Skip to main content

Mechanism and Approach to Fractured Filters

  • Chapter
  • First Online:
Placement and Retrieval of Inferior Vena Cava Filters

Abstract

The unintended consequence of implanted medical devices, like inferior vena cava filters, is metallic component fatigue and fracture. Filter fragments pose potentially dire health risks to patients, both immediately and potentially long term as well. Interventional radiologists play a key role in the management of fractured IVC filter fragments. Strategies include avoiding inadvertent fracture during retrieval, using advanced endovascular techniques for retrieval, and careful surveillance of retained fragments.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Greenfield LJ, The PREPIC Study Group. Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism: the PREPIC (Prevention du Risque d’Embolie Pulmonaire par Interruption Cave) Randomized Study. Perspect Vasc Surg Endovasc Ther. 2006;18(2):187–8.

    Article  Google Scholar 

  2. Durack JC, et al. Perforation of the IVC: rule rather than exception after longer indwelling times for the Gunther Tulip and Celect retrievable filters. Cardiovasc Intervent Radiol. 2012;35(2):299–308.

    Article  Google Scholar 

  3. Becher RD, et al. Late erosion of a prophylactic Celect IVC filter into the aorta, right renal artery, and duodenal wall. J Vasc Surg. 2010;52(4):1041–4.

    Article  Google Scholar 

  4. Saeed I, Garcia M, McNicholas K. Right ventricular migration of a recovery IVC filter’s fractured wire with subsequent pericardial tamponade. Cardiovasc Intervent Radiol. 2006;29(4):685–6.

    Article  Google Scholar 

  5. Buehler WJ, Gilfrich JV, Wiley RC. Effects of low-temperature phase changes on the mechanical properties of alloys near composition TiNi. J Appl Phys. 1963;34(5):1475–7.

    Article  CAS  Google Scholar 

  6. Jia Z, et al. Allergic reaction following implantation of a nitinol alloy inferior vena cava filter. J Vasc Interv Radiol. 2015;26(9):1375–7.

    Article  Google Scholar 

  7. Lin ZN, Denison A. Medical device materials II: proceedings of materials and processes for medical devices nitinol fatigue resistance—a strong function of surface quality; 2004.

    Google Scholar 

  8. Hull JE, Robertson SW. Bard recovery filter: evaluation and management of vena cava limb perforation, fracture, and migration. J Vasc Interv Radiol. 2009;20(1):52–60.

    Article  Google Scholar 

  9. Sano M, et al. Frequent fracture of TrapEase inferior vena cava filters: a long-term follow-up assessment. Arch Intern Med. 2012;172(2):189–91.

    Article  Google Scholar 

  10. Laborda A, et al. Influence of breathing movements and Valsalva maneuver on vena caval dynamics. World J Radiol. 2014;6(10):833–9.

    Article  Google Scholar 

  11. Kuo WT, et al. Complex retrieval of fractured, embedded, and penetrating inferior vena cava filters: a prospective study with histologic and electron microscopic analysis. J Vasc Interv Radiol. 2013;24(5):622–630 e1; quiz 631.

    Article  Google Scholar 

  12. Ferris EJ, et al. Percutaneous inferior vena caval filters: follow-up of seven designs in 320 patients. Radiology. 1993;188(3):851–6.

    Article  CAS  Google Scholar 

  13. McCowan TC, et al. Complications of the nitinol vena caval filter. J Vasc Interv Radiol. 1992;3(2):401–8.

    Article  CAS  Google Scholar 

  14. Tam MD, et al. Fracture and distant migration of the Bard Recovery filter: a retrospective review of 363 implantations for potentially life-threatening complications. J Vasc Interv Radiol. 2012;23(2):199–205. e1

    Article  Google Scholar 

  15. Nicholson W, et al. Prevalence of fracture and fragment embolization of Bard retrievable vena cava filters and clinical implications including cardiac perforation and tamponade. Arch Intern Med. 2010;170(20):1827–31.

    Article  Google Scholar 

  16. Hull JE, Han J, Giessel GM. Retrieval of the recovery filter after arm perforation, fracture, and migration to the right ventricle. J Vasc Interv Radiol. 2008;19(7):1107–11.

    Article  Google Scholar 

  17. Desjardins B, Kamath SH, Williams D. Fragmentation, embolization, and left ventricular perforation of a recovery filter. J Vasc Interv Radiol. 2010;21(8):1293–6.

    Article  Google Scholar 

  18. Vijay K, et al. Fractured Bard Recovery, G2, and G2 express inferior vena cava filters: incidence, clinical consequences, and outcomes of removal attempts. J Vasc Interv Radiol. 2012;23(2):188–94.

    Article  Google Scholar 

  19. An T, et al. Prevalence and clinical consequences of fracture and fragment migration of the Bard G2 filter: imaging and clinical follow-up in 684 implantations. J Vasc Interv Radiol. 2014;25(6):941–8.

    Article  Google Scholar 

  20. Stavropoulos SW, et al. The DENALI Trial: an interim analysis of a prospective, multicenter study of the Denali retrievable inferior vena cava filter. J Vasc Interv Radiol. 2014;25(10):1497–505, 1505 e1.

    Article  Google Scholar 

  21. Kuo WT, Robertson SW. Bard Denali inferior vena cava filter fracture and embolization resulting in cardiac tamponade: a device failure analysis. J Vasc Interv Radiol. 2015;26(1):111–5. e1

    Article  Google Scholar 

  22. Zhou D, et al. Retrospective review of 120 celect inferior vena cava filter retrievals: experience at a single institution. J Vasc Interv Radiol. 2012;23(12):1557–63.

    Article  Google Scholar 

  23. Wang W, et al. Fracture and migration of Celect inferior vena cava filters: a retrospective review of 741 consecutive implantations. J Vasc Interv Radiol. 2013;24(11):1719–22.

    Article  Google Scholar 

  24. Hoffer EK, et al. Safety and efficacy of the Gunther Tulip retrievable vena cava filter: midterm outcomes. Cardiovasc Intervent Radiol. 2013;36(4):998–1005.

    Article  Google Scholar 

  25. Iqbal SI, et al. Preliminary experience with option inferior vena cava filter. Vasc Endovasc Surg. 2013;47(1):24–9.

    Article  Google Scholar 

  26. Tsui B, et al. Retrospective review of 516 implantations of option inferior vena cava filters at a single health care system. J Vasc Interv Radiol. 2016;27(3):345–53.

    Article  Google Scholar 

  27. Trerotola SO, Stavropoulos SW. Management of fractured inferior vena cava filters: outcomes by fragment location. Radiology. 2017;284(3):887–96.

    Article  Google Scholar 

  28. Jia Z, et al. Caval penetration by inferior vena cava filters: a systematic literature review of clinical significance and management. Circulation. 2015;132(10):944–52.

    Article  Google Scholar 

  29. Kesselman AJ, et al. Endovascular removal of fractured inferior vena cava filter fragments: 5-year registry data with prospective outcomes on retained fragments. J Vasc Interv Radiol. 2018;29(6):758–64.

    Article  Google Scholar 

  30. Stavropoulos SW, et al. Embedded inferior vena cava filter removal: use of endobronchial forceps. J Vasc Interv Radiol. 2008;19(9):1297–301.

    Article  Google Scholar 

  31. Mintz JD, Stavropoulos SW, Trerotola SO. Is a venacavogram necessary after inferior vena cava filter retrieval? J Vasc Interv Radiol. 2016;27(12):1857–64.

    Article  Google Scholar 

  32. Kalva SP, et al. “Recovery” vena cava filter: experience in 96 patients. Cardiovasc Intervent Radiol. 2006;29(4):559–64.

    Article  Google Scholar 

  33. Duncan C, Trerotola SO, Stavropoulos SW. Endovascular removal of inferior vena cava filters with arterial penetration. J Vasc Interv Radiol. 2018;29(4):486–90.

    Article  Google Scholar 

  34. Yoshida Rde A, et al. Endovascular treatment of late aortic perforation due to vena cava filter. Ann Vasc Surg. 2012;26(6):859 e9–12.

    Google Scholar 

  35. Haga M, et al. Penetration of an inferior vena cava filter into the aorta. Ann Vasc Dis. 2014;7(4):413–6.

    Article  Google Scholar 

  36. Malgor RD, et al. Persistent abdominal pain caused by an inferior vena cava filter protruding into the duodenum and the aortic wall. Ann Vasc Surg. 2012;26(6):858 e3–6.

    Article  Google Scholar 

  37. Knavel EM, et al. Complex inferior vena cava filter retrieval complicated by migration of filter fragment into the aorta and subsequent distal embolization. J Vasc Interv Radiol. 2016;27(12):1865–8.

    Article  Google Scholar 

  38. Holly BP, et al. Vena cava filter retrieval with aorto-iliac arterial strut penetration. Cardiovasc Intervent Radiol. 2018;41(8):1184–8.

    Article  Google Scholar 

  39. Hannawa KK, et al. Percutaneous extraction of embolized intracardiac inferior vena cava filter struts using fused Intracardiac ultrasound and electroanatomic mapping. J Vasc Interv Radiol. 2015;26(9):1368–74.

    Article  Google Scholar 

  40. Thakur K, et al. Wire in the heart: fracture and fragment embolization of retrievable inferior vena cava filter into the right ventricle. Case Rep Cardiol. 2015;2015:938184.

    PubMed  PubMed Central  Google Scholar 

  41. Mehanni S, Higley M, Schenning RC. Expectoration of an inferior vena cava filter strut. BMJ Case Rep. 2016;2016.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert K. Ryu .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Hong, M., Brown, M.A., Ryu, R.K. (2020). Mechanism and Approach to Fractured Filters. In: Desai, K., Ahmed, O., Van Ha, T. (eds) Placement and Retrieval of Inferior Vena Cava Filters. Springer, Cham. https://doi.org/10.1007/978-3-030-45150-9_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-45150-9_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-45149-3

  • Online ISBN: 978-3-030-45150-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics