Late complication from a retrievable inferior vena cava filter with associated caval, aortic, and duodenal perforation: A case report

Vascular Surgery and Organ Transplant Unit-Department of Surgery, Transplantation and Advanced Technologies, University Hospital of Catania, Catania, Italy.
Journal of Vascular Surgery (Impact Factor: 3.02). 07/2008; 48(1):223-5. DOI: 10.1016/j.jvs.2008.02.002
Source: PubMed


Inferior vena cava filters are an excellent therapeutic method for those patients in whom anticoagulant therapy is contraindicated or ineffective. However, filter placement is associated with a high rate of serious complications (>30%), with death occurring in 3.7% of patients. The most common complication is an asymptomatic inferior vena cava penetration and perforation. In some rare circumstances, however, therapeutic intervention may be required because of perforation of adjacent organs. We report a clinical case of a patient with simultaneous caval, duodenal, and aortic perforation resulting from penetration of inferior vena cava filter hooks. A brief review of the literature discusses presenting symptoms and treatment of such rare complications.

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    • ", F EGD ϩ BE ϩ colonoscopy ϩ abdominal US ϩ cavogram ϩ CT al Zaharani et al (1995) 15 55, M EGD ϩ CT of the abdomen/pelvis Bianchini et al (1996) 16 29, M Plain AXR ϩ EGD Sarkar et al (1997) 17 68, F EGD Dardik et al (1997) 18 36, M Plain AXR ϩ UGI series ϩ EGD ϩ CT Guillem et al (2001) 19 60, F Abdominal US ϩ EGD ϩ CT of the abdomen/pelvis Feezor et al (2002) 20 40, M Plain AXR ϩ abdominal US ϩ CT ϩ EGD ϩ cavogram Formentini et al (2005) 21 23, F Plain AXR ϩ EGD ϩ CT of the abdomen/pelvis Mansour et al (2005) 22 41, M UGI series ϩ EGD ϩ CT of the abdomen/pelvis Durairaj et al (2006) 23 83, F Abdominal US ϩ CT of the abdomen/pelvis ϩ ERCP Botsios et al (2006) 24 77, F EGD ϩ CT of the abdomen/pelvis Ibele et al (2008) 25 48, F CT of the abdomen/pelvis Veroux et al (2008) 6 46, F Duplex US of the lower extremity ϩ CT of the chest/abdomen/pelvis Parkin et al (2009) "
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    ABSTRACT: A systematic review of the literature on symptomatic duodenal perforation caused by inferior vena cava (IVC) filters. Three databases, PubMed MEDLINE, Web of Sciences, and Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), reference lists of review articles and conference proceedings were searched. All articles containing data on clinical presentation, diagnostic strategy, and available treatment of symptomatic duodenal perforation caused by an IVC filter were included regardless of design, language, size, or length of follow-up. Seventy-two articles were selected for full-text screening, being 21 case reports were selected. The median age was 46 years old (range, 21-83 years old). Abdominal pain was reported in 11 patients and gastrointestinal bleed in 5 patients. The indications for IVC filter placement in this cohort of patients were contraindication of anticoagulation and recurrent pulmonary embolism (PE) despite therapeutic levels in 8 and 5 patients, respectively. Three different imaging modalities were obtained in 9 patients (43%) before confirming the diagnosis. All but 1 patient underwent open approach through laparotomy with or without removal of the filter. No PEs or deaths were reported and only 1 patient had a severe clinical complication of IVC and bilateral iliac vein thrombosis with massive lower extremities edema. Duodenal perforation caused by IVC filters is a rare complication that frequently requires extensive workup. Excellent outcomes with low complication rate have been reported in cases where an open procedure was performed with either extraction of the filter or removal of the offending struts.
    Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 12/2011; 55(3):856-861.e3. DOI:10.1016/j.jvs.2011.09.082 · 3.02 Impact Factor
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    • "It was reported that IVC filter placement was associated with a high rate of serious complications (> 30%), with death occurring in 3.7% of patients [9] , and that IVC thrombosis was a complication that occurs in 1- 32% of patients inserted with IVC filters. The risk of complications could be either during its insertion, e.g. "
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    ABSTRACT: Pulmonary embolism remains a serious challenge for health care. Anticoagulation is considered the first line of treatment; however, in patients with anticoagulation failure or contraindication, inferior vena cava filter placement has been widely performed for the prevention of pulmonary embolism. This study is a retrospective review of King Abdulaziz University Hospital two years experience (2008-2009). Nineteen patients who had venous thromboembolic manifestations were subjected to inferior vena cava filter insertion. The main reasons for inferior vena cava filter insertion were the occurrence of venous thromboembolism on top of anticoagulants, and bleeding resulted from heparin induced thrombocytopenia. All of the patients were presented with one or more risk factors and co-morbidities among malignancies were the most common (52.6%). Insertion was successful for all cases, except one patient who had pre-existing massive inferior vena cava thrombosis. No complications were recorded during filter insertion or on the short term, after filter insertion. Medical indications for inferior vena cava filters in our hospital are not different from what was cited in the literature. Although, each individual patient had multiple risk factors and co-morbidities, nevertheless our patients had no complications related to inferior vena cava filter insertion, which denotes that inferior vena cava filters can be inserted properly and safely.
  • Gefässchirurgie 01/2010; 15(2):120-124. DOI:10.1007/s00772-009-0754-5 · 0.24 Impact Factor
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