Vena Cava Filter on Patient with Deep Vein Thrombosis
Author : I.F. Ramdhani, J.Nugroho
Upload Date : 19-04-2018
Background: The use of inferior vena cava filters (IVCF) has increased dramatically in recent decades. Inferior vena cava filters were developed to prevent pulmonary embolism (PE) and reduce venous thromboembolism (VTE) related mortality. Inferior vena cava filters remain the only treatment option for patients with an acute proximal deep vein thrombosis (DVT) or pulmonary embolism and an absolute contraindication to anticoagulation. In modern practice inferior vena cava filters are inserted for multiple indications ranging from prophylaxis in high-risk patients to prevention of recurrent VTE in patients who cannot receive anticoagulation due to an acute bleed or need for surgery.
Case: A 59 years old male came to emergency room and complained of swelling of right leg since the last 2 weeks. The swelling worsened over time, accompanied with pain and redness. He had a history of hepatocellular carcinoma, and underwent TACE procedure 2 months ago. The patient had normal vital sign, with anemia and icterus, palpable liver 2 cm under costal arch, and right leg oedem. Patient had Wells’ score of 3, which is high risk for DVT. The patient was diagnosed with deep vein thrombosis and underwent IVC filter placement.
Discussion: IVC Filter is indicated in patients who is contraindicated to anticoagulants, have recurrent PE and bleeding complications. Its contraindications include no accessible route, severe coagulopathy, and bacteremia.
Conclusion: It has been reported a man, 59 years old, with DVT in lower right extremity, and hepatocellular carcinoma with a history of TACE. Venous thromboemboli can cause life-threatening complications, therefore, early and accurate diagnosis and treatment is necessary. Vena cava filter is the treatment of choice for venous thromboemboli with contraindications to anticoagulant therapy
KEYWORDS : inferior vena cava filter, venous thromboembolism, deep vein thrombosis.