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Victory JH, Minc SD, Zaslau S, Elbakry AA, Almenoff MI. Open retrieval management of inferior vena cava filter erosion resulting in symptomatic hydroureteronephrosis. J Vasc Surg Cases Innov Tech 2023; 9:101188. [PMID: 37799839 PMCID: PMC10547826 DOI: 10.1016/j.jvscit.2023.101188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/28/2023] [Indexed: 10/07/2023] Open
Abstract
Inferior vena cava filters are effective for the management of thromboembolic disease but can erode into adjacent organ systems in rare instances. Endovascular retrieval of eroded filters has been the preferred management for this complication. We present a case for which endovascular retrieval was not appropriate because of filter orientation and erosion into the ureter and describe successful management using open retrieval of a permanent filter with erosion into the renal collecting system requiring reconstruction. Although minimally invasive retrieval is preferred over open repair, this approach should be considered when filter erosion is not amenable to endovascular retrieval.
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Affiliation(s)
| | - Samantha D. Minc
- Division of Vascular Surgery, Department of Cardiovascular and Thoracic Surgery, WVU Heart and Vascular Institute, West Virginia University, Morgantown, WV
| | - Stanley Zaslau
- Department of Urology, School of Medicine, West Virginia University, Morgantown, WV
| | - Amr A. Elbakry
- Department of Urology, School of Medicine, West Virginia University, Morgantown, WV
| | - Maxwell Ian Almenoff
- Division of Vascular Surgery, Department of Cardiovascular and Thoracic Surgery, WVU Heart and Vascular Institute, West Virginia University, Morgantown, WV
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2
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Robinson E, Jordano L, Mirza AK, Eisenmenger L, Skeik N, Manunga J. Management of a contained ruptured infrarenal abdominal aortic pseudoaneurysm caused by inferior vena cava struts injury: A case report and literature review. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2021; 7:438-442. [PMID: 34278079 PMCID: PMC8263528 DOI: 10.1016/j.jvscit.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/04/2021] [Indexed: 11/20/2022]
Abstract
Aortic pseudoaneurysms are rare entities caused by infection, trauma, atherosclerotic plaque rupture, or aortic instrumentation. Their natural course remains unknown; however, repair is invariably recommended. We present a case of a 71-year-old man with a history of recurrent deep venous thrombosis and pulmonary embolisms who underwent an inferior vena cava filter placement 8 years prior and was found to have a 3.6-cm contained ruptured infrarenal aortic pseudoaneurysm on imaging performed for abdominal pain. His pseudoaneurysm was excluded using a Gore Excluder Endoprosthesis. We further reviewed literature on the subject to highlight the various surgical approaches to this lethal condition.
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Affiliation(s)
- Emilie Robinson
- Section of vascular & Endovascular Surgery, Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minn
| | - Lia Jordano
- Section of vascular & Endovascular Surgery, Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minn
| | - Aleem K. Mirza
- Section of vascular & Endovascular Surgery, Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minn
| | - Laura Eisenmenger
- Division of Neuroradiology, Department of Radiology, University of Wisconsin at Madison, Madison, Wisc
| | - Nedaa Skeik
- Section of vascular & Endovascular Surgery, Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minn
| | - Jesse Manunga
- Section of vascular & Endovascular Surgery, Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minn
- Correspondence: Jesse Manunga, MD, FACS, Section of Vascular and Endovascular Surgery, Minneapolis Heart Institute @ Abbott Northwestern Hospital, 920 E 28th St, Ste 300, Minneapolis, MN 55407
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3
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Functional Superior Mesenteric Artery Syndrome Induced by an Optional IVC Filter. Case Rep Surg 2019; 2019:6543934. [PMID: 31485366 PMCID: PMC6710772 DOI: 10.1155/2019/6543934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 08/01/2019] [Indexed: 11/20/2022] Open
Abstract
This patient suffered multiple injuries in a motor vehicle crash. She had an optional IVC filter placed in the usual fashion and location which resulted in a functional obstruction of the third part of the duodenum much as one would expect with a Superior Mesenteric Artery (SMA) syndrome. The symptoms persisted over the sixteen-day filter dwell time and resolved completely with the retrieval of the filter.
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4
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Shimizu T, Kubota K, Suzuki T, Matsumoto T, Shiraki T, Sakuraoka Y, Mori S, Iso Y, Kato M, Ishizuka M, Aoki T. A technique for taping inferior vena cava caudal to the duodenum: duodenal penetration by IVC filter strut after retroperitoneal lymph node dissection-usefulness of the mesenteric approach. Surg Case Rep 2019; 5:69. [PMID: 31020425 PMCID: PMC6482199 DOI: 10.1186/s40792-019-0626-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 04/09/2019] [Indexed: 11/24/2022] Open
Abstract
Background Although an inferior vena cava (IVC) filter is used for preventing pulmonary thromboembolism (PTE) in patients with deep vein thrombosis, IVC filter penetration in the duodenum is a rare complication. Case presentation A 35-year-old man had previously undergone retroperitoneal lymph node dissection (RPLND) for testicular cancer and IVC filter placement for prevention of PTE. Esophagogastroduodenoscopy (EGD) for his epigastric pain revealed penetration of the IVC filter in the duodenum. The IVC filter was retrieved through cavotomy, and the duodenal penetration was repaired using EGD clipping. Although it was difficult to mobilize the duodenum due to adhesion resulting from RPLND, the use of a mesenteric approach enabled encircling of the IVC caudal to the duodenum. The mesenteric approach is useful and safe for taping the IVC caudal to the duodenum in cases where it is difficult to mobilize the duodenum. Conclusion IVC taping using the mesenteric approach allowed safe retrieval of the IVC filter after RPLND without postoperative complications.
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Affiliation(s)
- Takayuki Shimizu
- Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan.
| | - Keiichi Kubota
- Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Takashi Suzuki
- Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Takatsugu Matsumoto
- Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Takayuki Shiraki
- Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Yuhki Sakuraoka
- Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Shozo Mori
- Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Yukihiro Iso
- Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Masato Kato
- Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Mitsuru Ishizuka
- Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Taku Aoki
- Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
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Malone CD, Shin DS, Ingraham CR. Arteriocaval Fistula and Retroperitoneal Hemorrhage after Removal of Caval Filter Near the Right Renal Artery. J Vasc Interv Radiol 2018; 29:1620-1622. [PMID: 30368319 DOI: 10.1016/j.jvir.2018.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 07/13/2018] [Accepted: 07/14/2018] [Indexed: 11/19/2022] Open
Affiliation(s)
- Christopher D Malone
- Interventional Radiology Section, Department of Radiology, 1959 NE Pacific Street, University of Washington, Seattle, WA 98195
| | - David S Shin
- Interventional Radiology Section, Department of Radiology, 1959 NE Pacific Street, University of Washington, Seattle, WA 98195
| | - Christopher R Ingraham
- Interventional Radiology Section, Department of Radiology, 1959 NE Pacific Street, University of Washington, Seattle, WA 98195
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Vena Cava Filter Retrieval with Aorto-Iliac Arterial Strut Penetration. Cardiovasc Intervent Radiol 2018; 41:1184-1188. [DOI: 10.1007/s00270-018-1963-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/10/2018] [Indexed: 11/26/2022]
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7
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Lee BE, Van Allan RJ, Friedman ML, Lipshutz HG. Complications and retrieval characteristics of Celect Platinum inferior vena cava filters. J Vasc Surg Venous Lymphat Disord 2018; 6:163-172. [DOI: 10.1016/j.jvsv.2017.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 09/18/2017] [Indexed: 10/18/2022]
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Duncan C, Trerotola SO, Stavropoulos SW. Endovascular Removal of Inferior Vena Cava Filters with Arterial Penetration. J Vasc Interv Radiol 2018; 29:486-490. [PMID: 29477624 DOI: 10.1016/j.jvir.2017.12.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 12/08/2017] [Accepted: 12/15/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To evaluate the safety and outcomes of endovascular percutaneous removal of inferior vena cava filters (IVCFs) with elements penetrating an artery. MATERIALS AND METHODS From an IVCF retrieval database, computerized tomographic scans of patients who underwent IVCF retrieval from 2011 to 2017 were reviewed for IVCF elements penetrating through the caval wall and into an adjacent arterial wall (AW) or penetrating into an adjacent arterial lumen (AL). Forty-two patients were identified, including 20 with elements penetrating into an AW and 22 with elements penetrating into an AL; 30 of these IVCFs were tip embedded. RESULTS All of the filters in both groups were removed. Of the arterial-interacting filters, 9 were removed with the use of standard techniques and 33 with the use of endobronchial forceps. Arterial access was obtained before removal in 3 patients (7%) with post-removal arteriography revealing no abnormalities, such as extravasation, pseudoaneurysm, or new fractured components. There was no significant difference between groups in tip embedding, retrieval technique, or fluoroscopy time. CONCLUSIONS Endovascular removal of IVCFs with elements that have penetrated into adjacent arterial walls or lumens can be performed safely in the majority of patients.
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Affiliation(s)
- Christopher Duncan
- Department of Radiology, Division of Interventional Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, 1 Silverstein 3400 Spruce Street, Philadelphia, PA 19104
| | - Scott O Trerotola
- Department of Radiology, Division of Interventional Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, 1 Silverstein 3400 Spruce Street, Philadelphia, PA 19104.
| | - S William Stavropoulos
- Department of Radiology, Division of Interventional Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, 1 Silverstein 3400 Spruce Street, Philadelphia, PA 19104
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9
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Baptista Sincos APW, Sincos IR, Labropoulos N, Donegá BC, Klepacz A, Aun R. Symptomatic duodenal perforation by inferior vena cava filter. Phlebology 2017; 33:523-533. [DOI: 10.1177/0268355517731049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives Duodenal perforation by an inferior vena cava filter is rare and life threatening. Our objective is to find out number of occurrences and compare diagnosis and treatments. Method The reference list of Malgor’s review in 2012 was considered as well as all new articles with eligible features. Search was conducted on specific databases: MEDLINE, Web of Sciences, and Literatura Latino-Americana e do Caribe em Ciências da Saúde. Results Most of the patients presented with upper abdominal pain and the use of radiologic studies was crucial for diagnosis. The most common treatment was laparotomy with filter or strut removal plus duodenum repair. However, clinical conditions of patients must be considered and the endovascular technique with endograft deployment into inferior vena cava may be an alternative. Conclusion Duodenal perforation by an inferior vena cava filter is uncommon and in high-risk surgical patients endovascular repair must be considered.
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Affiliation(s)
| | - Igor R Sincos
- Department of Endovascular Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Nicos Labropoulos
- Department of Endovascular Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Bruno C Donegá
- Department of Endovascular Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Andrea Klepacz
- Department of Endovascular Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Ricardo Aun
- Department of Endovascular Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil
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Chauhan Y, Al Jabbari O, Abu Saleh WK, Loh T, Ali I, Lumsden A. Open Removal of Penetrating Inferior Vena Cava Filter with Repair of Secondary Aortic Dissection: Case Report. Ann Vasc Surg 2016; 32:130.e9-12. [DOI: 10.1016/j.avsg.2015.10.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 10/17/2015] [Accepted: 10/25/2015] [Indexed: 11/15/2022]
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11
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Abdel-Aal AK, Ezzeldin IB, Moustafa AS, Ertel N, Oser R. Inferior vena cava filter penetration following Whipple surgical procedure causing ureteral injury. J Radiol Case Rep 2015; 9:37-43. [PMID: 27200175 DOI: 10.3941/jrcr.v9i12.2508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We report a case of an indwelling inferior vena cava filter that penetrated the IVC wall after Whipple's pancreatico-duodenectomy procedure performed in a patient with ampullary carcinoma, resulting in right ureteral injury and obstruction with subsequent hydroureter and hydronephrosis. This was incidentally discovered on a computed tomography scan performed as routine follow up to evaluate the results of the surgery. We retrieved the inferior vena cava filter and placed a nephrostomy catheter to relieve the ureteral obstruction. Our case highlights the importance of careful inferior vena cava manipulation during abdominal surgery in the presence of an inferior vena cava filter, and the option of temporary removal of the filter to be placed again after surgery in order to avoid this complication, unless protection is required against clot migration during the surgical procedure.
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Affiliation(s)
- Ahmed Kamel Abdel-Aal
- Department of Radiology, University of Alabama at Birmingham (UAB), Birmingham, Alabama. USA
| | - Islam B Ezzeldin
- Department of Radiology, University of Alabama at Birmingham (UAB), Birmingham, Alabama. USA
| | - Amr Soliman Moustafa
- Department of Radiology, University of Alabama at Birmingham (UAB), Birmingham, Alabama. USA
| | - Nathan Ertel
- Department of Radiology, University of Alabama at Birmingham (UAB), Birmingham, Alabama. USA
| | - Rachel Oser
- Department of Radiology, University of Alabama at Birmingham (UAB), Birmingham, Alabama. USA
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12
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Chana-Rodríguez F, Mañanes RP, Rojo-Manaute J, Haro JAC, Vaquero-Martín J. Methods and Guidelines for Venous Thromboembolism Prevention in Polytrauma Patients with Pelvic and Acetabular Fractures. Open Orthop J 2015; 9:313-20. [PMID: 26312115 PMCID: PMC4541309 DOI: 10.2174/1874325001509010313] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Revised: 04/26/2015] [Accepted: 05/18/2015] [Indexed: 11/26/2022] Open
Abstract
Sequential compression devices and chemical prophylaxis are the standard venous thromboembolism (VTE) prevention for trauma patients with acetabular and pelvic fractures. Current chemical pharmacological contemplates the use of heparins or fondaparinux. Other anticoagulants include coumarins and aspirin, however these oral agents can be challenging to administer and may need monitoring. When contraindications to anticoagulation in high-risk patients are present, prophylactic inferior vena cava filters can be an option to prevent pulmonary emboli. Unfortunately strong evidence about the most effective method, and the timing of their commencement, in patients with pelvic and acetabular fractures remains controversial.
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Affiliation(s)
- Francisco Chana-Rodríguez
- Department of Traumatology and Orthopaedic Surgery, General University Hospital Gregorio Marañón, Madrid, Spain
| | - Rubén Pérez Mañanes
- Department of Traumatology and Orthopaedic Surgery, General University Hospital Gregorio Marañón, Madrid, Spain
| | - José Rojo-Manaute
- Department of Traumatology and Orthopaedic Surgery, General University Hospital Gregorio Marañón, Madrid, Spain
| | - José Antonio Calvo Haro
- Department of Traumatology and Orthopaedic Surgery, General University Hospital Gregorio Marañón, Madrid, Spain
| | - Javier Vaquero-Martín
- Department of Traumatology and Orthopaedic Surgery, General University Hospital Gregorio Marañón, Madrid, Spain
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13
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Genovese EA, Jeyabalan G, Marone LK, Avgerinos ED, Makaroun MS, Chaer RA. Endovascular management of symptomatic gastrointestinal complications associated with retrievable inferior vena cava filters. J Vasc Surg Venous Lymphat Disord 2015; 3:276-82. [DOI: 10.1016/j.jvsv.2015.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 03/15/2015] [Indexed: 02/03/2023]
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Haga M, Hosaka A, Miyahara T, Hoshina K, Shigematsu K, Watanabe T. Penetration of an inferior vena cava filter into the aorta. Ann Vasc Dis 2014; 7:413-6. [PMID: 25593628 DOI: 10.3400/avd.cr.14-00066] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 08/23/2014] [Indexed: 11/13/2022] Open
Abstract
Transvenous placement of inferior vena cava (IVC) filters is commonly performed in selected patients with deep venous thrombosis and pulmonary embolism. However, filter placement is sometimes associated with serious complications. A common complication is asymptomatic perforation of the IVC and penetration of adjacent organs by the filter. Here, we report a case of an 83-year-old man whose prophylactic IVC filter penetrated the aorta. The patient was closely followed without surgical intervention for more than a year, and no additional complications were observed.
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Affiliation(s)
- Makoto Haga
- Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
| | - Akihiro Hosaka
- Current institution: Department of Surgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Takuya Miyahara
- Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
| | - Katsuyuki Hoshina
- Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
| | - Kunihiro Shigematsu
- Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
| | - Toshiaki Watanabe
- Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
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15
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Bos A, Van Ha T, van Beek D, Ginsburg M, Zangan S, Navuluri R, Lorenz J, Funaki B. Strut penetration: local complications, breakthrough pulmonary embolism, and retrieval failure in patients with Celect vena cava filters. J Vasc Interv Radiol 2014; 26:101-6. [PMID: 25446424 DOI: 10.1016/j.jvir.2014.09.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Revised: 09/10/2014] [Accepted: 09/16/2014] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To investigate strut penetration in patients with Celect filters, specifically local complications and association with breakthrough pulmonary embolism (PE) or retrieval failure. MATERIALS AND METHODS A retrospective single-center study was conducted to evaluate patients who received Celect filters between January 2007 and May 2013. A total of 595 filters were placed during the study period. Primary indications included thromboembolic disease (93%) and primary surgical prophylaxis (7%). Complications and retrieval data were assessed by computed tomography (CT) and electronic medical records. RESULTS A total of 193 patients underwent follow-up abdominal CT at a mean follow-up interval of 176.2 days (range, 0-1,739 d). The rate of strut penetration more than 3 mm outside the caval wall was 28.5% (n = 55). One patient had CT evidence of clinically major strut penetration (1.8%) with strut compression of the right ureter causing hydronephrosis. Indwelling filter time longer than 100 days was associated with strut penetration (P < .001). Age, sex, and history of thromboembolic disease were not associated with strut penetration (P = .51, P = .81, and P = .89). Sixty-three patients presented for follow-up CT pulmonary angiography at a mean of 128.1 days (range, 1-895 d). The rate of breakthrough PE was 12.7%. The overall retrieval success rate was 96.7% (n = 150). Strut penetration was not associated with breakthrough PE or retrieval failure (P = .49 and P = .22). CONCLUSIONS Although strut penetration is a common complication with Celect filters, there is no association with breakthrough PE or retrieval failure. CT evidence of local complications associated with strut penetration is rare.
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Affiliation(s)
- Aaron Bos
- Department of Radiology, University of Chicago Medical Center, 5841 S. Maryland Ave., MC 2026, Chicago, IL 60637.
| | - Thuong Van Ha
- Department of Radiology, University of Chicago Medical Center, 5841 S. Maryland Ave., MC 2026, Chicago, IL 60637
| | - Darren van Beek
- Department of Radiology, University of Chicago Medical Center, 5841 S. Maryland Ave., MC 2026, Chicago, IL 60637
| | - Michael Ginsburg
- Department of Radiology, University of Chicago Medical Center, 5841 S. Maryland Ave., MC 2026, Chicago, IL 60637
| | - Steven Zangan
- Department of Radiology, University of Chicago Medical Center, 5841 S. Maryland Ave., MC 2026, Chicago, IL 60637
| | - Rakesh Navuluri
- Department of Radiology, University of Chicago Medical Center, 5841 S. Maryland Ave., MC 2026, Chicago, IL 60637
| | - Jonathan Lorenz
- Department of Radiology, University of Chicago Medical Center, 5841 S. Maryland Ave., MC 2026, Chicago, IL 60637
| | - Brian Funaki
- Department of Radiology, University of Chicago Medical Center, 5841 S. Maryland Ave., MC 2026, Chicago, IL 60637
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Twine CP, Winterbottom A, Shaida N, Boyle JR. Retroperitoneal aortic hemorrhage caused by penetration of an endovascular stent-graft anchoring barb. J Endovasc Ther 2013; 20:568-70. [PMID: 23914869 DOI: 10.1583/12-4200.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To report a rare case of acute intraoperative retroperitoneal hemorrhage secondary to aortic penetration by the suprarenal anchoring barb on a stent-graft. CASE REPORT A 75-year-old patient on dual antiplatelet therapy for coronary stents and low-molecular-weight heparin for atrial thrombus underwent elective endovascular repair of a 6.7-cm infrarenal abdominal aortic aneurysm. A device with suprarenal fixation and metal anchoring barbs was implanted, and a molding balloon was used that at no time covered the proximal bare metal stents or barbs. In recovery, the patient became tachycardic and hypotensive. After resuscitation, imaging identified an anterior barb penetrating the aortic wall, causing the acute retroperitoneal hemorrhage. A decision to treat conservatively rather than resort to open surgery was difficult but ultimately influenced by the patients' high risk for open surgery. The patient was treated by aggressive reversal of heparin and platelet transfusion, and the bleed settled spontaneously. CONCLUSION Major surgery and subsequent morbidity may be avoided by medical management of what would appear to be a surgical problem.
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Affiliation(s)
- Christopher P Twine
- Department of Vascular Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
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17
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Uterine trauma with fetal loss associated with chronic perforation of the inferior vena cava by an infrarenal vena cava filter. J Vasc Surg Venous Lymphat Disord 2013; 1:412-4. [PMID: 26992765 DOI: 10.1016/j.jvsv.2013.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 04/15/2013] [Accepted: 04/20/2013] [Indexed: 11/21/2022]
Abstract
Gestational complications in pregnant women have been considered a theoretical sequelae of vena cava filters (VCFs) positioned in the infrarenal segment of the inferior vena cava. We describe a 32-year-old woman who became pregnant with the known existence of an asymptomatic but chronically perforated, permanent infrarenal VCF. At 24 weeks gestation, uterine trauma leading to massive intraperitoneal hemorrhage and fetal loss occurred. Our case documents that gestational risk, heretofore theoretical, is real and calls for heightened awareness of the need for appropriate VCF management in women of childbearing age and consideration for preconception evaluation of the filter-bearing inferior vena cava in women considering pregnancy in whom VCFs have been previously implanted.
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18
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McLoney ED, Krishnasamy VP, Castle JC, Yang X, Guy G. Complications of Celect, Günther tulip, and Greenfield inferior vena cava filters on CT follow-up: a single-institution experience. J Vasc Interv Radiol 2013; 24:1723-9. [PMID: 24041915 DOI: 10.1016/j.jvir.2013.07.023] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/19/2013] [Accepted: 07/19/2013] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To evaluate and compare the rates of complications on follow-up computed tomography (CT) studies of patients with Celect, Günther Tulip, and Greenfield inferior vena cava (IVC) filters. MATERIALS AND METHODS Retrospective review of CT studies obtained 0-1,987 days after infrarenal placement of an IVC filter identified 255 Celect, 160 Tulip, and 50 Greenfield filters. Follow-up CT studies were independently evaluated by two observers for IVC perforation, contact with adjacent organs, and filter fracture. Multivariate analysis was performed to identify factors associated with higher rates of IVC perforation, including age, IVC diameter, sex, and history of malignancy. RESULTS IVC perforation was observed in 126 of 255 Celect filters (49%) with a mean follow-up of 277 days, 69 of 160 Tulip filters (43%) with a mean follow-up of 437 days, and one of 50 Greenfield filters (2%) with a mean follow-up of 286 days. A significantly higher IVC perforation rate was observed in women (45.5%) compared with men (30.8%; P = .002) and in patients with a history of malignancy (43.7%) compared with patients with no history of malignancy (29.9%; P < .001). Filter fracture was rare, observed in two of 255 Celect filters (0.8%), one of 160 Tulip filters (0.6%), and none of 50 Greenfield filters. CONCLUSIONS No significant difference was observed in IVC perforation rate between Celect and Tulip filters. Greenfield filters had a significantly lower rate of IVC perforation than Celect and Tulip filters. Higher IVC perforation rates were observed in women and patients with a history of malignancy.
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Affiliation(s)
- Eric D McLoney
- Department of Radiology, The Ohio State University Medical Center, 395 W. 12th Ave., Columbus, OH 43210.
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Gyang E, Zayed M, Harris EJ, Lee JT, Dalman RL, Mell MW. Factors impacting follow-up care after placement of temporary inferior vena cava filters. J Vasc Surg 2013; 58:440-5. [PMID: 23588109 DOI: 10.1016/j.jvs.2012.12.085] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 12/19/2012] [Accepted: 12/31/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Rates of inferior vena cava (IVC) filter retrieval have remained suboptimal, in part because of poor follow-up. The goal of our study was to determine demographic and clinical factors predictive of IVC filter follow-up care in a university hospital setting. METHODS We reviewed 250 consecutive patients who received an IVC filter placement with the intention of subsequent retrieval between March 2009 and October 2010. Patient demographics, clinical factors, and physician specialty were evaluated. Multivariate logistic regression analysis was performed to identify variables predicting follow-up care. RESULTS In our cohort, 60.7% of patients received follow-up care; of those, 93% had IVC filter retrieval. Major indications for IVC filter placement were prophylaxis for high risk surgery (53%) and venous thromboembolic event with contraindication and/or failure of anticoagulation (39%). Follow-up care was less likely for patients discharged to acute rehabilitation or skilled nursing facilities (P < .0001), those with central nervous system pathology (eg, cerebral hemorrhage or spinal fracture; P < .0001), and for those who did not receive an IVC filter placement by a vascular surgeon (P < .0001). In a multivariate analysis, discharge home (odds ratio [OR], 4.0; 95% confidence interval [CI], 1.99-8.2; P < .0001), central nervous system pathology (OR, 0.46; 95% CI, 0.22-0.95; P = .04), and IVC filter placement by the vascular surgery service (OR, 4.7; 95% CI, 2.3-9.6; P < .0001) remained independent predictors of follow-up care. Trauma status and distance of residence did not significantly impact likelihood of patient follow-up. CONCLUSIONS Service-dependent practice paradigms play a critical role in patient follow-up and IVC filter retrieval rates. Nevertheless, specific patient populations are more prone to having poorer rates of follow-up. Such trends should be factored into institutional quality control goals and patient-centered care.
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Affiliation(s)
- Elsie Gyang
- Department of Surgery, Division of Vascular Surgery, Stanford University School of Medicine, Stanford, CA 94305-5642, USA
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Retrospective Review of 120 Celect Inferior Vena Cava Filter Retrievals: Experience at a Single Institution. J Vasc Interv Radiol 2012. [DOI: 10.1016/j.jvir.2012.08.016] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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21
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Hutchinson RC, Thiel DD, Igel TC. Erosion of inferior vena caval filter noted during robotic assisted laparoscopic partial nephrectomy. Int Braz J Urol 2012; 38:704-6. [PMID: 23131513 DOI: 10.1590/s1677-55382012000500018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Inferior Vena Cava (IVC) filters are mechanical devices implanted to provide prophylaxis against pulmonary emboli in patients for whom standard anticoagulation is either inadequate or contraindicated. A 67-year-old female with a 10-year-old indwelling IVC filter underwent robotic assisted laparoscopic partial nephrectomy for a right upper pole renal mass. Renal hilum dissection was complicated by adhesions secondary to eroded IVC filter struts. IVC filter erosion is a well-described phoenomena in both the radiologic and surgical literature. As many as 25% of filters are noted to be radiographically eroded; however, the incidence of clinically significant erosion is much less. Given the placement of endovascularly delivered IVC filters in close proximity to many urologic operative fields, it is important for urologists to be aware of the potential of eroded devices when pursuing para-caval dissections.
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Affiliation(s)
- Ryan C Hutchinson
- Department of Urology, Mayo Clinic, Jacksonville, Florida 32224, USA
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Caldwell EH, Fridley TL, Erb EL, Fleischer SR. Endovascular Retrieval of an Inferior Vena Cava Filter With Simultaneous Caval, Aortic, and Duodenal Perforations. Vasc Endovascular Surg 2012; 46:671-4. [DOI: 10.1177/1538574412465479] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 47-year-old female presented to the emergency department complaining of diffuse abdominal pain and melena. She previously had a Bard G2X inferior vena cava filter placed before undergoing a laparoscopic Roux-en-Y gastric bypass 3 years before her current presentation. She had a history of an anastomotic ulcer that was treated medically. A repeat endoscopic evaluation revealed no evidence of a recent bleed and the ulcer was healed. Computed tomography revealed evidence of multiple filter struts penetrating through the caval wall into the duodenum and aorta. The filter was successfully removed using an En Snare without complications. Reviewing the current literature, open surgical repair has been the treatment of choice for similar patient presentations. We present a successful case of the endovascular retrieval of an inferior vena cava filter with simultaneous caval, aortic, and duodenal penetrations.
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Affiliation(s)
| | - Todd L. Fridley
- Department of Surgery, Kettering Health Network, Dayton, OH, USA
| | - Edward L. Erb
- Department of Vascular Surgery, Kettering Health Network, Dayton, OH, USA
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Open surgical inferior vena cava filter retrieval for caval perforation and a novel technique for minimal cavotomy filter extraction. J Vasc Surg 2012; 56:256-9; discussion 259. [DOI: 10.1016/j.jvs.2011.12.065] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 12/07/2011] [Accepted: 12/24/2011] [Indexed: 11/17/2022]
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Malgor RD, Labropoulos N. A systematic review of symptomatic duodenal perforation by inferior vena cava filters. J Vasc Surg 2012; 55:856-861.e3. [DOI: 10.1016/j.jvs.2011.09.082] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 09/12/2011] [Accepted: 09/24/2011] [Indexed: 10/14/2022]
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Bae MJ, Chung SW, Lee CW, Kim S, Song S. Duodenal perforation caused by an inferior vena cava filter. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2012; 45:69-71. [PMID: 22363914 PMCID: PMC3283790 DOI: 10.5090/kjtcs.2012.45.1.69] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 09/18/2011] [Accepted: 10/15/2011] [Indexed: 11/16/2022]
Abstract
The inferior vena cava (IVC) filter is known as an effective and safe method for preventing fatal pulmonary thromboembolism in patients with deep vein thrombosis. Usually, the remaining IVC filters are asymptomatic and do not cause clinical problems. We report a case of duodenal perforation caused by a remaining IVC filter.
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Affiliation(s)
- Mi Ju Bae
- Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Korea
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Bélénotti P, Sarlon-Bartoli G, Bartoli MA, Benyamine A, Thevenin B, Muller C, Serratrice J, Magnan PE, Weiller PJ. Vena Cava Filter Migration: An Unappreciated Complication. About Four Cases and Review of the Literature. Ann Vasc Surg 2011; 25:1141.e9-14. [DOI: 10.1016/j.avsg.2011.03.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 02/25/2011] [Accepted: 03/01/2011] [Indexed: 02/03/2023]
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Abstract
Venous thromboembolic disease is associated with significant morbidity and mortality. Anticoagulation has been the mainstay of treatment and prevention. Unfortunately, anticoagulation frequently fails or is contraindicated. Use of inferior vena cava filters can be an effective alternative in these scenarios. Though inferior vena cava filters have been used for > 4 decades, the evidence behind their use is limited. Use of IVC filters is associated with both minor and major complications. More randomized prospective trials are needed to evaluate these devices. In this article, we review issues concerning the use of inferior vena cava filters.
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Affiliation(s)
- Adarsh Sahni
- University of Missouri-Kansas City, Kansas City, MO, USA.
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Advanced Techniques for Removal of Retrievable Inferior Vena Cava Filters. Cardiovasc Intervent Radiol 2011; 35:741-50. [DOI: 10.1007/s00270-011-0205-z] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Accepted: 05/22/2011] [Indexed: 10/18/2022]
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