Percutaneous Retrieval of IVC Filters With Struts Penetrating the Vertebral Body

Vascular and Endovascular Surgery
Prasoon P MohanJason T Salsamendi

Abstract

Inferior vena cava (IVC) filter penetration of the caval wall is a well-documented complication. Less frequently, the struts of an IVC filter can penetrate a vertebral body that can lead to symptoms of abdominal pain. Vertebral penetration poses a management challenge, and characteristics for successful endovascular retrieval of such filters has not been reported. We present 2 cases of IVC filters with vertebral body penetration that were successfully retrieved through an endovascular approach. On preprocedure computed tomography, both patients had a small zone of osteolysis surrounding the penetrated struts into the vertebral body. The procedures were done via right internal jugular access using an Ensnare device. In one of the cases, the hangman technique was used to release the filter apex from the vessel wall. Both filters were able to be retrieved without using excessive force, follow-up venacavograms showed no sign of extravasation, and no postprocedure complications developed. Preprocedure CT imaging is essential prior to IVC filter removal if vertebral penetration is suspected. The zone of osteolysis seen around the struts in both cases are likely the result of constant cardiorespiratory motion of the filter. Based on t...Continue Reading

References

Feb 5, 2013·QJM : Monthly Journal of the Association of Physicians·K ShaheenM C Alraies
Mar 20, 2016·Journal of Vascular Surgery. Venous and Lymphatic Disorders·Elizabeth A GenoveseRabih A Chaer
May 13, 2017·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·S Regus, W Lang

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Citations

Sep 19, 2020·Journal of Vascular Surgery. Venous and Lymphatic Disorders·Joseph KalliniRichard J Van Allan
Oct 10, 2020·Current Problems in Diagnostic Radiology·Benjamin J McCaffertyAndrew J Gunn

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