This was a Gunther Tulip IVC filter placed 17 years prior (2005) to the current radiographs due to a lower extremity DVT after knee surgery and history of MTHFR mutation. This was meant to be a temporary IVC filter, but unfortunately, it was never removed. The patient is not on any lifelong anti-coagulation despite the presence of a fractured IVC filter. There are fractures of at least two of the struts of the IVC filter. A Gunther Tulip filter should typically have 4 struts visible; all 4 can be accounted for here and should be done so via plain film imaging. Chest radiographs did not show any other displaced strut superiorly. The patient’s lower back pain is likely due to lower lumbar spondylosis and is unrelated to her fractured IVC filter.

Generally speaking, retrievable IVC filters have a hooked end and are removed within 6 months after determining that there is a low risk of a clot traveling to the lungs. If the risk of clots traveling to the lung persists and the patient has contraindications to anticoagulation, then a retrievable filter can be left in place permanently. Although these filters can still be removed several years down the line, risks and benefits have to be determined in each case. A single report has been published with the removal of Gunther Tulip IVC filter >9 years after placement¹. Otherwise, in this case, the patient has had the filter in place for 17 years and it is unlikely that the filter will have to be removed simply due to it being in place for too long.