IVC filter presentation

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By: roberttaylor (119 month(s) ago)

“Unnecessary risks are being taken by patients seeking the liberation treatment.” says Dr. Avneesh Gupte of the CCSVI Clinic. “It has been our contention since we started doing minimally invasive venous angioplasties nearly 6 years ago that discharging patients who have had neck vein surgery on an outpatient basis is contra-indicated. We have been keeping patients hospitalized for a week to 10 days as a matter of safety and monitoring them for symptoms. Nobody who has the liberation therapy gets discharged earlier than that. During that time we do daily Doppler Ultrasounds, blood work and blood pressure monitoring among other testing. This has been the safe practice standard that we have adopted and this post-procedure monitoring over 10 days is the subject of our recent study as it relates to CCSVI for MS patients.” For more information Log on to http://ccsviclinic.ca/?p=866 OR Call on Toll Free: 888-419-6855.

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 ).

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 7: 

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 10: 

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

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 16: 

Thank You

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