Misplaced Inferior Vena Caval Filter in Right Renal Vein with Erosion into Renal Collecting System

Abstract

Misplacement of an inferior vena caval (IVC) filter is an infrequent event. We describe a patient who underwent IVC filter placement after lower extremity trauma. Fourteen years later, the presence of microscopic hematuria prompted evaluation. Computed tomography urography revealed an IVC filter within the right renal vein. Ureteroscopy revealed penetration of a filter tine into the collecting system. The patient is being followed conservatively.

A systematic review of symptomatic duodenal perforation by inferior vena cava filters

“…1 However, IVC filters are not exempt from complications that encompass migration or fracture of filter struts, IVC thrombosis, and perforation of the venous wall causing bleeding or penetration into surrounding structures such as the aorta, portal, and renal veins, vertebral body, kidney and liver parenchyma, duodenum, large intestine, diaphragm, urinary tract, and the retroperitoneum. [2][3][4][5][6][7] The incidence of perforation of the IVC wall is found in about 0.2% of the patients who underwent Greenfield filter placement, but the actual occurrence of duodenal perforation has not been reported. 8 Symptomatic duodenum perforation by an IVC filter is rare and data on diagnosis and treatment have been inconsistently published.…”

CT of inferior vena cava filters: normal presentations and potential complications

“…10) [47]. Additionally, there has been a report of an IVC filter which was misplaced in the right renal vein without initial complications [48]. Fourteen years later, the patient presented with asymptomatic microscopic hematuria.…”

Open retrieval management of inferior vena cava filter erosion resulting in symptomatic hydroureteronephrosis

“…Filter erosion resulting in symptomatic organ involvement occurs in <0.5% of filter placements, 4 and only 16 cases of ureteropelvic junction perforation have been reported before the present case ( Table ). 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 Although rare, our case highlights the possibility of symptomatic urinary collecting system penetration by IVC filters. Symptoms consistent with urinary tract infections or obstruction in patients with an indwelling IVC filter should be considered a possible consequence of filter erosion because of the close anatomic nature between the IVC and urologic structures.…”

“…Of the 16 reported cases of urinary collecting system penetration by eroded filters, management ranged from no intervention required 7 , 8 to life-long nephrostomy tube dependence after failed stent placement. 9 However, the most common intervention has been endovascular 6 , 9 , 10 , 11 or open 12 , 13 , 14 , 15 , 16 retrieval of the filter.…”