Duplex scan–directed placement of inferior vena cava filters: A five-year institutional experience

Abstract

Our experience indicates that duplex ultrasound-directed IVC filter placement is safe, cost-effective, and convenient for patients who need IVC filter placement.

Prospective implementation of an algorithm for bedside intravascular ultrasound-guided filter placement in critically ill patients

“…The outcomes in this study compare favorably with other published bedside filter experiences, [7][8][9][10][11][12][13][14][15][16][17][18][19] but what is different in this study is the prospective algorithm-driven decision making that supported bedside placement. Furthermore, although other published reports advocate single-or dual-access techniques, the prospective algorithm in this study included a pathway preferring a single-access approach (94.4%) first, reserving dual access (5.6%) for inadequate imaging with single access or if direct visualization of the filter-delivery catheter tip at the renal vein was required.…”

“…[7][8][9][10][11][12][13][14][15][16][17][18][19] Because of increasing demands for filter placement at our institution, bedside techniques using IVUS guidance were disseminated according to prior experience levels and a proctored process.…”

Technical Factors Affecting the Accuracy of Bedside IVC Filter Placement Using Intravascular Ultrasound

“…Our 6% incidence of filter malposition is similar to the reported series (0-7%) using double puncture, pullback or single puncture, and single sheath techniques. [1][2][3][4][5][6][7][8][9][10]12 Filter tilt was recorded in only 3 of these institutional series, but we have shown that filter excessive tilt and malpositioning were most prevalent with procedures done via left femoral access and can be minimized with a single puncture, single sheath technique through a right femoral access site. Use of preprocedural duplex ultrasound to evaluate the right common femoral vein is recommended.…”

“…[1][2][3][4] A bedside procedure using ultrasound imaging is advantageous, especially for the patients in the intensive care unit (ICU), since the risk associated with inhospital transport of critically ill patients is eliminated, as is the need for intravenous contrast or radiation exposure to staff. Bedside procedures can be performed at any time and can avoid scheduling conflicts in the OR or angiography suite.…”

A Complication of Ultrasound-Guided Inferior Vena Cava Filter Placement

“…Ultrasound guidance also obviates the need for ionizing radiation and nephrotoxic contrast administration. [2][3][4][5] The techniques described in the literature include guidance with transabdominal US or with a combination of intravascular US (IVUS) and transabdominal US guidance.…”