Bard Recovery filter: evaluation and management of vena cava limb perforation, fracture, and migration

To report on the evaluation and management of Bard Recovery filter limb perforation, fracture, and migration.

In 2007, all patients who received a Bard Recovery filter at a single institution were contacted for consultation and evaluation by noncontrast computed tomography. Rates of limb perforation, fracture, and migration were evaluated on early (<180 days) and final images. Retrieval success and complications were evaluated.

Fourteen of 16 patients with Bard Recovery filters were evaluated. The early images in nine patients (mean, 30 days; range, 0-126 d +/- 40) demonstrated arm perforations in 56% (n = 5), leg perforation in 11% (n = 1), and no early fractures or migrations. Final images (mean, 899 days; range, 119-1,218 d +/- 320) demonstrated filter arm perforations in all 14 patients. Leg perforations were seen in 36% of patients (n = 5), and there were a total of four fractures with migration in 21% of patients (n = 3). All fractures occurred in arms that had perforated the vena cava on early images. Two patients had already had their filters retrieved at 119 and 302 days, respectively; the remaining 12 patients elected to have their filters retrieved after evaluation. All 12 filters were retrieved at a mean of 1,021 days (range, 119-1,242 d +/- 134). Leg hook fractures occurred during eight of 12 filter retrieval procedures (67%).

Recovery filter limb perforation of the vena cava increases over time and is associated with a 21% incidence of filter arm fracture and migration. Follow-up imaging is recommended. Filter retrieval has a high success rate and is the authors' preferred management strategy.