US-assisted CDT of IVC thrombosis using EKOS device. (a) Coronal reformatted contrast enhanced CT image demonstrates an IVC filter with thrombosis extending to the iliac veins. (b) Following puncture of the common femoral veins, a bilateral EKOS device was placed and 0.5 mg/hr tPA was infused for 8 hours from each groin. (c) Postvenogram demonstrates complete resolution of the thrombus with minimal thrombus at the apex of the IVC filter. This filter was subsequently removed.