Upside-down positioning of a peri-interventional cava filter during endovascular thrombectomy of a septic superior vena cava thrombosis

Abstract

A 43-year-old male patient with advanced colon carcinoma presented with disseminated staphylococcus aureus bacteremia and central venous catheter associated septic thrombosis of the superior vena cava. Despite appropriate antimicrobial therapy and surgical debridement of distant foci, bacteremia persisted, so an endovascular thrombectomy was performed. Contrary to the usual application, the Capturex® peri-interventional cava filter was positioned upside down, in the direction of the blood flow, in the superior vena cava to prevent septic embolism during mechanical thrombectomy. The wall-adherent septic thrombus was mechanically detached using a RAT fragmentation basket® followed by Aspirex® rotational thrombectomy. Final phlebography showed complete thrombus removal. Small thrombus fragments could be demonstrated in the filter after retrieval. The adapted technique of a reverse positioning of the Capturex® filter in the superior vena cava seems feasible and effective.

Acute septic thrombophlebitis of the lower extremities due to foreign body injury and infection: a case report

“…At present, iatrogenic factors related to venous catheter infection are the main causes of STP [ 9 , 10 ]. Various central venous catheters and haemodialysis tubes are placed in vessels for a long time due to improper nursing care or decreased resistance to infection, resulting in the infection of venous catheters and then the formation of iatrogenic septic thrombosis.…”

“…There are different methods for the management of septic thrombosis, including conservative treatment [ 10 ], interventional thrombectomy [ 9 , 12 ], and open thrombectomy. In addition to STP, the patient had severe infection in the surrounding tissues, and bacteria was cultured from the blood.…”

Acute septic deep venous thrombosis of the lower extremities due to foreign body injury and infection: a case report

“…At present, iatrogenic factors related to venous catheter infection are the main causes of septic thrombosis [11][12][13][14][15]. Septic thrombosis caused by drug abusers repeatedly piercing their own deep veins without strict disinfection has also been reported [16,17].…”

“…There are different methods for the management of septic thrombosis, including conservative treatment [13,14,17], interventional thrombectomy [10,11], and open thrombectomy [14]. In addition to septic thrombosis, the patient had severe infection in the surrounding tissues and bacteria cultured in the blood.…”