Western Michigan University Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI, 49008, USA.
Department of Pathology, Western Michigan University Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI, 49008, USA.
Forensic Sci Med Pathol. 2020 Dec;16(4):693-696. doi: 10.1007/s12024-020-00278-5. Epub 2020 Jul 16.
Venous thromboembolism impacts as many as 600,000 individuals each year in the United States, leading to significant morbidity and mortality. While typically treated with anticoagulants, retrievable inferior vena cava (IVC) filters may also be used for acute prevention of pulmonary embolism. The FDA recommends removing IVC filters within 29-54 days because long dwelling filters are associated with serious complications from the filter itself, such as perforation of adjacent structures and filter fracture. We report an unusual case in which a patient had an inferior venous cava filter in place for two years before experiencing spontaneous rupture of the left iliac vein. There was no evidence of filter migration or inferior venous cava perforation. Spontaneous iliac vein ruptures are rare, with fewer than 50 reported cases, and are not typically seen with a long-dwelling IVC. This case describes a unique complication of retrievable filters and highlights the importance of retrieving filters as soon as the acute danger of pulmonary embolism has resolved.
在美国，每年有多达 60 万人受到静脉血栓栓塞的影响，导致严重的发病率和死亡率。虽然通常使用抗凝剂治疗，但可回收的下腔静脉（IVC）过滤器也可用于急性预防肺栓塞。FDA 建议在 29-54 天内取出 IVC 过滤器，因为长期留置的过滤器会导致过滤器本身的严重并发症，如相邻结构穿孔和过滤器断裂。我们报告了一个不寻常的病例，患者在经历左侧髂静脉自发性破裂之前，已经放置了下腔静脉过滤器两年。没有证据表明过滤器迁移或下腔静脉穿孔。自发性髂静脉破裂很少见，不到 50 例，而且通常不会与长期留置的 IVC 一起出现。本例描述了可回收过滤器的一种独特并发症，并强调了一旦急性肺栓塞危险解除，尽快取出过滤器的重要性。
