Successful retrieval of a vena cava filter in a patient with duodenal perforation by open surgery: a case report and literature review

Vena cava filter placement represents a safe and effective intervention to prevent the potential occurrence of pulmonary embolism caused by the dislodgement of deep vein thrombosis. However, prolonged indwelling can lead to some severe and life-threatening complications such as duodenal perforation. In 2023, a 60-year-old woman was admitted to our hospital with a three-month history of intermittent lower abdominal and back pain. She underwent a vena cava filter implantation in 2016, to prevent pulmonary embolism. However, she didn’t receive a systematic follow-up after the procedure, and the filter was not promptly retrieved. The abdominal contrast-enhanced computed tomography scan showed that the filter was tilted and had penetrated the duodenal lumen through the wall of the inferior vena cava. Due to the clinical complexity and the missed retrieval window, open surgery retrieval was performed with concurrent repair. In this case, the filter strut perforated the inferior vena cava wall and entered the duodenum. After radiological evaluation and analysis of the possible filter-associated complications, the vena cava filter was successfully retrieved via open surgery, despite the high failure rate of endovascular retrieval techniques reported in the literature. Furthermore, we conducted a PubMed-based literature review to highlight the characteristics of patients associated with vena cava filter-associated duodenal perforation cases, and to contextualize our findings.