Vena cava filter migration: an unappreciated complication. About four cases and review of the literature.
Inferior vena cava filter placement is performed to prevent pulmonary risk secondary to deep venous thrombosis. Indications for this treatment are limited to patients experiencing recurrences under well-managed anticoagulant treatment or presenting with contraindication to anticoagulant treatment. Nowadays, as these clinical situations are rare, this device is less and less used, all the more since, for several years now, thrombosis, fracture, or infectious complications as well as filter migration have been reported. Filter migrations are responsible for atypical and varied clinical presentations likely to defer diagnosis. To treat them, the filter is extracted, which is very risky in patients with a thromboembolic history. In our center, during a period of 14 years, we retrospectively collected and studied partial or complete vena cava filter migration cases that had been treated by extraction. We are reporting four very different clinical cases and, more specifically, the second published case of migration to a renal vein, which mimicked a systemic disease. Because of its very atypical clinical presentations, cava filter migration is an unappreciated and certainly underdiagnosed complication. However, this complication must not question cava filter placement when it is justified. In contrast, it prompts early filter extraction or long-term radiological surveillance.
Service de Médecine Interne, Université de la Méditerranée, Assistance Publique Hôpitaux de Marseille, Hôpital de la Timone, Marseille, France. pauline.belenotti@ap-hm.fr
Pauline
P
Bélénotti
Gabrielle
G
Sarlon-Bartoli
Michel-Alain
MA
Bartoli
Audrey
A
Benyamine
Benjamin
B
Thevenin
Cyril
C
Muller
Jacques
J
Serratrice
Pierre-Edouard
PE
Magnan
Pierre-Jean
PJ
Weiller
D000328:Adult; D020878:Device Removal; D005260:Female; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D016306:Vena Cava Filters / Q000009:adverse effects*