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Objectives <p>We report a case of an 82-year-old female patient admitted with severe abdominal and lumbar pain. She had a history of deep vein thrombosis in the lower extremities, complicated by pulmonary embolism, which led to the placement of a vena cava filter. This manuscript provides also a current literature review.</p> Methods <p>CT scans revealed chronic collateralized thrombosis and shrinkage of the inferior vena cava, along with the extramural displacement of the filter's metallic arms. One arm penetrated the ventral wall of the abdominal aorta, causing a pseudoaneurysm (PSA). We describe the successful treatment of the PSA with percutaneous endovascular aneurysm repair (PEVAR) and the ongoing extraction of the cava filter, evacuation of the PSA hematoma, lavage, and drainage performed via an extraperitoneal approach due to persistent inflammatory signs.</p> Results <p>The patient remained clinically well during subsequent follow-ups.</p> Conclusion <p>(P)EVAR is a safe and justified procedure when the abdominal wall is penetrated due to a displaced cava filter. If there is concomitant penetration of the intestinal wall, open surgery is required, either alone or following endovascular treatment. The authors consider it important to note that, to date, no guidelines have been revealed to objectively recommend a specific approach in patients with caval filter penetration. For this reason, we consider a multidisciplinary approach essential as the mainstay of treatment.</p>

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Acute Iatrogenic Distal Aortic Pseudoaneurysm Caused by Metallic Arm of Displaced Vena Cava Filter—Case Report and Review of the Literature

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月17日

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  • Roman Slyško,
  • Ivan Vulev,
  • Šimon Smoter

摘要

Objectives

We report a case of an 82-year-old female patient admitted with severe abdominal and lumbar pain. She had a history of deep vein thrombosis in the lower extremities, complicated by pulmonary embolism, which led to the placement of a vena cava filter. This manuscript provides also a current literature review.

Methods

CT scans revealed chronic collateralized thrombosis and shrinkage of the inferior vena cava, along with the extramural displacement of the filter's metallic arms. One arm penetrated the ventral wall of the abdominal aorta, causing a pseudoaneurysm (PSA). We describe the successful treatment of the PSA with percutaneous endovascular aneurysm repair (PEVAR) and the ongoing extraction of the cava filter, evacuation of the PSA hematoma, lavage, and drainage performed via an extraperitoneal approach due to persistent inflammatory signs.

Results

The patient remained clinically well during subsequent follow-ups.

Conclusion

(P)EVAR is a safe and justified procedure when the abdominal wall is penetrated due to a displaced cava filter. If there is concomitant penetration of the intestinal wall, open surgery is required, either alone or following endovascular treatment. The authors consider it important to note that, to date, no guidelines have been revealed to objectively recommend a specific approach in patients with caval filter penetration. For this reason, we consider a multidisciplinary approach essential as the mainstay of treatment.