03:54 PM Abstract No. 195 Does prolonged dwell time predict failure? Results from a multicenter study of inferior vena cava filter retrieval success for inferior vena cava filters implanted for over 1 year

Abstract

The majority of retrievable inferior vena cava filters (rIVCF) are not removed. Prolonged rIVCF dwell time has been shown to be associated with retrieval failure, and an increase in device-related adverse events (AE). The use of advanced retrieval techniques improves retrieval rates, even with longer dwell times; however, data supporting safety, generalizability, and technical success of advanced techniques remain limited. We aim to examine how rIVCF dwell time of greater than one year impacts the likelihood of retrieval technical success, procedural AE and the need for advanced retrieval techniques. We included all rIVCF retrievals with dwell times greater than 1 year performed from November 2011-August 2018 at four medical centers. Standard retrieval technique (vascular sheath and snare device) was initially attempted in most cases. When this technique failed, advanced techniques (loop snare/forceps/laser) were used. Utilizing multivariable logistic regression, the relationship between retrieval technical success, rIVCF dwell time, and use of advanced techniques. Similarly, the relationship between major procedural AE (SIR grade C or greater), rIVCF dwell time, and patient age/sex was examined. Significance was accepted at p<0.05. During the study period, 369 retrieval procedures were performed. Mean patient age was 54 (SD 15.3) years, and 203 were female (55%). Overall technical success rate was 97.6%; advanced techniques were necessary in 298 (80.8%) procedures; the latter was significantly associated with technical success (p=0.01). Dwell time did not affect technical success (p=0.69). One procedure-related major adverse event occurred (0.2%); no procedure-related mortality occurred. The rate of AE was not associated with filter dwell time, patient age, or gender. Retrieval of rIVCF with greater than 1 year implantation time is successful in the large majority of cases, with a favorable safety profile. To achieve these results, advanced retrieval techniques are necessary in most cases.