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Permanent IVC filter strut penetration into an abdominal aortic aneurysm
Juehea Lee1, Graham Roche-Nagle2
1Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada juehea.lee@mail.utoronto.ca.
BMJ Case Reports
|June 8, 2021
Summary
An elderly patient with an abdominal aortic aneurysm (AAA) developed deep vein thrombosis (DVT) complicated by an inferior vena cava (IVC) filter penetrating the AAA. Management involved anticoagulation and close monitoring due to patient factors.
Area of Science:
- Vascular Surgery
- Cardiovascular Medicine
- Interventional Radiology
Background:
- Abdominal aortic aneurysms (AAA) pose unique challenges in patients requiring inferior vena cava (IVC) filters.
- Permanent IVC filters are used to prevent pulmonary embolism in high-risk patients.
- Complications can arise when IVC filters interact with pre-existing vascular conditions like AAAs.
Observation:
- An 85-year-old male with a known AAA presented with acute deep vein thrombosis (DVT) of the left leg.
- CT angiography revealed a proximal DVT and a Bird's Nest IVC filter penetrating the AAA.
- The patient had significant comorbidities and advanced age.
Findings:
- The IVC filter was found to be penetrating the abdominal aortic aneurysm.
- Deep vein thrombosis was diagnosed in the left leg.
- The patient was initiated on apixaban for anticoagulation.
Implications:
- This case underscores the complex management of IVC filter complications in patients with AAAs.
- Close observation of the IVC filter and AAA is crucial in such cases.
- Treatment decisions must consider patient age, comorbidities, and the specific anatomical challenges presented.
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