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 th e access for IVUS interrogation of the IVC. After the anatomy is defined wi th IVUS, the same guidewire is used for percutaneous IVC filter insertion. Intraoperative fluoroscopy, used as a backup, corroborates the proposed ins ertion location before deployment of the device. Postoperative flat-plate a bdominal 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 fo r the proper deployment of an IVC filter. The deployment of IVC filters und er IVUS has the potential to further simplify an established therapy for de ep venous thrombosis and pulmonary embolism.