Abstract No. 650 Suprarenal inferior vena cava filter retrieval: a single-center 10-year experience

Abstract

To evaluate the safety and efficacy of retrieval for inferior vena cava filters (IVCFs) placed in a suprarenal position. Transjugular retrieval of IVCFs placed in a suprarenal position was performed in thirteen patients (5 men, 8 women; mean age: 45.1 ± 13.8 years) between July 2006 and July 2017 using a standard loop-snare technique. Patient charts were reviewed for patient demographics and procedural information. Descriptive analysis was performed using Microsoft Excel. Indications for IVCF placement, positioning, and retrieval are noted in Table 1. IVCFs retrieved included Option Elite (Argon Medical Devices, Inc., Athens, TX) (n = 9, 69%) and Günther Tulip (Cook Medical Inc., Bloomington, IN) (n = 4, 31%). Pulmonary embolism was suspected and ruled out in three patients (23%) during the indwelling period. Follow-up serum creatinine was available for 7 patients (54%), none of whom developed acute renal failure. Eleven suprarenal IVCFs (84%) were successfully retrieved after a median indwelling time of 1.8 months (range, 0.03-12.1). Retrieval was unsuccessful in 2 patients with Option Elite filters, one in whom the filter hook could not be snared (placed 2.5 months prior), and one with IVC wall implantation (placed 11.6 months prior). Thrombosis was not detected in any patients on preretrieval cavogram. There were no periprocedural complications. In the setting of VTE with contraindications to infrarenal IVCF deployment, temporary placement and endovascular retrieval of IVCFs placed in a suprarenal position is safe and feasible.Table 1Indications for Placement, Position, and RetrievalIndication for Placement (N %) Augment AC3 (23) Preoperative3 (23) Contraindication to AC2 (15) VTE + pregnancy2 (15) VTE lysis prophylaxis2 (15) Failure of AC1 (8)Indication for Suprarenal Position (N %) Infrarenal IVC thrombosis4 (31) Renal vein thrombosis3 (23) Pregnancy2 (15) Gonadal vein thrombosis2 (15) Prior infrarenal IVCF thrombosis1 (8) Nonthrombotic infrarenal IVC narrowing1 (8)Indication for Retrieval (N %) Routine11 (84) Preoperative1 (8) Repositioning1 (8)AC, anticoagulation; IVC, inferior vena cava; IVCF, inferior vena cava filter; VTE, venous thromboembolism. Open table in a new tab