Percutaneous thrombectomy of filter-associated inferior vena cava occlusion

Ilio-caval thrombosis is a highly morbid and technically challenging complication of inferior vena cava (IVC) filters. Here, we present our technique for utilizing the FLowTriever and ClotTriever thrombectomy system (Inari Medical, Irving, CA) in the management of extensive DVT and supra-IVC filter thrombosis in four consecutive patients. Thrombectomy was performed via bilateral popliteal access in addition to IJ access for embolic protection. Any residual stenosis in the ilio-caval segment was treated with angioplasty and adjunctive stenting as appropriate. Technical success, defined by significant thrombus removal and restoration of in-line flow without robust collateral filling, was achieved in all four patients.