title: Incidence and complications of accidental cannulation of retroperitoneal veins during venography for inferior vena cava filter placement.
abstract: BACKGROUND
  The purpose of this study was to evaluate the incidence and complications of accidental cannulation of retroperitoneal veins during venography for inferior vena cava (IVC) filter placement.
  
  
  METHODS
  In total, 641 patients who underwent IVC filter placement were retrospectively reviewed. Incidence of accidental cannulation of retroperitoneal veins during venography (using 633 sheaths and 18 catheters, including 11 pigtail type and 7 end-hole-type catheters), along with the associated complications, were evaluated.
  
  
  RESULTS
  The overall frequency of accidental cannulation of retroperitoneal veins was 5.4% (35 of 651) via venous approaches: 5.8% (24 of 411) via a right femoral approach, 3.9% (5 of 129) via a left femoral approach, and 5.4% (6 of 111) via a jugular approach. The most frequent veins cannulated were the ascending lumbar veins (4.6%, 25 of 540) via a femoral approach, and the median sacral vein (3.6%, 4 of 111) via a jugular approach. No significant difference in the frequency of accidental cannulation was observed between venography through sheaths and catheters (5.4% [n = 34] vs. 5.6% [n = 1; using an end-hole-type catheter]; P = 1.000). Injuries to 5 veins (0.8%), including 3 ascending lumbar veins, were observed. Inadvertent filter placement within the right ascending lumbar vein was observed in 1 patient (0.2%).
  
  
  CONCLUSIONS
  Accidental cannulation of retroperitoneal veins during venography for IVC filter placement is an infrequent occurrence, and in this patient series did not result in negative clinical outcomes. However, operators should be aware of the risk of accidental cannulation to prevent avoidable complications such as venous injury or filter misplacement.
authors.affiliation: Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA.
authors.forename: Gunvir
authors.initials: G
authors.lastname: Gill
authors.forename: Satoru
authors.initials: S
authors.lastname: Morita
authors.forename: Takashi
authors.initials: T
authors.lastname: Kitanosono
authors.forename: Adam
authors.initials: A
authors.lastname: Fang
authors.forename: David
authors.initials: D
authors.lastname: Lee
authors.forename: David
authors.initials: D
authors.lastname: Waldman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000517:prevention & control*; D012187:Retroperitoneal Space / Q000098:blood supply; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional; D014481:United States / Q000453:epidemiology; D057772:Vascular System Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D016306:Vena Cava Filters; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000293:injuries*; D055815:Young Adult