Summary: One venous puncture, rather than two, is a safe and effective approach to intravascular ultrasound-guided inferior vena cava filter placement in critically-ill patients
April 24, 2013 - One venous puncture, rather than
two, is a safe and effective approach to intravascular ultrasound-guided
inferior vena cava (IVC) filter placement in critically-ill patients, a new study shows.
"The majority of institutions use a dual venous
puncture technique, while we use a single venous puncture technique," said
Dr. Andrew Gunn, of Massachusetts General Hospital in Boston, MA, regarding a study
presented at the American Roentgen Ray Society
(ARRS) annual meeting on April 19 in Washington,
DC. "We were interested to know if the different approaches affected
technical success, clinical success or the rate of complications with the procedure."
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, said Dr. Gunn. The rate for deep
venous thrombosis at the venous access site was 2%. This compares to
approximately 4% with the double puncture approach.
Dr. Gunn noted that contrast venography is the most
common method employed for guiding inferior vena cava filter placement;
however, intravascular ultrasound-guided placement is particularly useful 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.
For more information:
http://www.arrs.org/ and http://www.appliedradiationoncology.com