Digital background removal and placement of inferior vena cava filter

This is an automatically translated article.

The article was professionally consulted by Specialist Doctor I Tran Cong Trinh - Radiologist - Radiology Department - Vinmec Central Park International General Hospital.
Digital subtraction angiography (DSA) and placement of a filter on the inferior vena cava to prevent large thrombus from moving into the pulmonary circulation and heart chambers, help patients reduce complications and mortality.

1. The role of digital imaging to erase the background and place the inferior vena cava filter

There are many causes of stenosis - obstruction of the superior and inferior vena cava systems (intravascular thrombosis, tumor compression...). Pulmonary embolism is one of the most dangerous complications in patients with venous thrombosis of the lower extremities or in the pelvis.
Digital subtraction angiography (DSA) of veins and placement of inferior vena cava filters to prevent large thrombus from moving to the heart chambers and pulmonary circulation.
Based on the method of placement, there are 2 common procedures for mesh placement today:
Placement of the inferior vena cava through the right internal jugular vein Placement of the inferior vena cava through the common femoral vein

2. Indications and contraindications for background digitization and placement of inferior vena cava filter

Indications for venipuncture and vena cava filter placement in the following cases:
Mediastinal tumor bronchial carcinoma causing vena cava obstruction Mediastinal lymphadenopathy due to metastatic cancer causing vena cava obstruction Lymphoma Hodgkin's or non-Hodgkin's causes vena cava to obstruct vena cava stenosis after radiotherapy and chemotherapy Venous occlusion due to fibrosis: After long-term catheterization (catheter), surgery, trauma, infection. Contraindicated and complicated with anticoagulation therapy Relatively indicated for large thrombus, suspended in the vascular lumen Contraindicated for venous DSA and inferior vena cava filter in case of:
Chronic thrombosis inferior vena cava Abnormalities in the anatomy of the vena cava impeding interventional techniques Severe renal failure (grade IV) Coagulopathy, loss of control. Pregnancy Reactions to iodinated contrast agents

3. Steps to conduct digital scan to remove background and place inferior vena cava filter

Step 1: Prepare tools including: Digital angiography machine to erase the background, dedicated electric pump, image storage system, X-ray shielder; local anesthetics, pre-anesthetics and general anesthetics, anticoagulants, anticoagulant neutralizers, water-soluble iodinated contrast agents, antiseptic solutions for skin, mucous membranes and medical supplies. Step 2: Ask the patient to lie on their back. Install a monitor to monitor breathing, pulse, blood pressure, electrocardiogram, SpO2. Disinfect the skin and then cover with a sterile towel with holes. Step 3: Have the patient lie on his back on the imaging table and place an intravenous line and local anesthetic. Step 4: Incision of the skin and subcutaneous tissue to puncture the right internal jugular vein under ultrasound guidance. Insert the catheter and catheter into the right internal jugular vein under the guidance of an enhanced fluorescein screen. Step 5: Insert the catheter into the inferior vena cava at the level of the vena cava - iliac junction to scan the inferior vena cava and evaluate the morphology and hemodynamics of the inferior vena cava Step 6: Insert the mesh filter kit into the vein the inferior aorta through the lumen. Place the filter below the level of the renal veins Step 7: Remove the sheath to release the filter into the lumen of the inferior vena cava and take the inferior vena cava. Vinmec International General Hospital with a system of modern facilities, medical equipment and a team of experts and doctors with many years of experience in neurological examination and treatment, patients can completely rest in peace. examination and treatment center at the Hospital.
Before taking a job at Vinmec Central Park International General Hospital, the position of Doctor of Radiology from September 2017, Doctor Tran Cong Trinh worked at Gia Dinh People's Hospital since 2007. -2017. In his role, Dr. Tran Cong Trinh has participated in guiding the teaching of students, residents, specialists and new doctors entering the department
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