Abstract: Objective To explore the efficacy and feasibility of color Doppler flow imaging (CDFI)-guided inferior vena caval
filter (IVCF) insertion through the right internal jugular vein for prevention of pulmonary embolism in patients with deep
venous thrombosis (DVT). Methods Thirty-eight patients with lower extremity DVT confirmed by clinical and CDFI
examinations underwent IVCF insertion through the right internal jugular vein under guidance of CDFI for prevention of
pulmonary embolism. The shape and position of IVCF were monitored by CDFI regularly. After 32 to 45 days, the retrievable
filters were removed under CDFI guidance via the right internal jugular vein. All patients were followed up to monitor the
occurrence of filter complications and pulmonary embolism PE. Results Preoperative CDFI clearly displayed the locations of
the right internal jugular vein, inferior vena caval (IVC), bifurcation of the common iliac vein, and the bilateral renal veins in
all the 38 patients. All the veins were free of anatomical variations or embolism. Under CDFI guidance, 23 retrievable IVCF and
15 permanent IVCF were placed without technical difficulty via the right internal jugular vein. Follow-up examination with
CDFI and abdominal plain X-ray film showed that all the filters were placed in right positions with complete opening. The 23
retrievable filters were retrieved via the right internal jugular vein after 32-45 days. IVCF captured venous emboli in 14 cases
(36.5%). None of the patients had filter displacement, tilting, or fracture or showed IVC perforation or the occurrence of
pulmonary embolism. Conclusion CDFI-guided IVCF insertion via the jugular vein is safe and feasible. Compared with X-ray
guidance, CDFI guidance is convenient and substantially reduces the procedural cost and avoids the risk of radiation exposure.