Bedside vena cava filter placement with intravascular ultrasound: A simple, accurate, single venous access method

• Published in: Journal of vascular surgery 2007-12, Vol.46 (6), p.1284-1286
• Main Authors: Jacobs, Donald L., MD, Motaganahalli, Raghunandan L., MD, Peterson, Brian G., MD
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Catheterization, Peripheral - methods; Diseases of the cardiovascular system; Emergency and intensive care: renal failure. Dialysis management; Femoral Vein; Humans; Intensive care medicine; Medical sciences; Point-of-Care Systems; Prosthesis Design; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Renal Veins - diagnostic imaging; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Ultrasonography, Interventional; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Vena Cava Filters; Vena Cava, Inferior - diagnostic imaging
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2007.09.015

Two techniques of vena cava filter placement with intravascular ultrasound (IVUS) guidance have been described previously. Placement with real-time IVUS imaging requires two venous access sites, one for the filter delivery system and one for the IVUS catheter, which makes the procedure more invasive. Alternatively, a single-access technique of IVUS imaging of the vena cava requires measuring the distance from the access site to the desired location for filter placement and then delivering the filter to that distance blindly, risking filter misplacement. We describe in this article a single puncture technique that allows for real-time imaging to position the filter delivery sheath using IVUS and reduces the uncertainty of the blind positioning of the filter delivery system.