1:57 PM Abstract No. 178 - Effectiveness and complications of routine and advanced inferior vena cava filter retrieval techniques

Abstract

PurposeTo investigate complications and effectiveness of routine and advanced inferior vena cava (IVC) filter retrieval techniques.Materials and MethodsA retrospective review was performed of patients who underwent IVC filter placement and/or retrieval attempt over a 10 year period. Patient demographics, retrieval technique(s), pre-retrieval computed tomography, pre-retrieval venography, and clinical/imaging follow-up for 30 days post-retrieval were analyzed.ResultsA total of 1060 retrievable IVC filter placements were reviewed. There were 231 filter retrieval attempts included in our analysis, with success rates of 73.2% (169/231) and 94.7% (54/57) for routine and advanced filter retrieval techniques, respectively. In 227 cases with routine and advanced techniques utilized sequentially, the success rate of filter retrieval was 98.2% (223/227). Overall filter retrieval complication rate was 1.7% (4/231); complications in 4 patients (with multiple complications in some cases) included IVC dissection, IVC intussusception, IVC thrombus/stenosis, filter fracture with embedded strut, IVC injury with hemorrhage, and vascular injury from complicated venous access. The rate of complication associated with advanced technique was significantly higher compared to routine technique (5.3% vs. 0.4%). Longer dwell time, more transverse tilt, and presence of embedded hook were associated with significantly increased rates of failed routine retrieval technique. There was no significant difference in success or complication rates associated with various utilized advanced retrieval techniques including wire loop and snare, endobronchial/endomyocardial forceps, balloon displacement, loop snare, and tilted-filter straightening techniques. The Gunther Tulip filter (Cook Inc, Bloomington, In) was associated with significantly lower rates of failed routine technique and embedded hook compared to other retrievable filter types.ConclusionIVC filter retrieval techniques are highly effective with a low complication rate; however, advanced filter retrieval techniques are associated with a significantly higher complication rate compared to routine technique. PurposeTo investigate complications and effectiveness of routine and advanced inferior vena cava (IVC) filter retrieval techniques. To investigate complications and effectiveness of routine and advanced inferior vena cava (IVC) filter retrieval techniques. Materials and MethodsA retrospective review was performed of patients who underwent IVC filter placement and/or retrieval attempt over a 10 year period. Patient demographics, retrieval technique(s), pre-retrieval computed tomography, pre-retrieval venography, and clinical/imaging follow-up for 30 days post-retrieval were analyzed. A retrospective review was performed of patients who underwent IVC filter placement and/or retrieval attempt over a 10 year period. Patient demographics, retrieval technique(s), pre-retrieval computed tomography, pre-retrieval venography, and clinical/imaging follow-up for 30 days post-retrieval were analyzed. ResultsA total of 1060 retrievable IVC filter placements were reviewed. There were 231 filter retrieval attempts included in our analysis, with success rates of 73.2% (169/231) and 94.7% (54/57) for routine and advanced filter retrieval techniques, respectively. In 227 cases with routine and advanced techniques utilized sequentially, the success rate of filter retrieval was 98.2% (223/227). Overall filter retrieval complication rate was 1.7% (4/231); complications in 4 patients (with multiple complications in some cases) included IVC dissection, IVC intussusception, IVC thrombus/stenosis, filter fracture with embedded strut, IVC injury with hemorrhage, and vascular injury from complicated venous access. The rate of complication associated with advanced technique was significantly higher compared to routine technique (5.3% vs. 0.4%). Longer dwell time, more transverse tilt, and presence of embedded hook were associated with significantly increased rates of failed routine retrieval technique. There was no significant difference in success or complication rates associated with various utilized advanced retrieval techniques including wire loop and snare, endobronchial/endomyocardial forceps, balloon displacement, loop snare, and tilted-filter straightening techniques. The Gunther Tulip filter (Cook Inc, Bloomington, In) was associated with significantly lower rates of failed routine technique and embedded hook compared to other retrievable filter types. A total of 1060 retrievable IVC filter placements were reviewed. There were 231 filter retrieval attempts included in our analysis, with success rates of 73.2% (169/231) and 94.7% (54/57) for routine and advanced filter retrieval techniques, respectively. In 227 cases with routine and advanced techniques utilized sequentially, the success rate of filter retrieval was 98.2% (223/227). Overall filter retrieval complication rate was 1.7% (4/231); complications in 4 patients (with multiple complications in some cases) included IVC dissection, IVC intussusception, IVC thrombus/stenosis, filter fracture with embedded strut, IVC injury with hemorrhage, and vascular injury from complicated venous access. The rate of complication associated with advanced technique was significantly higher compared to routine technique (5.3% vs. 0.4%). Longer dwell time, more transverse tilt, and presence of embedded hook were associated with significantly increased rates of failed routine retrieval technique. There was no significant difference in success or complication rates associated with various utilized advanced retrieval techniques including wire loop and snare, endobronchial/endomyocardial forceps, balloon displacement, loop snare, and tilted-filter straightening techniques. The Gunther Tulip filter (Cook Inc, Bloomington, In) was associated with significantly lower rates of failed routine technique and embedded hook compared to other retrievable filter types. ConclusionIVC filter retrieval techniques are highly effective with a low complication rate; however, advanced filter retrieval techniques are associated with a significantly higher complication rate compared to routine technique. IVC filter retrieval techniques are highly effective with a low complication rate; however, advanced filter retrieval techniques are associated with a significantly higher complication rate compared to routine technique.