PMC5498201_01
An enhanced CT showed a left extensive ileofemoral thrombus at 37 weeks of gestation. The lines (a-i) in the coronal section (A) show the levels of transverse sections (a-i in panels B). The arrows indicate a large thrombus in the vein.
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A: Continuous images of an enhanced CT after delivery showed that a large thrombus had been captured in the transient inferior vena cava filter (t-IVCF) (red arrows). B: Although we performed mechanical thrombus fragmentation using a pigtail catheter (yellow arrow), the size of thrombus did not change (red arrows).
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However, an enhanced CT showed that a large thrombus had been captured in the filter (Fig. 2A red arrows), believed to be due to DVT in a lower extremity. Although we performed catheter thrombus fragmentation using a pigtail catheter (Fig. 2B yellow arrow), the size of the thrombus did not change (Fig. 2B red arrows).
Continuous images of an enhanced CT one week after thrombolytic therapy revealed that the thrombus had shrunk significantly, but a few clots remained in the filter (red arrows).
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We therefore started thrombolytic therapy by the systemic administration of urokinase (480,000 units/day) for 1 week, and an enhanced CT revealed that the thrombus had shrunk significantly, although a few small clots remained within the t-IVCF (Fig. 3 red arrows).
A schematic illustration of the aspiration procedure. After starting aspiration from a side-hole of the sheath, the t-IVCF containing clots was pulled back into the sheath (A). The clots within the t-IVCF were then squeezed out (B) and aspirated into the sheath (C).
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We then removed the t-IVCF under constant negative pressure by aspiration from a side-hole of the sheath (Fig. 4).
The aspirated clots consisted of a combination of fresh (A blue arrows and B) and old organized thrombi (A yellow arrows and C).
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The aspirated clots consisted of a combination of fresh (Fig. 5A blue arrows and B) and old organized thrombi (Fig. 5A yellow arrows and C).