SlideShare a Scribd company logo
1 of 47
When to implant a permanent or retrievable filter in the vena cava? Quand poser un filtre cave temporaire ou définitif? Dr Guy-André Pelouze Chirurgien thoracique & cardiovasculaire Perpignan Conflict of interest: None declared January 27th 2012 Société Française d’Angéiologie
Is DVT a benign disease?
Rudolf Ludwig Karl Virchow (1821-1902) ,[object Object]
How PE occurs? ,[object Object],[object Object],[object Object]
Present Pulmonary embolism prevalence and mortality ,[object Object],[object Object],[object Object]
Caval interruption Devices ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Numerous publications and only 2 RCTs !
 
Rational of filter placement ,[object Object],[object Object],[object Object]
Technique ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications of permanent caval filters ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Complications of IVCF (1):Thrombosis
Complications of IVCF (2):Thrombosis
 
Aortic pseudoaneurism due to perforation of the two walls by a VCF
Potential indications of filter placement ,[object Object],[object Object],[object Object],[object Object]
 
 
Methodological quality summary: review authors’ judgements about each methodological quality
PREPIC 1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NEJM
Results (1) Référence
Kaplan-Meier analysis of time to pulmonary embolism
Kaplan-Meier analysis of time to deep vein thrombosis
Kaplan Meyer analysis of survival
Cochrane data base review (2010) ,[object Object],[object Object]
Future of caval interruption (1): Retrievable Filters ,[object Object],[object Object],[object Object],[object Object]
Future of caval interruption (2a): New devices with new design and better synergy of prevention
Future of caval interruption (2b): New devices with new design and better synergy of prevention ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Future of caval interruption (3): new RCT(s)
PREPIC 2 study ,[object Object],[object Object],[object Object],[object Object]
If you decide to implant a filter which is the best ?
PE prevention
DVT after placement
VC Thrombosis after placement
The trauma patient
Cohort studies reporting PE in trauma patients (observational studies)
Cohort studies reporting DVT (observational studies)
Indications for IVC filter placement ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Conclusion (1): non trauma patients Risk: Overtreatment because of overdiagnosis and fear of PE in recent era? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conclusion (2): trauma patients Risk: underutilisation because of rare indications or overuse in large prophylactic indications ,[object Object]
If you have understood the problem of caval filters would you like to share it?
 
Look at my preferred social network!
Merci de votre attention [email_address]

More Related Content

What's hot

Combined carotid and coronary disease the strategy should be
Combined carotid and coronary disease the strategy should beCombined carotid and coronary disease the strategy should be
Combined carotid and coronary disease the strategy should beuvcd
 
Medium and long term results following evar success or disappointment
Medium and long term results following evar success or disappointmentMedium and long term results following evar success or disappointment
Medium and long term results following evar success or disappointmentuvcd
 
Dvt prophylaxis in orthopaedic surgery
Dvt prophylaxis in orthopaedic surgeryDvt prophylaxis in orthopaedic surgery
Dvt prophylaxis in orthopaedic surgeryNamithRangaswamy
 
Evar in inflammatory aaa
Evar in inflammatory aaaEvar in inflammatory aaa
Evar in inflammatory aaauvcd
 
Current status of endovenous ablation for the treatment of venous insufficiency
Current status of endovenous ablation for the treatment of venous insufficiencyCurrent status of endovenous ablation for the treatment of venous insufficiency
Current status of endovenous ablation for the treatment of venous insufficiencyuvcd
 
Hybrid tevar for the treatment of aortic dissection
Hybrid tevar for the treatment of aortic dissectionHybrid tevar for the treatment of aortic dissection
Hybrid tevar for the treatment of aortic dissectionuvcd
 
Contemporary management of iliofemoral venous thrombosis
Contemporary management of iliofemoral venous thrombosisContemporary management of iliofemoral venous thrombosis
Contemporary management of iliofemoral venous thrombosisuvcd
 
Interventiontionist Treatment of Acute DVT
Interventiontionist Treatment of Acute DVTInterventiontionist Treatment of Acute DVT
Interventiontionist Treatment of Acute DVTSalutaria
 
Management of bleeding in trauma
Management of bleeding in traumaManagement of bleeding in trauma
Management of bleeding in traumaFaisalRawagah1
 
Allograft replacement for infrarenal aortic graft infection
Allograft  replacement  for infrarenal  aortic graft infectionAllograft  replacement  for infrarenal  aortic graft infection
Allograft replacement for infrarenal aortic graft infectionuvcd
 
Management of aaa clinical practice guidelines of the esvs
Management of aaa clinical practice guidelines of the esvsManagement of aaa clinical practice guidelines of the esvs
Management of aaa clinical practice guidelines of the esvsuvcd
 
Journal club 19 08-2015
Journal club 19 08-2015Journal club 19 08-2015
Journal club 19 08-2015Kunal Mahajan
 
CPG: Prevention and Treatment of Venous Thromboembolism (VTE)
CPG: Prevention and Treatment of Venous Thromboembolism (VTE)CPG: Prevention and Treatment of Venous Thromboembolism (VTE)
CPG: Prevention and Treatment of Venous Thromboembolism (VTE)Khairunnisa Zamri
 
anaesthesia for Lung transplant
anaesthesia for Lung transplantanaesthesia for Lung transplant
anaesthesia for Lung transplantprateek gupta
 
Options for tough situation
Options  for tough situationOptions  for tough situation
Options for tough situationuvcd
 
ICU Care of the Lung Transplant Recipient
ICU Care of the Lung Transplant RecipientICU Care of the Lung Transplant Recipient
ICU Care of the Lung Transplant RecipientSpectrum Health System
 

What's hot (20)

Combined carotid and coronary disease the strategy should be
Combined carotid and coronary disease the strategy should beCombined carotid and coronary disease the strategy should be
Combined carotid and coronary disease the strategy should be
 
Medium and long term results following evar success or disappointment
Medium and long term results following evar success or disappointmentMedium and long term results following evar success or disappointment
Medium and long term results following evar success or disappointment
 
Dvt prophylaxis in orthopaedic surgery
Dvt prophylaxis in orthopaedic surgeryDvt prophylaxis in orthopaedic surgery
Dvt prophylaxis in orthopaedic surgery
 
Evar in inflammatory aaa
Evar in inflammatory aaaEvar in inflammatory aaa
Evar in inflammatory aaa
 
Current status of endovenous ablation for the treatment of venous insufficiency
Current status of endovenous ablation for the treatment of venous insufficiencyCurrent status of endovenous ablation for the treatment of venous insufficiency
Current status of endovenous ablation for the treatment of venous insufficiency
 
Hybrid tevar for the treatment of aortic dissection
Hybrid tevar for the treatment of aortic dissectionHybrid tevar for the treatment of aortic dissection
Hybrid tevar for the treatment of aortic dissection
 
Endovenous evidence talk
Endovenous evidence talkEndovenous evidence talk
Endovenous evidence talk
 
Contemporary management of iliofemoral venous thrombosis
Contemporary management of iliofemoral venous thrombosisContemporary management of iliofemoral venous thrombosis
Contemporary management of iliofemoral venous thrombosis
 
Interventiontionist Treatment of Acute DVT
Interventiontionist Treatment of Acute DVTInterventiontionist Treatment of Acute DVT
Interventiontionist Treatment of Acute DVT
 
Management of bleeding in trauma
Management of bleeding in traumaManagement of bleeding in trauma
Management of bleeding in trauma
 
Allograft replacement for infrarenal aortic graft infection
Allograft  replacement  for infrarenal  aortic graft infectionAllograft  replacement  for infrarenal  aortic graft infection
Allograft replacement for infrarenal aortic graft infection
 
Management of aaa clinical practice guidelines of the esvs
Management of aaa clinical practice guidelines of the esvsManagement of aaa clinical practice guidelines of the esvs
Management of aaa clinical practice guidelines of the esvs
 
Myths and facts dvt
Myths and facts dvtMyths and facts dvt
Myths and facts dvt
 
Journal club 19 08-2015
Journal club 19 08-2015Journal club 19 08-2015
Journal club 19 08-2015
 
Vte prophylaxis
Vte prophylaxisVte prophylaxis
Vte prophylaxis
 
CPG: Prevention and Treatment of Venous Thromboembolism (VTE)
CPG: Prevention and Treatment of Venous Thromboembolism (VTE)CPG: Prevention and Treatment of Venous Thromboembolism (VTE)
CPG: Prevention and Treatment of Venous Thromboembolism (VTE)
 
anaesthesia for Lung transplant
anaesthesia for Lung transplantanaesthesia for Lung transplant
anaesthesia for Lung transplant
 
VTE.Dr..Nasib
VTE.Dr..NasibVTE.Dr..Nasib
VTE.Dr..Nasib
 
Options for tough situation
Options  for tough situationOptions  for tough situation
Options for tough situation
 
ICU Care of the Lung Transplant Recipient
ICU Care of the Lung Transplant RecipientICU Care of the Lung Transplant Recipient
ICU Care of the Lung Transplant Recipient
 

Similar to When to implant a caval filter?

Pulmonary Embolism lecture 2022
Pulmonary Embolism lecture 2022Pulmonary Embolism lecture 2022
Pulmonary Embolism lecture 2022Dr.Marwan Sneymeh
 
Pulmonary embolism@ghanem@.2013
Pulmonary embolism@ghanem@.2013Pulmonary embolism@ghanem@.2013
Pulmonary embolism@ghanem@.2013Islam Ghanem
 
prophylatic inferior vena cava (IVC) filters in trauma
prophylatic inferior vena cava (IVC)  filters in traumaprophylatic inferior vena cava (IVC)  filters in trauma
prophylatic inferior vena cava (IVC) filters in traumaMubasharHashmi1
 
Endovascular and surgical treatment of pulmonary embolism 26.11.17
Endovascular and surgical treatment of pulmonary embolism 26.11.17Endovascular and surgical treatment of pulmonary embolism 26.11.17
Endovascular and surgical treatment of pulmonary embolism 26.11.17Ivo Petrov
 
Deep vein thrombosis
Deep vein thrombosisDeep vein thrombosis
Deep vein thrombosisorthoprince
 
Thoracic anesthesia and One Lung ventilation
Thoracic anesthesia and One Lung ventilationThoracic anesthesia and One Lung ventilation
Thoracic anesthesia and One Lung ventilationWasihun Aragie
 
The univentricular repair indications, procedures, outcomes and controversies
The univentricular repair indications, procedures, outcomes and controversiesThe univentricular repair indications, procedures, outcomes and controversies
The univentricular repair indications, procedures, outcomes and controversiesJoel Regondola
 
The univentricular repair indications, procedures, outcomes and controversies
The univentricular repair indications, procedures, outcomes and controversiesThe univentricular repair indications, procedures, outcomes and controversies
The univentricular repair indications, procedures, outcomes and controversiespatacsi
 
thoracicanesthesia-191114091229.pptx
thoracicanesthesia-191114091229.pptxthoracicanesthesia-191114091229.pptx
thoracicanesthesia-191114091229.pptxAkmalFahrezzy1
 
ECMO - Part 1 by Dr.Tinku Joseph
ECMO - Part 1 by Dr.Tinku JosephECMO - Part 1 by Dr.Tinku Joseph
ECMO - Part 1 by Dr.Tinku JosephDr.Tinku Joseph
 
DEEP VEIN THROMBOSIS
DEEP VEIN THROMBOSISDEEP VEIN THROMBOSIS
DEEP VEIN THROMBOSISVinay Teradal
 

Similar to When to implant a caval filter? (20)

Deep vein thrombosis
Deep vein thrombosis   Deep vein thrombosis
Deep vein thrombosis
 
DVT
DVTDVT
DVT
 
RTC DVT AND PE.ppt
RTC DVT AND PE.pptRTC DVT AND PE.ppt
RTC DVT AND PE.ppt
 
Pulmonary Embolism lecture 2022
Pulmonary Embolism lecture 2022Pulmonary Embolism lecture 2022
Pulmonary Embolism lecture 2022
 
Pulmonary embolism@ghanem@.2013
Pulmonary embolism@ghanem@.2013Pulmonary embolism@ghanem@.2013
Pulmonary embolism@ghanem@.2013
 
prophylatic inferior vena cava (IVC) filters in trauma
prophylatic inferior vena cava (IVC)  filters in traumaprophylatic inferior vena cava (IVC)  filters in trauma
prophylatic inferior vena cava (IVC) filters in trauma
 
Venous Thromboembolism
Venous ThromboembolismVenous Thromboembolism
Venous Thromboembolism
 
Endovascular and surgical treatment of pulmonary embolism 26.11.17
Endovascular and surgical treatment of pulmonary embolism 26.11.17Endovascular and surgical treatment of pulmonary embolism 26.11.17
Endovascular and surgical treatment of pulmonary embolism 26.11.17
 
Vte 2014
Vte 2014Vte 2014
Vte 2014
 
Iliofemoral DVT thrombolysis
Iliofemoral DVT thrombolysisIliofemoral DVT thrombolysis
Iliofemoral DVT thrombolysis
 
Deep vein thrombosis
Deep vein thrombosisDeep vein thrombosis
Deep vein thrombosis
 
Thoracic anesthesia and One Lung ventilation
Thoracic anesthesia and One Lung ventilationThoracic anesthesia and One Lung ventilation
Thoracic anesthesia and One Lung ventilation
 
The univentricular repair indications, procedures, outcomes and controversies
The univentricular repair indications, procedures, outcomes and controversiesThe univentricular repair indications, procedures, outcomes and controversies
The univentricular repair indications, procedures, outcomes and controversies
 
The univentricular repair indications, procedures, outcomes and controversies
The univentricular repair indications, procedures, outcomes and controversiesThe univentricular repair indications, procedures, outcomes and controversies
The univentricular repair indications, procedures, outcomes and controversies
 
thoracicanesthesia-191114091229.pptx
thoracicanesthesia-191114091229.pptxthoracicanesthesia-191114091229.pptx
thoracicanesthesia-191114091229.pptx
 
DVT Current Concept
DVT Current ConceptDVT Current Concept
DVT Current Concept
 
09 hashem et al
09 hashem et al09 hashem et al
09 hashem et al
 
ECMO - Part 1 by Dr.Tinku Joseph
ECMO - Part 1 by Dr.Tinku JosephECMO - Part 1 by Dr.Tinku Joseph
ECMO - Part 1 by Dr.Tinku Joseph
 
DEEP VEIN THROMBOSIS
DEEP VEIN THROMBOSISDEEP VEIN THROMBOSIS
DEEP VEIN THROMBOSIS
 
Deep Vein Thrombosis
Deep Vein ThrombosisDeep Vein Thrombosis
Deep Vein Thrombosis
 

More from Pelouze Guy-André

L’hôpital public_ une entreprise paralysée 23_11_2019.pptx
L’hôpital public_ une entreprise paralysée 23_11_2019.pptxL’hôpital public_ une entreprise paralysée 23_11_2019.pptx
L’hôpital public_ une entreprise paralysée 23_11_2019.pptxPelouze Guy-André
 
Pour sortir le système de soins de l'impasse actuelle
Pour sortir le système de soins de l'impasse actuellePour sortir le système de soins de l'impasse actuelle
Pour sortir le système de soins de l'impasse actuellePelouze Guy-André
 
Covid 19 - petit état des lieux de la pandémie après le variant BA.2.pdf
Covid 19 - petit état des lieux de la pandémie après le variant BA.2.pdfCovid 19 - petit état des lieux de la pandémie après le variant BA.2.pdf
Covid 19 - petit état des lieux de la pandémie après le variant BA.2.pdfPelouze Guy-André
 
How the low fat obsession enabled the obesity epidemic
How the low fat obsession enabled the obesity epidemicHow the low fat obsession enabled the obesity epidemic
How the low fat obsession enabled the obesity epidemicPelouze Guy-André
 
Red meat bashing and human ancestral diet
Red meat bashing and human ancestral dietRed meat bashing and human ancestral diet
Red meat bashing and human ancestral dietPelouze Guy-André
 
Richard Feinman et les études observationnelles sur l'alimentation
Richard Feinman et les études observationnelles sur l'alimentationRichard Feinman et les études observationnelles sur l'alimentation
Richard Feinman et les études observationnelles sur l'alimentationPelouze Guy-André
 
How the low fat obsession enabled the obesity epidemic
How the low fat obsession enabled the obesity epidemicHow the low fat obsession enabled the obesity epidemic
How the low fat obsession enabled the obesity epidemicPelouze Guy-André
 
L'alimentation industrielle est addictive
L'alimentation industrielle est addictiveL'alimentation industrielle est addictive
L'alimentation industrielle est addictivePelouze Guy-André
 
La dextérité des jeunes chirurgiens mise à mal par l'usage des écrans
La dextérité des jeunes chirurgiens mise à mal par l'usage des écransLa dextérité des jeunes chirurgiens mise à mal par l'usage des écrans
La dextérité des jeunes chirurgiens mise à mal par l'usage des écransPelouze Guy-André
 
Emergency treatment for type 1 endoleak after evar
Emergency treatment for type 1 endoleak after evarEmergency treatment for type 1 endoleak after evar
Emergency treatment for type 1 endoleak after evarPelouze Guy-André
 
Fructose connexion: la stéato-hépatite non alcoolique
Fructose connexion: la stéato-hépatite non alcooliqueFructose connexion: la stéato-hépatite non alcoolique
Fructose connexion: la stéato-hépatite non alcooliquePelouze Guy-André
 
Télémédecine cardiovasculaire
Télémédecine cardiovasculaireTélémédecine cardiovasculaire
Télémédecine cardiovasculairePelouze Guy-André
 
We need to revise asymptomatic carotid atheroma guidelines
We need to revise asymptomatic carotid atheroma guidelinesWe need to revise asymptomatic carotid atheroma guidelines
We need to revise asymptomatic carotid atheroma guidelinesPelouze Guy-André
 
Lait, Fromages et produits laitiers industriels
Lait, Fromages et produits laitiers industrielsLait, Fromages et produits laitiers industriels
Lait, Fromages et produits laitiers industrielsPelouze Guy-André
 
Why Numerus clausus failed in France since 40 years
Why Numerus clausus failed in France since 40 yearsWhy Numerus clausus failed in France since 40 years
Why Numerus clausus failed in France since 40 yearsPelouze Guy-André
 
Statines en France: éléments de preuves pour favoriser le bon usage
Statines en France: éléments de preuves pour favoriser le bon usageStatines en France: éléments de preuves pour favoriser le bon usage
Statines en France: éléments de preuves pour favoriser le bon usagePelouze Guy-André
 
Numerus Clausus: les mauvais résultats d'un système depuis 40 ans
Numerus Clausus: les mauvais résultats d'un système depuis 40 ansNumerus Clausus: les mauvais résultats d'un système depuis 40 ans
Numerus Clausus: les mauvais résultats d'un système depuis 40 ansPelouze Guy-André
 
Le régime anti-inflammatoire dans l'athérome
Le régime anti-inflammatoire dans l'athéromeLe régime anti-inflammatoire dans l'athérome
Le régime anti-inflammatoire dans l'athéromePelouze Guy-André
 

More from Pelouze Guy-André (20)

L’hôpital public_ une entreprise paralysée 23_11_2019.pptx
L’hôpital public_ une entreprise paralysée 23_11_2019.pptxL’hôpital public_ une entreprise paralysée 23_11_2019.pptx
L’hôpital public_ une entreprise paralysée 23_11_2019.pptx
 
Pour sortir le système de soins de l'impasse actuelle
Pour sortir le système de soins de l'impasse actuellePour sortir le système de soins de l'impasse actuelle
Pour sortir le système de soins de l'impasse actuelle
 
Covid 19 - petit état des lieux de la pandémie après le variant BA.2.pdf
Covid 19 - petit état des lieux de la pandémie après le variant BA.2.pdfCovid 19 - petit état des lieux de la pandémie après le variant BA.2.pdf
Covid 19 - petit état des lieux de la pandémie après le variant BA.2.pdf
 
How the low fat obsession enabled the obesity epidemic
How the low fat obsession enabled the obesity epidemicHow the low fat obsession enabled the obesity epidemic
How the low fat obsession enabled the obesity epidemic
 
Red meat bashing and human ancestral diet
Red meat bashing and human ancestral dietRed meat bashing and human ancestral diet
Red meat bashing and human ancestral diet
 
Richard Feinman et les études observationnelles sur l'alimentation
Richard Feinman et les études observationnelles sur l'alimentationRichard Feinman et les études observationnelles sur l'alimentation
Richard Feinman et les études observationnelles sur l'alimentation
 
How the low fat obsession enabled the obesity epidemic
How the low fat obsession enabled the obesity epidemicHow the low fat obsession enabled the obesity epidemic
How the low fat obsession enabled the obesity epidemic
 
L'alimentation industrielle est addictive
L'alimentation industrielle est addictiveL'alimentation industrielle est addictive
L'alimentation industrielle est addictive
 
La dextérité des jeunes chirurgiens mise à mal par l'usage des écrans
La dextérité des jeunes chirurgiens mise à mal par l'usage des écransLa dextérité des jeunes chirurgiens mise à mal par l'usage des écrans
La dextérité des jeunes chirurgiens mise à mal par l'usage des écrans
 
Emergency treatment for type 1 endoleak after evar
Emergency treatment for type 1 endoleak after evarEmergency treatment for type 1 endoleak after evar
Emergency treatment for type 1 endoleak after evar
 
Fructose connexion: la stéato-hépatite non alcoolique
Fructose connexion: la stéato-hépatite non alcooliqueFructose connexion: la stéato-hépatite non alcoolique
Fructose connexion: la stéato-hépatite non alcoolique
 
Le retour en grâce du gras
Le retour en grâce du grasLe retour en grâce du gras
Le retour en grâce du gras
 
Télémédecine cardiovasculaire
Télémédecine cardiovasculaireTélémédecine cardiovasculaire
Télémédecine cardiovasculaire
 
We need to revise asymptomatic carotid atheroma guidelines
We need to revise asymptomatic carotid atheroma guidelinesWe need to revise asymptomatic carotid atheroma guidelines
We need to revise asymptomatic carotid atheroma guidelines
 
Lait, Fromages et produits laitiers industriels
Lait, Fromages et produits laitiers industrielsLait, Fromages et produits laitiers industriels
Lait, Fromages et produits laitiers industriels
 
Why Numerus clausus failed in France since 40 years
Why Numerus clausus failed in France since 40 yearsWhy Numerus clausus failed in France since 40 years
Why Numerus clausus failed in France since 40 years
 
Statines en France: éléments de preuves pour favoriser le bon usage
Statines en France: éléments de preuves pour favoriser le bon usageStatines en France: éléments de preuves pour favoriser le bon usage
Statines en France: éléments de preuves pour favoriser le bon usage
 
Numerus Clausus: les mauvais résultats d'un système depuis 40 ans
Numerus Clausus: les mauvais résultats d'un système depuis 40 ansNumerus Clausus: les mauvais résultats d'un système depuis 40 ans
Numerus Clausus: les mauvais résultats d'un système depuis 40 ans
 
Les repas paléo aujourd'hui
Les repas paléo aujourd'huiLes repas paléo aujourd'hui
Les repas paléo aujourd'hui
 
Le régime anti-inflammatoire dans l'athérome
Le régime anti-inflammatoire dans l'athéromeLe régime anti-inflammatoire dans l'athérome
Le régime anti-inflammatoire dans l'athérome
 

Recently uploaded

VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...Garima Khatri
 
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...Dipal Arora
 
Chandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableChandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableDipal Arora
 
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...perfect solution
 
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escortsvidya singh
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...chandars293
 
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomLucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomdiscovermytutordmt
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...narwatsonia7
 
Call Girls Mumbai Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Mumbai Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Mumbai Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Mumbai Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...Taniya Sharma
 
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...jageshsingh5554
 
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Russian Escorts Girls Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
Russian Escorts Girls  Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls DelhiRussian Escorts Girls  Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
Russian Escorts Girls Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls DelhiAlinaDevecerski
 
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...Taniya Sharma
 
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsBangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsGfnyt
 
VIP Call Girls Indore Kirti 💚😋 9256729539 🚀 Indore Escorts
VIP Call Girls Indore Kirti 💚😋  9256729539 🚀 Indore EscortsVIP Call Girls Indore Kirti 💚😋  9256729539 🚀 Indore Escorts
VIP Call Girls Indore Kirti 💚😋 9256729539 🚀 Indore Escortsaditipandeya
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...hotbabesbook
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeCall Girls Delhi
 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 

Recently uploaded (20)

VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
 
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
 
Chandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableChandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD available
 
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
 
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
 
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomLucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
 
Call Girls Mumbai Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Mumbai Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Mumbai Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Mumbai Just Call 9907093804 Top Class Call Girl Service Available
 
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
 
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
 
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
 
Russian Escorts Girls Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
Russian Escorts Girls  Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls DelhiRussian Escorts Girls  Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
Russian Escorts Girls Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
 
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
 
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsBangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
 
VIP Call Girls Indore Kirti 💚😋 9256729539 🚀 Indore Escorts
VIP Call Girls Indore Kirti 💚😋  9256729539 🚀 Indore EscortsVIP Call Girls Indore Kirti 💚😋  9256729539 🚀 Indore Escorts
VIP Call Girls Indore Kirti 💚😋 9256729539 🚀 Indore Escorts
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
 

When to implant a caval filter?