Case Report: Vena Cava Filter Implantation to Prevent Lethal Pulmonary Embolism in Patients with Deep Venous Thrombosis after Transfer of Acetabulum Operation.

We treated a patient who had been suffering from a wide range of deep venous thrombosis (DVT) in the lower right extremity after the right transfer of the acetabulum. The patient noticed swelling and pain in the lower right extremity two weeks after the operation. The defects of the contrast medium were seen between the right common iliac vein and calf venula when venography was performed. A slight wedgeshaped defect was also seen in the lower left lung when lung blood flow scintigram was performed. The patient was diagnosed as DVT with slight pulmonary embolism (PE). Immediately we routinely treated this patient with anticoagulant therapy that consists of intravenous heparin medication. In order to prevent lethal PE during the therapy, we implanted a percutaneous infra vena cava filter (IVC filter) capable of trapping large thrombus and inducing spontaneous fibrinolysis at this site. Furthermore, fibrinolytic therapy consisting of intravenous urokinase medication was added. During the therapy, swelling and pain of the lower right extremity improved with the decreasing in the serum D-dimer. The IVC filter seems to be useful for preventing acute lethal PE following a wide range of DVT after hip surgery. However, long term follow-up of this patient seems to be required.