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Recurrent fracture of a recovery inferior vena cava filter with pulmonary migration.

Vossen JA, Thawait SK, Golia JS, Chamarthy M, Cholewczynski W, Velasco N - Yale J Biol Med (2012)

Bottom Line: Imaging revealed sequential fracturing and embolization of two of the IVC filter arms to the pulmonary arteries.IVC filter fracture and subsequent migration to the lung is a rare complication.Systematic long-term follow-up in patients with IVC filters and, if possible, filter removal should be considered to prevent possible complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Yale School of Medicine, Bridgeport, Connecticut, USA. jvossen1@jhmi.edu

ABSTRACT
Inferior vena cava (IVC) filters are indicated in patients with venous thromboembolic disease in whom standard anticoagulation therapy is contraindicated or ineffective. A 32-year-old female presented to our hospital with chest pain 5 years after IVC filter placement. Imaging revealed sequential fracturing and embolization of two of the IVC filter arms to the pulmonary arteries. IVC filter fracture and subsequent migration to the lung is a rare complication. Systematic long-term follow-up in patients with IVC filters and, if possible, filter removal should be considered to prevent possible complications.

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Axial CT image of the chest demonstrating the fractured and migrated IVC filter strut as a bright radiolucent structure within a right pulmonary artery branch (arrow). The surrounding enhancing pulmonary branches appear bright as well, due to administration of contrast, and are difficult to distinguish from the IVC filter strut.
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Figure 4: Axial CT image of the chest demonstrating the fractured and migrated IVC filter strut as a bright radiolucent structure within a right pulmonary artery branch (arrow). The surrounding enhancing pulmonary branches appear bright as well, due to administration of contrast, and are difficult to distinguish from the IVC filter strut.

Mentions: During the following 5 years, the patient presented to the hospital several times with chest pain and shortness of breath. The workup for PE remained negative. Five years after placement of the IVC filter, a plain chest radiograph showed two linear filter struts projecting over the right hemithorax (Figure 1). An abdominal CT study showed the absence of two of the short “alignment” arms of the Recovery filter. Retrospective review of prior abdominal CT scans showed sequential flexion of these arms, followed by their fracture and migration (Figures 2 and 3). Furthermore, the fractures’ fragments within the pulmonary arteries could not be easily identified on the prior pulmonary CTA scans (Figure 4).


Recurrent fracture of a recovery inferior vena cava filter with pulmonary migration.

Vossen JA, Thawait SK, Golia JS, Chamarthy M, Cholewczynski W, Velasco N - Yale J Biol Med (2012)

Axial CT image of the chest demonstrating the fractured and migrated IVC filter strut as a bright radiolucent structure within a right pulmonary artery branch (arrow). The surrounding enhancing pulmonary branches appear bright as well, due to administration of contrast, and are difficult to distinguish from the IVC filter strut.
© Copyright Policy - open access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3375713&req=5

Figure 4: Axial CT image of the chest demonstrating the fractured and migrated IVC filter strut as a bright radiolucent structure within a right pulmonary artery branch (arrow). The surrounding enhancing pulmonary branches appear bright as well, due to administration of contrast, and are difficult to distinguish from the IVC filter strut.
Mentions: During the following 5 years, the patient presented to the hospital several times with chest pain and shortness of breath. The workup for PE remained negative. Five years after placement of the IVC filter, a plain chest radiograph showed two linear filter struts projecting over the right hemithorax (Figure 1). An abdominal CT study showed the absence of two of the short “alignment” arms of the Recovery filter. Retrospective review of prior abdominal CT scans showed sequential flexion of these arms, followed by their fracture and migration (Figures 2 and 3). Furthermore, the fractures’ fragments within the pulmonary arteries could not be easily identified on the prior pulmonary CTA scans (Figure 4).

Bottom Line: Imaging revealed sequential fracturing and embolization of two of the IVC filter arms to the pulmonary arteries.IVC filter fracture and subsequent migration to the lung is a rare complication.Systematic long-term follow-up in patients with IVC filters and, if possible, filter removal should be considered to prevent possible complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Yale School of Medicine, Bridgeport, Connecticut, USA. jvossen1@jhmi.edu

ABSTRACT
Inferior vena cava (IVC) filters are indicated in patients with venous thromboembolic disease in whom standard anticoagulation therapy is contraindicated or ineffective. A 32-year-old female presented to our hospital with chest pain 5 years after IVC filter placement. Imaging revealed sequential fracturing and embolization of two of the IVC filter arms to the pulmonary arteries. IVC filter fracture and subsequent migration to the lung is a rare complication. Systematic long-term follow-up in patients with IVC filters and, if possible, filter removal should be considered to prevent possible complications.

Show MeSH
Related in: MedlinePlus