A case series of inferior vena cava filter implantation in three COVID-19 patients with deep venous thrombosis

The coronavirus disease 2019 (COVID-19) can cause venous thromboembolism, including deep venous thrombosis (DVT) and pulmonary embolism (PE), but there has been little research on the implantation of an inferior vena cava filter (IVCF) to prevent lethal PE complications. The purpose of this study is to determine the feasibility and effectiveness of IVCF implantation in DVT-COVID-19 patients through the aid of X-ray and bedside color ultrasound (US) techniques. We present three COVID-19 cases that were simultaneously confirmed as acute DVT. The first DVT-COVID-19 patient suffered from unexpected hemiplegia in the right limb. Due to the possibility of a cerebral hemorrhage, we performed X-ray-guided IVCF insertion to prevent PE occurrence. The second patient was diagnosed as having right limb gangrene. Due to the severe infection, we performed one bedside US-guided IVCF implantation before his acute right thigh amputation on the same day. The third patient complained of a feeling of paralysis in his left lower extremity. The X-ray radiograph determined thoracic and lumbar vertebra fractures. We also performed one bedside US-guided IVCF implantation before his vertebra internal fixation surgery. After the standard treatments, the first and third patients were discharged, while the second patient died due to an unexpected acute cardiovascular disease event in the intensive care unit. US-guided IVCF implantation is an effective method that can be considered as a precautionary strategy for preventing lethal PE occurrence, especially for critical DVT-COVID-19 patients who are not suitable to be transferred to a routine X-ray operation room.