Fracture and Embolization of an Inferior Vena Cava Filter Strut Leading to Cardiac Tamponade

Departments of Internal Medicine, University of Texas Southwestern Medical Center, Dallas 75390-9047, USA.
Circulation (Impact Factor: 14.43). 06/2009; 119(18):2535-6. DOI: 10.1161/CIRCULATIONAHA.108.817247
Source: PubMed

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    • "The risk of complications could be either during its insertion, e.g. penetration of the IVC) [13] , penetration to the aortic lumen or vertebral body [14] , or occlusion after insertion by filter thrombus [12] , migration of the filter in a whole [15] [16] [17] [18] [19] [20] [21] or in part in the form an embolus of fractured part [22] . "
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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.
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