Successful Retrieval of a Vena Cava Filter in a Patient with Duodenal Perforation by Open Surgery: A Case Report and Literature Review

Abstract Background: Vena cava filter implantation is a safe and effective method to prevent pulmonary embolism in patients with deep venous thrombosis. However, the prolonged indwelling may induce some complications, such as duodenal perforation, which is severe and potentially life-threatening. Case Presentation: A 60-year-old female patient was admitted to our hospital in 2023 due to intermittent lower abdominal pain and backache for three months. In 2016, she developed deep venous thrombosis in her right limb. As anticoagulation was ineffective, she received vena cava filter implantation at another hospital. The patient failed to receive systematic follow-up after the procedure, and the vena cava filter was not promptly retrieved after the disappearance of clots. The abdominal contrasted computed tomography scan revealed that the filter was tilted, penetrating the wall of the vena cava and entering the duodenum. Given the complexity of the patient's condition and the missed optional retrieval time window, open surgery was performed to retrieve the vena cava filter and repair the vena cava and duodenum. Conclusions: In this case, the filter strut penetrated the wall of the vena cava and entered the duodenum after the vena cava filter was implanted 8 years ago. Following a radiological evaluation, considering the coexistence of multiple filter-associated complications, the vena cava filter was successfully retrieved through open surgery despite the high failure rate of endovascular retrieval. Furthermore, some reports on vena cava filter-associated duodenal perforation were analyzed and reviewed based on PubMed to summarize our findings in this study.