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Case Reports
. 2012 Jun;85(2):255-9.
Epub 2012 Jun 25.

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

Josephina Anna Vossen  1 , Shrey Kumar Thawait, Jennifer Susan Golia, Murthy Chamarthy, Walter Cholewczynski, Noel Velasco
Affiliations
Case Reports

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

Josephina Anna Vossen et al. Yale J Biol Med. 2012 Jun.

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.

Keywords: complications; fracture; inferior vena cava filter; migration; pulmonary embolism.

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Figures

Figure 1
Figure 1
A. Frontal chest X-ray 2 years after filter placement showing a single linear opacity in the right lower lung field (blue). B. Frontal chest X-ray 5 years after filter placement showing an additional linear metallic foreign body within the right lung (red).
Figure 2
Figure 2
A. Axial CT image demonstrating the Recovery filter within the inferior vena cava, in close relationship to the spine and right kidney. The six upper arms of the Recovery filter (numbered 1 to 6) and the six legs (not numbered) are intact. B. Axial CT image obtained 3 years later demonstrating a missing filter arm. C and D. Axial CT images obtained 4 years and 5 years later, respectively, demonstrating two missing filter arms.
Figure 3
Figure 3
A. Coronal reformatted CT image demonstrating flexion of one of the upper arms of the Recovery filter 3 years after initial filter placement. B. Coronal reformatted CT image obtained 1 year later demonstrating the previously flexed filter arm now to be missing. C. Coronal reformatted CT image obtained 6 months later showed another filter arm flexed upward.
Figure 4
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.
See this image and copyright information in PMC

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