Presentation and treatment outcomes of patients with symptomatic inferior vena cava filters.
BACKGROUND
Use of inferior vena cava filters (IVCFs) has become more prevalent for the prevention of venous thromboembolism in part due to their ease of deployment and retrieval. Nonthrombotic complications of IVCFs are unusual but have been described. This study characterizes this cohort of patients and elucidates their clinical outcome.


METHODS
Between January 1, 2006 and December 31, 2011, six patients were identified with nonthrombotic symptoms attributed to their IVCF. Symptoms included abdominal/back pain, hypertension from renal artery compression, and hydroureter from ureteral compression.


RESULTS
The average age of the patients was 38.8 years (range 21 to 71 years) and all were female. Indication for IVCF placement included deep vein thrombosis (n = 2), deep vein thrombosis with pulmonary embolism (n = 1), and perioperative prophylaxis (n = 3). Filter types included the Ninitol Bard G2 (n = 3), Cook Celect (n = 1), Gunther Tulip (n = 1), and ALN (n = 1). The median time from IVCF placement to retrieval was 285 days (range 20 to 2091 days). At presentation, all IVCFs were tilted and had struts penetrating through the vena cava wall. Every IVCF was successfully removed: four by endovascular approach and two by open surgery. All patients had complete resolution of symptoms and there were no procedural complications.


CONCLUSIONS
Symptomatic IVCFs occur in female patients, and are always associated with device strut erosion outside the inferior vena cava. Successful retrieval can be safely achieved by an endovascular or open surgical technique, resulting in symptom resolution.
Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, 15 Parkman St., Boston, MA 02114, USA.
Junaid Y
JY
Malek
Christopher J
CJ
Kwolek
Mark F
MF
Conrad
Virendra I
VI
Patel
Michael T
MT
Watkins
R Todd
RT
Lancaster
Glenn M
GM
LaMuraglia
D015746:Abdominal Pain / Q000209:etiology / Q000628:therapy; D000328:Adult; D000368:Aged; D001416:Back Pain / Q000209:etiology / Q000628:therapy; D020878:Device Removal / Q000379:methods; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000209:etiology / Q000628:therapy; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D012078:Renal Artery Obstruction / Q000209:etiology / Q000628:therapy; D012086:Reoperation; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000209:etiology / Q000628:therapy; D016306:Vena Cava Filters / Q000009:adverse effects*; D054556:Venous Thromboembolism / Q000517:prevention & control*; D055815:Young Adult