https://orcid.org/0000-0002-8268-4068
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Suresh Babu, Tahira Kumar, IVC filter: a life-saving device, Postgraduate Medical Journal, Volume 95, Issue 1123, May 2019, Pages 285–286, https://doi.org/10.1136/postgradmedj-2018-135564
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A 37-year-old woman was admitted to the hospital with acute swelling of her left lower limb. There was no significant medical history of note. Initial investigation with an ultrasound and CT scan of the left lower limb revealed acute thrombosis of the left iliac, femoral and leg veins. The patient elected to have thrombectomy and thrombolysis of the acute deep venous thrombosis (DVT). As a precaution to prevent pulmonary embolism, a permanent retrievable inferior vena cava (IVC) filter (Celect, Cook Medical, Denmark) was deployed below the renal veins via jugular access. After that, left leg venography was done via left popliteal vein, in which a 7 F sheath was inserted for repeated access. Immediate thrombectomy was performed and recanalised. A large free-floating thrombus in the distal IVC was aspirated. However, thrombolysis was commenced for residual thrombus and continued for 2 days, and repeat venography was done everyday to assess. In addition, an acute severe stenosis of the origin of left common iliac vein (figure 1) was stented and then angioplastied. Full recanalisation was achieved on the third day which was confirmed on the venography (figure 2). The patient reported total symptomatic relief and resumed normal activities. Follow-up Doppler ultrasound of the left lower limb revealed resolution of DVT. The patient was commenced on new-generation oral anticoagulant, dabigatron, at a dose of 150 mg two times a day.
