Two Venous Punctures Not Always Required for Intravascular Ultrasound-Guided Inferior Vena Cava Filter Placement

One venous puncture, instead of two, is an effective and safe way to intravascular ultrasound-guided inferior vena cava filter positioning in critically ill patients, a new study revealed. Inferior vena cava filter placement is performed to prevent or treat pulmonary emboli or deep venous thrombosis (DVT).

“The majority of institutions use a dual venous puncture technique, while we use a single venous puncture technique,” said Dr. Andrew Gunn, from Massachusetts General Hospital (Boston, MA, USA). “We were interested to know if the different approaches affected technical success, clinical success, or the rate of complications with the procedure,” Dr. Gunn said.

In a study of 99 patients, the single puncture technique was technically successful in almost 94% of cases, which is comparable to the dual puncture approach, according to Dr. Gunn. The rate for DVT at the venous access site was 2%. This compares to approximately 4% with the double puncture approach, he said.

Dr. Gunn noted that contrast venography is the most common technique utilized for guiding inferior vena cava filter placement; however, intravascular ultrasound-guided placement is especially beneficial in treating critically ill patients, patients who have contrast allergies as well as those who have compromised renal function. “Intravascular ultrasound-guided placement can be done at the patient’s bedside, eliminating the need for time-consuming and often difficult patient transport,” he said. About 41% of the inferior vena cava filter placements were done at the bedside. “The filter was slightly more likely to be malpositioned if the procedure was done at the patient's bedside,” Dr. Gunn added.

Dr. Gunn presented the study’s findings at the American Roentgen Ray Society (ARRS) annual meeting on April 19, 2013, in Washington DC (USA).


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