Duplex directed caval filter insertion in multi-trauma and critically ill patients

This study was undertaken to determine the safety and feasibility of inferi or vena cava (IVC) filter insertion at the bedside using duplex imaging in multi-trauma and/or critically ill patients. From February 1996 to August 1 997, 53 multi-trauma and/or critically ill patients, who were in the intens ive care unit and referred for an IVC filter, were prospectively evaluated for possible duplex directed caval filter (DDCF) insertion. Screening IVC d uplex scans were performed in all patients. Satisfactory ultrasound visuali zation in 46 patients (87%) allowed attempted DDCF insertion. All procedure s were percutaneously performed at the bedside using Vena Tech IVC filters. The results from this series showed that DDCF insertion can be safely and rapidly performed at the bedside in multi-trauma or critically ill patients . The procedure is dependent on satisfactory visualization of the IVC by du plex ultrasonography, which was possible in 45 out of 53 (85%) patients. In sertion at the bedside substantially reduces the procedural cost and avoids the need for transport, radiation exposure, and intravenous contrast.