Fracture and distant migration of the Bard Recovery filter: a retrospective review of 363 implantations for potentially life-threatening complications

J Vasc Interv Radiol. 2012 Feb;23(2):199-205.e1. doi: 10.1016/j.jvir.2011.10.017. Epub 2011 Dec 20.


Purpose: To report the occurrence of fracture of the Recovery filter and incidence of potentially life-threatening complications associated with fractured fragment migration.

Materials and methods: A retrospective study of images obtained after placement of Recovery inferior vena cava (IVC) filters from 2003 to 2006 was conducted at a single tertiary-care center. Images were reevaluated for fracture and migration; complications related to filter fracture were investigated. Kaplan-Meier survival analysis was performed to investigate the relationship between time in situ and fracture.

Results: A total of 363 Recovery filters were placed; 97 were retrieved, leaving 266 filters in situ (135 patients subsequently died of other causes). The following images were evaluated: 130 chest computed tomography (CT) scans, 153 abdominal CT scans, 254 chest radiographs, 148 radiographs of the abdomen/pelvis, and 106 cavagrams. Mean imaging follow-up interval was 18.4 months (maximum, 81.3 mo). No en bloc migration occurred outside the IVC. Twenty-six limb fractures (all short limbs) were identified in 20 patients; the earliest occurred at 4.1 months. Eight fragment migrations occurred into pulmonary arteries, seven into iliac/femoral veins, one into the right ventricle, and one into the renal vein. Seven fragments were intracaval near the filter, one was extracaval, and one could not be located. Kaplan-Meier survival estimates predicted a fracture rate of 40% at 5.5 years. Of the 20 patients with filter fractures, three died of unrelated causes and 17 remain asymptomatic.

Conclusions: Recovery filter fractures occurred at the short limb only, with a suggested 5.5-year fracture risk of 40%. No life-threatening events occurred in patients with filter fracture.

MeSH terms

  • Comorbidity
  • Device Removal / mortality*
  • Equipment Failure / statistics & numerical data*
  • Female
  • Foreign-Body Migration / diagnostic imaging
  • Foreign-Body Migration / mortality*
  • Humans
  • Male
  • Middle Aged
  • Ohio / epidemiology
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / mortality*
  • Prevalence
  • Radiography
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome
  • Vena Cava Filters / statistics & numerical data*
  • Venous Thromboembolism / diagnostic imaging
  • Venous Thromboembolism / mortality*