Symptomatic caval penetration by a Celect inferior vena cava filter

Area of Science:

• Vascular surgery
• Interventional radiology
• Medical device complications

Background:

• Inferior vena cava (IVC) filters are used to prevent pulmonary embolism.
• Klippel-Trénaunay syndrome is a rare congenital vascular disorder.
• Complications associated with IVC filters can include migration, fracture, and perforation.

Observation:

• A 17-year-old female with Klippel-Trénaunay syndrome presented with abdominal and leg pain 17 days post-IVC filter placement.
• Radiography revealed caudal migration and significant splaying of the Celect caval filter struts.
• Contrast-enhanced CT confirmed all four primary struts had perforated the IVC wall, with minimal retroperitoneal hemorrhage.

Findings:

• Complete penetration of the inferior vena cava wall by all four primary struts of the Celect caval filter.
• The patient experienced acute lower abdominal and right leg pain secondary to filter malposition.
• No injury to surrounding vessels or viscera was noted.

Implications:

• This case highlights a rare but serious complication of Celect caval filters, particularly in patients with underlying vascular abnormalities.
• Prompt diagnosis and retrieval are crucial to prevent potentially life-threatening hemorrhage.
• Further research into filter design and patient selection may be warranted to minimize such risks.