• J. Vasc. Surg. · Jan 2014

    Review

    Strategies for prevention of iatrogenic inferior vena cava filter entrapment and dislodgement during central venous catheter placement.

    • Alex Wu, Naseem Helo, Eunice Moon, Matthew Tam, Baljendra Kapoor, and Weiping Wang.
    • Section of Interventional Radiology, Imaging Institute, Cleveland Clinic, Cleveland, Ohio.
    • J. Vasc. Surg. 2014 Jan 1;59(1):255-9.

    BackgroundIatrogenic migration of inferior vena cava (IVC) filters is a potentially life-threatening complication that can arise during blind insertion of central venous catheters when the guide wire becomes entangled with the filter. In this study, we reviewed the occurrence of iatrogenic migration of IVC filters in the literature and assessed methods for preventing this complication.MethodsA literature search was conducted to identify reports of filter/wire entrapment and subsequent IVC filter migration. Clinical outcomes and complications were identified.ResultsA total of 38 cases of filter/wire entrapment were identified. All of these cases involved J-tip guide wires. Filters included 23 Greenfield filters, 14 VenaTech filters, and one TrapEase filter. In 18 cases of filter/wire entrapment, there was migration of the filter to the heart and other central venous structures. Retrieval of the migrated filter was successful in only four of the 18 cases, and all of these cases were complicated by strut fracture and distant embolization of fragments. One patient required resuscitation during retrieval. Successful disengagement was possible in 20 cases without filter migration.ConclusionsIatrogenic migration of an IVC filter is an uncommon complication related to wire/filter entrapment. This complication can be prevented with knowledge of the patient's history, use of proper techniques when placing a central venous catheter, identification of wire entrapment at an early stage, and use of an appropriate technique to disengage an entrapped wire.Copyright © 2014 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

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