Jornal Vascular Brasileiro
https://app.periodikos.com.br/journal/jvb/article/doi/10.1590/1677-5449.202600711
Jornal Vascular Brasileiro
Therapeutic Challenge

Implante de filtro de veia cava em gestante: desafio terapêutico

Vena cava filter placement during pregnancy: a therapeutic challenge

Mateus Alves Borges Cristino; Ronald Luiz Gomes Flumignam; Gustavo Braga Murta; Marcos Arêas Marques

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Resumo

A embolia pulmonar é a principal causa de morte materna durante o ciclo gravídico-puerperal em países desenvolvidos. O diagnóstico do tromboembolismo venoso na gravidez é dificultado pelas mudanças fisiológicas que ocorrem na gestação. O tratamento com anticoagulantes é a abordagem de escolha, sendo intervenções endovasculares procedimentos de exceção. Relatamos um caso de implante de filtro de veia cava inferior removível em gestante com trombose venosa ilíaco-femoral esquerda em período de parto latente. Após o parto, o filtro de veia cava inferior foi removido com sucesso, sem complicações maternas ou fetais, e a anticoagulação foi retomada. Considerando os riscos associados ao filtro de veia cava inferior em gestantes, seu uso deve ser restrito a casos com contraindicações formais à anticoagulação e alto risco de embolia pulmonar. Precauções adicionais minimizam a exposição fetal à radiação. A decisão pelo filtro de veia cava inferior na gravidez é complexa, requer discussão interdisciplinar e, além disso, pesquisas adicionais são necessárias para avaliar seu impacto.

Palavras-chave

gravidez de alto risco; trombose venosa profunda; embolia pulmonar; filtros de veia cava; período pós-parto; anticoagulantes

Abstract

Pulmonary embolism (PE) is the leading cause of maternal death during the antepartum-postpartum cycle in developed countries. The diagnosis of venous thromboembolism during pregnancy is complicated by the physiological changes that occur during gestation. Management with anticoagulants is the treatment of choice, while endovascular interventions are reserved for exceptional cases. We report a case of placement of a removable inferior vena cava filter (IVCF) in a pregnant woman with left iliofemoral venous thrombosis during latent labor. After delivery, the IVCF was successfully removed with no maternal or fetal complications and anticoagulation was resumed. Considering the risks associated with IVCFs in pregnant women, their use should be restricted to cases with formal contraindications to anticoagulation and high risk of PE. Additional precautions minimize fetal radiation exposure. The decision to place an IVCF during pregnancy is complex and requires interdisciplinary discussion. Further research is needed to assess its impact.

Keywords

pregnancy, high-risk; venous thrombosis; pulmonary embolism; vena cava filters; postpartum period; anticoagulants

References

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Submitted date:
04/02/2026

Accepted date:
07/23/2026

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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