TITLE:
Thrombus Propagation across an Inferior Vena Cava Filter Resulting in Fatal Pulmonary Embolism: A Case Report
AUTHORS:
Gordon Offei-Larbi, Martin Nartey Tamatey, Mark Mawutor Tettey, Isaac Okyere, Kwame Adomako
KEYWORDS:
Inferior Vena cava Filter, Thrombus Propagation, Fatal Pulmonary Embolism
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.12 No.10,
October
8,
2022
ABSTRACT: 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.