Subscribe to RSS
DOI: 10.1055/s-2007-971197
The Use of Paired Optionally Retrievable Günther Tulip Filters in Trauma Patients with Anatomical Variants
Publication History
Publication Date:
27 March 2007 (online)
![](https://www.thieme-connect.de/media/sir/200701/lookinside/thumbnails/10.1055-s-2007-971197-1.jpg)
ABSTRACT
Inferior vena cava (IVC) filtration is commonly performed to protect against pulmonary embolism in acutely injured patients with contraindications for anticoagulation therapy. Increasingly, optionally retrievable IVC filters are utilized, particularly in younger patients with longer life expectancies. There are well-described anatomical variants that preclude the typical infrarenal deployment of IVC filters. We describe three cases in which trauma patients with congenital anomalies required temporary prophylaxis with IVC filters. One patient had a duplication of the IVC requiring filter deployment in each IVC limb. The second patient had a low inserting accessory left renal vein, and a third patient had a megacava. Both of these patients required filter deployment in each common iliac vein. In each case, a pair of optionally retrievable Günther Tulip filters was deployed and subsequently retrieved.
KEYWORDS
Inferior vena cava - filter - anatomical variant
REFERENCES
- 1 Rosenthal D, Wellons E D, Levitt A B, Shuler F W, O'Conner R E, Henderson V J. Role of prophylactic temporary inferior vena cava filters placed at the ICU bedside under intravascular ultrasound guidance in patients with multiple trauma. J Vasc Surg. 2004; 40 958-964
- 2 Hoff W S, Hoey B A, Wainwright G A et al.. Early experience with retrievable inferior vena cava filters in high-risk trauma patients. J Am Coll Surg. 2004; 199 869-874
- 3 Decousus H, Leizorovicz A, Parent F et al.. A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. N Engl J Med. 1998; 338 409-415
- 4 Rosenthal D, Wellons E D, Lai K M, Bikk A. Retrievable inferior vena cava filters: early clinical experience. J Cardiovasc Surg (Torino). 2005; 46 163-169
- 5 Prevention of venous thrombosis and pulmonary embolisms. NIH Consensus Development. JAMA. 1986; 256 744-749
- 6 Linsenmaier U, Rieger J, Schenk F, Rock C, Mangel E, Pfeifer K J. Indications, management, and complications of temporary inferior vena cava filters. Cardiovasc Intervent Radiol. 1998; 21 464-469
- 7 Rohrer M J, Cutler B S. Placement of two Greenfield filters in a duplicated vena cava. Surgery. 1988; 104 572-574
- 8 Anne N, Pallapothu R, Holmes R, Johnson M D. Inferior vena cava duplication and deep venous thrombosis: case report and review of literature. Ann Vasc Surg. 2005; 19 740-743
- 9 Putnam III S G, Ball D, Cohen G S. Placement of bilateral Simon Nitinol filters for an inferior vena caval duplication through a single groin access. J Vasc Interv Radiol. 1999; 10 431-433
- 10 Trigaux J P, Vandroogenbroek S, De Wispelaere J F, Lacrosse M, Jamart J. Congenital anomalies of the inferior vena cava and left renal vein: evaluation with spiral CT. J Vasc Interv Radiol. 1998; 9 339-345
- 11 Mano A, Tatsumi T, Sakai H et al.. A case of deep venous thrombosis with a double inferior vena cava effectively treated by suprarenal filter implantation. Jpn Heart J. 2004; 45 1063-1069
- 12 Baron H C, Klapholz A, Nagy A A, Wayne M. Bilateral iliac vein filter deployment in a patient with mega cava. Ann Vasc Surg. 1999; 13 634-636
- 13 Prince M R, Novelline R A, Athanasoulis C A, Simon M. The diameter of the inferior vena cava and its implications for the use of vena caval filters. Radiology. 1983; 149 687-689
- 14 Lopera J E, Araki J U, Kirsch D et al.. A modified technique to minimize filter tilting during deployment of the Gunther Tulip filter: in vitro study. J Vasc Interv Radiol. 2005; 16 1539-1544
- 15 Terhaar O A, Lyon S M, Given M F, Foster A E, McGrath F, Lee M J. Extended interval for retrieval of Gunther Tulip filters. J Vasc Interv Radiol. 2004; 15 1257-1262
Nghia-Jack VoM.D.
Department of Radiology, Section of Vascular and Interventional Radiology, University of Washington
1959 N.E. Pacific, Seattle, WA 98195