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Case Reports
. 2017 Jan-Mar;13(1):34-36.
doi: 10.14797/mdcj-13-1-34.

Robotic-Assisted Inferior Vena Cava Filter Retrieval

Shahin Owji  1 , Tony Lu  1 , Thomas M Loh  1 , Adeline Schwein  1 , Alan B Lumsden  1 , Jean Bismuth  1
Affiliations
Case Reports

Robotic-Assisted Inferior Vena Cava Filter Retrieval

Shahin Owji et al. Methodist Debakey Cardiovasc J. 2017 Jan-Mar.

Abstract

Although anticoagulation remains the mainstay of therapy for patients with venous thromboembolism, guidelines recommend the use of inferior vena cava (IVC) filters in those who fail anticoagulation or have contraindications to its use. Short-term use of filters has proven effective in reducing the rate of pulmonary embolism. However, their extended use is associated with a variety of complications such as thrombosis, filter migration, or caval perforation, thus making a case for timely filter retrieval. This is the case of a 68-year-old female with a history of chronic oral anticoagulation use for multiple deep venous thrombi (DVT) and pulmonary emboli (PE) who required cervical and thoracic spinal intervention for spondylosis and foramina stenosis. Given her increased risk of recurrent DVT and PE perioperatively, we elected to place a Cook Celect™ IVC filter (Cook Medical, Bloomington, IN) after oral anticoagulation was stopped for the procedure. Her treatment course was prolonged due to wound-healing complications. We elected to use the Magellan Robotic Catheter System (Hansen Medical, Mountain View, CA) for filter retrieval when she presented 6 months later with caval perforation from the filter struts. With its ease of use, superior mechanical stability, and maneuverability, robot-assisted IVC filter retrieval may be a safer and more reliable substitute for traditional navigation techniques when presented with challenging filter retrievals.

Keywords: IVC retrieval; Robotic Catheter System; anticoagulation; inferior vena cava filter; venous thromboembolism.

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Conflict of interest statement

The authors have completed and submitted the Methodist DeBakey Cardiovascular Journal Conflict of Interest Statement and none were reported.

Figures

Figure 1.
Figure 1.
(A) A venogram demonstrates no thrombus within the filter. (B) A 9F sheath is guided with the Magellan Robotic System proximal to the inferior vena cava (IVC) filter. (C) The CloverSnare 4-Loop Vascular Retriever is advanced through the sheath and situated above the filter. (D) The filter hook is captured and the filter is delivered through the sheath. (E) A completion angiography displays no signs of thrombosis or residual portions of the filter within the IVC.
See this image and copyright information in PMC

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