ABSTRACT
PURPOSE: To retrospectively review the outcomes after placement and retrieval of retrievable inferior vena cava (IVC) filters at two academic medical centers. MATERIALS AND METHODS: All patients who underwent retrievable filter placement between May 2001 and December 2005 were included. Hospital records at both institutions were reviewed, and relevant data were collected concerning the placement and retrieval of all removable filters. RESULTS: A total of 197 patients underwent placement of a retrievable IVC filter. Of those, 143 patients (72.5%) had Günther Tulip filters (GTFs) placed, and 54 patients (27.5%) had Recovery filters placed. A total of 94 patients underwent attempted filter retrieval, accounting for just less than half of all retrievable filters placed during the study period (47.7%). Retrievals were successful in 80 patients (85.1%). Half the retrieval failures (n = 7) were the result of thrombus within the filter, and technical difficulties (eg, filter embedded in IVC wall, tilted filter) were the cause of retrieval failure in the other half. There was no significant difference in retrieval failure rates between the GTF and Recovery filter (16.4% vs 9.5%, respectively). GTFs were removed after a median implantation time of 11 days (range, 1-139 d), whereas Recovery filters were removed after a median implantation time of 28 days (range, 6-117 d). CONCLUSIONS: Placement and retrieval of nonpermanent IVC filters can be performed safely with a high technical success rate. In patients at high risk for venous thromboembolism and contraindication to anticoagulation, retrievable filters may be used aggressively to prevent the potentially devastating outcome of pulmonary embolism.
Subject(s)
Prosthesis Implantation/methods , Thrombosis/prevention & control , Vena Cava Filters , Vena Cava, Inferior , Humans , Medical Records , Retrospective Studies , Thrombosis/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
Acute abdominal aortic occlusion is a devastating event with high associated rates of morbidity and mortality even with surgical intervention. This report describes a case of acute aortoiliac and femoral artery occlusion likely resulting from a hypercoagulable state caused by diabetic ketoacidosis (DKA). Vascular thrombosis is a little-known but potentially devastating complication of DKA that should be considered in every patient treated for DKA and should be added to the differential diagnoses when attempting to determine the etiology of a thrombosed vessel.
Subject(s)
Aorta, Abdominal , Diabetic Ketoacidosis/complications , Femoral Artery , Iliac Artery , Thrombosis/complications , Acute Disease , Amputation, Surgical , Arterial Occlusive Diseases/complications , Arterial Occlusive Diseases/diagnosis , Arterial Occlusive Diseases/surgery , Diabetic Ketoacidosis/diagnosis , Embolectomy , Fatal Outcome , Humans , Magnetic Resonance Angiography , Male , Middle Aged , Retrospective Studies , Thrombosis/diagnosis , Thrombosis/surgery , Tomography, X-Ray ComputedABSTRACT
Splenic artery pseudoaneurysm is a well-known and potentially life-threatening complication of pancreatitis for which immediate endovascular or surgical treatment is indicated. An unusual case of spontaneous thrombosis of a splenic artery pseudoaneurysm with associated partial splenic infarction was encountered in the setting of chronic pancreatitis during intravenous octreotide administration, with recanalization 9 months later.