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      Catheter Directed Thrombectomy Under Temporary Catheter Based Filter Protection in Renal Vein Thrombosis and Contraindication to Anticoagulation

      case-report

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          Abstract

          Introduction

          A 55 year old man who suffered from recurrent traumatic multi-organ bleeding presented with deterioration in kidney function and pulmonary embolism caused by a newly diagnosed renal vein thrombosis during hospitalisation.

          Report

          Complete clot removal was performed successfully by catheter directed aspiration. Thrombotic emboli were captured in a temporary filter device. A post-interventional computed tomography scan showed full restoration of the occluded renal vein.

          Discussion

          Use of a temporary catheter based vena cava filter (Capturex) during catheter directed thrombectomy is safe and should be considered to prevent thrombo-embolism in selected cases when any rheolytic therapy is contraindicated.

          Highlights

          • •

            Catheter-based vena cava filter usage may increase the patient's safety during endovascular thrombectomy.

          • •

            Renal vein thrombosis is a differential diagnosis for renal function deterioration.

          • •

            Thrombo-embolism may occur during catheter directed thrombectomy.

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          Most cited references10

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          Patent foramen ovale is an important predictor of adverse outcome in patients with major pulmonary embolism.

          M. Olschewski, L Blümel, A Geibel … (1998)
          Right-to-left shunt through a patent foramen ovale is frequently diagnosed by contrast echocardiography and can be particularly prominent in the presence of elevated pressures in the right side of the heart. Its prognostic significance in patients with pulmonary thromboembolism, however, is unknown. The present prospective study included 139 consecutive patients with major pulmonary embolism diagnosed on the basis of clinical, echocardiographic, and cardiac catheterization criteria. All patients underwent contrast echocardiography at presentation. The end points of the study were overall mortality and complicated clinical course during the hospital stay defined as death, cerebral or peripheral arterial thromboembolism, major bleeding, or need for endotracheal intubation or cardiopulmonary resuscitation. Patent foramen ovale was diagnosed in 48 patients (35%). These patients had a death rate of 33% as opposed to 14% in patients with a negative echo-contrast examination (P=.015). Logistic regression analysis demonstrated that the only independent predictors of mortality in the study population were a patent foramen ovale (odds ratio [OR], 11.4; P<.001) and arterial hypotension at presentation (OR, 26.3; P<.001). Patients with a patent foramen ovale also had a significantly higher incidence of ischemic stroke (13% versus 2.2%; P=.02) and peripheral arterial embolism (15 versus 0%; P<.001). Overall, the risk of a complicated in-hospital course was 5.2 times higher in this patient group (P<.001). In patients with major pulmonary embolism, echocardiographic detection of a patent foramen ovale signifies a particularly high risk of death and arterial thromboembolic complications.
          Article 0 comments Cited 46 times – based on 0 reviews     Review now
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            Renal vein thrombosis.

            M. Asghar, K. Ahmed, S.S. Shah … (2007)
            The aim of this article is to review the published English literature on aetiology, pathology, clinical presentation, diagnostic methods and treatment of renal vein thrombosis. We searched the published literature from Medline & Pubmed using keywords renal vein thrombosis, anti-phospholipid syndrome and nephrotic syndrome. Data was extracted from individual case reports, case series, articles on pathology, diagnostic tests, treatment modalities, and previous reviews. Case reports which did not add any new information were excluded. We selected 60 references based on the above criteria. Renal vein thrombosis is relatively rare. CT angiography is considered the investigation of choice. Alternatives include MR angiography or renal venography in highly selected patients. As the condition is relatively uncommon, consensus on the best form of therapy for this condition has been slow to evolve. The trend in management has shifted to non-surgical therapies particularly systemic anticoagulation except in highly selected group of patients.
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              Endovascular Management of Deep Vein Thrombosis with Rheolytic Thrombectomy: Final Report of the Prospective Multicenter PEARL (Peripheral Use of AngioJet Rheolytic Thrombectomy with a Variety of Catheter Lengths) Registry

              Robert A Lookstein, Rahul Malhotra, Ali Amin … (2015)
              Article 0 comments Cited 29 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Axel Haine
                Journal
                Journal ID (nlm-ta): EJVES Vasc Forum
                Journal ID (iso-abbrev): EJVES Vasc Forum
                Title: EJVES Vascular Forum
                Publisher: Elsevier
                ISSN (Electronic): 2666-688X
                Publication date PMC-release: 19 September 2020
                Publication date Collection: 2020
                Publication date (Electronic): 19 September 2020
                Volume: 49
                Pages: 16-19
                Affiliations
                [a ]Division of Angiology, Swiss Cardiovascular Centre, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
                [b ]Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
                Author notes
                [∗ ]Corresponding author. Division of Angiology, Swiss Cardiovascular Centre, University Hospital Bern, 3010, Bern, Switzerland. axel.haine@ 123456gefaesszentrum-bern.ch
                Article
                Publisher Item ID: S2666-688X(20)30066-6
                DOI: 10.1016/j.ejvsvf.2020.09.001
                PMC ID: 7560707
                SO-VID: dcb54635-4e8d-4691-aec6-f7e6f8610711
                Copyright © © 2020 The Author(s)
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 19 February 2020
                Date revision received : 11 August 2020
                Date accepted : 11 September 2020
                Categories
                Subject: Case Report

                Keywords: mechanical thrombectomy,pulmonary embolism,thrombosis,vena cava filter
                Data availability:
                Keywords: mechanical thrombectomy, pulmonary embolism, thrombosis, vena cava filter

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