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IVC Filters - Ticking Time Bombs

By: Robert L. Shepherd, MS, Certified Medical Illustrator, President & CEO, MediVisuals Inc.

IVC (Inferior Vena Cava) Filters are implanted in patients who physicians feel might be at high risk for DVT (Deep Vein Thrombosis).  DVT is a condition resulting in formation of clots in the veins of the lower extremities - primarily due to inactivity while hospitalized.  IVC filters are placed as a precautionary measure to prevent the blood clots in the leg veins from breaking off and traveling to the heart and lungs (pulmonary emboli).  Pulmonary emboli can vary greatly in their severity.  Major pulmonary emboli can stop the flow of blood to the lungs and cause almost immediate death.  

Many IVC filters are designed to be removed once the patient is no longer at high risk for DVT.  The filters are placed in the IVC just below the level of the renal veins (see the below figure).  An excellent public awareness video addressing the risks of these devices can be seen below or by using the following link: https://youtu.be/cyFkhnNLXoI

Tuesday November 15, 2016

Figure 1: Public awareness video addressing the risks of the IVC (Inferior Vena Cava) filters. 

Unfortunately, those filters that are not designed to be removed, or those that are designed to be removed but are not removed for some reason, pose significant risks: they are essentially time bombs.  The risks involved with retained IVC filters include erosion of the legs through the walls of the IVC (see the below illustration) and into surrounding major blood vessels, such as the aorta, or into nearby major organs, such as the intestines.

Figure 2:  The risks involved with retained IVC filters include erosion of the legs through the walls of the IVC and into surrounding major blood vessels, such as the aorta, or into nearby major organs, such as the intestines.

Another known risk associated with IVC filters is that the simple pumping action of the heart over time can cause metal fatigue, resulting in a leg (or legs) eventually breaking off and traveling to the heart (see the below figures).

Figure 3: The simple pumping action of the heart over time can cause metal fatigue, resulting in a leg (or legs) eventually breaking off  of the IVC filter and traveling to the heart

Once inside the heart, the leg fragments can perforate the heart wall.  Depending upon the site of the perforation, it can lead to a condition known as cardiac tamponade - a collection of blood between the heart and the pericardial sac (a connective tissue layer surrounding the heart).  Cardiac tamponade prevents the heart chambers from expanding as it relaxes between each contraction, resulting in a severe reduction in the heart’s ability to pump blood through the body.  Without prompt medical attention, this condition can rapidly result in serious complications or even death.  For more information about cardiac tamponade, see the below images, or go to the below link to view a video: http://medivisuals.com/cardiac-tamponade-animation/

Figure 4: Heart with cardiac tamponade - a collection of blood between the heart and the pericardial sac. 

Many people who were hospitalized for prolonged periods of time may have received IVC filters without even knowing.  If you or a loved one have an IVC filter, or were hospitalized for a long time and may have an IVC filter that you aren't aware of, check with your physician.  It is also important to consult with an attorney, as the injuries and surgeries associated with these devices may be the responsibility of the filter manufacturer.