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Open Inferior Vena Cava Filter Removal

Michael M. McNally, MD; Taylor M. Harris, BS; Michael B. Freeman, MD

Product Details
Product ID: ACS-5676
Year Produced: 2018
Length: 7 min.
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There are increasing reports describing complications from retrievable inferior vena cava filters, including IVC perforation, erosion into adjacent structures, migration, and filter fracture. This report and video focuses on the open surgical removal technique for inferior vena cava filters that have failed percutaneous retrieval. A 51-year-old woman presented with a history of an IVC filter and abdominal pain. The retrievable IVC filter was placed in 2017 following a diagnosis of pulmonary embolus. She was on chronic anticoagulation therapy with no further problems of venous occlusive disease. She recently underwent a prolonged and unsuccessful percutaneous attempt at IVC filter removal that resulted in filter malposition with the proximal tip in the right renal vein and penetration of struts through the vena cava abutting the duodenum. She reported increased positional abdominal pain after this unsuccessful procedure. Informed consent was obtained for an open IVC filter removal. The patient underwent an uncomplicated open IVC filter removal. The attached video depicts important technical aspects such as exposure of the IVC, ligation of lumbar veins, sequential IVC clamping/assessment and IVC filter removal. The patient had an uncomplicated postoperative hospital course. She was anticoagulated on postoperative day one and discharged home on postoperative day three. With the increasing number of late complications from unretrieved IVC filters, open inferior vena cava filter removal will be more frequently required. This video illustrates the steps for open surgical technique for removal of retrievable inferior vena cava filters.