An inferior vena cava filter did not prevent fatal pulmonary embolism in a 62-year-old woman, as the thrombus propagated across the filter leading to death two weeks after insertion.
Case Report (n=1)
This case report highlights that fatal pulmonary embolism can still occur after IVC filter insertion through the unusual mechanism of thrombus propagation across the filter.
Inferior vena cava (IVC) filters have since been implanted in the 1970s. The aim of implantation is to prevent the occurrence of fatal pulmonary embolism (PE). However, fatal pulmonary embolisms have been occurring after filter insertion. The mechanism is that either a thrombus or an embolus was already located cranial to the site of deployment of the filter within the inferior vena cava. And so after the filter implantation significant embolism can still occur. We present the case of a 62-year-old woman who had an IVC filter but died two weeks later from pulmonary embolism, through an unusual mechanism. The patient had a fracture of the left tibia, had open reduction and internal fixation developed pulmonary embolism secondary to deep vein thrombosis of the left lower limb. Anticoagulation was started, an IVC filter was inserted and she was discharged home with a therapeutic INR. However, she passed away two weeks later from pulmonary embolism, through the unusual mechanism of thrombus propagation across the IVC filter. The clinical significance of this article is to draw clinicians’ attention to the existence of another mechanism of fatal pulmonary embolism after an IVC filter insertion. The thrombus can propagate across the IVC filter leading to fatal pulmonary embolism.
Offei-Larbiら（Sat、）は、深部静脈血栓症に起因する肺塞栓症の症例報告を行った（n=1）。下大静脈（IVC）フィルターは致死的な肺塞栓症について評価された。62歳の女性において、下大静脈フィルターは致死的な肺塞栓症を防げず、血栓がフィルターを越えて進行し、挿入から2週間後に死亡した。