Researchers are warning that IVC filter removal might be difficult in pediatric patients, especially if the devices have tilted out of position or become embedded.

In the 10-year study, published in the medical journal Pediatric Radiology on Jan. 21, researchers from the Children’s Hospital of Philadelphia found that while all IVC filter removal procedures performed on children were successful, a significant percentage required adjunctive techniques, typically because the IVC filter had migrated out of position.

IVC filters are positioned in the inferior vena cava, where they catch blood clots that have broken loose from other veins before the clots can travel to the heart and lungs. Retrievable devices, like those cited in the Pediatric Radiology study, are intended to be removed once a patient is no longer at risk for blood clots.

Since 2009, the U.S. Food & Drug Administration (FDA) has issued two health alerts regarding serious IVC filter complications. The alerts were prompted by hundreds of reports indicated that the devices had perforated veins, or migrated out of position.

The research team at the Children’s Hospital of Philadelphia conducted 10-year review of 20 children, including 13 males and 7 females, between the ages of 12 and 19, who underwent IVC filter removal.  While the IVC filters were successfully retrieved in all cases, 15% of the children had to undergo adjunctive techniques to remove the devices. In about a quarter of these IVC filter removal cases, the IVC filter had tilted out of position from eight degrees to 40 degrees.

One patient experienced perforation of the inferior vena cava, while another suffered embedment of the filter tip.

Two IVC filter complications related to the retrieval procedure were also noted, including one child in the group who suffered an IVC mural dissection. In the second, a snare catheter fractured during IVC filter removal.

“In children, IVC filter retrieval can be performed safely but may be challenging, especially in cases of filter tilt or embedding,” the authors of the report concluded. “Adjunctive techniques may increase filter retrieval rates” in these children, but may come with their own risk of IVC filter complications.

Lawsuits Over IVC Filter Complications

The publication of the study comes as hundreds of plaintiffs pursue IVC filter lawsuits against C.R. Bard, Inc. and Cook Medical, Inc., for serious IVC filter complications allegedly associated with their devices. Federal cases filed over Bard’s Recovery and G2 IVC filters have been centralized in the U.S. District Court, District of Arizona.

A scheduling proposal recently submitted by the parties involved in that proceeding could allow certain cases to start heading to trial early next year.

Lawsuits involving IVC filter complications allegedly associated with Cook Medical’s Celect and Gunther Tulip products have been consolidated in the U.S. District Court, Southern District of Illinois. Court documents indicate that the first trials in the Cook litigation could begin sometime after September 2016.

If you received a IVC filter in the past, and you have since suffered problems with filter migration, filter fracture, filter embolization, perforation of the vena cava, or other IVC filter complications, consult a experienced IVC filter attorney to discuss your legal options.