Vena caval occlusion after bird's nest filter placement

BACKGROUND: Inferior vena caval thrombosis as a result of intracaval barrie r devices occurs in 6.5% of patients with Greenfield filters. The incidence is less well defined in patients in whom bird's nest filters have been pla ced. We reviewed our experience with bird's nest filters to determine the i ncidence of filter-induced caval thrombosis. METHODS: The records of 140 patients with bird's nest filters were reviewed , living patients were interviewed, and the inferior vena cava examined in 37 patients by duplex scanning. RESULTS: Ninety-three patients were available for evaluation. Five of these patients were found to have caval thrombosis by duplex scanning and 2 had clinical symptoms and signs compatible with caval thrombosis. The majority of these patients were on anticoagulants at the time of filter thrombosis. CONCLUSION: The incidence of filter-induced vena caval thrombosis in patien ts with bird's nest filters (7%) is comparable with that of Greenfield filt ers. Because of the catastrophic manifestations of this complication and th e increasing application of vena caval filters, the role of these filters i n the treatment of thrombotic disease needs further critical evaluation. Am J Surg. 1998;176:598-600, (C) 1998 by Excerpta Medica, Inc.