부산대학교 도서관

PURPOSE: Measuring success rates for retrieving tilted and/or embedded IVC filters with a rigid endobronchial forceps along with an endovascular snare in a local community hospital. TECHNIQUE: The technique is demonstrated among 18 patients from an inner city community hospital. Retrieval attempts were performed via right internal jugular vein access. A 5 French sheath was placed, through which a guidewire and catheter were placed below the filter and a cavogram was performed. After confirmation of the absence of caval thrombus, a 10 French sheath was placed through the existing access and attempts were made using an 18-30 mm endovascular snare to engage the hook of the filter. If the filter hook could not be engaged, the snare catheter was removed and the sheath was upsized to a 12 French by 40 cm sheath. An endobronchial forceps was then advanced directly through the sheath. The forceps were then used to grasp the filter and reposition it such that the hook would be in a more favorable position for retrieval. The endovascular snare device was then re-inserted and the hook of the IVC filter would be successfully engaged. The 12 French sheath would then be advanced over the filter thus collapsing it while maintaining traction with the endovascular snare and both sheath and filter were successfully retrieved. CONCLUSION: Using endobronchial forceps in combination with a traditional endovascular snare can be used safely to retrieve tilted and/or embedded IVC filters in a community based hospital. [ABSTRACT FROM AUTHOR]