Double series Filters in Treating Inferior Vena Cava Filter-mediated Thrombosis

AbstractBackground:As the exponential increase in the number of inferior vena cava (IVC) filters in China, it has become a major predisposing factor for IVC filters-mediated thrombosis. This is an important risk factor for thrombosis recurrence. What’s more, the long-term implantation of the filter will bring many uncertainties. This study is aim to summarize our experience and introduce a strategy safely in treating IVC filters-mediated thrombosis.Methods:The clinical data were collected and analyzed from seven patients (3 female and 4 male) who suffered IVC filters-mediated thrombosis in our center from August 2018 to June 2022. In this group, the time of IVC filters thrombosis was not exceeding two weeks. According to the location and morphology of the thrombosis in the filter, we adopt two access (Femoral vein or Jugular vein) puncture to implant the supra-renal IVC filter. Then, all steps were performed under the protecting to retrieval the double series IVC filters and thrombosis. Pulmonary Embolism(PE) assessment was taken measure by computed tomography pulmonary angiography (CTPA) .Results:In this study, Technical success rate was 100% to retrieval the double series IVC filters. The volume of IVC filters-mediated thrombosis in those patients was exceeded 1 mL.71.4% (5/7) of cases present the existing thrombosis located in the filters, 1 patient (14.3%, 1/7) has the thrombosis located both inside and floating above the filter, as well as 1 patient (14.3%, 1/7) having thrombosis located both inside and underneath the filter. Six patients removed the suprarenal IVC filters in I stage, and only one patient removed it in II stage. On removing the thrombosis, five patients were removed completely and only two were partially, including 3 patients with the help of catheter-directed thrombolysis(CDT)therapy. No procedure-related complications were observed. The median follow-up time was 22.5 months. No recurrence of thrombus symptoms was reported, B ultrasound and CTPA showed that the blood flow in the inferior vena cava and pulmonary artery were smooth.Conclusions:For the patients who suffered from IVC filters-mediated thrombosis no longer than two weeks, using double series IVC filters to protect the patients is a safe approach and could improve the retrieve rate of IVC filters at early stages.