title: Vena Tech LGM filter retrieval 16 years after implantation: piecemeal removal by intentional mechanical fracture.
abstract: A 48-year-old man presented with symptomatic inferior vena cava (IVC) occlusion from a chronically thrombosed and embedded Vena Tech LGM filter resulting in exercise intolerance from diminished cardiac preload and postthrombotic syndrome from chronic venous insufficiency. The patient was treated using a new PRIME technique--Piecemeal Removal by Intentional MEchanical fracture--to achieve successful filter retrieval 16 years after implantation. Removal of the obstructing filter permitted endovascular IVC recanalization with restoration of venous outflow and alleviation of venous obstructive symptoms. Cardiac preload was restored, allowing the patient to resume long-distance running, and he successfully completed a half-marathon 3 months after treatment.
authors.affiliation: Division of Vascular and Interventional Radiology, Department of Radiology, Stanford University Medical Center, 300 Pasteur Dr., H-3651, Stanford, CA 94305-5642. Electronic address: wkuo@stanford.edu.
authors.forename: William T
authors.initials: WT
authors.lastname: Kuo
authors.forename: Steven E
authors.initials: SE
authors.lastname: Deso
authors.forename: Scott W
authors.initials: SW
authors.lastname: Robertson
mesh_terms: D000800:Angioplasty, Balloon / Q000295:instrumentation; D002908:Chronic Disease; D020878:Device Removal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D054070:Postthrombotic Syndrome / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D015607:Stents; D013314:Stress, Mechanical; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016306:Vena Cava Filters; D014689:Venous Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000628:therapy*
keywords: DVT; EM; IVC; PRIME; deep vein thrombosis; electron microscopy; inferior vena cava; piecemeal removal by intentional mechanical fracture