Retirada de filtro de veia cava inferior por cirurgia convencional: uma série de casos
Open surgical removal of inferior vena cava filters: a case series
Helio Bergantini Neto; Antônio Carlos Passos Martins; Laís Terem de Almeida Teixeira; Marina Artimonte Farjallat; Julio Cesar Saucedo Marino; André Echaime Vallentsits Estenssoro; Nayara Cioffi Batagini; Celso Ricardo Bregalda Neves
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Abstract
Inferior vena cava filters (IVCFs) are indicated in venous thromboembolism when anticoagulation therapy is contraindicated or fails. Although retrievable models are preferred, many remain implanted for prolonged periods, and are associated with fracture, thrombosis, or perforation of the inferior vena cava (IVC). We present a retrospective series of four patients who underwent open surgical removal of IVCFs between 2013 and 2023, after endovascular failure, due to refractory pain, perforation, or IVC thrombosis. All patients underwent laparotomy with complete filter removal and IVC reconstruction using a bovine pericardial patch or synthetic graft, with technical success in all cases. Two patients had sustained clinical improvement with no new thromboembolic events, one was lost to follow-up after initial improvement, and one had graft occlusion and post-thrombotic syndrome. Open surgical removal may be a viable option when the endovascular route is not feasible, but the heterogeneous outcomes highlight the need for individualized indication.
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References
1 Ayad MT, Gillespie DL. Long-term complications of inferior vena cava filters. J Vasc Surg Venous Lymphat Disord. 2019;7(1):139-44.
2 Angel LF, Tapson V, Galgon RE, Restrepo MI, Kaufman J. Systematic review of the use of retrievable inferior vena cava filters. J Vasc Interv Radiol. 2011;22(11):1522-30.e3.
3 Decousus H, Leizorovicz A, Parent F, et al. A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. N Engl J Med. 1998;338(7):409-15.
4 Mismetti P, Laporte S, Pellerin O, et al. Effect of a retrievable inferior vena cava filter plus anticoagulation vs anticoagulation alone on risk of recurrent pulmonary embolism: a randomized clinical trial. JAMA. 2015;313(16):1627-35.
5 Kaufman JA, Barnes GD, Chaer RA, et al. Society of Interventional Radiology clinical practice guideline for inferior vena cava filters in the treatment of patients with venous thromboembolic disease. J Vasc Interv Radiol. 2020;31(10):1529-44.
6 Kalva SP, Athanasoulis CA, Greenfield LJ. Removal of trapped inferior vena cava filters by open surgery. J Vasc Interv Radiol. 2006;17(12):2015-20.
7 Desai KR, Pandhi MB, Seedial SM, et al. Retrievable inferior vena cava filters: comprehensive review of device-related complications and advanced retrieval techniques. Radiographics. 2017;37(4):1236-45.
8 Grewal S, Chamarthy MR, Kalva SP. Complications of inferior vena cava filters. Cardiovasc Diagn Ther. 2016;6(6):632-41.
9 Maués Filho JJB, Britto KF, Rocha SO. Desafio terapêutico: retirada de filtro de veia cava após 4 anos de implante. J Vasc Bras. 2025;24:e20230138.
10 Sobreira ML, Marques MA, Paschôa AF, et al. Diretrizes sobre trombose venosa profunda da Sociedade Brasileira de Angiologia e Cirurgia Vascular. J Vasc Bras. 2024;23:e20230107. PMid:39286300.
11 Ahmed O, Sheikh S, Tran P, et al. Inferior vena cava filter evaluation and management for the diagnostic radiologist: a comprehensive review including inferior vena cava filter-related complications and PRESERVE trial filters. Can Assoc Radiol J. 2019;70(4):367-82.
Submitted date:
07/15/2026
Accepted date:
08/29/2026
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