The patient in this report was a middle aged female with history of deep vein thrombosis (dvt) and she was morbidly obese."when trying to remove the bard inferior vena cava (ivc) filter with the bard retrieval snare the snare broke inside the patient.All pieces were retrieved from the patient" snare was inserted and the hook of the filter was captured and carefully lined in a straight line.Inner sheath was advanced over the proximal hook and filter and advanced approximate 1 cm and would not go any further.Outer sheath was taken over and multiple attempts were made to pass the sheath system in combination and singly over the filter with back pressure on the snare.This was attempted multiple times with multiple passes in the snare burst.Snare and its components were then carefully removed along with the first set of sheaths and a second retrieval system was opened and placed over the wire and a new snare was brought down and the snare was used to grab the hook and again multiple attempts were made to pass the new system over top of the filter collapsing it in good back pressure was again applied.This would not budge the filter would not collapse.With this information snare was then released with some difficulty and sheaths were removed pressure was held over the neck and the patient was discharged recovery in stable condition to have the site monitored and to be discharged home to follow-up in the office.
|