Gazda Alexis, Squillante Marc
Department of Emergency Medicine, University of Illinois College of Medicine - Peoria, Peoria, USA.
Cureus. 2022 Jun 24;14(6):e26308. doi: 10.7759/cureus.26308. eCollection 2022 Jun.
The use of Inferior Vena Cava (IVC) filters is increasing for patients who cannot otherwise receive anticoagulation for a deep vein thrombosis (DVT) or pulmonary embolism (PE). In this case, a 60-year-old man presenting with abdominal pain was found to have migration of his IVC filter into his intrahepatic IVC. Interventional radiology (IR) and vascular surgery were consulted as the migrated IVC filter was felt to be the likely cause of the patient's pain. Consideration was given to transferring the patient to a liver transplant center to retrieve the migrated filter. When patients with a history of IVC filter placement present to the emergency department, a high index of suspicion for IVC filter complication should be maintained and there should be a low threshold for ordering CT imaging. If a severe IVC filter complication is discovered, patients may ultimately require transfer to a center with hepatic surgery capability for definitive treatment given the complex vasculature involved.
对于因深静脉血栓形成（DVT）或肺栓塞（PE）而无法接受抗凝治疗的患者，下腔静脉（IVC）滤器的使用正在增加。在这种情况下，一名出现腹痛的60岁男性被发现其IVC滤器迁移至肝内IVC。由于认为迁移的IVC滤器可能是患者疼痛的原因，于是咨询了介入放射科（IR）和血管外科。曾考虑将患者转至肝移植中心以取出迁移的滤器。当有IVC滤器置入史的患者到急诊科就诊时，应高度怀疑IVC滤器并发症，且开具CT成像检查的门槛应较低。如果发现严重的IVC滤器并发症，鉴于涉及复杂的脉管系统，患者最终可能需要转至具备肝脏手术能力的中心进行确定性治疗。
