Chronic Inferior Vena Cava Filter-Related Occlusion: Presentation, Diagnosis, Management, and Controversy

Abstract

Inferior vena cava filters (IVCF) are caval interruption devices designed to decrease the incidence of pulmonary embolism by capturing thrombus in-transit. Rare, long-term complications of IVCF include fracture, migration, caval perforation, recurrent deep venous thrombosis (DVT) and IVCF-related caval occlusion. Chronic IVCF-related caval occlusion is a challenging complication with a variable presentation, potential for significant morbidity, and limited evidence guiding management. In symptomatic patients, first-line treatment includes endovascular caval reconstruction utilizing various techniques including, venoplasty, thrombolysis, thrombectomy and/or stenting with or without removal of indwelling IVCF.