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Article Abstract

This case report describes a 52-year-old male patient, with the incidental finding of inferior vena cava filter (IVCF) fragments impacted into the right ventricle, secondary to IVCF fragmentation and subsequent embolization. While IVCFs are prescribed to prevent pulmonary embolizations when anticoagulation is either contraindicated, or has failed, IVCF embolizations to the heart represent an extremely rare, but potentially life-threatening complication. Of note, at the time of writing, the utility and effectiveness of IVCF are not fully established. Intracardiac embolizations of IVCF typically present with complications such as hypotension, cardiac tamponade, arrhythmias, ventricle perforation, bleeding, cardiac arrest, and death. To our knowledge, this is the first case report of an asymptomatic kidney transplant recipient found to have right ventricle embolizations of IVCF fragments through routine assessment. Additionally, this is also the first report of an asymptomatic patient who presented IVCF fragments embolized to the right ventricle and left gonadal vein in the same clinical setting.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068924PMC
http://dx.doi.org/10.1055/s-0041-1730451DOI Listing

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Article Synopsis
  • Retrievable inferior vena cava filters (IVCF) were developed to reduce the risk of recurrent deep vein thrombosis compared to permanent filters.
  • A study of 85 patients who underwent IVCF retrieval found that intrafilter thrombi were present in 81% of cases, while 88% had venous wall fragments.
  • Despite these findings, the presence of thrombi or fragments did not correlate with an increased risk of recurrent venous thromboembolism or death within three months after retrieval.
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This case report describes a 52-year-old male patient, with the incidental finding of inferior vena cava filter (IVCF) fragments impacted into the right ventricle, secondary to IVCF fragmentation and subsequent embolization. While IVCFs are prescribed to prevent pulmonary embolizations when anticoagulation is either contraindicated, or has failed, IVCF embolizations to the heart represent an extremely rare, but potentially life-threatening complication. Of note, at the time of writing, the utility and effectiveness of IVCF are not fully established.

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Inferior vena cava filters (IVCFs) are metal alloy devices that mechanically trap fragmented thromboemboli from the deep leg veins en route to the pulmonary circulation. Filters are introduced (and in the case of retrievable filters, removed) percutaneously. Although their deployment seems of theoretical benefit, their clinical efficacy and adverse event profile are unclear because there are very few controlled and randomized data.

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