CRT 2012 Primer for Endovascular Interventions IVC Filters
- Slides: 54
CRT 2012 Primer for Endovascular Interventions
IVC Filters: When? Which Ones? And How?
Anthony C. Venbrux, MD Professor of Radiology and Surgery Director, Vascular and Interventional Radiology The George Washington University Medical Center Washington, DC
Anthony Venbrux, MD Honoraria received for medical lectures: Cook, Inc. Cordis Endovascular Bard Peripheral Vascular Terumo Interventional Systems Medrad-Possis Interventional Rex Medical Consultant - Bard Peripheral Vascular Consultant - Art. Ventive Medical
Special Thanks To: Shawn N. Sarin, MD Andrew S. Akman, MD Albert K. Chun, MD Amy P. Harper, ACNP-BC Noel Clay Haskins, MD Frank Lynch, MD John Kaufman, MD Shundra D. Dinkins
Objectives 1) 2) 3) 4) Background Techniques of deployment Clinical applications Complications
Ideal Caval Filter Easily deployed Percutaneous approach Small puncture site Biocompatible
Ideal Caval Filter Nonthrombogenic Stress resistant Percutaneously removed
Greenfield Meditech-Boston Scientific
When ?
Classic Filter Indications Thrombo-embolic disease (TED) with Contraindication for anticoagulation. Complication of anticoagulation. Failure of anticoagulation. Massive pulmonary embolism. Chronic, recurrent pulmonary embolism.
Extended Indications - Off Label DVT/PE with poor compliance. “Widow maker” thrombus. Poor respiratory/pulmonary reserve. Unsteady patient (fall risk). No DVT/PE but at high risk for development.
Which Filter ?
Vena Cava Filters
Current U. S. Optional Filter Designs MERIDIAN Opt. Ease™ Tulip™ Celect™ Option™ ALN ™
How ?
Cook Inc.
Removal of optional filters using currently available percutaneous techniques
What do you need?
Favorable anatomy
IVC Filter Removal Straight forward and Complex
Equipment Sheaths Directional catheters Directional guidewires Loop snares Grasping devices Baskets
ev 3
Amplatz GOOSE NECK® Snare Kit (ev 3) • Nitinol cable with gold plated tungsten loop & platinum-iridium marker band. • 90 degree snare loop. • Wide range of loop diameters: 5 mm – 35 mm. • Catheter length = 102 cm. • Snare length = 120 cm.
EN Snare® (Angiotech / Hatch Medical) • Three nitinol loops with interwoven platinum strands for radiopacity and radiopaque band. • Angled catheter tip (15°) • Wide range of loop diameters: 6 mm. – 45 mm. • Catheter length = 100 cm. Snare length = 120 cm.
EXPRO Elite™ Snare (Radius Med. Tech. ) • Helical shaped loop made from cobalt chromium makes loop and tip radiopaque. • Wide range of loop diameters: 5 mm – 35 mm. • Snare & catheter length = 150 cm. (integrated system). • Distributed by both Vascular Solutions and by Abbott.
Removal of an “Intravascular Foreign Body” Straight forward Loop snare Grasping device Complex Multiple devices used including angioplasty balloons, bronchoscopy forceps, and the“in situ” snare technique.
Retrieval with a snare and a long sheath or guiding catheter Günther Tulip (Cook) Celect (Cook) Opt Ease (Cordis Endovascular) Option (Angiotech) G 2 X, Eclipse, Meridian (Bard)
Retrieval with a “grasping”device Recovery Filter, G 2 (Bard Peripheral Vascular) Aln (Aln Implants)
Snare Retrieval En. Snare
G 2 Filter Cone Bard Peripheral Vascular.
Bard Peripheral Vascular.
Recovery (G 2) Retrieval
Can a Permanent IVC Filter be Removed?
Take Home Points
- Ivc plethora definition
- Ivc paralegal program
- Denali ivc filter mri
- Nc ivc first examination
- Ivc transfer center
- Ivc summer classes for high school students
- Hepatic portal vein
- Cystanche
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- Ivc iniciacion a la vida cristiana
- Digital filters
- Filter is basically selective circuit
- Spectral transformation of iir filters
- Hailstop hail guard netting
- Ironport outbreak filters
- Skimage.filters.gaussian
- Lymph nodes: “filters of the blood”
- Perceptual filters
- Hpf lpf bpf
- Vertical blinds
- Wet etch clean filters
- Authentication filters in mvc 5
- Advantage of active filter
- Design of analog filters schaumann
- Discriminative training of kalman filters
- Barracuda internet filter
- Applications of active filters
- Emfab filters
- Use of large volume parenterals
- Argument vs opinion
- Disc filters galaxy 4 spin klin series
- Bypass regex filters
- Filters in weka
- Active vs passive low pass filter
- Erp boot camp
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- Compare analog and digital filters
- Our personal filters assumptions
- Joint legacy viewer website
- Difference between linear and nonlinear spatial filters
- Event list filters packet tracer
- Where is the heart located
- Bacterial filters ppt
- Ent
- Types of analog filters
- Shingelfrisyren
- Karttecken sten
- Mjälthilus
- Kraft per area
- Uppställning multiplikation
- Toppslätskivling effekt
- Elektronik för barn
- Borra hål för knoppar
- Mat för unga idrottare
- Smärtskolan kunskap för livet