Department of Cardiology, Texas Heart Institute, Houston, Texas 77030.
Department of Cardiology, CHI St. Luke's Health-Baylor St. Luke's Medical Center, Houston, Texas 77030.
Tex Heart Inst J. 2020 Apr 1;47(2):140-143. doi: 10.14503/THIJ-18-6704.
Inferior vena cava (IVC) filter thrombosis can be fatal when it is not detected and treated. Its management can be challenging, because little evidence supports specific treatments. We present the case of a 72-year-old man with a history of deep vein thrombosis in whom IVC filter thrombosis developed 7 years after filter placement. Recanalization with oral anticoagulation had failed. Using intravascular ultrasonography, we performed pharmacomechanical thrombolysis, deploying 2 stents simultaneously through the IVC filter and then 2 more into the iliac veins, with excellent results. One year later, the patient's veins and IVC filter were patent, his symptoms were greatly improved, and only nonobstructive neointimal hyperplasia was seen. This case highlights the usefulness of balloon venoplasty and double-barrel stent placement in restoring blood flow through an occluded IVC, and the value of intravascular ultrasonography during and after such procedures.
下腔静脉（IVC）滤器血栓形成如果未被发现和治疗可能是致命的。其管理具有挑战性，因为几乎没有证据支持特定的治疗方法。我们报告了 1 例 72 岁男性患者的病例，该患者在放置滤器 7 年后发生 IVC 滤器血栓形成。口服抗凝治疗后再通失败。我们使用血管内超声进行了药物机械溶栓，通过 IVC 滤器同时放置 2 个支架，然后将另外 2 个支架放入髂静脉，效果极佳。1 年后，患者的静脉和 IVC 滤器通畅，症状明显改善，仅见非阻塞性新生内膜增生。该病例强调了球囊血管成形术和双筒支架置入在恢复闭塞 IVC 血流方面的作用，以及血管内超声在这些手术过程中和之后的价值。
