral or right internal jugular vein after the thrombus had dissolved. Technical and clinical outcome, complications and postoperative pulmonary embolism were monitored. A total of 5 filters were implanted and 6 filters were retrieved later. Technically and clinically successful recanalization and thrombolysis were achieved in 5 of 5 patients and 10 of 10 symptomatic limbs. The median thrombolysis period was 13 days (range, 8-14 days). The median dwell time for the filters that were removed was 50.5 days (range, 14-73 days). No major bleeding occurred during the current study. During clinical follow-up, no clinically detectable pulmonary embolism was observed. Endovascular recanalization and transcatheter thrombolysis of IVC thrombosis are efficient, feasible and safe in the presence of an IVC filter.
authors: Department of Radiology, The First Hospital of China Medical University, Liaoning, Shenyang 110001;
authors: Liang
authors: L
authors: Xiao
authors: Jing
authors: J
authors: Shen
authors: Jia-Jie
authors: JJ
authors: Tong
authors: Zhe
authors: Z
authors: Zhang
authors: Xiao-Lin
authors: XL
authors: Mu
authors: Zheng-Jia
authors: ZJ
authors: Yi
authors: Shuo
authors: S
authors: Bai
authors: Ke
authors: K
authors: Xu
keywords: efficiency; filter; inferior vena cava; thrombolysis; thrombosis
references: Ann Vasc Surg. 2010 May;24(4):480-6
references: 19900783
references: Ann Vasc Surg. 2010 Jul;24(5):690.e5-7
references: 20144530
references: Acta Radiol. 2011 Jul 1;52(6):643-5
references: 21521727
references: Cardiovasc Intervent Radiol. 2001 Jul-Aug;24(4):257-9
references: 11779016
references: Am Surg. 2003 Aug;69(8):654-9
references: 12953821
references: J Vasc Interv Radiol. 2008 Aug;19(8):1165-70
references: 18656008
references: J Vasc Interv Radiol. 1999 Feb;10(2 Pt 1):137-42
references: 10082099
references: Cardiovasc Intervent Radiol. 2002 Sep-Oct;25(5):440-3
references: 12016520
references: J Vasc Surg. 1992 Nov;16(5):750-61
references: 1433663
references: Clin Nephrol. 2009 Apr;71(4):456-9
references: 19356383
references: J Vasc Interv Radiol. 2003 Mar;14(3):381-5
references: 12631645
references: J Vasc Interv Radiol. 1998 Nov-Dec;9(6):917-25
references: 9840035
references: Chest. 2010 Apr;137(4):877-82
references: 19880907
references: J Vasc Interv Radiol. 2009 Dec;20(12):1548-56
references: 19864160
references: Cardiovasc Intervent Radiol. 1998 Nov-Dec;21(6):464-9
references: 9853163
references: J Vasc Surg. 2011 Jul;54(1):153-61
references: 21316900
references: Radiology. 1999 Apr;211(1):39-49
references: 10189452
references: Cardiovasc Intervent Radiol. 2010 Apr;33(2):285-9
references: 19688372
references: J Vasc Surg. 1995 Feb;21(2):235-45; discussion 245-6
references: 7853597
references: AJR Am J Roentgenol. 1999 Mar;172(3):667-72
references: 10063857
references: Clin Nephrol. 2010 May;73(5):408-12
references: 20420804
references: Cardiovasc Intervent Radiol. 2007 Sep-Oct;30(5):820-7
references: 17763901
references: J Vasc Interv Radiol. 2002 Jun;13(6):577-80
references: 12050297
references: J Vasc Interv Radiol. 2003 Jul;14(7):893-903
references: 12847197
references: Eur Radiol. 1997;7(7):996-1001
references: 9265661
references: J Thromb Thrombolysis. 2009 Nov;28(4):500-5
references: 19521667
references: Radiology. 2000 Jan;214(1):133-8
references: 10644112
references: Cardiovasc Revasc Med. 2008 Jan-Mar;9(1):36-40
references: 18206636
references: Circulation. 2005 Jul 19;112(3):416-22
references: 16009794
references: J Vasc Interv Radiol. 2003 Apr;14(4):425-40
references: 12682199
references: J Vasc Surg. 2000 Jul;32(1):130-7
references: 10876214
references: Eur Respir J. 1996 Oct;9(10):2012-6
references: 8902459