title: Bard Denali inferior vena cava filter fracture and embolization resulting in cardiac tamponade: a device failure analysis.
abstract: A 46-year-old woman underwent inferior vena cava filter placement before bariatric surgery and returned within 6 months for routine removal. She complained of a 1-week history of severe chest pain, and during retrieval, two fractured filter components were identified including one arm in the right ventricle. The filter body and one fragment were successfully retrieved, but the fragment in the right ventricle was refractory to percutaneous retrieval. During open-heart surgery, the fragment was found traversing through the ventricular wall resulting in cardiac tamponade. Electron microscopic fragment analysis revealed high-cycle metal fatigue indicating the filter design failed to withstand this patient's natural inferior vena cava biomechanical motions.
authors.affiliation: Division of Vascular and Interventional Radiology, Department of Radiology, Stanford University Medical Center, 300 Pasteur Drive, H-3651, Stanford, CA 94305-5642.. Electronic address: wkuo@stanford.edu.
authors.forename: William T
authors.initials: WT
authors.lastname: Kuo
authors.affiliation: Fathom Engineering, Berkeley, California.
authors.forename: Scott W
authors.initials: SW
authors.lastname: Robertson
mesh_terms: D002305:Cardiac Tamponade / Q000209:etiology*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology*; D015641:Radiography, Interventional; D016306:Vena Cava Filters / Q000009:adverse effects*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging*