Robotic-Assisted Inferior Vena Cava Filter Retrieval

Although anticoagulation remains the mainstay of therapy for patients with venous thromboembolism, guidelines recommend the use of inferior vena cava (IVC) filters in those who fail anticoagulation or have contraindications to its use. Short-term use of filters has proven effective in reducing the r...

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Bibliographic Details
Published in:Methodist DeBakey cardiovascular journal 2017-01, Vol.13 (1), p.34-36
Main Authors: Owji, Shahin, Lu, Tony, Loh, Thomas M, Schwein, Adeline, Lumsden, Alan B, Bismuth, Jean
Format: Article
Language:English
Subjects:
Aged
Case Report
Device Removal - methods
Endovascular Procedures
Female
Humans
Prosthesis Design
Prosthesis Implantation - instrumentation
Radiography, Interventional
Robotics
Treatment Outcome
Vena Cava Filters
Vena Cava, Inferior - diagnostic imaging
Venous Thromboembolism - diagnostic imaging
Venous Thromboembolism - therapy
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Summary:Although anticoagulation remains the mainstay of therapy for patients with venous thromboembolism, guidelines recommend the use of inferior vena cava (IVC) filters in those who fail anticoagulation or have contraindications to its use. Short-term use of filters has proven effective in reducing the rate of pulmonary embolism. However, their extended use is associated with a variety of complications such as thrombosis, filter migration, or caval perforation, thus making a case for timely filter retrieval. This is the case of a 68-year-old female with a history of chronic oral anticoagulation use for multiple deep venous thrombi (DVT) and pulmonary emboli (PE) who required cervical and thoracic spinal intervention for spondylosis and foramina stenosis. Given her increased risk of recurrent DVT and PE perioperatively, we elected to place a Cook Celect IVC filter (Cook Medical, Bloomington, IN) after oral anticoagulation was stopped for the procedure. Her treatment course was prolonged due to wound-healing complications. We elected to use the Magellan Robotic Catheter System (Hansen Medical, Mountain View, CA) for filter retrieval when she presented 6 months later with caval perforation from the filter struts. With its ease of use, superior mechanical stability, and maneuverability, robot-assisted IVC filter retrieval may be a safer and more reliable substitute for traditional navigation techniques when presented with challenging filter retrievals.
ISSN:1947-6094
1947-6108
DOI:10.14797/mdcj-13-1-34