[Non-deployment of branches of a vena cava filter. Elements of prevention]

Non-deployment of an L.G.M. percutaneous vena cava filter is rare. The aim of this paper is to report a new case of this complication. A second filter was inserted between the non-deployed filter and the renal veins to prevent proximal migration of the transvenous interruption device to the pulmonary artery or the right side of the heart, and to guarantee an effective prophylaxis of further pulmonary embolization. Two years later, the vena cava was still patent. The best way to avoid this accident is a perfect insertion technique: after a preoperative cavography to check diameter and patency of the vena cava, the filter must be deployed by retracting the introducer sheath while maintaining the position of the inner canula, and not pushing the filter out of the introducer sheath. A second filter must always be available in the operating room in case of incomplete opening of the filter. The use of vena cava filter is not devoid of risks. Restricted indications are therefore recommended.