Implante de filtro de veia cava inferior guiado por ultra-som: relato de dois casos

Abstract

The percutaneous placement of inferior vena cava filters is traditionally carried out in angiosuite or operating room using fluoroscopy and infusion of iodinated contrast for proper positioning of the device. However, for patients hospitalized in intensive care units under poor conditions for transportation, and for patients with impaired renal function, their displacement and the nephrotoxicity of the iodinated contrast agents are frequently matters of concern. Thus, the bedside placement of inferior vena cava filters guided by ultrasound may be a reasonably safe and attractive alternative for these patients.

Implante de filtro em veia cava inferior dupla: relato de caso e revisão da literatura

“…Some authors have also described filter placement using ultrasound control when there is a duplicated vena cava. [6][7][8] There are few reports of filter placement in the vena cava in this situation. We report a case of vena cava filter placement in suprarenal position in a patient with duplicated IVC.…”

Tomographic anatomy of the vena cava and renal veins: features relevant to vena cava filter placement

“…Studies have shown that it is feasible to implant vena cava filters with guidance by abdominal ultrasonography, particularly for high-risk patients or those with significant renal dysfunction. 5,17,18 The objective of this study was to identify simple parameters that could serve, in the majority of cases, as an aid to anatomical assessment to guide safe release of vena cava filters. Considering that the vertebral bodies can be seen during radioscopy, correlations between the anatomic positions of the renal veins and these structures could be used as a guide to the ideal site for release.…”

Implante profilático e temporário de filtro de veia cava inferior no trauma

“…Some studies have advocated preventative (in the absence of proven deep venous thrombosis or pulmonary embolism) implantation of a vena cava filter after a trauma, on the basis that it reduces the incidence of severe thromboembolic events in these cases and because it involves temporary interruption of the vena cava [9][10][11][12] . The majority of filters are fitted with the aid of fluoroscopy, using iodine-based contrasts in specific sectors, but for patients at high risk from transportation, they can be fitted at the bedside with the aid of vascular Doppler ultrasound 13 . The rate of removal of retrievable filters is still low, which can be attributed to the clinical conditions of multiple trauma patients and to failures by the services that implant filters to follow-up their patients afterwards 14 .…”