29 July 2026
: Case report 
Catheter-Directed Thrombolysis and Direct Oral Anticoagulant Class Switch to Prevent Pulmonary Embolism From Large Inferior Vena Cava Thrombus
Management of emergency care, Rare coexistence of disease or pathology
Takashi Araki ABCDEF 1*, Kazuyuki Nishimura DEF 1, Yusuke Hitora DEF 1, Kenichiro Yokoi DEF 1, Takashi Yamada DEF 1, Manabu Miura DEF 1DOI: 10.12659/AJCR.953199
Am J Case Rep 2026; 27:e953199
Figure 1 Contrast-enhanced CT findings on admission and at follow-up, and imaging during catheter-directed thrombolysis. On contrast-enhanced CT at admission, thrombi were identified in the bilateral pulmonary arteries (A), along with a massive thrombus in the IVC (B). One week after IVC filter placement and initiation of anticoagulation, the IVC thrombus remained unchanged (C). A pulse-spray catheter (Fountain infusion catheter) was subsequently inserted via the right internal jugular vein, with the side holes positioned across the thrombotic segment of the IVC (D). CT, computed tomography; IVC, inferior vena cava.