Nate, sounds like a command performance.... Most of the filters we place are in unstable patients in the ICU, and moving them to the radiology suite or the OR places the patient at great risk. I have been placing filters at the bedside with great results. This is much safer for the patient and more cost effective.
I start out getting a sonogram to measure the IVC diameter, determine if there is a left sided IVC, or some other abnormality, and the extent of DVT (if present). I also mark the insertion site vein. I use either via the femoral vein under ultrasonic guidance in skinny patients, (or via the right internal jugular under fluoroscopy guidance in patients with obesity or with an ileus). The new filters are designed to be very small in diameter. You only need to prep the groin if using ultrasound. The probe and abdomen do not need to be sterile. You can easily see the carrier move up the iliac vein. Your landmark for ultrasound insertion is the crossing left renal vein. Just talk your physician to the right location and have him/her deploy the filter a few cm distal to the renal vein. Good luck,
Donald P. Spadone, MD; N513 DC077; Division of Vascular Surgery; University of Missouri-Columbia; University Hospital and Clinics; One Hospital Drive; Columbia, MO 65212; Phone # 573 882 - 1308; Fax # 573 884 - 4585; e-mail [log in to unmask]
From: Nathan Hoog [mailto:[log in to unmask]]
Sent: Wednesday, March 06, 2002 10:18 PM
To: [log in to unmask]
Subject: Re: ivc filter placement
I performed this procedure by ultrasound while our Medical Director (Vascular Surgeon) introduced the filter at bedside when I was at University of Missouri Hospital Vascular Lab. It went very well and was used to teach Residents and Fellows as well as offering an alternative to the O.R. suite. We didn't perform it often, primarily due to timing and manpower Vs performing other tests in the lab.
Don Spadone was the Med. Director. If you're still on flownet, you might add your input Dr. Spadone. Thank you.
Nathan Hoog, BS, RVT