Failed Retrieval of an Inferior Vena Cava Filter During Pregnancy Because of Filter Tilt: Report of Two Cases

Thromboembolic disease during pregnancy is an important cause of obstetric morbidity and mortality. Pregnant patients with venous thromboembolism are usually managed by conventional anticoagulation. However, this must be discontinued during vaginal or caesarian delivery to avoid haemorrhage and to r...

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Veröffentlicht in:Cardiovascular and interventional radiology 2009-01, Vol.32 (1), p.174-177
Hauptverfasser: McConville, R. M., Kennedy, P. T., Collins, A. J., Ellis, P. K.
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container_issue 1
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container_title Cardiovascular and interventional radiology
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creator McConville, R. M.
Kennedy, P. T.
Collins, A. J.
Ellis, P. K.
description Thromboembolic disease during pregnancy is an important cause of obstetric morbidity and mortality. Pregnant patients with venous thromboembolism are usually managed by conventional anticoagulation. However, this must be discontinued during vaginal or caesarian delivery to avoid haemorrhage and to reduce the risk of possible epidural haematoma. Retrievable inferior vena cava filters (IVCFs) offer protection against pulmonary embolism during this high-risk period, when anticoagulation is discontinued, while avoiding potential long-term sequelae of a permanent IVCF. Here we report two patients who presented in the third trimester of pregnancy with floating ileofemoral deep vein thrombosis. Both patients were initially treated with standard anticoagulation; however, shortly before delivery both patients had a retrievable IVCF placed in a suprarenal position. In both patients, retrieval failed at 28 days after insertion because of filter tilt. The timing and mechanism of filter tilt remains uncertain. We believe that a number of factors could have been involved, including change in the anatomic configuration with lateral displacement of the IVCF as a result of the gravid uterus as well as forceful uterine contractions during labour, which modified the shape and diameter of the IVC. We showed that failure to retrieve the IVCF has had considerable implications for the two young patients regarding long-term anticoagulation and have highlighted the need for further clinical trials regarding the safe use of retrievable IVCFs during pregnancy.
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We showed that failure to retrieve the IVCF has had considerable implications for the two young patients regarding long-term anticoagulation and have highlighted the need for further clinical trials regarding the safe use of retrievable IVCFs during pregnancy.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>18677532</pmid><doi>10.1007/s00270-008-9393-6</doi><tpages>4</tpages></addata></record>
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subjects Adult
BLOOD VESSELS
BODY
Cardiology
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
Case Report
Device Removal
DISEASES
FAILURES
Female
FILTERS
Humans
Imaging
Medicine
Medicine & Public Health
Nuclear Medicine
ORGANS
PREGNANCY
Pregnancy Complications, Cardiovascular - diagnostic imaging
Pregnancy Trimester, Third
Pulmonary Embolism - prevention & control
Radiology
RADIOLOGY AND NUCLEAR MEDICINE
THROMBOSIS
Treatment Failure
Ultrasonography
Ultrasound
VASCULAR DISEASES
VEINS
Vena Cava Filters - adverse effects
Venous Thrombosis - complications
Venous Thrombosis - diagnostic imaging
title Failed Retrieval of an Inferior Vena Cava Filter During Pregnancy Because of Filter Tilt: Report of Two Cases
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