PMC7560707_01
Computed tomography scan on day 7 showing (A) left renal vein thrombus (arrow) and (B) right lobe peripheral pulmonary embolism (arrow).
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At that time, CT scan newly demonstrated an obstructive left RVT and unilateral distal PE (Fig. 1).
(A) Venogram of the selectively catheterised left renal vein prior to thrombus removal (B) Fluoroscopy after deployment of the filter catheter in the inferior vena cava (arrow) with the need to retract the filter 1 cm prior to treatment, and coils placed for initial arterial embolisation (stars) (C) Venogram after catheter directed thrombus removal with minor residual thrombus and restored venous outflow (arrow).
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Terumo, Tokyo, Japan) was inserted. The left renal vein was selectively catheterised with a 5F shepherd hook shaped catheter (Beacon, Cook, Bloomington, IN, USA) and a venogram was performed (Fig. 2A). The catheter based filter (Capturex, Straub Medical, Wangs, Switzerland) was placed in the IVC and the filter's distal end opened at the level of the renal vein ostium shaped like a funnel (Figs. 2B and 3). The final venogram showed subtotal thrombus elimination (Fig. 2C).
Photograph of the catheter based vena cava filter (Capturex), with an elongated thrombus and smaller emboli captured inside.
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The catheter based filter (Capturex, Straub Medical, Wangs, Switzerland) was placed in the IVC and the filter's distal end opened at the level of the renal vein ostium shaped like a funnel (Figs. 2B and 3). Lastly, the filter basket containing the thrombotic material was retrieved (Fig. 3).
Computed tomography scan six weeks after left renal vein thrombus removal showing (A) no residual thrombus in the vein (arrow) and (B) residual arterial parenchymal perfusion.
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A contemporaneous final CT scan showed both absence of residual thrombosis in the left renal vein and preserved arterial perfusion of the renal parenchyma (Fig. 4A and B).