Bedside Insertion of Vena Cava Filters in the Intensive Care Unit Using Intravascular Ultrasound to Locate Renal Veins

Abstract

Intravascular ultrasound is a safe and effective imaging method that may be used for the bedside placement of vena cava filters in the ICU. This technique avoids the use of nephrotoxic intravenous contrast and eliminates the risk of transporting a critically injured patient to the operating room or x-ray department.

Intravascular Ultrasound-Guided Inferior Vena Cava Filter Placement Using a Single-Puncture Technique in 99 Patients

“…, [8][9][10][11][12][13][14]21 Using a single-venous puncture technique and without the use of real-time US during filter deployment, we had a technical success rate of 94% (n ¼ 93/99), comparable to those of prior reports (94%-100%) in which the authors have used a double-puncture technique within the femoral vein and real-time US during filter deployment. 8,9,[12][13][14]17,21 These findings demonstrate that using a single-puncture technique without real-time US during filter deployment is just as technically feasible and successful as the double-puncture technique, while having the advantage of requiring less time and materials. The clinical success of filters placed under IVUSguidance in the prevention of new or progressive PE was 100%.…”

“…Indeed, IVUS-guided placement of IVC filters has been shown to be safe, effective, and minimally invasive. [8][9][10][11][12][13][14] The IVUS-guided IVC filter placement using a doublepuncture technique within the femoral vein (either 2 access sites in 1 femoral vein or bilateral femoral venous access) allows for real-time IVUS guidance during filter deployment. Such technique, however, is often associated with higher access site complications and prolonged procedure times in comparison to a single venous puncture technique.…”

Bedside Placement of Removable Vena Cava Filters Guided by Intravascular Ultrasound in the Critically Injured

“…As a result, we had a low complication rate related to technique: one filter was misplaced and that error could be corrected immediately by fluoroscopy and one hematoma at the access site was treated without major consequences. In the literature the incidence of VCF misplacement after IVUS guidance ranges from 0% to 8% [20, 21, 39], and the incidence of access hematoma ranges from 0% to 3% [20, 34].…”

Ultrasound-guided interventional radiology in critical care

“…Furthermore, anasarca and ileus must resolve, often delaying filter placement. In contrast, intravascular ultrasound has been reported to be an easy and safe technique used to perform bedside placement of an IVC filter, with more accurate localization of the renal veins than contrast venography (21,22).…”