Challenging inferior vena cava filter removal complicated by strut penetration and prolonged dwell

TL;DR

This case report discusses the challenges of removing an IVC filter after 12 years due to strut penetration into the spine and artery.

Contribution

The report highlights a rare, long-term complication of IVC filters and successful removal despite complex anatomical issues.

Findings

Strut erosion into the L4 vertebral body occurred after 12 years of IVC filter placement.

Successful filter retrieval resolved the patient's symptoms and restored stability.

The patient remains stable on anticoagulation therapy post-removal.

Abstract

Temporary placement of inferior vena cava (IVC) filters for pulmonary embolism prevention is indicated for patients with contraindications to or unsuccessful anticoagulation therapy. However, timely IVC filter removal is necessary to avoid common complications, including filter strut penetration through the IVC wall into surrounding organs and structures. This report and describes IVC filter removal in a patient with symptomatic strut erosion into the L4 vertebral body and abutment of the proximal right common iliac artery, which was performed 12 years after placement. After filter retrieval, the patient's symptoms resolved, and he remains stable on anticoagulation therapy.

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