PROCEDURE:  Inferior venacavagram and IVC filter removal with followup cavogram       

INDICATION:    

DATE:    

OPERATORS: 

MEDICATIONS:    

CONTRAST:     ml of nonionic contrast

FLUOROSCOPY TIME:    

FILTER TYPE:    

ACCESS SITE:      with ultrasound guidance

COMPLICATIONS: None

 

TECHNIQUE:

The risks, benefits, and alternatives to the procedure and sedation were explained to the    .  The specific risks of vascular damage and pulmonary embolus were detailed and accepted. Written informed consent was obtained. 

The patient was assessed for conscious sedation and found to be an adequate candidate. A dedicated nurse monitored heart rate, blood pressure, and oxygen saturation throughout the procedure. A time out was performed.

The  ____was prepped and draped in sterile fashion. Under ultrasound guidance, the     vein was accessed with a micropuncture needle.  Vein patency and needle entry were documented.  Images were stored and transferred to PACS.   A 0.018″ wire was placed and the needle exchanged for a 5 French dilator. A sheath was placed at the access site.

A  multisidehole catheter was advanced over the wire and positioned below the IVC filter under fluoroscopy. Inferior venacavography was then performed to assess the filter for captured thrombus.

The  catheter was exchanged for the filter removal system.  This was positioned just above the filter tip. The ____ was advanced over the wire and deployed just above the central tip of the IVC filter. The filter was engaged with confirmation in multiple projections. The filter was then pulled through the retrieval sheath under fluoroscopic guidance. 

A pigtail catheter was advanced over the wire and positioned in the infrarenal IVC.  Inferior venacavography was performed to assess  IVC integrity after filter retrieval.  The images were reviewed.

The catheter, wire and right jugular sheath were removed  and hemostasis achieved with compression.

No immediate complication occurred, and the patient was discharged from the angiography suite in satisfactory condition.

 

FINDINGS:

  1. There is no significant thrombus within the infrarenal IVC filter. 
  2. The filter was removed without incident. 
  3. Post removal cavography shows no contrast extravasation or leak. The IVC is intact.

 

IMPRESSION:

  1. No evidence for significant captured thrombus within the infrarenal IVC filter. 
  2. Uneventful image guided retrieval of an infrarenal  IVC filter as described.