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Chest pain from excluded inferior vena cava filter after stent placement

William F Johnston1, Amit Jain1, Wael E Saad2

  • 1Division of Vascular and Endovascular Surgery, University of Virginia, Charlottesville, Va.

Journal of Vascular Surgery. Venous and Lymphatic Disorders
|March 20, 2016
PubMed

Insights

A patient

Area of Science:

  • Vascular surgery
  • Interventional radiology
  • Cardiology

Background:

  • Inferior vena cava (IVC) filters and stents are used to prevent pulmonary embolism.
  • Complications associated with IVC devices can occur, necessitating careful monitoring.
  • Chronic chest pain can have various etiologies, requiring comprehensive diagnostic evaluation.

Purpose of the Study:

  • To report a novel complication of IVC filters and stents.
  • To highlight referred chest pain as a potential symptom of IVC device malposition.
  • To emphasize the importance of continued surveillance for patients with IVC devices.

Main Methods:

  • Case presentation of a 52-year-old patient with chronic substernal chest pain.
  • Diagnostic work-up to exclude other causes of chest pain.
  • Surgical removal of the IVC filter and stent.
  • Intraoperative findings of filter strut penetration.

Main Results:

  • The patient experienced chronic chest pain 18 months after IVC filter and stent placement.
  • No other cause for the chest pain was identified.
  • Removal of the IVC device led to complete resolution of chest pain.
  • Intraoperative examination revealed IVC filter struts penetrating the caval wall and abutting the periaortic neural plexus.

Conclusions:

  • Penetration of the inferior vena cava wall by filter struts can cause referred chest pain.
  • This represents a novel complication of both IVC filters and IVC stents.
  • Continued surveillance is crucial for patients with indwelling IVC devices to detect such complications early.

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