case_images: PMC11250597_01
case_images: Enhanced CT images before and after procedure. (A,B) The filter retraction hook entered SVC wall, and the tip was close to the right pulmonary artery. (C,D) No haematoma, dissection or cardiac fluid accumulation in the superior vena cava or right pulmonary artery after filter removal.
case_images: fcvm-11-1412571-g001.jpg
case_images: PMC11250597_01_fcvm-11-1412571-g001.jpg
case_images: F1
case_images: The filter retraction hook was likely to penetrate the SVC wall, and its tip was very close to the right pulmonary artery (Figures 1A,B). CTPA (Figures 1C,D) was performed one week after the procedure.
case_images: Images of the loop-snare technique steps. (A,B) Multiangle angiography of the superior vena cava. Red arrows marked the interspace between the filter and the SVC wall where the wire loop was formed. (C,D) The pigtail catheter shape with its tip partly cut. (E) Modified loop-snare technique using a decapitated pigtail catheter.
case_images: fcvm-11-1412571-g002.jpg
case_images: PMC11250597_01_fcvm-11-1412571-g002.jpg
case_images: F2
case_images: Repeated multiangle angiography showed that the filter retraction hook had possibly entered the SVC wall (Figures 2A,B). To solve this issue, we utilized a modified loop-snare technique by introducing a pigtail catheter and a hydrophilic guidewire (Figure 2E). The pigtail catheter had its tip partially cut (Figures 2C,D) and was rotated to be guided into the interspace between the filter and the SVC wall (Figure 2B, red arrows).
case_images: Filter removal process images. (A,B) Modified loop-snare technique for cutting the proliferated tissue around the retraction hook, with the guidewire directly suspending the retraction hook. (C,D) After the filter was successfully removed, no damage to the superior vena cava was observed by contrast imaging, and the filter was completely removed. (E,F) The deformed shape of the filter retrieval devices.
case_images: fcvm-11-1412571-g003.jpg
case_images: PMC11250597_01_fcvm-11-1412571-g003.jpg
case_images: F3
case_images: A wire loop was formed across the proliferative tissue and was used to cut and destroy the proliferative tissue surrounding the retraction hook through the exertion of counteracting forces by the guidewire and retrieval sheath (Figures 3A,B), and the filter was successfully removed by directly suspension of the guidewire. Repeated multiangle angiography showed no contrast medium spillage (Figure 3C). Finally, the filter was removed successfully and completely (Figure 3D). We also observed that the tip of the retrieval sheath was significantly deformed (Figures 3E,F).