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May 20, 2026American Journal of Respiratory and Critical Care Medicine

B64-27 When Prevention Becomes the Catalyst: Paradoxical Pulmonary Embolism After IVC Filter Removal Despite Anticoagulation

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Key result

IVC filter removal and thrombectomy linked to paradoxical submassive PE despite therapeutic anticoagulation.

  • n=1

Why the study?

IVC filters may paradoxically serve as a nidus for thrombosis or embolic complications if not retrieved timely, presenting management challenges when balancing thrombotic and bleeding risks.

Population

A 76-year-old woman with recurrent DVT, prior IVC filter, and history of subdural hematoma

Design

Case report

Authors

OBO BaruaCentegra Hospital McHenrySRS A ReddyCentegra Hospital McHenryASA SureshCentegra Hospital McHenry

Discussion

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Implication

Low retrieval rates may heighten long-term thrombotic risks in patients with indwelling IVC filters; leaves open optimal follow-up strategies.

Key Points

  • The aim is to illustrate the paradoxical occurrence of pulmonary embolism after IVC filter removal in a patient on anticoagulation therapy.
  • Case report of a 76-year-old woman with recurrent VTE and an IVC filter, showcasing her clinical management and interventions.
  • Initial imaging studies and complications were documented alongside anticoagulation strategies applied post-thrombectomy.
  • Patient developed submassive pulmonary embolism despite therapeutic heparin post-filter removal, indicating risk of thrombus migration.
  • Post-procedure evaluations showed residual thrombus in lower extremities, emphasizing the need for careful anticoagulation management.

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
A 76-year-old woman with a history of breast cancer on anastrozole, subdural hematoma post-burr hole evacuation, and recurrent deep vein thrombosis (DVT) with prior IVC filter placement (off anticoagulation).
I
Intervention
IVC filter removal with bilateral iliofemoral and femoral-popliteal thrombectomy, followed by therapeutic heparin infusion and emergent bilateral pulmonary artery thrombectomy.
O
Outcome
Development of paradoxical bilateral submassive pulmonary embolism with right-heart strain.

This case highlights the risk of paradoxical pulmonary embolism from thrombus migration following IVC filter manipulation and thrombectomy, even while on therapeutic anticoagulation.

Cite This Study

Barua et al. (2026) conducted a case report in Venous thromboembolism and IVC filter thrombosis (n=1). IVC filter removal and thrombectomy was evaluated. IVC filter removal and thrombectomy in a 76-year-old woman with extensive IVC thrombosis resulted in paradoxical submassive pulmonary embolism despite therapeutic anticoagulation.

synapsesocial.com/papers/6a0d4fbff03e14405aa9b2ebhttps://doi.org/10.1093/ajrccm/aamag162.5665

Topics

Pulmonary embolism
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Recurrent Deep Vein Thrombosis (DVT) and Inferior Vena Cava (IVC) Filter: Should a Computed Tomography (CT) Venogram and Inferior Vena Cavagram Be the Standard of Care?2024 · 3 citations
  2. 2C63-21 From Vein to Ventricle: Multisystem Embolization of a Fractured Inferior Vena Cava Filter2026
  3. 3Pulmonary thromboembolism exacerbated by thrombus migration through an inferior vena cava filter: a case report2026
  4. 4Indwelling inferior vena cava filter as a persistent thrombotic risk factor: recurrent venous thromboembolism after anticoagulation withdrawal2026
  5. 5Concurrent inferior vena cava syndrome and spontaneous retroperitoneal hemorrhage secondary to inferior vena cava filter thrombosis, treated with large bore mechanical thrombectomy: a case report2026