Recently, umbrella filters in the inferior vena cava have been used to prevent pulmonary emboli in seriously ill patients. Reported complications include misplacement, tilting, retro-peritoneal hematoma, duodenal perforation, plus dislodgement and migration of the umbrella. To our knowledge, distal migration has been reported only once.1
Report of a Case.—An 82-year-old man was well until Meniere's syndrome made him sedentary. Pulmonary embolism developed and did not improve with heparin sodium therapy. A 28-mm vena cava umbrella filter was positioned just below the renal veins. Terminally, cardiac massage was performed. An abdominal roentgenogram just before this showed the umbrella in an appropriate position.
At autopsy, thromboemboli filled the pulmonary arteries. The umbrella was implanted by two of its six tines in the left iliac vein with thromboembolus above it and within the right iliac vein. The original implantation site just below the renal veins was defined by six short intimal