August 3, 2016 — Doctors at Baylor University have published a case report of a young woman who experienced severe complications when an IVC filter was left in her body for more than six years.
The report (PDF) describes a 29 year-old female who was implanted with a temporary G2 filter made by C.R. Bard.
During an unrelated CT scan, doctors discovered that two legs of the G2 filter had fractured. The filter was also tilted more than 15º and was perforating her vena cava. The patient underwent emergency surgery.
The vena cava carries a massive amount of blood, but its walls are remarkably thin. With every heartbeat, the vena cava flexes and squeezes the IVC filter. Over time, this can weaken the filter and cause it to fracture. The chances of a perforation also increase.
The researchers blamed her injuries on “foreshortening and flattening” of the vena cava, warning:
“Transmitted motion can ultimately result in one of two fracture modes: high-cycle metal fatigue secondary to accumulated damage and metal overload sustained from acute stress.”
There is no clear reason why the filter was implanted so long. She had no evidence of blood clots, could walk, and had only remote bleeding.
In May 2014, the FDA asked doctors to remove temporary IVC filters within 29-54 days if possible. The risk of complications increases the longer it remains implanted.
Unfortunately, retrieval rates for IVC filters remain low. In one study of filters placed from 2001-2006, only 73 out of 240 patients (30%) had the filter removed. Doctors were also unsuccessful in removing the filter in 25% of patients.
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