Inferior vena cava filter removal after 317-day implantation

A Günther Tulip inferior vena cava (IVC) filter was placed prophylactically in a 22-year-old trauma victim with spinal injuries. Attempts to retrieve the filter at 21 and 25 days after placement were aborted as a result of clot trapped in the filter. Despite the possible risk of an IVC laceration, a third attempt was made 317 days after placement in view of the young age of the patient. The filter started collapsing into the retrieval sheath but could not easily be separated from the IVC. During attempted redeployment, the filter would not reopen. The filter was ultimately retrieved with use of additional force. A mild stenosis of the IVC was noted immediately after retrieval. However, the IVC returned to its preretrieval diameter as seen on a 3-month follow-up venogram.