Share This Article:

Fracture Rate and Serious Complications of Vena Cava Filters

Full-Text HTML Download Download as PDF (Size:383KB) PP. 85-90
DOI: 10.4236/ojrad.2013.32013    3,783 Downloads   5,374 Views   Citations

ABSTRACT

Purpose: To retrospectively evaluate the prevalence of fracture and fragment embolization of inferior vena cava (IVC) filters. Methods: Electronic medical records and imaging studies of all Kaiser Permanente patients who received IVC filters from August 2000 until August 2010 were retrospectively reviewed for filter complications. Results: 283 patients received an IVC filter during the study period. 143 patients were deceased, while 140 are living. Among deceased patients, the average age at the time of death was 69.8 ± 15.3 [range: 24.7 - 99.2] years; 55.9% were men; the mean implantation-to-image time was 13.6 ± 20.6 [range: 0 - 92.4] months, and there were no reported major complications attributable to filter migration or fracture at a mean of 16.8 ± 24.8 [range: 0 - 119.6] months following implantation. One of 14 (7.1%) G2 filters perforated the aorta, which already had a stent graft in place. Among those patients still living, the average age was 67.3 ± 15.2 [range: 15.2 - 97.3] years, 47.1% were men, the mean implantation-to-image time was 33.3 ± 36.5 [range: 0.1-141.7] months, and there were no reported major complications at a mean of 35.3 ± 36.5 [range: 0 - 141.7] months following implantation. Three of 60 (5.0%) Trapease filters were found to have at least 1 strut fracture. There were no cases of filter migration or fragment embolization. The overall fracture rate of all filters with an implantation-to-image-time greater than two years (mean implantation-to-image time 4.7 ± 2.7 [range: 2.0 - 11.8] years) was 3 of 67 (4.5%). Bard G2 and G2X filters had a 0% fracture and embolization rate at a mean of 19.0 ± 16.6 [range: 0.07 - 49.5] months after implantation. Conclusions: IVC filters, regardless of type, have a low prevalence of fracture and we found no cases of fragment embolization.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

M. Mitsunaga and H. Yoon, "Fracture Rate and Serious Complications of Vena Cava Filters," Open Journal of Radiology, Vol. 3 No. 2, 2013, pp. 85-90. doi: 10.4236/ojrad.2013.32013.

References

[1] M. D. Silverstein, J. A. Heit, D. N. Mohr, T. M. Petterson, W. M. O’Fallon and L. J. Melton Ⅲ, “Trends in the Incidence of Deep Vein Thrombosis and Pulmonary Embolism: A 25-Year Population-Based Study,” Archives of Internal Medicine, Vol. 158, No. 6, 1998, pp. 585-593. doi.org/10.1001/archinte.158.6.585
[2] I. A. Naess, S. C. Christiansen, P. Romundstad, S. C. Cannegieter, F. R. Rosendaal and J. Hammerstrom, “Incidence and Mortality of Venous Thrombosis: A Population-Based Study,” Journal of Thrombosis and Haemostasis, Vol. 5, No. 4, 2007, pp. 692-699. doi:10.1111/j.1538-7836.2007.02450.x
[3] J. A. Heit, M. D. Silverstein, D. N. Mohr, T. M. Petterson, W. M. O’Fallon and L. J. Melton Ⅲ, “Predictors of Survival after Deep Vein Thrombosis and Pulmonary Embolism: A Population-Based, Cohort Study,” Archives of Internal Medicine, Vol. 159, No. 5, 1999, pp. 445-453. doi:10.1001/archinte.159.5.445
[4] S. Laporte, P. Mismetti, H. Decousus, F. Uresandi, R. Otero, J. L. Lobo and M. Monreal, “Clinical Predictors for Fatal Pulmonary Embolism in 15,520 Patients with Venous Thromboembolism: Findings from the Registro Informatizado de la Enfermedad Trombo Embolica Venosa (RIETE) Registry,” Circulation, Vol. 117, No. 13, 2008, pp. 1711-1716. doi:10.1161/CIRCULATIONAHA.107.726232
[5] L. J. Greenfield and M. C. Proctor, “Filter Complications and Their Management,” Seminars in Vascular Surgery, Vol. 13, No. 3, 2000, pp. 213-216.
[6] W. Nicholson, W. J. Nicholson, P. Tolerico, B. Taylor, S. Solomon, T. Schryver, K. McCullum, H. Goldberg, J. Mills, B. Schuler, L. Shears, L. Siddoway, N. Agarwal and C. Tuohy, “Prevalence of Fracture and Fragment Embolization of Bard Retrievable Vena Cava Filters and Clinical Implications Including Cardiac Perforation and Tamponade,” Archives of Internal Medicine, Vol. 170, No. 20, 2010, pp. 1827-1831. doi:10.1001/archinternmed.2010.316
[7] U.S. Food and Drug Administration, “Removing Retrievable Inferior Vena Cava Filters: Initial Communication,” 2010. http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm221676.htm
[8] S. P. Kumar, A. Mahtabifard and J. N. Young, “Fractured Inferior Vena Cava Filter Strut Presenting as a Penetrating Foreign Body in the Right Ventricle: Report of a Case,” Journal of Cardiac Surgery, Vol. 23, No. 4, 2008, pp. 378-381. doi:10.1111/j.1540-8191.2007.00539.x
[9] I. Saeed, M. Garcia and K. McNicholas, “Right Ventricular Migration of a Recovery IVC Filter’s Fractured Wire with Subsequent Pericardial Tamponade,” CardioVascular and Interventional Radiology, Vol. 29, No. 4, 2006, pp. 685-686. doi:10.1007/s00270-005-0136-7
[10] S. P. Kalva, S. Wicky, A. C. Waltman and C. A. Athanasoulis, “Trapease Vena Cava Filter: Experience in 751 Patients,” Journal of Endovascular Therapy, Vol. 13, No. 3, 2006, pp. 365-372. doi:10.1583/05-1741.1
[11] M. D. Tam, J. Spain, M. Lieber, M. Geisinger, M. J. Sands and W. Wang, “Fracture and Distant Migration of the Bard Recovery filter: A Retrospective Review of 363 Implantations for Potentially Life-Threatening Complications,” Journal of Vascular and Interventional Radiology, Vol. 23, No. 2, 2012, pp. 199-205.
[12] K. Vijay, J. A. Hughes, A. S. Burdette, L. B. Scorza, H. Singh, P. N. Waybill and F. C. Lynch, “Fractured Bard Recovery, G2, and G2 Express Inferior Vena Cava Filters: Incidence, Clinical Consequences, and Outcomes of Removal Attempts,” Journal of Vascular and Interventional Radiology, Vol. 23, No. 2, 2012, pp. 188-194. doi:10.1016/j.jvir.2011.10.005
[13] M. A. Singer and S. L. Wang, “Modeling Blood Flow in a Tilted Inferior Vena Cava Filter: Does Tilt Adversely Affect Hemodynamics?” Journal of Vascular and Interventional Radiology, Vol. 22, No. 2, 2011, pp. 229-235. doi:10.1016/j.jvir.2010.09.032
[14] X. Zhu, M. D. Tam, J. Bartholomew, J. S. Newman, M. J. Sands and W. Wang, “Retrievability and Device-Related Complications of the G2 Filter: A Retrospective Study of 139 Filter Retrievals,” Journal of Vascular and Interventional Radiology, Vol. 22, No. 6, 2011, pp. 806-812. doi:10.1016/j.jvir.2011.01.430

  
comments powered by Disqus

Copyright © 2018 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.