Saturday, August 3, 2019

Could My Recent Pulmonary Embolism Have Been Caused by an IVC Filter?

The Problems with Inferior Vena Cava Filters

August 03, 2019 - IVC filters are small metal devices which are intended to halt the progress of a blood clot which is traveling toward the lungs, potentially causing a pulmonary embolism. The small device, which has tiny “spider legs,” is inserted into the inferior vena cava, which is the main vein in the body.

The inferior vena cava returns blood from the lower body to the heart, and should a blood clot form in the legs, the IVC filter catches the clot before it can cause serious damage. Generally, only those who have a significant risk of developing a pulmonary embolism, and who cannot take blood thinning drugs, are candidates for an IVC filter.

Patients who have: been in a serious car accident, who are victims of gunshot or stabbing injuries, who are undergoing dialysis treatment, those who are immobile or have a spinal cord injury, those undergoing cancer diagnosis or treatment, those who have taken a serious fall, and women who just delivered a baby are also candidates for implantation of an IVC filter.

IVC filters were first approved in 1979, and in 2012, nearly 260,000 IVC filters were inserted into patients across the United States. The American College of Cardiology found, in a 2016 analysis, that IVC filters were likely being over-used, and that while the IVC filters are “removable” (and should be removed when the risk of blood clot has passed), the actual retrieval rates are low.

The FDA and IVC Filters

In 2010, and again in 2014, the FDA warned of adverse event reports associated with IVC filters. These adverse events included:

  • Migration of the IVC filter;
  • Fracture of the IVC filter;
  • Embolization (movement of the entire filter or fragments of the filter to the heart or lungs);
  • IVC perforation;
  • IVC occlusion;
  • Lower limb deep vein thrombosis, and
  • Difficulty removing the IVC device.

The FDA recommended, in both warnings, that retrievable IVC devices be removed between the 29th and 54th days following implantation for the best results and fewer adverse effects.

Can IVC Filters Cause Pulmonary Embolism? According to an NCBI article, an IVC filter may be placed in patients at risk for pulmonary emboli, however the long-term benefits remain controversial, and the filter itself may cause pulmonary embolism in some patients. Further, when the heart and lungs are the primary source of emboli, the IVC filter may be of little benefit, and, should collateral vessels develop around the filter, there may be even less protection afforded.

A study done by Massachusetts General Hospital revealed a 5.6 percent prevalence of pulmonary emboli following IVC filter implantation, with fatal pulmonary emboli at about 3.7 percent.

The main issue appears to be that less than a third of retrievable IVC filters are ever actually retrieved. Leaving these temporary IVC filters in for a lengthy period of time hurts people—filter strut fracture can occur in as many as 40 percent of IVC filters left in for five years or more.

If you or a loved one has experienced a pulmonary embolism after having a retrievable IVC filter implanted, it could be beneficial to speak to an experienced IVC personal injury attorney. Your attorney can ensure your rights are fully protected, and will work hard to obtain compensation for your injuries.

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