PMC8645512_01
Unenhanced axial CT image of the indwelling inferior vena cava (IVC) filter from 2012, show all struts contained within the IVC (white arrow). None are visualized outside of the IVC or within the aorta (white arrowhead).
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F1
After uneventful thoracic aortic stent graft repair, serial follow-up CTA studies revealed progressive penetration of the IVCF into the false lumen of the chronic type B abdominal aortic dissection [Figures 1 and 2].
Contrast enhanced axial (a) and coronal (b) CT images reveal the inferior vena cava (IVC) filter struts penetrating (white arrow) into the false lumen of the abdominal aortic dissection (*). The lumen of the IVC appears contracted.
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F2
After uneventful thoracic aortic stent graft repair, serial follow-up CTA studies revealed progressive penetration of the IVCF into the false lumen of the chronic type B abdominal aortic dissection [Figures 1 and 2].
Intraprocedural fluoroscopic image demonstrates forcep capture of the inferior vena cava (IVC) filter apex. Bilateral wires extend from below across the IVC occlusion.
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F3
The RIJ sheath was exchanged for a 16 French x 45 cm sheath (Cook Medical), through which 2.5-mm x 55-cm rigid alligator forceps with double action (Karl Storz, El Segundo, CA) were introduced into the IVC to engage the IVCF [Figure 3].
Intraprocedural venography after removal of the inferior vena cava (IVC) filter revealing occlusion of the bilateral common iliac veins and IVC. Collateralization of venous flow is present.
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F4
Bard) and followed by venography [Figure 4].
Completion venography after iliocaval reconstruction with stents extending from the infrarenal inferior vena cava, across the common iliac veins bilaterally, and to the external iliac veins. Improved anterograde flow dynamics through the venous system are noted with collapse of the collateralized veins noted in Figure 4.
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F5
CFV, bilaterally. Completion venography and IVUS confirmed successful reconstruction of the IVC, robust venous inflow with prompt outflow, and decompression of collaterals [Figure 5].
Reconstructed CT image at follow-up reveals the relationship from the prior thoracic aortic repair (white arrowhead) and iliocaval reconstruction (white arrow).
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F6
At 3- and 6-month follow-up, the iliocaval stents remained patent with no injury to the false lumen of the chronic aortic dissection and the patient's symptoms had greatly improved with decreased leg swelling and improved ambulatory capacity [Figure 6].