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Obstructive Shock in Acute Vena Cava Filter Thrombosis: A Rare Presentation.
Kirran Bakhshi1, Sashi Inkollu2,3, Rohit Sharma4
1Department of Surgery, Marshfield Medical Center, Marshfield, WI, USA bakhshi.kirran@marshfieldclinic.org.
Clinical Medicine & Research
|October 22, 2024
Summary
Inferior vena cava (IVC) filters can cause acute thrombosis, leading to obstructive shock and death. This case highlights a rare but fatal complication of IVC filters requiring clinical vigilance.
Area of Science:
- Vascular Surgery
- Cardiology
- Critical Care Medicine
Background:
- Inferior vena cava (IVC) filters are used to prevent pulmonary emboli.
- These filters are known to be thrombogenic.
- Deep vein thrombosis (DVT) is a common indication for IVC filter placement.
Purpose of the Study:
- To report a case of acute IVC filter thrombosis presenting as obstructive shock.
- To highlight an uncommon and potentially fatal complication of IVC filters.
Main Methods:
- Case report of a 70-year-old male patient.
- Preoperative IVC filter placement for acute calf DVT.
- Postoperative monitoring and imaging.
- Initiation of therapeutic heparinization and percutaneous thrombectomy.
Main Results:
- Complete IVC occlusion caudal to the filter with extension to bilateral iliofemoral veins.
- Development of obstructive shock, tachycardia, hypotension, and lower extremity arterial insufficiency.
- Despite intervention, the patient experienced multi-organ failure and death.
Conclusions:
- Acute IVC filter thrombosis can lead to obstructive shock and mortality.
- Clinicians must maintain vigilance for this rare thrombotic complication of IVC filters.
- This case underscores the inherent risks associated with IVC filter placement.
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