Percutaneous closure of patent foramen ovale guided by intracardiac echocardiography and performed through the transfemoral approach in the presence of previously placed inferior vena cava filters: A case series

Abstract

We present three patients with cryptogenic stroke who underwent transcatheter closure of a patent foramen ovale. All patients have had history of deep venous thrombosis and pulmonary embolism with placement of inferior vena caval filters. The patients were not initially considered suitable candidates for the procedure because of risk of dislodgment of previously implanted inferior vena cava filter.

Navigating inferior vena cava filters in invasive cardiology procedures: A systematic review

“…This metaanalysis of eight studies incorporated a total of 100 patients who underwent 110 procedures. [17][18][19][20][26][27][28] All studies included were published between 2001 and 2020. The mean follow-up period was 7 months, 60% of patients were males, and the mean age was 67.8 years.…”

“…Soon after, many reported the safety and feasibility of transfemoral structural heart interventions across IVCFs including septal occluder device placement, transcatheter percutaneous balloon mitral valvuloplasty, atrial septostomy, and percutaneous mitral clip placement. 27,28,[44][45][46] Similarly, many EP procedures have been successfully performed across a range of IVCFs including percutaneous defibrillator lead extraction, cavotricuspid isthmus ablations, leadless pacemaker implantation, and pulmonary vein isolation. 41,[47][48][49][50][51][52][53][54] In each of these interventions, authors advocate using direct fluoroscopic guidance when traversing the IVCF and most used preprocedural CT scans or venograms to ensure filter patency.…”

Percutaneous Closure of a Patent Foramen Ovale via Left Axillary Vein Approach with the Amplatzer Cribriform Septal Occluder

“…As the practice of percutaneous closure continues to advance, anatomical variants and obstacles will be encountered. Although transit through IVC filters with diagnostic and Swan‐Ganz catheters is often performed, this may not be possible depending on the specific IVC filter, particularly in the presence of common femoral, common iliac, or IVC thrombus 7–10 . Furthermore, device entrapment and dislodgement is a well‐described complication and there are no reports of IVC filter passage in this particular device 11,12 .…”

Unpleasant findings during transcatheter closure of patent foramen ovale: The importance of venous Doppler ultrasound and femoro-iliac venography

“…Venous filter placement may be considered as the definitive therapy in such patients, despite transcatheter closure through the vein filter has been reported [4]. …”