Endovascular release of an Adams-DeWeese clip and iliocaval reconstruction for debilitating lower extremity swelling

Eric Sung; Joel L Ramirez; Devin Zarkowsky

doi:10.1016/j.jvscit.2024.101445

Endovascular release of an Adams-DeWeese clip and iliocaval reconstruction for debilitating lower extremity swelling

J Vasc Surg Cases Innov Tech. 2024 Feb 14;10(3):101445. doi: 10.1016/j.jvscit.2024.101445. eCollection 2024 Jun.

Authors

Eric Sung¹, Joel L Ramirez^{2

3}, Devin Zarkowsky⁴

Affiliations

¹ Division of Vascular and Endovascular Surgery, Department of Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA.
² Division of Vascular and Endovascular Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA.
³ Chan Zuckerberg Biohub, San Francisco, CA.
⁴ Division of Vascular Surgery, Department of Surgery, Scripps Clinic, La Jolla, CA.

Abstract

More than 10 million cases of venous thromboembolisms are reported on an annual basis and are major contributors to morbidity and mortality. Studies have found that ≤90% of pulmonary embolisms originate from the abdominal and lower extremity veins. The mainstay of venous thromboembolism treatment has been, and still continues to be, anticoagulation. However, for patients for whom anticoagulation is contraindicated or has failed, physicians have turned to surgical innovations such as inferior vena cava (IVC) filters to create partial interruption of the IVC. Before the invention of IVC filters, the Adams-DeWeese clip was developed to create caval interruption, which allowed for venous return while preventing pulmonary emboli from distal veins. We report a case of endovascular release of a long-term Adams-DeWeese clip, which had caused IVC occlusion and debilitating bilateral lower extremity swelling.

Keywords: Adam-DeWeese clip; Deep vein thrombosis; Iliocaval reconstruction; Inferior vena cava; Venous disease.

Publication types

Case Reports