A fractured inferior vena cava filter strut migrating to the left pulmonary artery

An Internal Hernia With Small Bowel Volvulus From an Inferior Vena Cava Filter Wire Strut: A Rare Cause of Acute Abdomen

The use of inferior vena cava (IVC) filters has been increasingly prevalent. Although they are relatively safe with clear indications, they are not without complications. Late-onset complications include IVC filter migration, IVC wire fracture, wire strut penetration, and perforation of organs in its vicinity. In this report, we present the case of a patient with small bowel volvulus secondary to an IVC wire strut migration, causing tethering of the mesentery and vascular compromise to the small bowel.

Strutting Through: Migration of Fractured Inferior Vena Cava Filter Through the Right Ventricle

A 68-year-old woman who had a retrievable inferior vena cava filter implanted 10 years ago presented with sudden-onset back pain. Initial computed tomography angiography demonstrated migration of a fractured strut that appeared embedded in the anterior right ventricular free wall without pericardial effusion. Subsequent gated computed tomography of the chest demonstrated further migration of the fragment, which was now penetrating the right ventricular free wall and extending into the pericardial sac. At the time of operative removal through a limited left anterior thoracotomy, the fractured strut had migrated completely through the heart and was positioned posteriorly in the pericardial sac.

Migrated Inferior Vena Cava (IVC) Filter Strut: A Rare Cause of Chronic Distal Pancreatitis with Likely Malignant Transformation

Patient: Female, 44-year-old

Final Diagnosis: Pancreatic adenocarcinoma

Symptoms: Abdominal pain

Medication:—

Clinical Procedure: Neoplasm

Specialty: Surgery

Inferior vena cava filter removal - Hope for the best and prepare for the worst: An anesthesiology perspective

A patient presented to our institution for an elective removal of an inferior vena cava (IVC) filter under local anesthesia. Once removed, it was noticed that the filter had a missing secondary leg. The patient had a chest CT done which showed a hyper-attenuating structure in the region of the tricuspid valve highly suspicious for the fractured strut of the filter. Upon these findings, the patient was taken once again to the surgical suite for an endovascular retrieval of the strut. For fear of a possible cardiac injury and a potential need for a sternotomy, the patient received general anesthesia and was placed with appropriate IV access and full cardiac monitors. The strut was removed successfully without any complications. Despite the relative benign nature of this endovascular procedure, one should always be prepared for an appropriate resuscitation in case of an occurrence of a surgical complication.

Study of helical flow inducers with different thread pitches and diameters in vena cava

Pulmonary embolism is a severe, potentially life-threatening condition. Inferior vena cava filters have been used to prevent recurrent pulmonary embolisms. However, the build-up of thrombosis in vena cava filters after deployment presents a severe problem to patients. Previous studies proposed that filters with helical flow are beneficial and capable of alleviating this problem. In this study, the hemodynamic performances of four typical helical flow inducers in the vena cava are determined using computational fluid dynamics simulations (steady-state and pulsatile flow) and compared. Pilot in vitro experiments were also conducted. The simulation results demonstrate that large-diameter inducers produce helical flow. Among inducers with identical diameter, those with a smaller thread pitch are more likely to induce increased helical flow. We also observed that the small thread pitch inducers can yield higher shear rates. Furthermore, a large diameter, small thread pitch helical flow inducer increases the time-averaged wall shear stress and reduces the oscillating shear index and relative residence time on the vessel wall in the vicinity of the helical flow inducer. In vitro experiments also verify that large diameter inducers generate a helical flow. A notable observation of this study is that the diameter is the key parameter that affects the induction of a helical flow. This study will likely provide important guidance for the design of interventional treatments and the deployment of filters associated with helical flow in the vena cava.

Complications of inferior vena cava filters

Inferior vena cava (IVC) filter placement is a relatively low risk alternative for prophylaxis against pulmonary embolism in patients with pelvic or lower extremity deep venous thrombosis who are not suitable for anticoagulation. There is an increasing trend in the number of IVC filter implantation procedures performed every year. There are many device types in the market and in the early 2000s, the introduction of retrievable filters brought an additional subset of complications to consider. Modern filter designs have led to decreased morbidity and mortality, however, a thorough understanding of the limitations and complications of IVC filters is necessary to weight the risks and benefits of placing IVC filters. In this review, the complications associated with IVC filters are divided into procedure related, post-procedure, and retrieval complications. Differences amongst the device types and retrievable filters are described, though this is limited by a significant lack of prospective studies. Additionally, the clinical presentation as well as prevention and treatment strategies are outlined with each complication type.