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CASE REPORT
Expectoration of an inferior vena cava filter strut
  1. Stephen Mehanni1,
  2. Meghan Higley2,
  3. Ryan C Schenning3
  1. 1University of California San Francisco, Hospital Medicine, San Francisco, California, USA
  2. 2Department of Diagnostic Radiology, Oregon Health and Science University, Portland, Oregon, USA
  3. 3Department of Vascular and Interventional Radiology, Oregon Health and Science University, Portland, Oregon, USA
  1. Correspondence to Dr Stephen Mehanni, stephen.mehanni{at}ucsf.edu

Summary

Inferior vena cava (IVC) filter use is widespread in patients with venous thromboembolism (VTE) and temporary contraindication to anticoagulation, though timely removal is often not performed. We report the case of an expectoration of an IVC filter strut. Review of the patient's prior imaging confirmed an infrarenal Bard G2 filter with an absent strut, which was visualised in the left lung base. The strut was presumed to have embolised to a pulmonary artery branch and eroded into an adjacent bronchus. Subsequent fluoroscopically guided filter retrieval was successful. The incidence of IVC filter fractures increases with longer dwell times. Filter fragment embolisation has resulted in major adverse events, including sudden death and cardiac tamponade. Recent evidence has suggested that retrieval of IVC filters with prolonged dwell times is feasible and safe. This report brings awareness to the range of complications with indwelling IVC filters, and highlights the importance of timely removal.

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Footnotes

  • Contributors SM contributed to the conception and drafting of the manuscript, and agrees to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved. MH and RCS contributed to the design, acquisition, analysis and interpretation of data, revising the article critically, and approval of the final version to be published.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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