Bedside intravascular ultrasound-guided fibrin sheath balloon maceration and inferior vena cava filter placement during extracorporeal membranous oxygenation decannulation

Abstract

Inferior vena cava filter placement during extracorporeal membranous oxygenation decannulation has been described as a technique to prevent potentially lethal pulmonary embolism in this critically ill population. With long-standing extracorporeal membranous oxygenation cannulae, venous fibrin sheaths may develop, which may predispose to filter maldeployment or inadequate embolus filtration. This report describes the use of a balloon catheter to disrupt a fibrin sheath at patient bedside using intravascular ultrasound guidance to facilitate inferior vena cava filter placement. Keywords: ECMO, IVC filter, Fibrin sheath, IVUS