Intravascular ultrasound-guided vena cava filter placement.

Purpose: To report a technique for the insertion of an inferior vena cava (IVC) filter under intravascular ultrasound (IVUS) guidance.

Technique: Using a Seldinger technique, a single groin puncture provides the access for IVUS interrogation of the IVC. After the anatomy is defined with IVUS, the same guidewire is used for percutaneous IVC filter insertion. Intraoperative fluoroscopy, used as a backup, corroborates the proposed insertion location before deployment of the device. Postoperative flat-plate abdominal radiographs are used to confirm satisfactory position. IVC filters have been successfully placed in 9 patients with no complications related to IVUS-guided insertion.

Conclusions: Intraluminal IVC interrogation using IVUS is ideally suited for the proper deployment of an IVC filter. The deployment of IVC filters under IVUS has the potential to further simplify an established therapy for deep venous thrombosis and pulmonary embolism.