Successful thrombolytic therapy for acute kidney injury secondary to thrombosis of suprarenal inferior vena cava filter

• Published in: Journal of thrombosis and thrombolysis 2009-11, Vol.28 (4), p.500-505
• Main Authors: Bihorac, Azra, Kitchens, Craig S.
• Format: Article
• Language: English
• Subjects: Acute Disease; Cardiology; Hematology; Humans; Kidney Diseases - drug therapy; Kidney Diseases - etiology; Male; Medicine; Medicine & Public Health; Middle Aged; Thrombolytic Therapy - methods; Vena Cava Filters - adverse effects; Venous Thrombosis - drug therapy; Venous Thrombosis - etiology
• ISSN: 0929-5305; 1573-742X
• DOI: 10.1007/s11239-009-0359-6

Inferior vena cava (IVC) thrombosis is a complication that occurs in 1–32% of patients inserted with IVC filters (IVCF). Deployment of the filter in the suprarenal position is advocated in certain clinical conditions, and some reports suggest a higher incidence of renal complications in that position, especially among patients with malignancy. We report a case of acute kidney injury (AKI) due to acute thrombosis of a suprarenal IVCF, which was successfully treated with systemic thrombolytic therapy. We also provide a review of the literature in regard to the indications, complications, and outcomes of suprarenal IVCF. Suprarenal IVCF placement should be performed rarely, and then only after careful evaluation of the underlying renal function, and likely should be avoided in patients with malignancy and known hypercoagulable state. Systemic thrombolytic therapy is a feasible treatment option for acute thrombotic episodes of IVCF, assuming it is diagnosed early and there are no known contraindications.