Inferior vena cava filter placement at bedside using computed tomography scan information: a new technique for accurate deployment

Abstract

BackgroundAn inferior vena cava filter (IVCF) is indicated for the prophylaxis of pulmonary embolism where anticoagulation is contraindicated. The majority of these filters are placed using fluoroscopy and venogram. We hypothesized that a computed tomography (CT) scan of the abdomen and pelvis provides sufficient information for successful deployment of an IVCF at bedside without the need for any further imaging during the procedure. MethodsA retrospective review of prospectively collected data of a bedside IVCF placement technique using measurements from abdominal/pelvic CT scans without additional intraoperative imaging in 38 patients at a level 1 trauma center was conducted. ResultsThe most common indication for IVCF placement was high-risk patients without deep venous thrombosis. All these procedures were performed at bedside. Nonretrievable (TrapEase) and retrievable (OptEase) type filters were used. All these IVCFs were placed below the renal veins without any complications. ConclusionsIVCFs can be placed based on measurements from abdominal CT scans without the need for further imaging such as fluoroscopy or an inferior vena cava venogram. This technique is as simple as bedside femoral venous line placement.