Open Surgical Retrieval of a Perforated Inferior Vena Cava Filter: A Case Report
Bibliographic record
Abstract
Inferior vena cava (IVC) filters are used to prevent fatal pulmonary embolism (PE) and may be associated with late-stage complications as filter hooks may deviate over time. Prolonged implantation and challenges in retrieving these filters can lead to damage to the surrounding organs. In this report, we described a case in which a thrombus in the IVC filter made retrieval difficult. Following 1.5 years of implantation, the IVC filter had perforated, necessitating surgical retrieval due to the risk of aortic injury. A 56-year-old woman presented with right lower extremity venous thrombosis and asymptomatic PE; anticoagulation therapy with edoxaban 60 mg once daily was started after the placement of an IVC filter. On the 10th day, computed tomography (CT) imaging revealed the development of venous thrombosis leading to thrombosis and occlusion of the IVC, which complicated filter retrieval. CT findings 1.5 years post-placement showed thrombus lysis and recanalization due to anticoagulation therapy with edoxaban 60 mg once daily. The patient was asymptomatic. However, filter perforation outside the IVC was observed, with one of the six perforated filter hooks located proximally to the abdominal aorta, raising concerns of potential aortic injury. Open surgical retrieval of the perforated IVC was performed under general anesthesia, with no evidence of aortic injury. The perforated hook was retrieved from outside the IVC, followed by a retrieval of the remaining filter body through venotomy. The patient's postoperative condition was stable; she was discharged without complications, and anticoagulation therapy with edoxaban 60 mg once daily was continued for six months postoperatively. IVC filter perforation is a common late complication associated with filter use. Currently, no clear consensus exists regarding these treatment strategies, and further research and case studies are warranted.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.004 | 0.003 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.008 | 0.005 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".