IVC Filter Internal Bleeding and Migration

Caused by defective IVC Filters

The majority of published data focus on permanent filters, and in contrast, the long-term results of newer retrievable filters are lacking. IVC filters can cause significant morbidity and in rare instances mortality. A brief inspection of the Maude database collected between 2002 and 2005 revealed 16 cases of filter migration to the heart, two cases of migration to other locations, five cases of internal bleeding, three cases of IVC perforation, and eight cases of filter fractures.

Migration

IVC filters can migrate from the deployed position to another part of the IVC, to the heart, or to the pulmonary outflow tract. The typical treatment is the percutaneous removal of the migrated device using loop snares and appropriate retrieval devices. However, in circumstances such as migration to the heart valves, right ventricle, or pulmonary outflow tract, percutaneous removal may be difficult or impossible, and surgery may be required for internal bleeding or retrieval of broken IVC devices. (Fig.).

IVC device exrrayed

A 48-year-old man with Recovery IVC filter (Bard, Covington, GA) placed for DVT prophylaxis. Approximately 1 year later, the patient was admitted for an unrelated reason. During this hospitalization, a patient complained of palpitation and chest …

Filter Fracture

As mentioned above, eight cases of filter fracture have been reported in the Maude database since the introduction of retrievable filters, though the type of filter in each case was not specified. Scattered reports of fractured permanent filters exist. One report on the Simon nitinol filter (Bard, Covington, GA) showed fractures of one strut in 6 of 38 patients, though none involved the basket portion. Fortunately, fractured struts are usually inconsequential, but can cause internal bleeding as well as organ damage.

IVC Perforation

Penetration of the wall of the IVC by filter struts is usually an incidental finding and typically clinically insignificant. The incidence is as high as 40 to 95%. Aortic penetration, ureteral perforation, and duodenal penetration by filter struts have also been reported. Recently, Putterman et al reported a case of aortic pseudoaneurysm secondary to penetration by a Simon nitinol filter. Laceration of a lumbar vessel causing significant internal bleeding has been reported. IVC erosion with complete filter perforation causing significant morbidity has been reported. Retrieval of temporary filters carries a theoretical risk of perforation or rupture of the IVC, particularly after extended implantation when portions of the filter may be well incorporated into the vessel wall. Studies are needed to evaluate the risk of this complication in relationship to extended periods of filter implantation.

Pulmonary Embolism

The study from Massachusetts General Hospital revealed a prevalence of PE after filter implantation to be 5.6% and fatal PE to be 3.7%. Others report a less than 5% rate of post filter PE.

Device Infection

IVC Filter

Bacteremia is a relative contraindication to IVC filter insertion. We avoid infected access sites and use retrievable filters in bacteremic patients to reserve the option for removal in the event of bacterial colonization. Needless to say, the strict sterile technique should be applied to all cases of filter insertion.

RETRIEVAL COMPLICATIONS

Long-term results for retrievable filters are lacking, though initial reports are promising. The fact that they can be removed confers advantages over traditional permanent filters. For filter retrieval, published complications include large clot burden wall apposition preventing removal, and difficult retrieval requiring extended procedure time and nonstandard retrieval techniques. The venogram showed clots within the cone of the filter. Large clot burden within the filter cone is a contraindication to routine removal. The Tulip filter (Cook, Bloomington, IN) is tilted and the hook is opposed to the IVC wall, preventing successful removal in this patient.

CONCLUSION

The safety and efficacy of the more traditional permanent IVC filters have been well documented. Nevertheless, various complications associated with these filters have been described, and early diagnosis and management are the keys to reducing patient morbidity and mortality. Limited studies of retrievable filters are promising, but further studies are warranted to fully evaluate the risks associated with both implantation and retrieval. Another Related article about an IVC Attorney Near Me now.

Other complications that can follow.

Methicillin-resistant Staphylococcus aureus (MRSA) is a type of bacteria that causes infections in different regions of the body. While most infections caused by MRSA aren’t as serious, some can be life-threatening, because it is not easily treated by antibiotics. Depending on where the infection is located, people may have a different set of symptoms.

Different types and strains of staph are present in our bodies. One out of three people has staph bacteria in his or her nose. You can be walking around with staph and not even know it. Staph becomes a bigger issue when it gets inside the body and causes an infection. While staph is most commonly treated with antibiotics, some strains of staph like MRSA have become resistant to these antibiotics.

Staph can be spread through contact. You may come in contact with another person carrying staph or an object that has this type of bacteria on it. You can reduce your chances of catching MRSA by practicing proper hygiene. Never share razors with someone and always clean your athletic gear after use. MRSA infections are common in individuals that have a weakened immune system, and for those residing in health care centers or nursing homes. Some MRSA has been known to affect those individuals outside of hospitals and other medical care facilities. This type of staph is called community-associated MRSA.

CA-MRSA occurs in populations that are in close contact with one another. This skin-to-skin contact is common among those attending or involved in daycares, athletic teams, prisons and military training camps. MRSA is sometimes an issue in medical malpractice cases involving hospital infections.

Identifying and Treating MRSA – Common Symptoms and Treatments

MRSA is most commonly referred to as a “superbug” because of its resistance to powerful treatment options and its ability to spread quickly to many individuals. Common symptoms of MRSA include small red bumps, pimples or boils. These tender or inflamed areas are often warm to the touch and irritated. Sometimes people confuse MRSA with spider bites. It’s important to seek medical attention to rule out this confusion and to begin treatment.

Because MRSA can affect people differently, it is important to pay attention to the different signs and symptoms. MRSA can look like a simple sunburn, a pimple or larger abscess. If you suspect MRSA, clean the wound properly and cover with a bandage. Always seek medical attention before this infection worsens or spreads among other individuals. In the case of more serious infections, your physician may have to drain, clean and wrap the affected area. Because MRSA isn’t treated by common types of antibiotics, your physician may write a prescription for another type of oral antibiotic.

While treating your MRSA, it’s important to finish your prescription completely. Even if your symptoms fade, failing to complete your prescription could cause the infection to come back.

Always keep the infected area covered and remember to wash all clothing, towels, and bedding that may have come in contact with this bacterial infection.

The above is posted for informational purposes only. The publisher is not a doctor or physician. If you believe you have any medical problem, you should always consult with a qualified doctor and not rely on informational posts of this nature. Article Source: http://EzineArticles.com/9329258

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