Collapse of inferior vena cava during complex filter retrieval with consequent intra-procedural systemic hypotension and bradycardia: a case report
Abstract Background Prolonged dwelling time of inferior vena cava (IVC) filters has been shown to increase the need for the use of complex IVC filter retrieval techniques. In this report, we describe a case of complex retrieval of an IVC filter with prolonged dwelling time, which was temporarily acc...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-03-01
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| Series: | CVIR Endovascular |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42155-023-00361-2 |
| _version_ | 1797863491855450112 |
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| author | Tushar Garg Izzet Altun Bill S. Majdalany Nariman Nezami |
| author_facet | Tushar Garg Izzet Altun Bill S. Majdalany Nariman Nezami |
| author_sort | Tushar Garg |
| collection | DOAJ |
| description | Abstract Background Prolonged dwelling time of inferior vena cava (IVC) filters has been shown to increase the need for the use of complex IVC filter retrieval techniques. In this report, we describe a case of complex retrieval of an IVC filter with prolonged dwelling time, which was temporarily accompanied by severe bradycardia and hypotension. Case presentation Fifty-nine-year-old male patient past medical history of morbid obesity, atrial fibrillation status post-ablation, obstructive sleep apnea, and end-stage renal disease presented for IVC filter retrieval 16 years after placement. When the IVC filter was covered by sheaths, and the IVC was temporarily collapsed and occluded, the patient developed severe bradycardia and hypotension without compensatory tachycardia. Contrast injection through the common femoral vein sheath showed complete occlusion of IVC while the IVC filter was covered by both sheaths, likely due to the embedment of the IVC filter in the wall by extensive fibrinous tissues. IVC filter was successfully retrieved, and the blood pressure and heart rate were improved immediately afterward. A large non-occlusive IVC thrombus was identified on the final venogram, which was aspirated using a mechanical thrombectomy device. Conclusion Complex retrieval of IVC filters with prolonged dwelled time can result in acute severe bradycardia and hypotension due to vasovagal reaction, acute collapse, and occlusion of IVC in the setting of IVC filter embedment in the wall by extensive fibrinous tissues. |
| first_indexed | 2024-04-09T22:36:20Z |
| format | Article |
| id | doaj.art-ad0591ef653348d6aff3c1e3e0aa51b2 |
| institution | Directory Open Access Journal |
| issn | 2520-8934 |
| language | English |
| last_indexed | 2024-04-09T22:36:20Z |
| publishDate | 2023-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | CVIR Endovascular |
| spelling | doaj.art-ad0591ef653348d6aff3c1e3e0aa51b22023-03-22T12:29:02ZengSpringerOpenCVIR Endovascular2520-89342023-03-01611410.1186/s42155-023-00361-2Collapse of inferior vena cava during complex filter retrieval with consequent intra-procedural systemic hypotension and bradycardia: a case reportTushar Garg0Izzet Altun1Bill S. Majdalany2Nariman Nezami3Division of Vascular and Interventional Radiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of MedicineDivision of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of MedicineDepartment of Radiology, University of Vermont Medical CenterDivision of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of MedicineAbstract Background Prolonged dwelling time of inferior vena cava (IVC) filters has been shown to increase the need for the use of complex IVC filter retrieval techniques. In this report, we describe a case of complex retrieval of an IVC filter with prolonged dwelling time, which was temporarily accompanied by severe bradycardia and hypotension. Case presentation Fifty-nine-year-old male patient past medical history of morbid obesity, atrial fibrillation status post-ablation, obstructive sleep apnea, and end-stage renal disease presented for IVC filter retrieval 16 years after placement. When the IVC filter was covered by sheaths, and the IVC was temporarily collapsed and occluded, the patient developed severe bradycardia and hypotension without compensatory tachycardia. Contrast injection through the common femoral vein sheath showed complete occlusion of IVC while the IVC filter was covered by both sheaths, likely due to the embedment of the IVC filter in the wall by extensive fibrinous tissues. IVC filter was successfully retrieved, and the blood pressure and heart rate were improved immediately afterward. A large non-occlusive IVC thrombus was identified on the final venogram, which was aspirated using a mechanical thrombectomy device. Conclusion Complex retrieval of IVC filters with prolonged dwelled time can result in acute severe bradycardia and hypotension due to vasovagal reaction, acute collapse, and occlusion of IVC in the setting of IVC filter embedment in the wall by extensive fibrinous tissues.https://doi.org/10.1186/s42155-023-00361-2Inferior vena cavaFilterRetrievalIVC collapseVasovagal reaction |
| spellingShingle | Tushar Garg Izzet Altun Bill S. Majdalany Nariman Nezami Collapse of inferior vena cava during complex filter retrieval with consequent intra-procedural systemic hypotension and bradycardia: a case report CVIR Endovascular Inferior vena cava Filter Retrieval IVC collapse Vasovagal reaction |
| title | Collapse of inferior vena cava during complex filter retrieval with consequent intra-procedural systemic hypotension and bradycardia: a case report |
| title_full | Collapse of inferior vena cava during complex filter retrieval with consequent intra-procedural systemic hypotension and bradycardia: a case report |
| title_fullStr | Collapse of inferior vena cava during complex filter retrieval with consequent intra-procedural systemic hypotension and bradycardia: a case report |
| title_full_unstemmed | Collapse of inferior vena cava during complex filter retrieval with consequent intra-procedural systemic hypotension and bradycardia: a case report |
| title_short | Collapse of inferior vena cava during complex filter retrieval with consequent intra-procedural systemic hypotension and bradycardia: a case report |
| title_sort | collapse of inferior vena cava during complex filter retrieval with consequent intra procedural systemic hypotension and bradycardia a case report |
| topic | Inferior vena cava Filter Retrieval IVC collapse Vasovagal reaction |
| url | https://doi.org/10.1186/s42155-023-00361-2 |
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