Aortic pseudoaneurysm caused by Tempofilter II inferior vena cava filter strut perforation: a case report.

Introduction: Inferior vena cava (IVC) filters are widely used in the management of pulmonary embolism (PE), although they carry risks of significant mechanical complications. Case presentation: We report the case of a patient with deep vein thrombosis and PE who developed an unexplained decrease in hemoglobin level following Tempofilter II filter placement and thrombolysis. Computed tomography angiography and digital subtraction angiography confirmed an abdominal aortic pseudoaneurysm caused by a penetrating filter strut. The filter was successfully retrieved, and the pseudoaneurysm was excluded via covered stent implantation, with favorable clinical outcomes. Discussion: Although rare, IVC filters can cause aortic pseudoaneurysm, a potentially life-threatening complication. Risk factors include advanced age, aortic tortuosity, and design-related propensity for migration of the Tempofilter II filter. This case study underscores the importance of thorough preoperative vascular assessment, prompt CT evaluation in patients with postprocedural back pain, individualized endovascular management, and patient education on activity restrictions. Conclusion: This case highlights the necessity of vigilant monitoring for rare but severe vascular complications following IVC filter placement.