Fractured Bard Recovery, G2, and G2 Express Inferior Vena Cava Filters: Incidence, Clinical Consequences, and Outcomes of Removal Attempts

Vijay, Kanupriya; Hughes, J. A.; Burdette, Allene; Scorza, Leslie B.; Singh, Harjit; Waybill, Peter N.; Lynch, Frank C.

doi:10.1016/j.jvir.2011.10.005

Cited by 66 publications

(51 citation statements)

References 14 publications

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“…Similarly, only 30% of patients in the study by Kalva et al [10] had follow-up for more than 1 year, and according to the authors of the Tam et al study [11], only 50% of their patients had follow-up imaging longer than 4 months. Finally, only those patients presenting back for filter retrieval were included in the study reported by Vijay et al [12]. In contrast, only 21 of the 143 (14.7%) deceased subjects in this study had no follow-up imaging prior to their deaths.…”

Section: Discussionmentioning

confidence: 94%

“…Vijay et al reported a total of 63 of 548 fractured Recovery, G2, and G2 Express IVC filters, for an overall fracture rate of 12%, with a distal embolization rate of fractured filter components of 13% at a mean dwell time of 22.7 months [12]. There were no immediate clinically significant complications associated with fracture component embolization or filter removal.…”

Section: Discussionmentioning

confidence: 99%

“…Vijay et al hypothesized that how and where the device was placed could be a major contributing factor, in addition to the various formulations of nitinol, most of which have electropolished surfaces. Potential factors that could accelerate fatigue and predispose filters to fracture include filters placed with elements engaged into renal veins or other vessels, filters that migrate, tilt, or perforate the IVC, and maldeployment [12].…”

Section: Discussionmentioning

confidence: 99%

“…In the study by Nicholson et al [6], malignant neoplasm prophylaxis was the indication for only 4% and 2% of patients receiving Recovery and G2 filters, respectively. In the study by Vijay et al [12], cancer was not listed as one of their indications for filter placement. Given the generally older age and higher incidence of cancer in patients included in this study, many of these patients may not have survived long enough to detect long-term IVC filter complications.…”

Section: Discussionmentioning

confidence: 99%

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Fracture Rate and Serious Complications of Vena Cava Filters

Mitsunaga¹,

Yoon²

2013

OJRad

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Purpose: To retrospectively evaluate the prevalence of fracture and fragment embolization of inferior vena cava (IVC) filters. Methods: Electronic medical records and imaging studies of all Kaiser Permanente patients who received IVC filters from August 2000 until August 2010 were retrospectively reviewed for filter complications. Results: 283 patients received an IVC filter during the study period. 143 patients were deceased, while 140 are living. Among deceased patients, the average age at the time of death was 69.8 ± 15.3 [range: 24.7 -99.2] years; 55.9% were men; the mean implantation-to-image time was 13.6 ± 20.6 [range: 0 -92.4] months, and there were no reported major complications attributable to filter migration or fracture at a mean of 16.8 ± 24.8 [range: 0 -119.6] months following implantation. One of 14 (7.1%) G2 filters perforated the aorta, which already had a stent graft in place. Among those patients still living, the average age was 67.3 ± 15.2 [range: 15.2 -97.3] years, 47.1% were men, the mean implantation-to-image time was 33.3 ± 36.5 [range: 0.1-141.7] months, and there were no reported major complications at a mean of 35.3 ± 36.5 [range: 0 -141.7] months following implantation. Three of 60 (5.0%) Trapease filters were found to have at least 1 strut fracture. There were no cases of filter migration or fragment embolization. The overall fracture rate of all filters with an implantation-to-image-time greater than two years (mean implantation-to-image time 4.7 ± 2.7 [range: 2.0 -11.8] years) was 3 of 67 (4.5%). Bard G2 and G2X filters had a 0% fracture and embolization rate at a mean of 19.0 ± 16.6 [range: 0.07 -49.5] months after implantation. Conclusions: IVC filters, regardless of type, have a low prevalence of fracture and we found no cases of fragment embolization.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Fracture Rate and Serious Complications of Vena Cava Filters

Mitsunaga¹,

Yoon²

2013

OJRad

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“…In addition, each patient who has a retrievable filter should be considered for filter retrieval. Vijay and associates 8 retrospectively reviewed a database of fractured IVC filters, to understand the risks of IVC filter fracture and embolization and the safety of removing fractured filters. In 63 fractured Recovery, G2, and G2 Express ® IVC filters identified in 548 patients, the overall fracture rate was nearly 12%.…”

Section: Discussionmentioning

confidence: 99%

Fractured Inferior Vena Cava Filter Strut Presenting with ST-Segment Elevation and Cardiac Tamponade

Khurana¹,

Raza²,

Abrol³

et al. 2015

Texas Heart Institute Journal

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The fracture of an inferior vena cava filter strut and its migration to the heart is a rare sequela of implanted inferior vena cava filters. Perforation I nferior vena cava (IVC) filters were first introduced in 1967, to prevent pulmonary embolism (PE) when anticoagulation is contraindicated or has failed in patients who have venous thromboembolic disease. In addition, IVC filters are used prophylactically in patients who have a high risk of PE. Implanted IVC filters are associated with such long-term sequelae as thrombotic occlusion of the IVC, vena cava perforation, and filter dislocation and migration. Inferior vena cava filter fracture has been reported in less than 1% of cases, 2 and the fracture of an IVC filter strut with its subsequent migration to the heart is apparently even less frequent. 3 We report the case of a man who presented with ST-segment elevation and cardiac tamponade after an IVC filter strut fractured, migrated, and perforated his right ventricle (RV). We also briefly review the relevant medical literature. Case ReportIn November 2010, a 53-year-old man presented at the emergency department 5 hours after the sudden onset of left-sided chest pain. His medical history included intracranial hemorrhage after head trauma 5 years earlier; afterwards, he had experienced seizures that were treated with antiepileptic medications. He had also had a Bard G2 ® retrievable IVC filter placed during his hospitalization for the intracranial hemorrhage; however, he did not report this to the physicians at the current admission. His vital signs on admission included a blood pressure of 90/56 mmHg, a heart rate of 101 beats/min, a respiration rate of 19 breaths/min, and an oxygen saturation of 98% on room air. An electrocardiogram showed sinus tachycardia at the rate of 117 beats/min and ST-segment elevation in the inferior leads.The patient was started on intravenous fluids and a dopamine infusion and was urgently taken to the cardiac catheterization laboratory. During angiography, the patient became hemodynamically unstable; his systolic blood pressure fell to 60 mmHg. Left-sided heart catheterization was performed through femoral access. The left main coronary artery was normal. There was an eccentric 70% stenosis in the proximal left anterior descending coronary artery (LAD) and a 60% stenosis in the mid-LAD. The first obtuse marginal branch was large and had an 80% stenosis. The ostial right coronary artery (RCA) had a 75% stenosis, and the mid RCA had a 70% stenosis. The patient's left ventricular ejection fraction (calculated by means of contrast ventriculography) was 0.70. During fluoroscopy, a small metal object was visible in the Case Reports

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