Transfemoral venous access through inferior vena cava filters for interventions requiring large sheaths.

The presence of a filter in the inferior vena cava (IVC) to prevent pulmonary embolism from lower extremity deep vein thrombosis has traditionally been a contraindication for venous catheterization from the femoral vein. Certain interventional procedures require femoral access and occasionally, patients with IVC filters require these procedures. The authors report two such patients, one with a Greenfield filter requiring balloon mitral valvuloplasty and one with a Trapease filter requiring atrial septostomy. These cases demonstrate the technical feasibility of interventions across vena cava filters. Based on this experience and a review of the literature we describe in detail the techniques that allowed the procedures to be performed safely and successfully. Copyright (c) 2006 Wiley-Liss, Inc.