04:21 PM Abstract No. 198 Comparison of the Captus device versus conventional snare for IVC filter retrieval

Abstract

Retrievable inferior vena cava filters (IVCF) should be removed when no longer indicated. IVCF retrieval has traditionally relied on capturing the filter hook with a conventional endovascular snare. A newly available retrieval device (Captus, Avantec Vascular, Sunnyvale, CA) features a novel conical design to aid in filter capture. This study aims to compare the Captus to a conventional snare for IVCF retrieval success. A prospectively acquired database of consecutive IVCF retrievals was analyzed. Two retrieval devices were compared: Captus and Ensnare (Merit Medical, South Jordan, UT). Patient demographics, filter type, dwell time, fluoroscopy time, and conversion to advanced methods of IVCF retrieval were evaluated. A complexity score was assigned to each case, derived from factors including tilt and extracaval penetration. Statistical analysis was performed using chi square and Mann-Whitney Wilcoxon Rank Sum tests with rejection of the null hypothesis at p<0.05. 30 Captus and 31 Ensnare consecutive IVCF retrievals were compared. Baseline demographics were similar with average dwell time of 157 days in the Captus group and 178 days in the Ensnare group (p=0.80). Complexity score was also similar (p=0.11). Primary retrieval success rate was 76.7% with Captus and 54.8% with Ensnare, with strong trend toward statistical significance (p=0.07). Technical success after adjunctive techniques was 100% in the Captus group and 93.5% in the Ensnare group (p=0.15). Captus had similar procedural sedation time compared to Ensnare (40 vs 35 min, p=0.90), and significantly less fluoroscopy time (4.8 vs 10.2 min, p<0.05). No procedural complications were encountered in the Captus group while four filters fractured in the Ensnare group (0% vs 12.9%, p=0.04). Captus is more effective as a primary means of IVCF retrieval than Ensnare. Captus requires significantly less fluoroscopy time than a traditional snare, possibly owing to improved ease of use. Validation of these preliminary results in larger series is forthcoming.