• Gunvir Gill, Satoru Morita, Takashi Kitanosono, Adam Fang, David Lee, and David Waldman.
• Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA.
• Ann Vasc Surg. 2013 Aug 1; 27 (6): 767-73.

BackgroundThe purpose of this study was to evaluate the incidence and complications of accidental cannulation of retroperitoneal veins during venography for inferior vena cava (IVC) filter placement.MethodsIn total, 641 patients who underwent IVC filter placement were retrospectively reviewed. Incidence of accidental cannulation of retroperitoneal veins during venography (using 633 sheaths and 18 catheters, including 11 pigtail type and 7 end-hole-type catheters), along with the associated complications, were evaluated.ResultsThe overall frequency of accidental cannulation of retroperitoneal veins was 5.4% (35 of 651) via venous approaches: 5.8% (24 of 411) via a right femoral approach, 3.9% (5 of 129) via a left femoral approach, and 5.4% (6 of 111) via a jugular approach. The most frequent veins cannulated were the ascending lumbar veins (4.6%, 25 of 540) via a femoral approach, and the median sacral vein (3.6%, 4 of 111) via a jugular approach. No significant difference in the frequency of accidental cannulation was observed between venography through sheaths and catheters (5.4% [n = 34] vs. 5.6% [n = 1; using an end-hole-type catheter]; P = 1.000). Injuries to 5 veins (0.8%), including 3 ascending lumbar veins, were observed. Inadvertent filter placement within the right ascending lumbar vein was observed in 1 patient (0.2%).ConclusionsAccidental cannulation of retroperitoneal veins during venography for IVC filter placement is an infrequent occurrence, and in this patient series did not result in negative clinical outcomes. However, operators should be aware of the risk of accidental cannulation to prevent avoidable complications such as venous injury or filter misplacement.Copyright © 2013 Elsevier Inc. All rights reserved.

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