An inferior vena cava (IVC) filter is often placed to prevent recurrent pulmonary thromboembolism (PTE), which is a major cause of death in patients suffering from deep vein thrombosis (DVT). There are various complications after placing an IVC filter. The incidence of filter migration, defined as <2-cm displacement from the initial location, is reportedly 1.3% . However, major migration, such as that to the heart, is a rare but life-threatening complication . We herein report a patient who underwent emergent operation for IVC filter migration to the heart. The ALN filter (ALN Implants Chirurgicaux, Bormes les Mimosas, France), which was used in our case, is a hydrodynamic retrievable IVC filter made from AISI 316 L stainless steel. It is characterized by six short legs that can adhere to the IVC wall and three long legs that can stabilize in the central position along the main axis of the vena cava . There is only one case report of major migration in which the ALN filter migrated significantly to the proximal IVC just below the right atrium. This patient had been asymptomatic, and the migration was found on the scheduled day of retrieval large amount of thrombus remained in the right iliac vein with inadequate anticoagulation after IVC filter placement. The migration may have occurred by increased venous pressure in the IVC because of trapping of the thrombus. Because the IVC filter is not enough to manage a large amount of deep vein thrombus, we should routinely begin adequate anticoagulation therapy, including intravenous administration of heparin sodium and oral warfarin potassium, immediately after insertion of the IVC filter as performed after the second operation.
Last date updated on June, 2014