Posters

Presenting Author

Matthew N. Parvus

Academic/Professional Position (Other)

MS3

Presentation Type

Poster

Discipline Track

Clinical Science

Abstract Type

Case Report

Abstract

Introduction: Inferior vena cava filters are often placed with the intention of removal and IVC filters are a temporary intervention, so leaving them in long term can present with significant risk of complications. When combined with protein C deficiency, the patient is at even greater risk.

Case: This case presents a 35-year-old Hispanic woman who presented to the emergency department for a one-week history of pain and swelling of the right leg. Past medical history includes protein C deficiency, chronic DVT, IVC filter (twelve-years ago), and venous insufficiency. Due to non-compliance, and financial difficulties, the patient didn’t continue her treatment and her IVC filter was never removed. The patient’s laboratory findings were PT 13.7 and INR 1.16. CT of the abdomen and pelvis showed that the IVC filter infiltrated past the walls of the IVC, which represented significant risk for removal. Ultimately, a second IVC filter was placed superior to the prior one after attempting thrombolysis.

Conclusion: The timeframe of removal for a retrievable filter is 2-3 weeks after anticoagulation, complications risk increases over time. One of the most common reasons that patients do not have their filter removed is that they are lost to follow up, as in this case. The patient noted that her current economic status, along with being incarcerated, kept her from following up and taking her anticoagulation medication appropriately. This case highlights the importance of removal of retrievable IVC filters, especially in patients with hypercoagulable conditions such as protein C deficiency.

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Chronic DVT in the Setting of a Long-Term IVC Filter, Protein C Deficiency, and Non-Compliance

Introduction: Inferior vena cava filters are often placed with the intention of removal and IVC filters are a temporary intervention, so leaving them in long term can present with significant risk of complications. When combined with protein C deficiency, the patient is at even greater risk.

Case: This case presents a 35-year-old Hispanic woman who presented to the emergency department for a one-week history of pain and swelling of the right leg. Past medical history includes protein C deficiency, chronic DVT, IVC filter (twelve-years ago), and venous insufficiency. Due to non-compliance, and financial difficulties, the patient didn’t continue her treatment and her IVC filter was never removed. The patient’s laboratory findings were PT 13.7 and INR 1.16. CT of the abdomen and pelvis showed that the IVC filter infiltrated past the walls of the IVC, which represented significant risk for removal. Ultimately, a second IVC filter was placed superior to the prior one after attempting thrombolysis.

Conclusion: The timeframe of removal for a retrievable filter is 2-3 weeks after anticoagulation, complications risk increases over time. One of the most common reasons that patients do not have their filter removed is that they are lost to follow up, as in this case. The patient noted that her current economic status, along with being incarcerated, kept her from following up and taking her anticoagulation medication appropriately. This case highlights the importance of removal of retrievable IVC filters, especially in patients with hypercoagulable conditions such as protein C deficiency.

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