To evaluate the complications of the temporary implanted inferior vena cava (IVC) filter and the feasibility of double-loop technique for removal of complicated IVC filters.
Methods
From January 2012 to December 2013, a total of 25 patients with IVC filter were referred for IVC filter retrieval. There were 20 Celect®, 3 OptEase®, and 2 Günther-Tulip® filters. All of the patients were evaluated with a pre-procedural CT scan to identify any complications. The IVC filters which had failed to be retrieved by the conventional method were evaluated, and retrieval was attempted with double loop technique.
Results
Sixteen of 25 (64%) filters had complications; IVC wall penetration (n = 11, 44%), tilted within IVC (n = 6, 24%), embedded struts (n = 3, 12%), and fracture of the strut (n = 1, 4%). The complications were overlapped in five patients. Two of them (8%) had also complained of filter-related pain. The success rate of IVC filter retrieval by double-loop technique was 14/16 (87.5%). There was no major filter retrieval-related complications.
Conclusions
The double-loop technique is a safe and feasible method for complicated IVC filter retrieval.
CaplinDMNikolicBKalvaSP. Quality improvement guidelines for the performance of inferior vena cava filter placement for the prevention of pulmonary embolism. J Vasc Interv Radiol2011; 22: 1499–1506.
6.
MillwardSFGrassiCJKinneyTB. Technology Assessment Committee of the Society of Interventional Radiology. Reporting standards for inferior vena caval filter placement and patient follow-up: Supplement for temporary and retrievable/optional filters. J Vasc Interv Radiol2009; 20(7 Suppl): S374–376.
7.
KaufmanJAKinneyTBStreiffMB. Guidelines for the use of retrievable and convertible vena cava filters: Report from the Society of Interventional Radiology multidisciplinary consensus conference. J Vasc Interv Radiol2006; 17: 449–459.
8.
RosenthalDWellonsEDHancockSM. Retrievability of the Günther Tulip vena cava filter after dwell times longer than 180 days in patients with multiple trauma. J Endovasc Ther2007; 114: 406–410.
9.
GoMRKeller-BiehlLStarrJE. Penetration of the inferior vena cava and adjacent organs after filter placement is common and associated with temporary filter type and length of time in place. J Vasc Surg2013; 58: 1433–1434.
StavropoulosSWDixonRGBurkeCT. Embedded inferior vena cava filter removal: Use of endobronchial forceps. J Vasc Interv Radiol2008; 19: 1297–1301.
15.
YanYGalfoioneMStavropoulosWS. Forceps retrieval of a tip-embedded superior vena cava filter. J Vasc Interv Radiol2013; 24: 592–595.
16.
LynchFC. Balloon-assisted removal of tilted inferior vena cava filters with embedded tips. J Vasc Interv Radiol2009; 20: 1210–1214.
17.
FoleyPJNathanDPWangGJ. A “fall-back” technique for difficult inferior vena cava filter retrieval. J Vasc Surg2012; 56: 1629–1633.
18.
SinghKMarcoSASandhuRK. A novel technique to remove inferior vena cava filters using a homemade snare device. J Vasc Surg2012; 56: 1821–1821.
19.
KuoWTOdegaardJIRosenbergJK. Excimer laser-assisted removal of embedded inferior vena cava filters: A single-center prospective study. Circ Cardiovasc Interv2013; 6: 560–566.
20.
RayCEJrMitchellEZipserS. Outcomes with retrievable inferior vena cava filters: A multicenter study. J Vasc Interv Radiol2006; 17: 1595–1604.
21.
IliescuBHaskalZJ. Advanced techniques for removal of retrievable inferior vena cava filters. Cardiovasc Intervent Radiol2012; 35: 741–750.
22.
SadafARasuliPOlivierA. Significant caval penetration by the Celect inferior vena cava filter: attributable to filter design?J Vasc Interv Radiol2007; 18: 1447–1450.
23.
ZhouDSpainJMoonE. Retrospective review of 120 Celect inferior vena cava filter retrievals: Experience at a single institution. J Vasc Interv Radiol2012; 23: 1557–1563.
24.
DurackJCWestphalenACKekulawelaS. Perforation of the IVC: Rule rather than exception after longer indwelling times for the Günther-Tulip and Celect retrievable filters. Cardiovasc Intervent Radiol2012; 35: 299–308.
25.
RimonUBensaidPGolanG. Optease vena cava filter optimal indwelling time and retrievability. Cardiovasc Intervent Radiol2011; 34: 532–535.
26.
KuoWTRobertsonSWOdegaardJI. Complex retrieval of fractured, embedded, and penetrating inferior vena cava filters: A prospective study with histologic and electron microscopic analysis. J Vasc Interv Radiol2013; 24: 622–630.
