UC Health Interventional Radiologist Finds, Removes Decade-Old Medical Device which Migrated to Patient’s Lung

By Rosie Ecker

Nicole Land, UC Health employee and mom of four, was about to turn 40 on Jan. 30, 2019. Weeks before her birthday, she made a promise to herself she was going to live life to the fullest. She created a bucket list of 40 things she was going to accomplish in her 40th year.

On Jan. 17, 2019, a new item landed on Nicole’s bucket list that she hadn’t planned for: overcoming a health problem.

Nicole Land works in both Psychiatry Emergency Services, or PES, and the Mobile Crisis team as a social worker. In January, Nicole went to the emergency room at University of Cincinnati Medical Center as a patient herself.

In 2008, Nicole was in a severe car accident that left her immobile for an extended period of time, which caused a blood clot in her leg. To solve this problem, a physician at a different health system placed an IVC (inferior vena cava) filter in a large vein to catch the blood clot and stop it from moving up to her heart and lungs. Once the blood clot is no longer a risk, a physician removes the IVC filter.

Nicole’s problem began when physicians didn’t remove the IVC filter when it was no longer needed.

More than a decade later, Nicole was short of breath, had an elevated heart rate and felt foggy. When she went over to UC Medical Center and received several tests, Bradley Abraham, MD, UC Health radiology resident, along with Kalpesh Panchal, MD, UC Health emergency radiologist and assistant professor of radiology at the UC College of Medicine, saw in her scans that this IVC filter was not only still inside of her, but that parts of it had broken off and were now lodged into her left lung.

Seetharam Chadalavada, MD, UC Health interventional radiologist, assistant professor of radiology at the UC College of Medicine and vice chair of Radiology–Informatics, received Nicole as his patient.

“Nicole’s clinical story is so intriguing that I had to map out her entire clinical situation from 2008 to 2019. She was someone who couldn’t do her job when I first met her,” Dr. Chadalavada said.

Quickly after her initial visit at UC Medical Center’s Emergency Department, Nicole had her first procedure to retrieve the IVC filter. This procedure was successful, but because of her bucket list, the second procedure to remove broken fragments of the filter would have to wait due to an impending trip to Iceland.

“I had just started living my life, and I couldn’t have this get in the way of my trip I had been planning for months,” Nicole said.
Within the week of her return, Nicole received her second procedure from Dr. Chadalavada, but the case proved more complex than anticipated. The rest of the broken IVC filter wouldn’t budge.

Dr. Chadalavada brainstormed with the rest of the Interventional Radiology team to create a game plan for Nicole’s care in the weeks following the second procedure. Nicole was still dealing with symptoms related to broken fragments in her lungs, such as sharp pain in her side and a pulmonary embolism—a blood clot that prevents the exchange of oxygen between lungs and blood.

As Nicole recovered from the pulmonary embolism, Dr. Chadalavada had ordered specialized equipment to retrieve the IVC filter fragments once and for all. In May 2019, Nicole was finally IVC-filter- and broken-parts-free.

Interventional radiologists are trained in minimally invasive procedures that are guided by imaging, such as ultrasounds or CT scans. A number of UC Health’s interventional radiologists specialize in IVC filter removal and brought these procedurals skills to Greater Cincinnati from advanced training programs. Dr. Chadalavada is specially trained in this area and studied Nicole’s case at length to solve her case. She is grateful to Dr. Chadalavada and even more grateful to UC Health as a whole.

Now, feeling better than ever, Nicole has signed up to be a certified accelerated freefall (AAF) sky diver. The morning after she shared her story, Nicole skydived for the 11th time since July 2019.

If you would like to make an appointment with UC Health Interventional Radiology, please call 513-585-UCIR (8247).

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