Volume 62, Issue 6 pp. 810-813
Medical Imaging—Case of the Month

Prolonged balloon tamponade in the initial management of inferior vena cava injury following complicated filter retrieval, without the need for surgery

Jonathan TL Lee

Jonathan TL Lee

Department of Radiology, Alfred Health, Melbourne, Victoria, Australia

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Gerard S Goh

Gerard S Goh

Department of Radiology, Alfred Health, Melbourne, Victoria, Australia

Monash University, Melbourne, Victoria, Australia

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Tim Joseph

Tim Joseph

Department of Radiology, Alfred Health, Melbourne, Victoria, Australia

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Jim Koukounaras

Jim Koukounaras

Department of Radiology, Alfred Health, Melbourne, Victoria, Australia

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Tuan Phan

Tuan Phan

Department of Radiology, Alfred Health, Melbourne, Victoria, Australia

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Warren Clements

Corresponding Author

Warren Clements

Department of Radiology, Alfred Health, Melbourne, Victoria, Australia

Monash University, Melbourne, Victoria, Australia

Correspondence

Dr Warren Clements, Department of Radiology, Alfred Health, 55 Commercial Road, Melbourne, Vic. 3004, Australia.

Email: [email protected]

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First published: 05 July 2018
Citations: 6
JTL Lee BMedSci (Hons), MBBS (Hons); GS Goh MBBS, FRANZCR, EBIR; T Joseph BSc, MBBS, FRANZCR; J Koukounaras BMBS, FRANZCR; T Phan MBBS, FRANZCR, EBIR, GradDipComp; W Clements BBiomedSc (Hons), MBBS, FRANZCR, EBIR.
Conflict of interest: None.

Summary

Advanced techniques have been described to remove embedded inferior vena cava (IVC) filters including the loop snare and modified loop snare (Hangman) techniques. Retrieval of embedded filters have been associated with higher rates of complications including IVC injury and stenosis. We report two challenging embedded retrievals complicated by IVC injury and haemorrhage. Haemostasis was successfully achieved with prolonged balloon tamponade, suggesting that injury to the IVC during filter retrieval may not need urgent surgery. However, both patients received short-term complications related to caval thrombosis and patients in this cohort should be closely observed after retrieval. These cases support rigorous attention to filter indication and follow-up.

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