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Misplacement of a vena cava filter into the spinal canal
Salvador A Cuadra1, Clifford M Sales, Adam C Lipson
1The Cardiovascular Care Group, and Union County Neurosurgical Associates, Westfield and Union, NJ 07090, USA. salcuadra@yahoo.com
Abstract:
We report the case of a 70-year-old male with a complication of misplacement of a vena cava filter into the spinal canal. This likely happened as a result of penetration of the wire and filter sheath through the iliac vein or vena cava into the retroperitoneum, vertebral foramina, and spinal canal at the level of L2 and L3. Due to the patient's condition, the filter was not removed and no neurologic symptoms have occurred. This represents the first reported case of a filter deployment into the spinal canal. Although placement of vena cava filters is a relatively safe procedure, complications are seen commonly due to the large number of procedures performed. Spinal complications, however, are rarely reported. This is the first reported case of the inadvertent placement of a vena cava filter into the spinal canal.
Insights
A 70-year-old male experienced a rare complication: a vena cava filter misplaced into the spinal canal. This first-ever reported case highlights potential risks during filter placement procedures.
Area of Science:
- Medical Case Reports
- Interventional Radiology
- Neurosurgery
Background:
- Inferior Vena Cava (IVC) filters are devices used to prevent pulmonary embolism.
- While generally safe, IVC filter placement carries risks of complications.
- Spinal complications following IVC filter placement are exceptionally rare.
Observation:
- A 70-year-old male patient developed an unusual complication during IVC filter placement.
- The filter and its delivery system inadvertently penetrated the iliac vein/vena cava, retroperitoneum, and entered the spinal canal at the L2-L3 level.
- The patient remained asymptomatic neurologically, and the filter was not removed due to clinical status.
Findings:
- This case represents the first documented instance of an IVC filter being deployed within the spinal canal.
- The mechanism involved wire and sheath penetration through vascular and retroperitoneal structures into the vertebral foramina.
- Absence of neurological symptoms despite intraspinal filter presence is notable.
Implications:
- This case underscores the importance of vigilance and meticulous technique during IVC filter placement.
- It highlights a previously unreported spinal complication, expanding the spectrum of known filter-related adverse events.
- Further investigation into preventing such rare but potentially severe misplacements may be warranted.
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