Use of the Arrow percutaneous thrombectomy device and transjugular liver biopsy cannula for mechanical thrombectomy of the inferior vena cava in a patient with Budd-Chiari syndrome.

Abstract

A 33-year-old woman with Budd-Chiari syndrome and hypercoagulability was sequentially treated with the placement of hepatic vein stents and transjugular intrahepatic portosystemic shunts (TIPS), all of which repeatedly thrombosed. Four months after TIPS revision with an endoprosthesis, a large inferior vena cava (IVC) thrombus developed caudal to an IVC stenosis. A percutaneous thrombectomy device was introduced coaxially through a transjugular liver biopsy cannula to extend its effective diameter range of attack and was steered within the IVC to successfully clear the thrombus. The condition recurred 9 months later, and the technique was repeated successfully. At subsequent 12-month follow-up, the IVC remains patient and symptoms resolved. This combination of cannula and percutaneous thrombectomy device proved essential in facilitating successful mechanical thrombectomy of the IVC.

• Authors: Ziv J Haskal
• Journal: Journal of vascular and interventional radiology : JVIR (J Vasc Interv Radiol) Vol. 18 Issue 7 Pg. 924-7 (Jul 2007) ISSN: 1051-0443 [Print] United States
• PMID: 17609456 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Angioplasty
• Biopsy
• Budd-Chiari Syndrome (pathology, therapy)
• Female
• Graft Occlusion, Vascular (diagnosis, therapy)
• Humans
• Jugular Veins
• Liver Function Tests
• Phlebography
• Portasystemic Shunt, Transjugular Intrahepatic (adverse effects)
• Radiography, Interventional
• Stents
• Thrombectomy (instrumentation)
• Vena Cava, Inferior (pathology)