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Inferior vena cava filter migration: updated review and case presentation
Muhammad Janjua1, Fatema M Omran, Tony Kastoon
1Department of Internal Medicine, William Beaumont Hospital, Royal Oak, Michigan, USA.
The Journal of Invasive Cardiology
|November 11, 2009
Summary
Inferior vena cava filter migration to the right ventricle is increasingly common with newer devices, leading to serious complications like ventricular tachycardia and death. Surgical removal is often necessary for these migrated filters.
Area of Science:
- Cardiovascular Medicine
- Interventional Radiology
Background:
- Inferior vena cava (IVC) filters are used to prevent pulmonary embolism.
- Filter migration is a known complication, with potential for serious adverse events.
Observation:
- A case of IVC filter migration to the right ventricle caused ventricular tachycardia and elevated troponin.
- Review of 27 cases revealed higher migration rates of newer retrievable filters (nitinol, phynox, elgioly) to the right ventricle compared to older filters.
- Migration to the right ventricle, versus the right atrium, has increased over the past decade.
Findings:
- Newer retrievable IVC filters demonstrate a significantly higher propensity for right ventricular migration.
- Complications and mortality rates are higher with migrated newer retrievable filters.
- Right ventricular filter migration is associated with increased incidence of severe symptoms, ventricular arrhythmias, and mortality.
Implications:
- The findings suggest a need for improved IVC filter design and patient monitoring.
- Increased right ventricular migration necessitates timely diagnosis and intervention, often surgical removal.
- This trend highlights potential risks associated with contemporary retrievable IVC filter technology.
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