Open surgical removal of retained and dislodged inferior vena cava filters.

Retained inferior vena cava (IVC) filters can lead to significant complications. Six patients underwent open surgical removal of complicated IVC filters that could not be removed endovascularly. Struts of the filter perforated the IVC wall in all patients and the adjacent viscera in five. Caval clamping and longitudinal cavotomy with direct closure were used in two patients to remove permanent filters. IVC clamping was not needed in three patients, in whom the filter was first collapsed and then removed through a stab venotomy in the IVC (n = 2) or lumbar vein (n = 1). A broken strut that infected the vertebra was removed outside the IVC in the sixth patient. No early or delayed complications, venous thrombosis, or pulmonary embolism was encountered at a mean follow-up of 1.3 years.