title: Open surgical removal of a tilted and dislodged inferior vena cava filter through a lumbar branch without cavotomy.
abstract: Retrievable inferior vena cava (IVC) filters decrease the risk of pulmonary embolism. Retrieval is recommended but device migration, tilting, or perforation of the IVC by the filter may prevent successful removal. We present a case of a tilted IVC filter with the retrieval hook lodged in a lumbar vein preventing endovascular removal. A subcostal incision was used for open removal. The thrombosed lumbar vein was encircled with vessel loops, facilitating collapse of the filter. No cavotomy was made. This technique, with minimal variation, can be used to remove most nonthrombosed retrievable filters from the IVC, without the need for venotomy.
authors.affiliation: Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn.
authors.forename: Nanette R
authors.initials: NR
authors.lastname: Reed
authors.affiliation: Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn. Electronic address: gloviczki.peter@mayo.edu.
authors.forename: Peter
authors.initials: P
authors.lastname: Gloviczki
authors.affiliation: Division of Vascular and Interventional Radiology, Mayo Clinic, Rochester, Minn.
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Stockland
authors.affiliation: Cardiovascular Division, Mayo Clinic, Rochester, Minn.
authors.forename: Robert D
authors.initials: RD
authors.lastname: McBane