Extravascular Migration of a Fractured Inferior Vena Cava Filter Strut

Abstract

A 20-year-old man presented with a femur fracture and epidural hemorrhage (EDH) following a fall. One month after fracture surgery, swelling developed in both legs, and he was diagnosed as having a deep-vein thrombosis and pulmonary embolism. A retrievable inferior vena cava filter (IVCF) was inserted, because EDH is a contraindication to anticoagulants. Four months later, he complained of abdominal pain, and a computed tomography scan showed a fractured IVCF strut. After percutaneous removal failed 3 times, the IVCF was surgically removed by orthopedists using a portable image intensifier without cardiopulmonary bypass.

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

“…Fracture of the IVC strut occurs in 3.4% of patients who have had an IVC filter [ 5 ]. Different mechanisms [ 6 , 7 ] were proposed for the limb fracture, including tilting of the filter, continuous strain on the engaged strut, and metal fatigue.…”

“…Different mechanisms [ 6 , 7 ] were proposed for the limb fracture, including tilting of the filter, continuous strain on the engaged strut, and metal fatigue. Migration of fractured IVC filter limb is occasionally reported, with an estimated incidence of 5% [ 5 ]. Filter migration was defined as change of position of more than 1 cm in either cephalic or caudal direction compared to the immediate post-placement film [ 8 ].…”

“…The number of IVC filter-related complications has increased with their growing utilization; these include [ 2 , 3 ] IVC thrombosis, filter migration, erosion or fracture. A broken filter strut can migrate inside the cardiovascular system, or penetrate vessels walls toward extravascular structures [ 4 , 5 ]. We report an extremely rare case of IVC filter fractured limb that migrated toward the pancreatic tail, manifested as chronic distal pancreatitis and possibly promoted metaplasia and neo-plastic transformation.…”