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Collapse of inferior vena cava during complex filter retrieval with consequent intra-procedural systemic hypotension and bradycardia: a case report

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...

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Autores principales: Garg, Tushar, Altun, Izzet, Majdalany, Bill S., Nezami, Nariman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10020385/
https://www.ncbi.nlm.nih.gov/pubmed/36928471
http://dx.doi.org/10.1186/s42155-023-00361-2
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author Garg, Tushar
Altun, Izzet
Majdalany, Bill S.
Nezami, Nariman
author_facet Garg, Tushar
Altun, Izzet
Majdalany, Bill S.
Nezami, Nariman
author_sort Garg, Tushar
collection PubMed
description 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.
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spelling pubmed-100203852023-03-18 Collapse of inferior vena cava during complex filter retrieval with consequent intra-procedural systemic hypotension and bradycardia: a case report Garg, Tushar Altun, Izzet Majdalany, Bill S. Nezami, Nariman CVIR Endovasc Case Report 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. Springer International Publishing 2023-03-16 /pmc/articles/PMC10020385/ /pubmed/36928471 http://dx.doi.org/10.1186/s42155-023-00361-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Case Report
Garg, Tushar
Altun, Izzet
Majdalany, Bill S.
Nezami, Nariman
Collapse of inferior vena cava during complex filter retrieval with consequent intra-procedural systemic hypotension and bradycardia: a case report
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 Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10020385/
https://www.ncbi.nlm.nih.gov/pubmed/36928471
http://dx.doi.org/10.1186/s42155-023-00361-2
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