“…Hence, the rate of complications due to indwelling filters may be significantly higher than that currently reported (►Table 2). 32,33 While complications may occur at any point following implantation, the majority occur following prolonged implantation, and indeed a systematic review by Angel et al 34 confirmed that the vast majority (93%) of complications with retrievable IVC filters occurred with long-term use (>30 days). Furthermore, the success of retrieval attempts has been shown to decrease with prolonged dwell times.…”
Section: Inferior Vena Cava Filter Retrieval Evidence For Removalmentioning
Pulmonary embolism (PE) is a common and feared result of deep vein thrombosis. While anticoagulation is the mainstay of management, interruption of flow of thrombus from leg veins to the pulmonary circulation is frequently desired either in lieu of or in addition to anticoagulation. Inferior vena cava filters have become frequently used to prevent PE despite a paucity of evidence for efficacy and increasing concerns about the long-term complications of indwelling filters.
“…Hence, the rate of complications due to indwelling filters may be significantly higher than that currently reported (►Table 2). 32,33 While complications may occur at any point following implantation, the majority occur following prolonged implantation, and indeed a systematic review by Angel et al 34 confirmed that the vast majority (93%) of complications with retrievable IVC filters occurred with long-term use (>30 days). Furthermore, the success of retrieval attempts has been shown to decrease with prolonged dwell times.…”
Section: Inferior Vena Cava Filter Retrieval Evidence For Removalmentioning
Pulmonary embolism (PE) is a common and feared result of deep vein thrombosis. While anticoagulation is the mainstay of management, interruption of flow of thrombus from leg veins to the pulmonary circulation is frequently desired either in lieu of or in addition to anticoagulation. Inferior vena cava filters have become frequently used to prevent PE despite a paucity of evidence for efficacy and increasing concerns about the long-term complications of indwelling filters.
“…13 and 14 ). CTV is preferred when assessing potential inferior vena cava (IVC) filter complications, such as malposition, migration, tilting, caval thrombosis or perforation [ 117 ]. Fig.…”
Non-invasive cross-sectional imaging techniques play a crucial role in the assessment of the varied manifestations of vascular disease. Vascular imaging encompasses a wide variety of pathology. Designing vascular imaging protocols can be challenging owing to the non-uniform velocity of blood in the aorta, differences in cardiac output between patients, and the effect of different disease states on blood flow. In this review, we provide the rationale behind—and a practical guide to—designing and implementing straightforward vascular computed tomography (CT) and magnetic resonance imaging (MRI) protocols.Teaching Points
• There is a wide range of vascular pathologies requiring bespoke imaging protocols.
• Variations in cardiac output and non-uniform blood velocity complicate vascular imaging.
• Contrast media dose, injection rate and duration affect arterial enhancement in CTA.
• Iterative CT reconstruction can improve image quality and reduce radiation dose.
• MRA is of particular value when imaging small arteries and venous studies.
Electronic supplementary materialThe online version of this article (10.1007/s13244-018-0597-2) contains supplementary material, which is available to authorised users.
“…In descending order, the most common sites for filter fragment embolization were pulmonary arteries (31%), iliac/femoral veins (27%), and the right ventricle and renal vein (3.8% each) [146]. Factors that increase the risk of filter migration and embolization include the so-called "mega-IVC" (e.g., IVC diameter ≥28mm), filter malpositioning, and a large embolus creating a "sail effect" that then dislodges the filter from the IVC, with subsequent embolization to the heart [147][148][149]. A fracture-free survival model described by Tam et al, predicted a fracture rate of 40% at 5.5 years [146].…”
Section: Ivc Filter Migration and Embolizationmentioning
Foreign intravascular object embolization (FIOE) is an important, yet underreported occurrence that has been described in a variety of settings, from penetrating trauma to intravascular procedures. In this chapter, the authors will review the most common types of FIOEs, including bullet or "projectile" embolism (BPE), followed by intravascular catheter or wire embolization (ICWE), and conclude with intravascular noncatheter object (e.g., coil, gelatin, stent, and venous filter) migration (INCOM). In addition to detailed topic-based summaries, tables highlighting selected references and case scenarios are also presented to provide the reader with a resource for future research in this clinical area.
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