Presentation
Patient with a past history of multiple deep vein thromboses (DVTs) and a crush injury to the right lower extremity, presenting with ongoing right lower extremity pain.
Patient Data
Axial arterial phase of abdominal and ilio-femoral runoff demonstrating an atretic inferior vena cava at the level of the IVC filter with occlusion of the IVC. A leg of the IVC filter is seen entering the right aortic wall and extending to the left lateral aortic wall, just proximal to the bifurcation of the common iliac arteries. A mural thrombus is seen surrounding the embedded leg of the IVC filter within the aorta, which does not cause hemodynamic stenosis of the abdominal aorta.
A leg of the IVC filter extends to the spine and is broken. One of the legs of the IVC filter extends to the right psoas muscle.
3D reconstruction of the abdominal aorta and its main branches demonstrating the penetrating leg of the IVC filter into the aortic wall extending to the left lateral aspect of the aorta.
Case Discussion
This case demonstrates a 35-year-old man who underwent an abdominal and ilio-femoral angiography runoff due to ongoing right lower extremity pain. He has a past history of an extensive crush injury to the distal right lower extremity approximately 9 years prior and multiple prior DVTs requiring life-long anticoagulation.
Incidentally visualized was an atretic IVC filter with penetration of a leg into the aorta extending into the left lateral aortic wall with surrounding mural thrombus.
The ordering physician was subsequently contacted, and interventional radiology consultation for IVC filter management was recommended.
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