Bard Recovery filter: evaluation and management of vena cava limb perforation, fracture, and migration.

PURPOSE: To report on the evaluation and management of Bard Recovery filter limb perforation, fracture, and migration.

MATERIALS AND METHODS: In 2007, all patients who received a Bard Recovery filter at a single institution were contacted for consultation and evaluation by noncontrast computed tomography. Rates of limb perforation, fracture, and migration were evaluated on early (<180 days) and final images. Retrieval success and complications were evaluated.

RESULTS: Fourteen of 16 patients with Bard Recovery filters were evaluated. The early images in nine patients (mean, 30 days; range, 0-126 d +/- 40) demonstrated arm perforations in 56% (n = 5), leg perforation in 11% (n = 1), and no early fractures or migrations. Final images (mean, 899 days; range, 119-1,218 d +/- 320) demonstrated filter arm perforations in all 14 patients. Leg perforations were seen in 36% of patients (n = 5), and there were a total of four fractures with migration in 21% of patients (n = 3). All fractures occurred in arms that had perforated the vena cava on early images. Two patients had already had their filters retrieved at 119 and 302 days, respectively; the remaining 12 patients elected to have their filters retrieved after evaluation. All 12 filters were retrieved at a mean of 1,021 days (range, 119-1,242 d +/- 134). Leg hook fractures occurred during eight of 12 filter retrieval procedures (67%).

CONCLUSIONS: Recovery filter limb perforation of the vena cava increases over time and is associated with a 21% incidence of filter arm fracture and migration. Follow-up imaging is recommended. Filter retrieval has a high success rate and is the authors' preferred management strategy.