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Errant percutaneous Greenfield filter placement into the retroperitoneum.
B A Adye1, R D Raabe, R L Zobell
1Department of Surgery, Sacred Heart Hospital, Spokane, WA.
Journal of Vascular Surgery
|July 1, 1990
Summary
A percutaneous Greenfield filter placement for pulmonary emboli led to retroperitoneal misplacement. Surgical correction and subsequent removal due to nerve irritation highlight potential complications of this inferior vena cava filter procedure.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Medical Device Complications
Background:
- Inferior vena cava (IVC) filters are used to prevent pulmonary emboli.
- Percutaneous placement via femoral vein is a common approach.
- Potential complications include filter migration and malpositioning.
Observation:
- A patient with pulmonary emboli experienced errant retroperitoneal placement of a Greenfield filter via femoral vein access.
- A second filter was surgically placed via the right internal jugular vein.
- The retroperitoneal filter caused genitofemoral nerve irritation.
Findings:
- Percutaneous Greenfield filter placement can result in serious malpositioning.
- Retroperitoneal placement can lead to significant patient discomfort and complications.
- Surgical intervention may be necessary for both placement and removal of malpositioned filters.
Implications:
- This case underscores the risks associated with percutaneous IVC filter placement.
- Careful patient selection and procedural monitoring are crucial.
- Alternative surgical approaches may be considered in complex cases or when complications arise.