Inferior vena cava, or IVC, filters are used when a patient is at risk for pulmonary embolism. Pulmonary embolisms happen when a blood clot travels into the lungs, and they are extremely dangerous. IVC filters work to prevent embolisms by capturing clots before they can travel to the lungs, keeping them in a safer place, such as the abdomen.
Because IVC filters can prevent life-threatening health events, their risks are generally accepted. However, some case studies suggest that new materials used to make filters, and/or certain manufacturers of filters, are causing increased complications—including deadly ones. This means that some patients with IVC filters may be at more risk than others.
Here are some of the risks associated with IVC filters, according to Seminars in Interventional Radiology:
Problems During Placement
The procedure for inserting an IVC filter is relatively noninvasive. Surgery is not required; rather, a simple nick in the skin provides enough access for placement.
Despite this simplicity, complications can occur, according to Seminars in Interventional Radiology. IVC filters are tiny, delicate structures that expand into the inferior vena canal where they are placed to catch clots. It isn’t uncommon for legs of the filter to get crossed, or for expansion to be incomplete. If this occurs, then the filter cannot properly do its job. It is also possible for the filter to be improperly placed, or malpositioned, which would also affect its function.
Less common complications include the same risks as other, similar procedures: bleeding, hematoma, arterial puncture, and infection.
While IVC filters catch clots, they unfortunately also increase the chances of forming clots, known as thrombosis. It has been recorded that a number of patients develop deep vein thrombosis (DVT) after IVC filter insertion.
Another possible problem, though rare, is that the filter may capture so many clots that blood flow past the filter is impeded. This can cause swelling in the legs and is probably more likely in patients who develop DVT after placement.
An additional potential issue is that the IVC filter struts, or “legs,” can penetrate the wall of the inferior vena canal where the filter is placed. While this sounds frightening, it rarely creates any symptoms, and possibly even occurs in the majority of IVC filter recipients.
When perforation does create symptoms, they can include internal bleeding, but again, this is rare.
IVC filter fractures occur when a part of the filter breaks off. Because filter parts are so small, they are likely to travel through the cardiovascular system when this occurs, winding up in the heart, lungs, or another blood vessel.
Fortunately, most people who experience a filter fracture don’t even realize it has happened. These fractures rarely cause symptoms and often go unnoticed until a patient is scanned for a different health issue. In one case, a woman who was experiencing shortness of breath was discovered to have an IVC filter strut in her heart, according to an article in a 2015 issue of Respiratory Medicine Case Reports. It wasn’t causing any additional symptoms, however, and was left in without issue. Some research cited in her case study suggested that certain manufacturers may produce IVC filters which are more likely to fracture.
Migration is perhaps the scariest of possible IVC filter complications. Rather than a small fragment of the filter traveling through the cardiovascular system, the entire structure may move. It can wind up in some dangerous places, such as the heart or pulmonary outflow tract, or wind up malpositioned somewhere else in the inferior vena canal. Left unnoticed, a poorly positioned filter will fail to do its job, quietly putting the patient back at risk for pulmonary embolism.
It’s possible that newer materials being used by IVC filter manufacturers are responsible for a recent increase in filter migration. This puts patients at a very dangerous increased risk, as a filter in the heart can cause tachycardia. Tachycardia is when the heart beats too fast, over 100 times per minute, and it can lead to cardiac arrest.
In many cases, migrated IVC filters can be retrieved through a non-surgical procedure similar to the one used for placement. However, removal, especially from the heart, can still be difficult and dangerous. In one man’s case, nonsurgical removal left damage to the heart. His case study cited research suggesting that newer construction of filters may contribute to rising migration rates.
In some cases, nonsurgical removal of an IVC filter is impossible, requiring open-heart surgery. In others, a filter in the heart leads to death.
Sadly, for some patients who accept the above risks in exchange for safety from pulmonary embolisms, the IVC filter simply does not work. Studies have revealed that up to 5.6% of patients who have a filter implanted experience a pulmonary embolism despite it, with 3.7% of patients dying as a result.
What Do These Risks Mean for Patients?
Despite these risks, IVC filters continue to be placed in patients who would otherwise likely experience a dangerous traveling blood clot. With concerns surrounding the materials used to make them and quality of manufacturers, it’s important for patients to get as much information as they can if a doctor recommends an IVC filter implantation.
Injured by an IVF Filter?
People are actively filing IVF filter lawsuits. If you or a loved one were injured by an IVC filter, contact our attorneys for a free, no-risk case evaluation. We have decades of experience trying mass torts such as these and have a legal team ready to investigate if you have a case.