 Normally compressible veins in the right lower extremity from the popliteal vein to the CFV.Normally compressible veins in the left lower extremity from the popliteal vein to the CFV.Iliac veins and IVC was difficult to visualize on ultrasound due to patient body habitus.Following a discussion of the procedure with the patient and/or family, including its risks, benefits, alternatives and steps to prevent infection, an informed written consent was obtained and documented in the patient's chart. The patient was placed supine on the angiography table. The right neck was prepped with chlorhexidine and covered with a full body drape in the usual sterile fashion. Local anesthesia was achieved with 1% lidocaine. Midazolam and fentanyl were administered IV by the nurses during continuous hemodynamic monitoring. All operators present for the case performed standard preprocedural prep including hand washing, sterile gloves, gown, mask and cap.The right internal jugular vein was accessed using a micropuncture system. An 0.035 guidewire was advanced into the inferior vena cava under fluoroscopic guidance and exchanged for a 5 French pigtail catheter. This was positioned with the tip in the inferior IVC just below the bifurcation. Contrast was injected obtaining an inferior venacavagram.VENACAVAGRAM: There is a single, normal caliber IVC with normal renal vein inflow. No evidence of caval thrombus. The level of the renal veins was calibrated with a ruler. The filter deployment system was advanced over an Amplatz wire and the filter was deployed in the infrarenal IVC under fluoroscopic guidance. FOLLOW UP VENACAVAGRAM: Follow up imaging shows proper full deployment of an infrarenal IVC filter. The introducer system was removed and hemostasis was achieved at the site. The patient tolerated the procedure well without immediate complication. Routine post procedure instructions were documented in the chart and relayed to the referring clinical team.FLUOROSCOPY TIME: 6.3 minutesAIR KERMA: 181 mGyStart time: 12:48PMFinish time: 1:15 PMESTIMATED BLOOD LOSS: Less than 5 ccCONTRAST: Omnipaque 300VOLUME: 70 mL
Successful placement of Cook Celect IVC filter. The patient was entered into the IVC filter tracking database and should return to the interventional radiology department in 3 months for consultation regarding optional IVC filter removal.