2004 Volume 15 Issue 5 Pages 391-395
Catheter-directed thrombolysis (CDT) is used as treatment of deep vein thrombosis, after retrievable TVC filter inserted, for prevention against pulmonary thromboembolism. A 28-year old woman, she was 9 weeks pregnant, was diagnosed of deep vein thrombosis by ultrasound. Retrievable inferior vena cava filter (IVC filter/Gunther tulip vena cava filter®) was inserted infrarenal vena cava before CDT preventing from pulmonary embolism due to isolated thrombus. CDT was performed administering urokinase that dose was 120,000 to 240,000 IU/day. Maintenance dosing of heparin and urokinase were 8,000 to 24,000 IU/day and 240,000IU/day. Seven days after inserted IVC filter, MRI revealed the complete occlusion of the IVC filter. We tried CDT administering urokinase dose 180,000 IU, but unsuccessful. The patient was underwent catheter thrombectomy using hydrodynamic thrombectomy catheter (Hydrolyzer®). We could eliminate thrombus and could retrieve IVC filter without complication of significant pulmonary thromboembolism.
The cause of acute inferior vena cava filter complete occlusion was unknown. But, hydrodynamic thrombectomy catheter therapy was effective and safe method for acute inferior vena cava filter thromboembolism.
