Percutaneously Inserted AngioVac Suction Thrombectomy for the Treatment of Filter-Related Iliocaval Thrombosis

Abstract

In the setting of acute iliocaval thrombosis due to reversible causes, thrombus removal is preferred by many in the management of inferior vena cava (IVC) thrombosis as it is thought likely to minimize the long-term complications of chronic venous insufficiency and post-thrombotic syndrome. When catheter-directed thrombolysis is not a viable or effective option, the treatment options are limited. We present the case of a 56-year-old hospitalized patient with a permanent IVC filter that had been inserted 10 years prior at an outside hospital with severe, incapacitating right leg swelling for which amputation was considered. The patient underwent suction thrombectomy after failure of thrombolysis. The patient’s presenting symptoms of right lower extremity swelling and pain improved upon discharge. In our single case, unassisted suction thrombectomy with percutaneously placed cannulae is an effective and safe method for the treatment of permanent IVC filter-related iliocaval thrombosis in cases refractory to catheter-directed thrombolysis.