TITLE:
Fracture Rate and Serious Complications of Vena Cava Filters
AUTHORS:
Myles M. Mitsunaga, Hyo-Chun Yoon
KEYWORDS:
Venous Thromboembolism; Inferior Vena Cava; IVC Filters; Pulmonary Embolism; Deep Venous Thrombosis; Complications
JOURNAL NAME:
Open Journal of Radiology,
Vol.3 No.2,
June
20,
2013
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.