"pre-existing infrarenal caval thrombus, in which case a suprarenal filter would need to be placed via a jugular approach."
"Post-procedure care"
"Specific technical steps may vary according to personal preference and the type of filter being used. Generally, the internal jugular or femoral vein is punctured under ultrasound guidance and a guide wire is placed in the IVC. A venogram is obtained by injecting contrast through a multisidehole catheter positioned in the lower IVC or distal common iliac vein. The venogram is used to reassess the IVC for patency, size and anomalies. The location of the renal veins is often indicated by the presence of contrast reflux or flow voids. The venous access is dilated using a dilator. The vena cava filter is subsequently deployed in a suitable location through a delivery sheath, typically the infra-renal IVC. Another venogram is obtained to ensure satisfactory deployment of the filter. The delivery sheath is removed. Haemostasis is secured using manual compression."
Expected headings
"Preprocedural evaluation"
"Positioning/room set up"
"Post-procedure care"
"review all available imaging to establish the indication for the procedure; previous studies can help assess IVC patency, size and presence of anomalies such as duplicated IVC and circumaortic renal vein"
"review all available imaging to establish the indication for the procedure; previous studies can help assess IVC patency, size and presence of anomalies such as duplicated IVC and circumaortic renal vein"
"Specific technical steps may vary according to personal preference and the type of filter being used. Generally, the internal jugular or femoral vein is punctured under ultrasound guidance and a guide wire is placed in the IVC. A venogram is obtained by injecting contrast through a multisidehole catheter positioned in the lower IVC or distal common iliac vein. The venogram is used to reassess the IVC for patency, size and anomalies. The location of the renal veins is often indicated by the presence of contrast reflux or flow voids. The venous access is dilated using a dilator. The vena cava filter is subsequently deployed in a suitable location through a delivery sheath, typically the infra-renal IVC. Another venogram is obtained to ensure satisfactory deployment of the filter. The delivery sheath is removed. Haemostasis is secured using manual compression."
"Suprarenal placement 6 is reserved for special indications as the suprarenal IVC is wider and shorter and its calibre is more variable (under more influence of the heart). There is no increase in renal dysfunction 7 nor other complications 8 when compared to infrarenal filters. The major indications for suprarenal filter placement are:"