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Introductio. The Angel® catheter (BiO2 Medical Inc, San Antonio, Texas, USA) is a novel device that combines a triple lumen central venous catheter with an inferior vena cava filter for prevention of pulmonary embolism (IVC filtercatheter). Case report. We present the case of a 53- yearold male patient with renal carcinoma and a history of recent deep venous thrombosis (DVT) on oral anticoagulation who was scheduled to undergo open radical nephrectomy. Because of concerns about the risks from documented pre-existing DVT, we decided to insert the Angel® catheter preoperatively in order to have central venous access during surgery and also to reduce the risk of perioperative pulmonary embolism. On the first postoperative day, active gastric bleeding was detected and nadroparine was stopped. Before removal of the Angel® catheter, a pre-removal cavagram revealed large thrombus mass in the catheter filter. Because of the presence of the thrombus mass, the catheter was removed surgically, after a permanent vena cava filter was inserted. Conclusion. This case suggests that the use of the Angel® IVC filter/3-lumen central catheter combination could be a reasonable option for pulmonary embolism prophylaxis in the patients at a high risk for DVT, such as the patients with malignant disease, paraneoplastic syndrome and chemotherapy who need to undergo surgery. [ABSTRACT FROM AUTHOR]

Purpose: To report a 10-year clinical experience with superior vena cava (SVC) retrievable filters., Methods: A retrospective review of patients with SVC filters was performed between 2008 and 2018 in a single tertiary medical center. Patient demographics, indications for filter placement, type of filter placed, and clinical evolution were recorded. Complications during placement, retrieval, and follow-up were determined., Results: Fifty patients ages 17-89 years (average 54) underwent SVC retrievable filter placement. Main indication for filter placement was deep venous thrombosis of the major upper extremity and/or internal jugular veins with contraindications to anticoagulation. Complications during placement included inadvertent filter placement in the right brachiocephalic vein in two patients, another patient had a leg of the filter entrapped in the tip of a hemodialysis catheter that required filter reposition and line exchange. Thirteen patients had attempted retrieval with 12 filters successfully removed 7-420 days after placement (mean 170). On follow-up images available in 24 patients, 13 filters were noted to be significantly tilted and 10 filters had evidence of leg penetration. No other serious late complications were noted., Conclusion: The use of retrievable SVC filters in patients with upper extremity DVT is highly questionable. There is a high incidence of filter malposition, filter tilting, and leg penetration., (© 2019 Wiley Periodicals, Inc.)