Key result
Prophylactic temporary IVC filter placement triggers fatal recurrent massive PE in obstructed cava case.
Why the study?
Pulmonary embolism is rare in young people and the prophylactic use of temporary IVC filters in cases with retroperitoneal tumor-related IVC obstruction may paradoxically induce recurrence of massive PE.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
Alerts to possible paradoxical embolism risk after prophylactic IVC filter in tumor-related obstruction; leaves open need for safety studies before wider use.
Pulmonary embolism (PE) is a fatal disease that is very rare in young people. A 21-year-old man developed PE because of a retroperitoneal tumor. The inferior vena cava (IVC) was obstructed by the tumor, and thrombus existed in the right common iliac vein. Thrombolysis and heparinization improved his symptoms prior to urgent tumor resection. A temporary IVC filter was inserted the day before the operation, but 8 h later fatal massive PE occurred. At autopsy, the retroperitoneal tumor was revealed as a metastatic choriocarcinoma. Prophylactic use of a temporary IVC filter might have paradoxically induced recurrence of massive PE in this case.
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Natsuaki et al. (2009) conducted a case report in Pulmonary embolism associated with retroperitoneal tumor (metastatic choriocarcinoma) (n=1). Temporary IVC filter insertion (Neuhaus Protect) was evaluated on Recurrence of fatal massive pulmonary embolism. Prophylactic insertion of a temporary IVC filter in a young man with a retroperitoneal tumor obstructing the IVC paradoxically resulted in a fatal recurrent massive pulmonary embolism 8 hours later.
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