PMC7736903_01
Step by step demonstration of the endovascular rescue technique (A) Standard access via the right internal jugular vein with inferior vena cava (IVC) filter retrieval kit (B) Using the loop-snare technique, the hook and collet of the filter were captured (C) Approximately halfway through removal of the filter through the sheath, the tip of the IVC filter was found to have perforated the side of the retrieval sheath (D) Via a 16 F, 45 cm sheath in the right common femoral vein, an Amplatz wire was used to cannulate the distal end of the perforated retrieval sheath and a six mm x four cm balloon was advanced into the distal end of the perforated retrieval sheath (E) After removing the Tuohy-Borst and Luer adapters on the perforated sheath, it was able to be internalised, along with the IVC filter, and removed via the femoral vein sheath. SVC = superior vena cava.
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fig1
The patient was brought to the catheterisation laboratory suite and, using the Cook Gunther Tulip Vena Cava Filter Retrieval Set (Cook Medical), standard access procedures were performed via the right internal jugular vein (Fig. 1A). Using the loop-snare technique, the hook and collet were captured (Fig. 1B) and the filter was collapsed into the retrieval sheath. The tip of the IVC filter was found to have perforated the side of the retrieval sheath (Figure 1, Figure 2). Amplatz wire was used to cannulate the distal end of the perforated retrieval sheath (Fig. 1D). A 6 mm x 4 cm balloon was then inflated in the distal end of the perforated retrieval sheath and was used to pull the sheath into the 16 F femoral vein sheath. After removing the Tuohy-Borst and Luer adapters on the perforated sheath, it was able to be internalised, along with the IVC filter, and removed via the femoral vein sheath (Fig. 1E).
Intra-operative fluoroscopy demonstrating inferior vena cava (IVC) filter perforation through the initial retrieval sheath placed via the right internal jugular vein. SVC = superior vena cava; RRV = right renal vein; LRV = left renal vein.
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The tip of the IVC filter was found to have perforated the side of the retrieval sheath (Figure 1, Figure 2).