Inferior Vena Cava Filter Complications
We’ve been reading quite a few research studies on IVC Filter Complications that are commonly noticed in patients. We’ll also cover up the article with some figures, statistics and IVC Filter Complications Symptoms!
From a research of 1731 patients that had undergone an IVC Filter placement, death rate was found to be 5.6%. From these, 3.7% were deaths of Pulmonary Embolism with an average of 4 days after the insert. In 2.7% of the patients was found that Vena Cava Thrombosis had occurred.
Here’s an infographic for IVC Filter Complications and Risks.
(Infographic by BLOODTHINNERHELP)
Keep in mind that the research — conducted in year 2000 — had a sample of research from 25 years of IVC Filter insertion. Design, medical technology and more experienced practitioners have lowered those numbers considerably.
However, complications from IVC Filters and Greenfield Filters still exist, especially if proper care isn’t taken during placement and after it. Before exploring the risks of Inferior Vena Cava Filters, let’s see what increases the chance of Deep Vein Thrombosis or Pulmonary Embolism:
- Pregnant women
- Patients that are hospitalized
- Patients with cancer
- Smokers
- Surgery patients
- Patients having urologic, gynaecologic, bariatric, orthopaedic, spinal or neuro surgery
- People taking estrogen or birth control pills
- Major trauma patients
- Patients with spinal cord injury
- Patients on bed-rest
- People on extended car or plane rides
IVC FILTER COMPLICATIONS
There have been reported cases of problems during IVC Filter placement. These are quite low in rates and are due to incorrect insertion or incidents
- Pneumothorax or Hemothorax
- Vena Cava Thrombosis
- Bleeding at the insertion site
- Hematoma at the insertion site
- Air Embolism
- Infection at the insertion site
- Broken or misplaced chatheters
- Penetrated caval walls from filter legs
- Intravascular migration
- Caval Thrombosis
Adding to the list is a rare but very serious complication. As the IVC Filter or Greenfield Filter is supposed to catch blood clots from a Deep Vein Thrombosis, Pulmonary Embolism may occur or reoccur. This may happen from a misplaced filter by the practitioner, the source of embolism was from a upper-body thrombosis or from the creation of lateral veins in the abdomen that bypasses the filter.
POST-PLACEMENT COMPLICATIONS OF IVC FILTERS
Many patients report pain or discomfort at the insertion site, but this is usual and symptoms are self-limited in most cases. Severe pains are reported and are found to be due to fistulization, hematoma, Inferior Vena Cava perforation or filter erosion.
In case of severe pain, iatrogenic injury (doctors and practitioners mistake) should be considered. Imaging studies and proper intervention should be undertaken immediately to diagnose and treat the complications.
RECURRENT PULMONARY EMBOLISM
An IVC Filter or Greenfield Filter is a way to prevent Pulmonary Embolism, but it isn’t 100% sure to prevent it in the future. Also, it doesn’t cure Deep Vein Thrombosis and nothing stops it from occurring again.
However, from a study in 400 patients with a high risk for Pulmonary Embolism, half of the sample were patients with an IVC Filter and half without the filter.
At the end of the study, it was found that 4.8% of the non-filter patients had a recurring Pulmonary Embolism in contrast with 1.1% of filter patients. This study shows a very important fact, that an Inferior Vena Cava Filter not only is a very good solution in preventing PE, but also decreases the chances of happening in the future.
STRUCTURAL IVC FILTER FAILURE
Structural filter failure happens when the individual legs of the filter get malformed. This structural change may decrease significantly the filter’s efficiency in preventing Pulmonary Embolism. Also it may cause physical damage to the vena cave.
The incidence is reported to be as high as 2%-10%, but recent designs and materials have dramatically decreased this type of failure.
IVC FILTER MIGRATION
Filter migration may happen due to a practitioner’s error or from physical reasons. Measurement errors from differences in patient positioning, radio-graphic equipment variability or radio-graphic parallax are common issues.
Physical reasons include larger than normal vena cava diameter or inappropriate filter positioning. The walls of the vena cava are known to move during respiration or in changes of the intra-abdominal pressure.
GREENFIELD FILTER COMPLICATIONS
The Greenfield Filter is a permanent type of filter and the risks and complications associated with it are basically the same as other types of IVC Filters. As a permanent type, it has the risks of life-long complications.
(Originally Published on — IVC Filter Complications)