PMC3017879_01
Retrograde tempofilter placement within superior vena cava in 67-year-old woman.. A. Contrast enhanced CT shows thrombus in right pulmonary artery (arrow). B. CT scan performed at aortic arch level shows thrombotic total occlusion of left brachiocephalic vein (arrows). Note presence of scanty collateral veins around left back area (arrowheads) and bilateral pleural effusions. These findings imply hemothorax after traffic accident. C. Left upper extremity venogram shows total occlusion and non-opacification of left axillary and brachiocephalic veins. There is also reflux flow at left internal jugular vein (arrows). Note presence of small, collateral vein development. D, E. Radiograms show temporary filter placement in superior vena cava. Tethered catheter has caudal direction, and radiopaque subcutaneous anchor is located around right inguinal area. Note filter struts without hooks. F. Left upper extremity venogram after mechanical thrombectomy on left brachiocephalic vein shows no residual thrombotic occlusion and abnormal collateral veins.
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A contrast-enhanced chest computed tomography (CT) revealed a pulmonary embolism in the right pulmonary artery and thrombosis in the left brachiocephalic vein (Fig. 1A, B). A left upper extremity venogram revealed complete obstruction of the brachiocephalic vein with lack of collaterals, implying the development of acute upper extremity DVT (Fig. 1C). After burying the anchoring device into the subcutaneous pocket, the incision was sutured (Fig. 1D, E). A follow-up venography performed after thrombus aspiration showed recanalization of the left brachiocephalic vein, regression of collateral veins (Fig. 1F), and didn't show any thrombus capture within the unit.