Fig. 6

This patient had a Gunther-Tulip IVC filter (Cook, Bloomington, IN) placed 4 months prior to removal. The sling technique was employed given significant filter tilt. After removal, the patient developed abdominal pain and hypotension. Venogram showed extravasation of contrast and a flow limiting dissection. Balloon tamponade was performed but failed to resolve extravasation. Two overlapping 25 mm Cook-Z Stents (Cook, Bloomington, IN) were placed with improvement of flow and resolution of extravasation. In cases of venous extravasation, uncovered stents can often resolve extravasation (Funaki et al. 1997). Partial caval thrombosis secondary to stasis from balloon tamponade developed and a new IVC filter was placed above this clot