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A new study finds that IVC filters may pose increased health risks the longer the devices remain in the body.
According to a study by the American Heart Association, a period of seven months or more is the threshold for a greater risk of failure during a retrieval procedure. The IVC filter study was published in the journal Circulation: Cardiovascular Interventions in June.
After the seven month period, the risk of failure when using the standard retrieval technique was just shy of 41 percent, compared with an 82 percent success rate before seven months, the study found.
The authors of the study looked at 762 retrieval procedures performed between 2009 and 2015. They also found that when advanced retrieval techniques were employed after standard retrieval techniques failed, the total retrieval success rate jumped to 98 percent.
According to RadiologyInfo.org, standard IVC filter retrieval is done by inserting a special catheter into a large vein in the neck or groin and advancing it to the site of the filter in the vena cava.
“A removable IVC filter has a small hook or knob at one end that enables the catheter to capture the filter, close it, pull it into the catheter and then withdraw it from the body,” according to the website.
When standard retrieval fails, more complicated, and risky, procedures are needed, such as endovascular laser sheath removal, which uses a laser inside a sheath, or covering, that is inserted into the inferior vena cava until it reaches the IVC filter, where the laser then ablates scar tissue attached to the filter, allowing the doctor to separate it from the inferior vena cava, according to the Northwestern (University’s) IVC Filter Clinic.
In 2010, the Food and Drug Administration (FDA) published an initial communication about IVC filters, explaining that the devices are frequently placed in patients at risk for pulmonary embolism—a blood clot in the lungs—when anticoagulant therapy cannot be used or is ineffective.
At that time, the FDA noted its concerns about retrievable IVC filters, intended for short-term placement, not being removed once a patient’s risk of pulmonary embolism subsided. As far back as 2010, the FDA acknowledged IVC filter side effects such as lower limb deep vein thrombosis (DVT), filter fracture, filter migration, filter embolization, and IVC perforation.
In that initial communication, the marked increase in the use of IVC filters was mentioned, noting that in 1979 just 2,000 were implanted, compared with 167,000 by 2007, and a predicted 259,000 by 2012.
The FDA reported receiving 921 adverse event reports involving IVC filter side effects, which included device migration, the detachment of device components, perforation of the vein, and filter fracture.
In May 2014, the federal agency issued what’s known as a safety communication, recommending that implanting doctors caring for patients with retrievable IVC filters consider removing the filter as soon as protection from pulmonary embolism is no longer needed.
In an interview with TCTMD.com, the website for the Cardiovascular Research Foundation, Dr. Kush R. Desai, lead author of the study on defining prolonged dwell time, cautioned medical professionals to “really consider” referring a patient who’s had an IVC filter for more than seven months to seek an advanced retrieval.
Retrievable inferior vena cava filters, or IVC filters, are tiny metal devices surgically implanted in the inferior vena cava, the body’s largest vein. IVC Filters are designed to trap blood clots before they reach the heart and lungs.
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