IVC filter presentation new

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By: MOHAMEDOMAR (51 month(s) ago)

excellent presentation prof sharkawy , keep the good work have a nice day

Presentation Transcript

Slide 1: 

Sharkawy M.I Professor of Vascular Surgery Faculty of medicine Cairo University EGYPT

I.V.C FILTER : 

I.V.C FILTER THE MOST RECENT WAY TO FILTER THE BLOOD PASSING THROUGH IVC TO GUARD AGAINEST PULMONARY EMBOLI

History : 

History John Hunter Ligated femoral vein 1784 . Bottini IVC ligation 1893. IVC suture , Stappling were developed 1930 . Mobin-Uddin umbrella was developed 1951 .

Absolute Indications : 

Absolute Indications DVT, PE in a patient with contraindication to anticoagulation . DVT + PE despite adequate anticoagulation. Complication of anticoagulation . After pulmonary embolectomy . During local thrombolytic therapy in a major vein DVT (Iliofemoral ).

Slide 9: 

Lt. CIV compression syndrome

Relative Indication : 

Relative Indication A large free floating ilio-femoral thrombus + →Propagation of ilio-femoral DVT despite adequate anticoagulation . Chronic PE in patient with core pulmonale or pulmonary hypertension . More than 50 % occlusion of pulmonary vascular bed . Recurrent septic embolism. During surgical thrombectomy.

Pulmonary Embolism : 

Pulmonary Embolism Is a common dissease . Is a lethal dissease . Is a preventable dissease .

Slide 17: 

Prevent fatal pulmonary emboli not all PE THE AIM IS TO

IVC Filter Shapes : 

IVC Filter Shapes Cone shaped Bird’s Nest Coils Double barrel With or without hooks

VenaTech LGM - Permanent VCF : 

VenaTech LGM - Permanent VCF Cone The one piece and proven conical shape effectively traps clots while maintaining caval patency Hooks The hooks ensure precise filter placement and prevent filter movement Stabilizers The stabilizing legs center the filter on deployment and prevent tilting. The long legs minimizes vessel trauma and incidence of caval perforation. Crampons The crampons maintain the stability of the filter and promote rapid endothelial growth

Slide 22: 

CENTRAL caudal extension for EASY Snaring and Removal BARBS for OPTIMAL resistance to migration

Technical Considerations : 

Technical Considerations Venous access under local anesthesia . Passing a guide wire and venography to IVC (less than 30mm , patent ) Infrarenal positioning The right way (femoral – Jugular ) Filter deployment . Check venography .

Access : 

Access Femoral Jugular Cephalic

Durability : 

Durability Permanent Filter Short Term Temporary Filter Long Term Temporary Filter Filter retrieval System

Slide 30: 

“Short term” Temporary filters Indicated to provide protection during thrombolysis. Catheter left in and out the body Up to 10 days

Slide 32: 

Benefits Allows the insertion of a 3 French catheter for directed thrombolysis Conical design MRI compatible

Slide 33: 

“Long Term” Temporary filters when temporary filter is needed for a long time (ex. surgery, pregnancy) Fully implanted (patient can stay outside the hospital) Up to 6 weeks

Problems : 

Problems Mal-alignment . Filter Migration . Filter occlusion . Filter perforation . Infection . Incomplete opening . IVC Thrombosis

MESSAGE : 

MESSAGE Adhere to strict indications only Proper anticoagulation means APTT=100-120 seconds ●The international incidence of IVC filter implantation rate is: 0.2% in all diagnosed infra-inguinal DVT 1-2% of Ilio-femoral DVT. 2-5% of post-pelvic surgery DVT

Slide 38: 

Thank You