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Inferior vena cava perforation during percutaneous filter removal
Adam C Hicks1, Daisy Sangroula1, Amit J Dwivedi1
1University of Louisville, Louisville, KY, USA.
Vascular
|October 21, 2022
Summary
Retrieving Inferior Vena Cava (IVC) filters can be complex. Advanced techniques may cause complications, suggesting open surgery may be safer for difficult cases.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Medical Device Retrieval
Background:
- Inferior Vena Cava (IVC) filter retrieval can be challenging due to filter angulation, embedding, or perforation.
- Advanced percutaneous retrieval techniques improve success rates but carry a high complication risk.
Observation:
- A 26-year-old female experienced IVC filter malposition and perforation after attempted retrieval using loop snare and endobronchial forceps techniques.
- These advanced endovascular methods led to filter deformity and IVC injury.
Findings:
- Open IVC filter removal via laparotomy and cavotomy successfully retrieved a deformed filter and associated thrombus.
- The patient experienced an uneventful recovery with no immediate or long-term complications.
Implications:
- Advanced endovascular retrieval techniques for IVC filters can lead to severe complications such as fracture, migration, and perforation.
- Proper filter deployment with minimal tilt is crucial to avoid retrieval difficulties.
- For embedded or excessively tilted filters, open surgical removal should be considered over aggressive endovascular manipulation.
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