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Complicated IVC Filter Placement in a Patient With Venous Abnormality: A Case Report
Maryam Mehrpooya1, Faeze Salahshour2, Massoud Ghasemi3
1Department of Cardiology, Imam Khomeini Medical Center, Tehran University of Medical Science, Tehran, Iran, tums.ac.ir.
Case Reports in Cardiology
|March 6, 2026
Summary
This case highlights a rare inferior vena cava (IVC) anomaly complicating filter placement for pulmonary embolism (PE) prevention. Identifying IVC abnormalities is crucial before such interventions.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Cardiology
Background:
- Deep venous thrombosis (DVT) and its complication, pulmonary embolism (PE), pose significant health risks.
- Inferior vena cava (IVC) filters are used to prevent PE in high-risk DVT patients.
- Standard IVC filter placement can be complicated by anatomical variations.
Purpose of the Study:
- To report a rare case of IVC anomaly encountered during IVC filter placement.
- To emphasize the importance of pre-procedural imaging for IVC anomalies.
- To discuss the management of IVC anomalies during filter placement.
Main Methods:
- A 35-year-old male with DVT and PE despite anticoagulation was evaluated for IVC filter placement.
- CT angiography diagnosed PE; IVC filter insertion was attempted.
- CT venography was performed due to procedural difficulty, revealing May-Thurner syndrome and a thrombotic anomaly.
Main Results:
- IVC filter placement was unsuccessful due to an IVC anomaly (May-Thurner syndrome with recanalized thrombosis).
- The IVC filter was retrieved, and anticoagulation was optimized.
- The patient's condition was managed successfully despite the anatomical challenges.
Conclusions:
- Anatomical variations of the IVC can significantly complicate filter placement.
- Pre-procedural imaging to identify IVC anomalies is essential for safe and effective interventions.
- Management requires careful consideration of the specific anomaly and patient factors.
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