Long-standing inferior vena cava filter with multidirectional strut penetration: A case report

Inferior vena cava (IVC) filter penetration is an increasingly recognized complication, particularly after prolonged dwell time or failed retrieval. Although often asymptomatic, multidirectional penetration into adjacent structures may pose a significant risk. We report a 61-year-old man presenting with non-traumatic radicular back pain whose CT imaging demonstrated a retrievable IVC filter placed nine years earlier with extensive strut penetration into the L3 vertebral body, perivertebral soft tissues, bowel loops, distal abdominal aorta, and right mesocolon, along with one fractured strut. Prior retrieval attempts had failed due to filter tilt and hook embedding, without evidence of hemorrhage or retroperitoneal leakage. The patient was referred for complex endovascular retrieval. This case underscores the importance of structured surveillance, timely retrieval, and specialized multidisciplinary management to prevent severe delayed complications.