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Joseph AS, Lopera JE. Digital radiograph (DR) guided bedside IVC filter placements in patients with intracranial pressure monitors. J Interv Med 2021; 4:208-211. [PMID: 35586379 PMCID: PMC8947998 DOI: 10.1016/j.jimed.2021.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/12/2021] [Accepted: 08/16/2021] [Indexed: 12/03/2022] Open
Abstract
Purpose The purpose of this study is to report a single center experience with portable digital radiographically (DR) guided bedside IVC filters placed in intensive care unit (ICU) patients with high ICP and elevated head of bed (HOB). Materials and methods A retrospective chart review was conducted on all bedside IVC filters placed from January 1, 2010 to September 16, 2020. Patients with high ICP and elevated head of bed requirements were included. Charts were reviewed for filter type, common femoral vein (CFV) access, filter location, pre procedure imaging, pre and post filter ICPs, glascow coma scale, number of radiographs taken, and filter removal. ICPs were obtained 1 h prior to procedure and 2 h post procedure and analyzed with a paired T test. Filters were placed by reviewing prior CT scan for IVC size, caval variants, renal and iliac veins and vertebral body landmarks. Then, CFV access was obtained and a Bentson wire was advanced 30–40 cm. A radiograph was used to confirm adequate position of the of the wire. The filter sheath was advanced and serial radiographs were used to position the filter sheath at the final predetermined position below the renal veins and above the iliac bifurcation. The filter was deployed, and a radiograph was obtained to confirm filter positioning. Results A total of 9 DR guided bedside IVC filters were placed (4 Denali, 3 Option Elite, 2 Celect). Indications included prophylactic placement (n = 8) and acute DVT (n = 1). The average patient age was 35.8 years (range: 18–56 years) CT abdomen and pelvis was used to assess for the level of renal veins in all patients (n = 9). No caval variants were encountered on pre-procedural planning. The average pre, intraprocedural, and post procedure intracranial pressure was 16 mmHg, 13 mmHg, and 16 mmHg, respectively. Confirmation of placement after final placement was available in 7 patients (4 DR, 2 CT and one fluoroscopic examination). Two non-procedural related deaths occurred. Technical success, defined as successful placement of IVC filter at the predetermined level, was achieved in 100% of patients (n = 9). The right CFV was used in most patients (n = 7). The left CFV was used for access in two patients due to right CFV thrombus (n = 1) and existing right femoral venous central line (n = 1). The average number of radiographs taken was 5.8 (range 4–9). In all cases, filters were placed below the level of the lowest renal vein (n = 9). A comparison of pre, during and post intervention ICP pressures is shown in table, 2. No differences between pre and post filter ICP was noted (p = 0.77). Three filters were later removed. One minor complication was reported, which was filter tilt (23%) in an Option filter. Conclusion Bedside IVC filters can be safely placed in patients with head trauma and high ICP who are unable to lay supine using portable DR guidance with a high rate of technical success and minimal complications.
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Zhu H, Du WJ, Wang XH, Yang Y, Dekyi, Chen YD, Zhao J. Feasibility study of hand-carried ultrasound-guided retrievable inferior vena cava filter placement. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:689. [PMID: 33987387 PMCID: PMC8106001 DOI: 10.21037/atm-21-1290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background With the development of ultrasonic diagnostic techniques in recent years, ultrasound-guided placement of inferior vena cava (IVC) filters has been widely used in clinics, and satisfactory results have been achieved. Our study aims to observe the accuracy of hand-carried ultrasound-guided retrievable vena cava filter placement, evaluate the feasibility and safety of this new method, and provide a scientific and effective interventional method and clinical data to prevent acute pulmonary embolism (PE) after battle injury of limbs. Methods Two hundred patients with post-traumatic thrombosis of the extremities were enrolled. The renal vein was located under the guidance of hand-carried ultrasound. The retrievable filter was fixed 1–2 cm below the opening of the renal vein. The self-expanding filter was used after the filter’s position was confirmed by injecting the contrast agent under the digital subtraction angiography (DSA) fluoroscopy. Results All the 200 patients underwent the operation successfully. The position of the hand-carried ultrasound localizer was consistent with the DSA localizer. All the filters were expanded smoothly. No complications related to the operation occurred. Conclusions The study concluded that the hand-carried ultrasound-guided retrievable vena cava filter placement has a high success rate and can prevent acute PE after limbs’ battle injury.
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Affiliation(s)
- Hang Zhu
- Department of Cardiovascular Medicine, Chinese PLA General Hospital, Beijing, China
| | - Wen-Juan Du
- Disciplinary Degree Office, Graduate School of Chinese PLA General Hospital, Beijing, China
| | - Xiao-Hua Wang
- Department of Nephrology, Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yang Yang
- Department of Clinical Medicine, The First Clinical College of Hainan Medical University, Haikou, China
| | - Dekyi
- Department of Cardiovascular Medicine at High Altitude, People's Hospital of Tibet Autonomous Region, Lasa, China
| | - Yun-Dai Chen
- Department of Cardiovascular Medicine, Chinese PLA General Hospital, Beijing, China
| | - Jing Zhao
- Scientific Research Office, Department of Medical Services, Chinese PLA General Hospital, Beijing, China
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Sodagari F, Katz DS, Menias CO, Moshiri M, Pellerito JS, Mustafa A, Revzin MV. Imaging Evaluation of Abdominopelvic Gunshot Trauma. Radiographics 2020; 40:1766-1788. [DOI: 10.1148/rg.2020200018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Sengodan P, Sankaramangalam K, Li M, Wang X, Subramaniam S, Alappan N. Comparative analysis of technical success rates and procedural complication rates of bedside inferior vena cava filter placement by intraprocedural imaging modality. J Vasc Surg Venous Lymphat Disord 2019; 7:601-609. [PMID: 31068274 DOI: 10.1016/j.jvsv.2019.01.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/31/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Transabdominal duplex ultrasound, intravascular ultrasound (IVUS), and fluoroscopy have been used to assist with inferior vena cava filter (IVCF) placement since the late 1990s. We sought to compare the technical success and procedural complications of bedside placement of IVCF by the three commonly used modalities, namely, duplex ultrasound, IVUS, and combined IVUS and fluoroscopy. METHODS All published reports including prospective and retrospective cohort studies and case series with a minimum of 10 patients from inception to August 2017 were identified by an electronic search of PubMed and Embase. The studies were then pooled to create a sample of patient data for statistical analysis. Bonferroni correction was used for comparison of the three groups. Values of P < .017 (two tailed) were considered statistically significant for the pairwise comparisons. RESULTS A total of 21 studies comprising 2166 patients were identified. No significant differences were found in technical success and complication rates between the duplex ultrasound and IVUS arm, the combined IVUS and IVUS with fluoroscopy arm, or the duplex ultrasound and the combined IVUS with fluoroscopy arm. However, there was a trend toward decreased complication rates in the duplex ultrasound arm compared with the other two arms. A trend toward increased technical success was also observed in the combined IVUS and fluoroscopy arm compared with the other two arms. CONCLUSIONS There are no significant differences in the technical success and complication rates between the three commonly used modalities of bedside IVCF placement.
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Affiliation(s)
- Prasanna Sengodan
- Department of Medicine, Cleveland Clinic Foundation - Fairview Hospital, Cleveland, Ohio.
| | | | - Manshi Li
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Xiaofeng Wang
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio
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Nikolaev KN, Zubritsky VF, Koltovich AP, Vardanyan AV, Kapustin SI, Dolidze DD, Vardanyan VA. [Prevention of venous thromboembolic complications in firearm injury]. Khirurgiia (Mosk) 2018:82-86. [PMID: 30307428 DOI: 10.17116/hirurgia2018090182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Prevention of venous thromboembolic complications in wounded is a complex problem which has not yet been fully resolved throughout the world. Current state of venous thrombosis prevention in wounded in different countries and certain ways of its improvement are analyzed in the article.
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Affiliation(s)
- K N Nikolaev
- Main military clinical hospital of Russian national guard troops', Balashikha, Russia; Kirov Military Medical Academy of the Ministry of Defense, Moscow branch, Moscow, Russia
| | - V F Zubritsky
- Main Clinical Hospital of the Ministry of Internal Affairs of Russia, Moscow, Russia; Institute of Medical and Social Technologies 'MSUPP', Moscow, Russia
| | - A P Koltovich
- Kirov Military Medical Academy of the Ministry of Defense, Moscow branch, Moscow, Russia
| | - A V Vardanyan
- Russian Medical Academy of Continuing Postgraduate Education of Healthcare Ministry of Russia, Moscow, Russia
| | - S I Kapustin
- Russian Research Institute of Hematology and Blood Transfusion of FMBA of Russia, St. Petersburg, Russia
| | - D D Dolidze
- Russian Medical Academy of Continuing Postgraduate Education of Healthcare Ministry of Russia, Moscow, Russia
| | - V A Vardanyan
- Pirogov Russian National Research Medical University, Moscow, Russia
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Ganguli S, Hawkins BM, Abtahian F, Abu-Fadel MS, Walker TG, MacKay C, Jaff MR, Weinberg I. Comparison of Inferior Vena Cava Filters Placed at the Bedside via Intravenous Ultrasound Guidance Versus Fluoroscopic Guidance. Ann Vasc Surg 2017; 39:250-255. [DOI: 10.1016/j.avsg.2016.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 06/07/2016] [Accepted: 06/09/2016] [Indexed: 10/21/2022]
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Abusedera MA, Cho K, Williams DM. Bedside intravascular ultrasound-guided inferior vena cava filter placement in medical-surgical intensive care critically-ill patients. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2015. [DOI: 10.1016/j.ejrnm.2015.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Correlation of intravascular ultrasound and computed tomography scan measurements for placement of intravascular ultrasound-guided inferior vena cava filters. J Vasc Surg 2014; 59:1066-72. [DOI: 10.1016/j.jvs.2013.10.071] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 09/12/2013] [Accepted: 10/10/2013] [Indexed: 11/22/2022]
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Hodgkiss-Harlow K, Back MR, Brumberg R, Armstrong P, Shames M, Johnson B, Bandyk DF. Technical Factors Affecting the Accuracy of Bedside IVC Filter Placement Using Intravascular Ultrasound. Vasc Endovascular Surg 2012; 46:293-9. [DOI: 10.1177/1538574411434495] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Kelley Hodgkiss-Harlow
- Division of Vascular and Endovascular Surgery, College of Medicine, University of South Florida, Tampa, FL, USA
| | - Martin R. Back
- Division of Vascular and Endovascular Surgery, College of Medicine, University of South Florida, Tampa, FL, USA
| | - Robert Brumberg
- Division of Vascular and Endovascular Surgery, College of Medicine, University of South Florida, Tampa, FL, USA
| | - Paul Armstrong
- Division of Vascular and Endovascular Surgery, College of Medicine, University of South Florida, Tampa, FL, USA
| | - Murray Shames
- Division of Vascular and Endovascular Surgery, College of Medicine, University of South Florida, Tampa, FL, USA
| | - Brad Johnson
- Division of Vascular and Endovascular Surgery, College of Medicine, University of South Florida, Tampa, FL, USA
| | - Dennis F. Bandyk
- Division of Vascular and Endovascular Surgery, College of Medicine, University of South Florida, Tampa, FL, USA
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Abstract
Venous thromboembolic disease is associated with significant morbidity and mortality. Anticoagulation has been the mainstay of treatment and prevention. Unfortunately, anticoagulation frequently fails or is contraindicated. Use of inferior vena cava filters can be an effective alternative in these scenarios. Though inferior vena cava filters have been used for > 4 decades, the evidence behind their use is limited. Use of IVC filters is associated with both minor and major complications. More randomized prospective trials are needed to evaluate these devices. In this article, we review issues concerning the use of inferior vena cava filters.
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Affiliation(s)
- Adarsh Sahni
- University of Missouri-Kansas City, Kansas City, MO, USA.
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Gillespie DL. Anticoagulation is the most appropriate method of prophylaxis against venous thromboembolic disease in high-risk trauma patients. Dis Mon 2010; 56:628-36. [PMID: 21081193 DOI: 10.1016/j.disamonth.2010.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Martin MJ, Blair KS, Curry TK, Singh N. Vena Cava Filters: Current Concepts and Controversies for the Surgeon. Curr Probl Surg 2010; 47:524-618. [DOI: 10.1067/j.cpsurg.2010.03.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Rosenthal D, Kochupura PV, Wellons ED, Burkett AB, Methodius-Rayford WC. Günther Tulip and Celect IVC filters in multiple-trauma patients. J Endovasc Ther 2009; 16:494-9. [PMID: 19702346 DOI: 10.1583/09-2728.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate results with the retrievable Günther Tulip (GT) and Celect inferior vena cava filters (IVCFs) placed at the intensive care unit (ICU) bedside under "real-time" intravascular ultrasound (IVUS) guidance in multiple-trauma patients. METHODS Between December 2004 and December 2008, 187 multiple-trauma patients (109 men; mean age 44+/-2 years, range 17-71) with contraindications to low-dose anticoagulation therapy or sequential compression devices had Günther Tulip (n = 97) or Celect (n = 90) retrievable IVCFs placed under real-time IVUS guidance. Günther Tulip filters were inserted using a "double-puncture" technique. The Celect IVCFs were placed with a simplified single-puncture technique in which the filter introducer sheath was advanced until the radiopaque tip "covered" the IVUS image of the renal vein, indicating that the filter sheath was in position for filter deployment. The 2 filter groups were compared on the endpoints of technical implantation success, retrievability, prevention of PE, and procedure-related deep vein thrombosis (DVT). RESULTS As verified by abdominal radiography, 93.1% (174/187) of IVCFs were placed without complications; 6 IVCFs (all GT; p = 0.03 versus Celect) were misplaced in the iliac vein but uneventfully retrieved and replaced in the IVC within 24 hours. Two insertion site femoral vein DVTs (both in the dual puncture group; p>0.2) and 5 groin hematomas occurred during follow-up. GT filters were in place a mean of 107 days and Celect 97 days. In this time, 2 pulmonary embolisms occurred (1 in each group; p>0.2). Of the 115 filters scheduled for retrieval (50 Günther Tulip, 65 Celect), 33 (23 Günther Tulip, 10 Celect) could not be retrieved (p = 0.0004). Vena cavography identified filter tilting (>20 degrees ) in 21 cases (15 GT, 6 Celect), while 12 filters (8 GT, 4 Celect) had extended indwell times (mean 187 days) and excessive tissue ingrowth covering the retrieval hook. Subjectively, the Celect filters were clinically "easier" to retrieve; they also had fewer cases of significant tilt (>20%) than the GT filters, but the difference was not statistically significant. CONCLUSION GT and Celect IVCFs placed at the ICU bedside under IVUS guidance in multiple-trauma patients was simple, safe, and avoided transporting critically ill patients out of the ICU. Further investigation of the single sheath IVUS technique and the role of retrievable IVCFs in multi-trauma patients is warranted.
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Affiliation(s)
- David Rosenthal
- Department of Vascular Surgery, Atlanta Medical Center, Atlanta, Georgia, USA.
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