UNDEPLOYMENT OF A VENA-CAVA FILTER - PREV ENTION

Undeployment of an L.G.M.(R) percutaneous vena cava filter is rare. Th e aim of this paper is to report a new case of this complication. A se cond filter was inserted between the undeployed filter and the renal v eins to prevent proximal migration of the transvenous interruption dev ice to the pulmonary artery or the right side of the heart, and to gua rantee an effective prophylaxis of further pulmonary embolization. Two years later, the vena cava was still patent. The hest way to avoid th is accident is a perfect insertion technique: after a preoperative cav ography to check diameter and patency of the vena cava, the filter mus t be deployed by retracting the introducer sheath while maintaining th e position of the inner canula, and not pushing the filter out of the introducer sheath. A second filter must always be available in the ope rating room in case of incomplete opening of the filter. The use of ve na cava filter is not devoid of risks. Restricted indications are ther efore recommended (J Mal Vasc 1996; 21: pages 312-314).