Inferior vena cava filters (IVC filters) are devices manufactured to prevent pulmonary embolism (PE), blood clots that travel to the heart or lungs. PE is the third most common cause of death in hospitals. While the IVC filter has saved lives, it also carries certain health risks including complications from: improper placement, remaining in the body too long, and the breaking and moving of the filter.
The function of IVC filters is to capture blood clots before they reach the heart or lungs. A doctor inserts the IVC into the inferior vena cava vein, the largest vein in the body. Without care, these blood clots can lead to a blockage of the pulmonary artery, which carries deoxygenated blood to the lungs, causing pulmonary embolism.
However, if the IVC filter migrates, it can perforate the vein or travel through the vein into other parts of the body. Filters can also break due to their extremely delicate nature, leaving fragments of the filter inside the body. Even IVC filters that successfully do their job can result in negative effects, especially if left in the body too long.
There are two types of IVC filter: temporary (retrievable) and permanent. The retrievable model is not built to last long, and therefore has a higher chance of splintering, migration, and perforation over time. Retrievable IVC filters often remain in the body too long, sometimes due to difficulties removing the IVC filter on the first attempt.
If an IVC filter is left in the body after the risk of PE has subsided, it could result in lower limb DVT, filter migration, filter perforation, and filter fractures. Risks increase the longer a filter is left inside of the body, and it becomes more difficult to retrieve. Other complications include bacteremia, or pathogenic bacteria in the blood, which can mean increased infection and longer hospital stays.
Out of 921 IVC filters with reported adverse reactions in 2010:
Migrating filters can travel through the IVC and reach the heart, lungs, or other organs, resulting in emergency surgery. In the case of an IVC filter with components detaching, the same risks apply, and surgery is required for immediate removal.
While the risk of PE is reduced using an IVC filter, the risk of deep vein thrombosis, or DVT, is increased. DVT is a blood clot in a deep vein, usually the leg. In patients with no prior evidence of DVT, 40% suffered incidences of DVT after an IVC placement.
Patient risk of caval thrombosis, another type of blood clot, is even higher, approaching 50% in a few studies. Caval thrombosis can cause painful swelling that, at its worst, can result in gangrene, sometimes resulting in limb removal. Risk of caval thrombosis increases the longer the IVC filter remains in the body.
There are also procedure-related complications that can arise from an IVC insertion, but these are usually minor:
Another complication related to IVC filter placement is malposition, in which the filter is not placed in the optimum position to stop a blood clot. Malposition cases will need surgery to repair. In some cases, the malpositioned IVC filter is left inside of the body if it’s in a location that isn’t dangerous to the patient, and a replacement IVC filter is given.
While there are potential benefits to IVC filters, a physician who doesn’t properly warn patients about their serious side effects can be found negligent, as can manufactures who knowingly provide faulty filters. Suffering from the effects of an IVC filter is difficult, but you don’t have to face it alone. Reach out to Sweeney Merrigan Law to discuss the ways in which we can help you or a loved one fight back.