Prophylactic Placement of an Inferior Vena Cava Filter During Aspiration Thrombectomy for Acute Deep Venous Thrombosis of the Lower Extremity.
OBJECTIVE
To evaluate the effect of an inferior vena cava (IVC) filter during aspiration thrombectomy for acute deep vein thrombosis (DVT) in the lower extremity.


METHODS
From July 2004 to December 2013, a retrospective analysis of 106 patients with acute DVT was performed. All patients received an IVC filter and were treated initially with aspiration thrombectomy. Among the 106 patients, DVT extension into the IVC was noted in 27 but was not evident in 79. We evaluated the presence of trapped thrombi in the filters after the procedure. The sizes of the trapped thrombi were classified into 2 grades based on the ratio of the maximum transverse length of the trapped thrombus to the diameter of the IVC (Grades I [≤ 50%] and II [> 50%]).


RESULTS
A trapped thrombus in the filter was detected in 46 (43%) of 106 patients on final venograms. The sizes of the trapped thrombi were grade I in 12 (26.1%) patients and grade II in 34 (73.9%). Among the 27 patients with DVT extension into the IVC, 20 (74.1%) showed a trapped thrombus in the filter, 75% (15 of 20) of which were grade II. Among the 79 patients without DVT extension into the IVC, 26 (32.9%) showed a trapped thrombus in the IVC filter, 73% (19 of 26) of which were grade II.


CONCLUSIONS
Thrombus migration occurred frequently during aspiration thrombectomy of patients with acute DVT in the lower extremity. However, further studies are needed to establish a standard protocol for the prophylactic placement of an IVC filter during aspiration thrombectomy.
Department of Radiology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Republic of Korea.
Se Hwan
SH
Kwon
Department of Radiology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Republic of Korea Department of Radiology, Gil Medical Center, Gachon University, Republic of Korea.
So Hyun
SH
Park
Department of Radiology, College of Medicine, Kyung Hee University Hospital, Kyung Hee University, Republic of Korea.
Joo Hyeong
JH
Oh
Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Republic of Korea.
Myung Gyu
MG
Song
Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Republic of Korea g1q1papa@korea.ac.kr.
Tae-Seok
TS
Seo
D000328:Adult; D000368:Aged; D000072226:Computed Tomography Angiography; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D011655:Pulmonary Embolism / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D017131:Thrombectomy / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D016306:Vena Cava Filters; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D055815:Young Adult
DVT; IVC filter; aspiration thrombectomy