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Pulmonary Embolism Despite Inferior Vena Cava Filter in a Polytrauma Patient: A Case Report
Gareth Ryan1, Kurt Wilde1, Robert Korley1
1Section of Orthopaedics, Department of Surgery, University of Calgary, Calgary, Alberta, Canada, ucalgary.ca.
Case Reports in Orthopedics
|April 15, 2026
Summary
A prophylactic inferior vena cava filter (IVCF) did not prevent pulmonary embolism (PE) in a trauma patient with Factor V Leiden. Further research is needed for de novo PE prevention and management in high-risk patients.
Area of Science:
- Trauma surgery
- Vascular surgery
- Hematology
Background:
- Factor V Leiden increases thrombotic risk.
- Motor-vehicle collisions cause severe injuries requiring surgical intervention.
- Inferior vena cava filters (IVCFs) are used prophylactically to prevent pulmonary embolism (PE) in high-risk patients.
Purpose of the Study:
- To report a case of pulmonary embolism (PE) occurring despite prophylactic inferior vena cava filter (IVCF) placement in a trauma patient.
- To highlight the limitations in current understanding of de novo PE prevention and management.
Main Methods:
- A 39-year-old female with Factor V Leiden sustained multiple injuries from a motor-vehicle collision.
- Prophylactic IVCF placement prior to femur fracture fixation.
- Subsequent orthopedic surgeries for tibial plateau and wrist fractures.
- IVCF removal and discharge with anticoagulation.
Main Results:
- The patient developed a pulmonary embolism (PE) on postinjury Day 3, despite prophylactic IVCF placement.
- The patient underwent successful fracture fixation and IVCF removal.
- Discharged on 3 months of anticoagulation therapy.
Conclusions:
- Pulmonary embolism (PE) can occur even with prophylactic inferior vena cava filter (IVCF) use.
- The prevention and management of de novo PE in trauma patients require further investigation.
- Future research should focus on improving strategies for high-risk thrombotic events.
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