snare-assisted retrieval via the IJV using an Amplatz Goose Neck Snare (Covidien Peripheral Vascular, Plymouth, MN). In 83.3% of cases (5/6), the filter was retrieved from the groin using Rat Tooth Alligator Jaw 2.8mm 165cm Grasping Forceps (Olympus America, Center Valley, PA) to grasp the neck of the filter and invert it into a CFV 18F 40cm Check Flo sheath (Cook Medical, Bloomington, IN) without damaging the CFV. In 16.7% of cases (1/6), the forceps were employed from CFV access to grasp onto the filter while it was sheathed and removed via IJV access. There were no major or minor adverse events at 30 days or access site bleeding complications. Conclusion: Endoscopic forceps employed through femoral access can be safely and effectively utilized to remove IVC filters when conventional techniques are unsuccessful.
Various minimally invasive, surgical, and laparoscopic interventions are performed for treatment and management of splenic artery steal syndrome in liver transplant and cirrhotic patients. Common approaches include splenic artery banding, ligation, stenting, and embolization to increase hepatic arterial flow. Splenic artery embolization has undergone further development to facilitate timely diagnosis, increase efficacy, decrease adverse outcomes, and improve patient selection. We review the current diagnostic modalities and technical advancements of splenic artery embolization to improve hepatic arterial perfusion in patients with splenic artery steal syndrome.
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