Matthew T. Major, Paul G. Bove, and Graham W. Long
This chapter will characterize complications from inferior vena cava (IVC) filter placement, such as access issues and filter malposition; late complications, such as filter fracture, migration, perforation and thrombosis; and those related to filter retrieval. However, a subset of patients develop bleeding complications or sustain a PE while on therapeutic anticoagulation. Vascular access complications for IVC filter insertion vary from 4-11%, similar to those for central venous catheter insertion. The authors routinely perform ultrasound-guided sheath placement, which may decrease access site complications. Rates of recurrent PE for patients with metastatic disease are reported at 10.4%, compared to 2.3% in those with non-metastatic malignancy. Reports in the literature describe its successful use for acute iliocaval thrombosis. Complications for retrieval performed within 30 days of filter placement are rare, and there are increasing numbers of the reports demonstrating safe retrieval with increasing dwell times.
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