J Korean Soc Radiol.  2010 Aug;63(2):115-122.

Effectiveness and Safety of the Tempofilter II to Prevent the Occurrence of Pulmonary Thromboembolism in Patients with Lower Extremity Deep Vein Thrombosis

• Baek BH
• Jung MY
• Oh HJ
• Jang NK
• Kim JK
• Lee HK

Abstract

PURPOSE
To evaluate the efficacy and safety of the Tempofilter II for the prevention of a pulmonary thromboembolism (PTE) in patients with lower extremity deep vein thrombosis (DVT).
MATERIALS AND METHODS
Between January 2007 and December 2008, thirteen patients with lower extremity DVT whom were implanted with the Tempofilter II to prevent PTE were analyzed. A chest CT was compared before and after filter placement, to evaluate effectiveness of preventing PTE. Clinical symptoms of PTE were checked. Fluoroscopy and a plain radiograph were examined to evaluate filter status.
RESULTS
The tempofilter II was successfully inserted in 13 patients. Nine patients underwent endovascular treatment after filter insertion. Trapping of thrombus was evaluated by following CT, venography, and filter retrieval. Trapped thrombus was detected in four patients by CT or retrieved filter. Two patients showed a decrease in thrombus in a follow-up chest CT. Not all patients showed symptoms of PTE. One filter was surgically removed due to the detachment of the anchoring device.
CONCLUSION
The placement and retrieval of the Tempofilter II is feasible and effective for the prophylaxis of PTE in patients with lower extremity DVT; especially for patients that underwent subsequent endovascular treatment.

MeSH Terms

Fluoroscopy
Follow-Up Studies
Humans
Lower Extremity
Lung Diseases
Phlebography
Pulmonary Embolism
Thorax
Thrombosis
Vena Cava Filters
Venous Thrombosis

Figure

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  Fig. 1 Schema of the implanted Tempofilter II shows filter in the inferior vena cava (white arrow), anchoring catheter (black arrow), and tethering catheter (arrow heads).

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  Fig. 2 50-year-old male with May-Thurner syndrome. A. Low extremity CT venogram shows DVT in left femoral vein and iliac vein. B-D. Tempofilter II was successfully deployed at the infrarenal IVC via right internal jugular vein. E. On prone position, catheter-directed Urokinase infusion and mechanical thrombectomy were done followed by stent insertion. F. In follow-up CT venogram venous flows were improved.

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  Fig. 3 50-year-old female with claudication. A. Low extremity CT venogram shows DVT in right iliac vein. B. Filter was successfully deployed at the infrarenal inferior vena cava. C, D. Follow up CT and plain radiograph show that one of filter limb (arrow) is dislocated into right ovarian vein. E. Trapped thrombus between filter strut is shown.

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  Fig. 4 59-year-old male with early detached anchoring device from tethering catheter. A. Radiograph shows that anchoring device (arrow) is detached from tethering catheter. B. The venogram shows the thrombotic filling defect (arrow) at the junction of right subclavian vein and right internal jugular vein without opacification of right internal jugular vein. C. Surgically removed tethering catheter and filter are shown.

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