Bai Yifei, Wang Kai, Xue Tongqing, Jia Zhongzhi
Department of Interventional and Vascular Surgery, Changzhou No. 2 People's Hospital, Changzhou, China.
Department of Interventional Radiology, Huaian Hospital of Huai'an City, Huai'an, China.
J Vasc Surg Venous Lymphat Disord. 2025 Mar;13(2):102009. doi: 10.1016/j.jvsv.2024.102009. Epub 2024 Nov 28.
Intracardiopulmonary migration of an inferior vena cava (IVC) filter is an uncommon but potentially life-threatening complication. A previous systematic review including data through 2008 found that the most common cause for migration was operator error and that open thoracotomy was the best first option for management. The aim of this study was to assess the clinical presentation and causes of intracardiopulmonary filter migration, as well as the most commonly used management strategies over the past 15 years.
A systematic search of the literature was conducted to identify studies pertaining to intracardiopulmonary IVC filter migration that were published between November 2008 and June 2024, and data were collected regarding clinical presentation, complications, type and location of filter migration, and management strategies.
A total of 156 cases of intracardiopulmonary migration of IVC filters were identified in 88 publications. Of the 66 patients whose symptoms status was listed, 50 patients had symptoms and 16 patients were asymptomatic. In the remaining patients, the symptom status was not listed. The most frequently reported symptom was chest pain (68.0%; 34/50). Of the 156 patients, 34 (22.8%) experienced intracardiopulmonary migration of the entire filter body, and the remaining 122 (78.2%) experienced filter fracture with migration of the fractured struts. Complications were reported in 30.1% of patients (47/156); these complications included myocardial injury (n = 37), damage of tricuspid valve (n = 12), and hemopericardium (n = 21). Endovascular (16 filters and 56 struts) or surgical (13 filters and 16 struts) retrieval was the primary management strategy for intracardiopulmonary migration of the filter or fractured strut.
The main cause of intracardiopulmonary migration of an IVC filter is filter fracture. Endovascular retrieval is gradually becoming the preferred management option for intracardiopulmonary migration of IVC filters.
下腔静脉（IVC）滤器发生心肺内移位是一种罕见但可能危及生命的并发症。一项截至2008年数据的既往系统评价发现，移位的最常见原因是术者操作失误，且开胸手术是最佳的初始处理选择。本研究的目的是评估心肺内滤器移位的临床表现、原因以及过去15年中最常用的处理策略。
对文献进行系统检索，以确定2008年11月至2024年6月发表的有关心肺内IVC滤器移位的研究，并收集有关临床表现、并发症、滤器移位的类型和位置以及处理策略的数据。
在88篇出版物中总共确定了156例IVC滤器心肺内移位病例。在列出症状状态的66例患者中，50例有症状，16例无症状。其余患者未列出症状状态。最常报告的症状是胸痛（68.0%；34/50）。在156例患者中，34例（22.8%）发生整个滤器主体的心肺内移位，其余122例（78.2%）发生滤器断裂伴断裂支杆移位。30.1%的患者（47/156）报告有并发症；这些并发症包括心肌损伤（n = 37）、三尖瓣损伤（n = 12）和心包积血（n = 21）。血管内（16个滤器和56个支杆）或手术（13个滤器和16个支杆）取出是滤器或断裂支杆心肺内移位的主要处理策略。
IVC滤器心肺内移位的主要原因是滤器断裂。血管内取出正逐渐成为IVC滤器心肺内移位的首选处理方式。
