Placement of Vena Cava Filters: Factors Affecting Technical Success and Immediate Complications
Michael A. Savin1,2,
Harish K. Panicker1,3,
Shahzad Sadiq1,
Yahya A. Albeer1,4 and
Ronald E. Olson5
1 Department of Radiology, St. Joseph Mercy — Oakland, 44405 Woodward
Ave., Pontiac, MI 48341.
2 Present address: Department of Radiology, William Beaumont Hospital, 3601 W.
13 Mile Rd., Royal Oak, MI 48073.
3 Present address: Department of Radiology, Wayne State University, DRH 3L-8,
4201 St. Antoine St., Detroit, MI 48201.
4 Present address: Department of Diagnostic Radiology, Yale—New Haven
Hospital, 20 York St., New Haven, CT 06504.
5 Oakland University, School of Health Sciences, Rochester, MI 48309.
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Fig. 1A. —68-year-old woman with acute lower extremity deep vein
thrombosis and contraindication to anticoagulation because of persistent
gastrointestinal bleeding. Radiograph shows unrecognized misplacement of
single, otherwise normal-appearing Simon nitinol filter (Bard, Covington, GA)
with basket at level of L1-L2.
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Fig. 1B. —68-year-old woman with acute lower extremity deep vein
thrombosis and contraindication to anticoagulation because of persistent
gastrointestinal bleeding. CT image at level of left renal vein
(arrow) shows suprarenal filter placement.
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Fig. 1C. —68-year-old woman with acute lower extremity deep vein
thrombosis and contraindication to anticoagulation because of persistent
gastrointestinal bleeding. CT image just below B at level of right
renal vein (arrow) confirms suprarenal placement.
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Fig. 2A. —59-year-old hypercoagulable man with lung cancer and acute
left lower extremity deep vein thrombosis. His anticoagulation therapy was
inadequate. Radiograph shows unrecognized filter misplacement in right common
iliac vein with hooks overlying sacrum. Patient presented with acute shortness
of breath 2 weeks later.
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Fig. 2B. —59-year-old hypercoagulable man with lung cancer and acute
left lower extremity deep vein thrombosis. His anticoagulation therapy was
inadequate. Normal ventilation scan, posterior view (B), and perfusion
scan (C) show multiple large defects that indicate high probability of
pulmonary embolism.
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Fig. 2C. —59-year-old hypercoagulable man with lung cancer and acute
left lower extremity deep vein thrombosis. His anticoagulation therapy was
inadequate. Normal ventilation scan, posterior view (B), and perfusion
scan (C) show multiple large defects that indicate high probability of
pulmonary embolism.
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Fig. 3A. —65-year-old man with acute deep vein thrombosis. While
receiving heparin, the patient developed gastrointestinal bleeding. Cavogram
shows left (arrow) and right iliac veins with typical confluence at
level of L5.
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Fig. 3B. —65-year-old man with acute deep vein thrombosis. While
receiving heparin, the patient developed gastrointestinal bleeding. Cavogram
shows unrecognized Simon nitinol filter (Bard, Covington, GA) misplacement in
right common iliac vein (arrow) with hooks overlying sacrum. Patient
subsequently became hemodynamically unstable, and CT scan showed large
retroperitoneal hematoma and filter misplacement in right iliac vein.
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Fig. 3C. —65-year-old man with acute deep vein thrombosis. While
receiving heparin, the patient developed gastrointestinal bleeding. Radiograph
shows second filter (arrow) that was placed above misplaced filter 6
days later.
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Copyright © 2002 by the American Roentgen Ray Society.
