Filter placement in duplicated inferior vena cava.

Abstract

A 51 year old man treated with warfarin for recurrent pulmonary embolism was admitted for chest pain, dyspnea and right calf pain. His past medical history included chronic myelocytic leukemia, splenectomy, Factor XI deficiency, and anti-protein C resistance. The right calf was swollen, reddened and tender, and Homan's sign was elicited. The INR was 1.8. Isotope venography revealed deep vein thrombosis in the right calf and bilateral pulmonary emboli. Doppler ultrasound showed patency of the right ileofemoral veins. The patient was referred to angiography for placement of an inferior vena cava filter.