Temporary IVC Filter and DVT Management

A temporary filter was inserted via the nonaffected femoral or jugular vein into the inferior vena cava (IVC) prior to the next procedure for patients with an extensive thrombus in the proximal vein that was evaluated as potentially life-threatening and was retrieved after the proximal DVT was removed and potentially life-threatening conditions were relieved. Consistent with local routines based on published guidelines [9 ], anticoagulant treatment was initiated immediately when DVT was identified with the use of subcutaneous low molecular weight heparin (LMWH) at a bolus dose of 100 units/kg twice daily. PTA and/or stent placement was encouraged for lesions that caused 50% or greater diameter narrowing of the iliac and/or common femoral vein, robust collateral filling, and/or a mean pressure gradient of more than 2 mmHg. At the end of LMWH, oral rivaroxaban was directly commenced at a dosage of 15 mg twice a day over the subsequent 21 days and 20 mg once a day thereafter for at least 6 months. In addition, the use of compression stockings (ankle pressure was approximately 30–40 mmHg) for more than 1 year was recommended.