Monday, December 26, 2016

What Are The Risks of IVC Filter Removal?

IVC filter removal is generally regarded as a safe procedure that can be performed using minimally invasive techniques on an outpatient basis.

As with any endovascular procedure, filter retrieval imparts a risk of bleeding. This may occur from the incision (which typically ranges from 3-5mm) or from adherence of the filter components to the inferior vena cava. Significant bleeding from IVC filter removal is a rare phenomenon and is typically treated with mechanical pressure on the site of bleeding (either with manual compression or angioplasty balloon tamponade).
IVC filters may be fractured during retrieval, and fractured components may migrate to the chest. Fracture is usually the result of mechanical fatigue of the filter components, often seen in the setting of prolonged dwell times. For this reason, a detailed conversation regarding the risks of removing filters with prolonged dwell times is necessary. It should be emphasized that continuing to keep an IVC filter in place also may result in filter fracture and the risk-benefit of retrieval in these patients is not well known. Thus, these cases are determined on a case-by-case basis.

As previously discussed, filter struts may penetrate the IVC and enter structures such as the small intestines (common), bone (rare), and arteries (rare). In such cases, removal of the IVC filter imparts a small risk of damaging these structures. Again, the specific risks of filter removal in situations such as these must be considered on a case-by-case basis.

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