CTICasesFractured and Embolized IVC Filter Struts
Imaging findings
In a patient with a longstanding IVC filter placed after a motorcycle crash, imaging obtained to evaluate for fractured struts identified several missing strut fragments, including ones in the right middle and lower lobes; careful review also revealed an additional fragment lodged in the main pulmonary artery extending into the right ventricular outflow tract and interventricular septum just below the aortic root, as well as a separate fragment that had eroded through the aorta and embolized into another artery.
Key takeaways
This case illustrates the range of embolization complications that can occur with fractured IVC filter struts, including migration into the pulmonary arterial tree with myocardial extension and aortic erosion with distal arterial embolization, complications that have prompted litigation against some filter manufacturers; identifying missing struts requires deliberate, systematic review since fragments can lodge in unexpected locations well beyond the filter site.
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