Filter Retrieval Research Articles

Factors Influencing the Indwelling Time of Retrievable Inferior Vena Cava Filters in Fracture Patients With Deep Vein Thrombosis: A Retrospective Cohort Study

AIM: To investigate factors influencing the indwelling time of retrievable inferior vena cava filters (IVCFs) in fracture patients with deep vein thrombosis (DVT), particularly comparing Denali and Cordis filters and analyzing the impact of thrombus location and patient characteristics. METHODS: A retrospective cohort study was conducted from June 2017 to December 2021 at Shenyang Orthopedic Hospital, China. We analyzed 802 patients with fractures and acute DVT who underwent successful IVCF retrieval. Patients were stratified into Denali (n = 360) and Cordis (n = 442) groups, with DVT categorized into four subgroups: above-knee DVT (AKDVT), popliteal vein thrombosis (PVT), below-knee DVT (BKDVT), and mixed DVT (MDVT). The normality of continuous variables was assessed using the Kolmogorov-Smirnov test (p ≥ 0.05). Statistical analyses included Cox regression for hazard ratios (HRs), independent t-tests for normally distributed variables, chi-square tests for categorical variables (e.g., gender, diabetes prevalence), and Mann-Whitney U tests for non-normally distributed variables. RESULTS: A total of 802 patients underwent IVCF insertion and had their filters successfully removed. Significant differences in the indwelling time for AKDVT, PVT, BKDVT, and MDVT were observed between the Denali and Cordis groups (p < 0.001). In the Denali group, the indwelling times for AKDVT, PVT, BKDVT, and MDVT were 58, 67, 42, and 51 days, respectively, while in the Cordis group, the corresponding times were 21, 15.5, 16, and 19 days (p < 0.001). Cox regression analysis revealed that age influenced the indwelling time in the Denali group. In both the Denali and Cordis groups, metabolic factors such as diabetes, hypertension, and blood lipids were not significantly correlated with indwelling time (p > 0.05). Multivariate Cox regression identified that age ≥60 years (adjusted HR = 1.3, 95% confidence interval (CI) = 1.051–1.609, p = 0.016) and BKDVT (BKDVT vs. AKDVT: HR = 1.802, 95% CI = 1.029–3.157, p = 0.039) were predictors of prolonged indwelling time in the Denali group, while PVT (p = 0.943) and MDVT (p = 0.831) showed no significant association. CONCLUSIONS: Denali filters require longer indwelling durations than Cordis filters, with age and DVT location (BKDVT) being critical determinants for Denali, whereas only DVT location affects Cordis. Clinicians should tailor follow-up schedules and prioritize early retrieval for Cordis filters to reduce complications. These findings underscore the importance of individualized IVCF management based on filter type and thrombus location.

Efficacy and Safety of Systemic Thrombolysis in the Treatment of Lower Extremity Fracture Complicated With Distal Deep Vein Thrombosis.

Objective To evaluate the efficacy and safety of systemic thrombolysis(ST)and standard anticoagulation(SA)in the treatment of lower extremity fracture complicated with distal deep vein thrombosis(DDVT).Methods We retrospectively analyzed the clinical data of 60 patients with lower extremity fracture complicated with DDVT treated from January 2021 to December 2023.When the lower limb venography indicated a calf thrombus burden score ≥3 points,a retrievable inferior vena cava filter(IVCF)was successfully placed in the healthy femoral vein before orthopedic surgery.The patients who received further anticoagulant or thrombolytic therapy after surgery were allocated into a ST group(n=30,urokinase ST and SA)and a SA group(n=30,only SA).The two groups were compared in terms of calf thrombus burden score,thrombus dissolution rate,IVCF placement time,IVCF retrieval rate,intercepted thrombi,hemoglobin level,platelet count,D-dimer level,and complications.Results There was no statistically significant difference in the calf thrombus burden score between the two groups before treatment(P=0.431).However,after treatment,the scores in both groups decreased(both P<0.001),with the ST group showing lower score than the SA group(P=0.002).The thrombus dissolution rate in the ST group was higher than that in the SA group(P<0.001).There was no statistically significant difference in the IVCF placement time between the two groups(P=0.359),and the IVCF retrieval rate was 100% in both groups.The ST group had fewer intercepted thrombi than the SA group(P=0.002).There was no statistically significant difference in hemoglobin level(P=0.238),platelet count(P=0.914),or D-dimer level(P=0.756)between the two groups before treatment.However,after treatment,both groups showed an increase in platelet count(both P<0.001)and a decrease in D-dimer level(both P<0.001).There was no statistically significant difference in the occurrence of complications between the two groups(P=0.704).Conclusions Both SA and ST demonstrate safety and efficacy in the treatment of lower extremity fractures complicated with DDVT,serving as valuable options for clinical application.Compared with SA,ST not only enhances the thrombus dissolution in the calf but also mitigates the risk of thrombosis associated with IVCF.

Managing an effective system for retrieving IVC filters: outcomes of a prospective patient database, 2012–2023

PurposeTo evaluate retrievable inferior vena cava (IVC) filter outcomes with a prospectively maintained database and active patient management by interventional radiology (IR).Materials & methodsPatients with retrievable IVC filters placed by IR from 2012 to 2023 at a single, tertiary institution were tracked in a prospective registry, and follow-up was organized by a designated IR physician assistant. Patients were contacted after the filter was placed by IR and a clinic visit arranged; filter removal was scheduled when deemed appropriate. Retrospective review of filter outcomes, including retrieval, patient death, and need for permanent filtration, was performed.ResultsOver the 12-year study period, 607 retrievable IVC filters were placed: 516 Denali, 63 Eclipse, 19 Günther Tulip, and 9 Celect Platinum. In total, 43% (260) were retrieved, 12% (75) were adjudicated to be permanent, and 42% (253) died with the filter in place. The remaining 3% (19) comprised patients alive with the filter not yet retrieved at study endpoint, 42% (8/19) of which were placed in 2023. Of this cohort, 8 still needed the filter and were being monitored to determine follow-up timing, 2 needed a follow-up appointment, and 9 were lost to follow-up due to repeated no-shows and/or inability to reach the patient despite multiple attempts. Overall, 1.5% (9/607) of all filters placed were not accounted for.ConclusionThis study demonstrates high accountability (98.5%) of retrievable IVC filters when using a prospective registry actively managed by an IR PA, providing an effective and feasible model for facilitating appropriate follow-up.

Research progress in biodegradable filters.

Research progress in biodegradable filters.

Two-Year Outcomes from the Cook Inferior Vena Cava Filter (CIVC) Study.

Two-Year Outcomes from the Cook Inferior Vena Cava Filter (CIVC) Study.

Enhancing Routine Reporting of IVC Filters: An Interventionalist's Approach to Improving Patient Safety in an Underserved Urban Area.

PurposeTo determine whether concurrent reporting and follow-up on diagnostic imaging could be used as an effective tool to raise IVC filter (IVCF) awareness in an underserved urban community. Methods: For this prospective study, radiologists at our institution flagged plain-film and cross-sectional imaging in which an IVCF was identified from October 2018 to October 2019. For consent, a phone survey was conducted to assess the patient's knowledge and understanding related to IVC filter placement. Key data points on the survey included patients' awareness of filter presence, placement date, location, difference between filters, satisfaction regarding peri-procedural education, and plan for filter removal. Patients desiring further information were scheduled for follow-up in the Vascular Interventional Radiology clinic. Results: 77 patients were identified with an IVC filter. 34 patients (15 males, 19 females; mean age 56y +/- 13.6 years) consented. 23.5% were unaware of their IVC filter. Of those aware, 61.5% were dissatisfied with their consultation/education during placement and 88% pursued further IR consultation indicating a desire to consult a clinician regarding their filter. During the study, 8 patients with IVCF (23.5%) were deemed no longer medically necessary; 6 underwent retrieval and 2 were pending at study conclusion. Conclusion: In underserved urban communities, patients with indwelling IVC filters may not have received appropriate follow-up instructions regarding filter retrieval or may be unaware they have one altogether. Diagnostic imaging is an effective tool to identify these patients, raise awareness, and improve retrieval of filters that are no longer indicated.

Unveiling the link between oversizing ratio and neointimal hyperplasia in a porcine model

Intimal hyperplasia (IH) is a major risk for inferior vena cava (IVC) filter retrieval failures and potentially fatal vascular trauma to the IVC or caudal vena cava (CVC) wall post-retrieval. However, demonstrating neointimal formation in humans presents challenges due to the difficulty in obtaining quantitative pathological evidence from the IVC. Here, it was hypothesized that the mismatch between the diameter of the CVC and the filter would correlate with increased IH. Radial force (RF) exerted by filter struts at various CVC diameters was tested in vitro. In vivo, Bama miniature swine were randomly fitted with IVC filters of 32 mm–20 mm diameter, and a three-dimensional digital subtraction angiography model was used to determine the oversizing ratio (OR). After dwelling times of 2, 3, and 4 weeks, the macroscopic CVC wall and intima in the areas adjacent to IVC filter struts were observed. The proliferation and thickness of IH and presentations of vascular smooth muscle cells (VSMCs) were evaluated. Masson trichrome staining was used to determine the production of collagen fiber. The RFs of the IVC filter consistently increased with the OR, suggesting a correlation coefficient (R2 = 0.74, p < 0.001). Notable response in the CVC wall after filter placement, characterized by vessel wall injury, VSMCs dedifferentiation, proliferation, and extracellular matrix secretion, which tended to increase and change over time. Increased ORs and dwelling time correlated linearly with greater IH thickness (adjusted R2 = 0.456, p < 0.001). Moreover, restricted cubic splines (RCS) analysis revealed that ORs had a non-linear relationship with the IH thickness after adjusting for the IVC filter dwelling time (nonlinear p = 0.047, p < 0.001). A linear correlation was also noted between increased ORs and dwelling time with the collagen area fraction (adjusted R2 = 0.860, p < 0.001). Furthermore, RCS indicated a consistently higher risk of increased collagen fiber content when the OR exceeded 100.75% (nonlinear p = 0.047, p < 0.001). IH developed in response to CVC injury, VSMCs proliferation, and secretion of the extracellular matrix collagen fiber. RFs increased with increased ORs. Increased ORs and dwelling time correlate linearly with greater IH thickness and increased production of collagen fiber.

Inferior Vena Cava Filter Placed in Neurologic Intensive Care Unit: Effectiveness, Retrieval Rate, and Mortality.

Patients in neurologic intensive care unit (NICU) often undergo inferior vena cava filter (IVCF) placement for venous thrombotic events. This study aims to determine the effectiveness of IVCF, filter retrieval, and mortality among patients that received IVCF in NICU. In this single institutional, noncomparative, retrospective study, all patients who were admitted to NICU and underwent IVCF placement from April 2015 to December 2020 were reviewed. IVCF was successfully deployed in all 175 patients [100%; median age 68 years, female 84/175 (48.0%)]. The 3 most common causes for NICU admission were intracranial hemorrhage (66/175, 37.7%), ischemic stroke (62/175, 35.4%), and traumatic brain injury (16/175, 9.1%). Deep vein thrombosis and pulmonary embolism (PE) were confirmed in 155 (88.6%) and 35 (20.0%) patients at the time of filter placement, respectively. Primary outcomes of interest were postfilter placement PE, filter retrieval, and inhospital mortality. Baseline characteristics were analyzed using t-tests and chi-squared test for continuous and noncontinuous variables, respectively. Factors associated with primary outcomes were analyzed with a logistic regression model. Post-IVCF PE occurred in 3 patients (1.7%) with a median follow-up of 3 months. Excluding 26 inhospital deaths (14.9%, none was related to PE), filters were retrieved in 31 discharged patients (20.8%) with a median filter dwelling time of 9 months. Advanced filter retrieval required a higher fluoroscopy time (median 3.3 minutes vs 8.3 minutes, p = 0.016) and contrast volume use (median 35.0 ml vs 57.5 ml, p = 0.0028) than standard technique. No procedure-related complication occurred during filter placement and retrieval. Sequential Organ Failure Assessment (SOFA, p = 0.012) and Simplified Acute Physiology Scores (SAPS, p = 0.016) were independently associated with inhospital mortality. Modified Rankin Score (mRS) at discharge was an independent predictor for filter retrieval (p < 0.001). Despite safety and effectiveness, IVCF retrieval rate for NICU patients was low, particularly those with worse mRS at time of hospital discharge. Worse SOFA and SAPS scores were associated with inhospital mortality.Clinical ImpactInferior vena cava filter (IVCF) is effective preventing post-filter pulmonary embolism (PE) in neurologic intensive care unit (NICU) patients, with only 1.7% experiencing PE post-placement, underscoring its role in managing venous thrombotic events in this high-risk population; however, the low retrieval rate of IVCFs, particularly in patients with poorer functional outcomes (worse mRS at discharge), and the association of higher SOFA and SAPS scores with increased inhospital mortality, emphasize the need for improved strategies to optimize filter retrieval and patient selection in critically ill neurologic patients.

A Multidisciplinary Quality Improvement Project Leads to Improved Patient Follow-up and Filter Retrieval Rate.

A Multidisciplinary Quality Improvement Project Leads to Improved Patient Follow-up and Filter Retrieval Rate.

Abstract No. 84 High Accountability of Retrievable IVC Filters with an Actively Managed Prospective Patient Database Over a 12-Year Period

Abstract No. 84 High Accountability of Retrievable IVC Filters with an Actively Managed Prospective Patient Database Over a 12-Year Period

High thrombus density ratio on CT venography is associated with inferior vena cava filters trapped embolus in patients with deep vein thrombosis.

High thrombus density ratio on CT venography is associated with inferior vena cava filters trapped embolus in patients with deep vein thrombosis.

A nomogram model to predict non-retrieval of short-term retrievable inferior vena cava filters.

To develop and validate a nomogram for predicting non-retrieval of the short-term retrievable inferior vena cava (IVC) filters. In this study, univariate and multivariate logistic regression analyses were performed to identify predictive factors of short-term retrievable filter (Aegisy or OptEase) non-retrieval, and a nomogram was then established based on these factors. The nomogram was created based on data from a training cohort and validated based on data from a validation cohort. The predictive value of the nomogram was estimated using area under the curve (AUC) and calibration curve analysis (Hosmer-Lemeshow test). A total of 1,321 patients who had undergone placement of short-term retrievable filters (Aegisy or OptEase) were included in the analysis. The overall retrieval rate was 68.7%. Age, proximal and distal deep vein thrombosis (DVT) vs. distal DVT, active cancer, history of long-term immobilization, VTE was detected in the intensive care unit, active/recurrent bleeding, IVC thrombosis, and history of venous thromboembolism were independent predictive risk factors for non-retrieval of filters. Interventional therapy for DVT, acute fracture, and interval of ≥14 days between filter placement and patient discharge were independent protective factors for non-retrieval of filters. The nomogram based on these factors demonstrated good ability to predict the non-retrieval of filters (training cohort AUC = 0.870; validation cohort AUC = 0.813. This nomogram demonstrated strong predictive accuracy and discrimination capability. This model may help clinicians identify patients who are not candidates for short-term retrievable filter placement and help clinicians make timely, individualized decisions in filter choice strategies.

Technical Complications Associated with Embolic Protection Device During Carotid Artery Stenting: Incidence, Risk Factors, Clinical Implications, and Rescue Maneuvers.

Background/Objectives: This study aimed to evaluate the incidence, risk factors, clinical implications, and rescue maneuvers of technical complications related to embolic protection devices (EPDs) during carotid artery stenting (CAS). Materials and Methods: We retrospectively reviewed all patients who had undergone CAS with EPDs between April 2018 and March 2024. The incidence and types of technical complication associated with EPDs were assessed. Clinical, angiographical, and procedural factors were analyzed to identify risk factors for the occurrence of EPD-related adverse events. Various rescue techniques for managing adverse events were investigated based on the procedure record. Results: Of the 158 enrolled patients, the rate of EPD-related technical complications was 23.4% (n = 37). Among them, complicated filter retrieval was the most common adverse event (n = 23, 14.6%). Older age, a higher degree of residual stenosis, and the type of the EPD were significant risk factors for complicated filter retrieval (p < 0.05). Although distal thrombus migration requiring thrombectomy was more frequent in patients with complicated filter removal (2.2% vs. 13.0%, p = 0.041), there was no significant increase in postprocedural thromboembolic and hemorrhagic complications. When complicated filter retrieval occurred, careful to-and-fro movement of the patients' neck, such as rotation, or asking them to swallow was tried first in all 23 patients. When these attempts failed, manipulation of a curved-tip guiding catheter, the balloon bridge technique, and alternative use of a 5 Fr angiocatheter as a retrieval sheath were sequentially tried, and all filters were successfully retrieved. Conclusions: Complicated filter retrieval was the most common technical complication during CAS. Various rescue techniques for successful filter removal were effective for ensuring safety of CAS.

Abstract 4128599: Facility-level Variation Underlying Low Inferior Vena Cava Filter Retrieval in the United States

Background: Inferior vena cava (IVC) filters are commonly implanted in patients with venous thromboembolism (VTE) who are unable to receive anticoagulation, to protect against clot migration to the heart. With prolonged implantation, IVC filters are associated with complications: device fracture, migration, penetration into adjacent organs and worsened VTE. Two Federal Drug Administration advisories and multi-society guidelines have emphasized the importance of timely retrieval but national retrieval rates remain low (&lt;30%). Aims: To quantify hospital-level variation in IVC filter retrieval, describe time-based retrieval rates and examine factors associated with retrieval. Methods: IVC Filter implantation for all patients &gt;= 18 years was identified in the 2016-2020 inpatient and outpatient 100% limited data set Medicare files using claims codes. Hospital information for the implanting facility was cross-linked from the American Hospital Association and Healthcare Cost Report Information System files, including identifying information, teaching status, census location, operating margin and % uncompensated care. IVC filter retrieval rates and time to retrieval from implantation was calculated. Bayesian hospital profiling methods were used to quantify 1-year retrieval rate for all U.S. facilities, adjusting for patient factors – demographics, diagnostic indications and comorbidities. Results: Among Medicare beneficiaries, there were 140,481 IVC Filter implantations across 2,850 facilities. Excluding patients who died within 90 days of implantation (25.7%), retrieval rates at 3 months, 1 year and anytime were 7.9%, 18.7% and 20.0% respectively. IVC Filter retrieval within 1 year varied significantly at the facility-level, from 0-100%. Focusing on facilities with at least 13 IVC filter implantations each year (top 25%ile volume), 1-year retrieval ranged from 0 to 74.5%. Higher 1-year retrieval was seen among higher implantation volume (12.4% bottom quartile, 20.5% top quartile), teaching (21.1% teaching vs. 16.9% nonteaching) and non-safety net (21.1% low uncompensated care, 15.0% high uncompensated care) hospitals. Retrieval rates did not vary significantly by hospital operating margin or rurality. Conclusion(s): There is low overall IVC filter retrieval in the United States with large underlying facility-level variation. Focused examination of high-performing facilities could yield insights on how to improve device retrieval nationally.

Clinical Application of DynaCT in the Study of Vascular Neointimal Hyperplasia Characteristics after Option Filter Placement.

The objective of this study was to analyze neointimal hyperplasia of the inferior vena cava (IVC) after Option filter implantation by DynaCT and to provide a reference for the safety of effective neointimal hyperplasia cutting after long retrieval window filter implantation in vivo. Clinical data on 22 patients with Option filters were retrospectively analyzed. DynaCT was used to analyze the characteristics of neointimal hyperplasia after filter implantation, including the distribution of neointimal hyperplasia and the maximum thickness of the neointimal hyperplasia. Correlation analysis was performed between the measurement results and the number of times the inner membrane of the filter was cut during filter retrieval, and correlation analysis also was performed between the measurement results and the time of filter placement. As measured by DynaCT, the neointimal hyperplasia after filter placement was located around the barbs of the filter plug, and the maximum neointimal hyperplasia thickness was located in the 1 to 5 points of the IVC. There was a linear trend between neointimal hyperplasia thickness of the IVC and filter neointimal cutting times by the retrieval catheter after filter placement. Correlation analysis showed a correlation coefficient of r = 0.609 (P = 0.003), indicating a significant correlation between the two. There also was a linear trend between neointimal hyperplasia thickness and implantation time. Correlation analysis showed that the correlation coefficient was r = 0.36 (P = 0.102), and the correlation between the two was not significant. Based on DynaCT, the characteristics of IVC neointimal hyperplasia after Option filter implantation were analyzed, and the cutting force and direction of neointimal hyperplasia could be controlled effectively and safely by changing the filter retrieval catheter. we can effectively and safely cut the hyperplastic intima by modifying the filter retrieval catheter to control the cutting force and direction and provide a reference for the safe and effective retrieval of the long-retrieval-time window filter after implantation in the body.

Comparing anticoagulant therapy alone, anticoagulant therapy in combination with catheter-directed thrombolysis, and anticoagulant therapy in combination with pharmacomechanical catheter-directed thrombolysis in the patients with optional inferior vena cava filter-related thrombosis: A single-center retrospective study.

To analyze the treatment methods and efficacy of inferior vena cava filter thrombosis (IVCFT). In this retrospective study, the clinical data for 47 patients with IVCFT who underwent sequential treatment at the Department of Vascular Surgery, Tianjin Medical University Second Hospital, from January 2020 to January 2023 were analyzed. Patients were divided into three groups according to the treatment method: anticoagulant therapy (AC group), anticoagulation plus catheter-directed thrombolysis (CDT group), and anticoagulation plus AngioJet thrombectomy plus catheter-directed thrombolysis (PCDT group). The evaluation criteria for efficacy mainly included preoperative and postoperative clinical symptoms (Villalta score), thrombus diameter, thrombus clearance rate, filter retrieval rate, filter retention time, and urokinase dosage. This study included 47 patients, of whom 31 were males (65.9%) and 16 females (34.1%), with a mean age of 72.05 ± 8.32years. An Aegisy filter was used in seven patients, whereas an Illicium filter was used in forty patients. There were a total of nineteen patients in the anticoagulation-only group, with complete dissolution of the intraluminal thrombus in five patients, a residual thrombus with a maximum diameter ≤1cm in three patients, and a residual thrombus with a maximum diameter >1cm in eleven patients. The Villalta score was 7.16 ± 0.6 before treatment and decreased to 3.79 ± 0.59 after treatment. The thrombus diameter decreased from an average of 1.46 ± 0.2cm before treatment to an average of 0.85 ± 0.14cm after treatment. The retrieval rate for the filters was 42.11% (8/19), with an average dwell time of 27.4 ± 1.3days for the filters. The CDT group consisted of 17 patients. Among whom we observed, complete dissolution of the intraluminal thrombus was observed in six patients, residual thrombus with a maximum diameter ≤1cm in nine patients, and residual thrombus with a maximum diameter >1cm in two patients. The Villalta score decreased from 7.53 ± 0.83 before treatment to 2.06 ± 0.39 after treatment. The thrombus diameter also decreased from 1.46 ± 0.16cm before treatment to 0.35 ± 0.11cm after treatment. The retrieval rate of the filters was 88.24% (15/17), and the average filter indwelling time was 19.25 ± 4.5days. The PCDT group consisted of 11 patients. We observed complete dissolution of the intraluminal thrombus in four patients, residual thrombus with a maximum diameter ≤1cm in six patients, and residual thrombus with a maximum diameter >1cm in one patient. The Villalta score decreased from 7.45 ± 0.76 before treatment to 2.09 ± 0.55 after treatment. The thrombus diameter decreased from 1.50 ± 0.21cm before treatment to 0.33 ± 0.35cm after treatment, and the rate of filter retrieval was 90.91% (10/11). The three treatments of anticoagulation therapy, CDT, and PCDT were meaningful for preoperative and postoperative thrombolysis and symptom improvement in patients with IVCFT. The application of CDT and PCDT was superior to anticoagulation therapy, while there was no significant difference between the CDT and PCDT group. The retrieval rate of filters in the anticoagulation therapy group was the lowest, with no significant difference between the CDT and PCDT group.

Planning for complex inferior vena cava filter retrievals: the implementation and effectiveness of 3D printed models

BackgroundInferior vena cava filter (IVC) retrieval is most often routine but can be challenging with high morbidity in complex cases, especially those with an extended dwelling time. While risk of morbidity in complex retrievals is decreased with advanced filter retrieval techniques, deciding when and which to use these requires detailed pre-procedural planning. The purpose of our study was to evaluate patient-specific 3D printed anatomic IVC filter models for aiding complex IVC filter retrievals.MethodsAll IVC filter retrieval patients between June 2021 and September 2022 at one academic medical hospital were prospectively screened. Nine met criteria for complex retrieval, and their CT images were used to 3D print patient-specific IVC and filter models. Models were used in pre-procedural planning and clinical utility was assessed using the Anatomic Model Utility Likert Questionnaire and estimations of the procedural and fluoroscopy time saved.ResultsThe usage of 3D printed models in pre-procedural planning had high clinical utility based on the Likert questionnaire (Anatomic Model Utility Points 366.7 ± 103.1). Using a model significantly increased confidence in planning (p = 0.03) and modified the treatment plan in seven cases. It also led to cost-efficient use of resources in the procedure suite with estimated reduction in procedure and fluoroscopy time of 29.0 [20.3] (p = 0.003) and 10.2 [6.7] (p = 0.002) minutes, respectively.Conclusion3D printed anatomic models for patients who require complex IVC filter retrieval demonstrated Likert-based high clinical utility and led to estimated reductions of procedural and fluoroscopy time.

Efficacy and safety of a novel vena cava filter on pulmonary embolism prophylaxis: a prospective, multicenter, randomized, parallel, positive-controlled, noninferiority clinical trial.

There are different types of vena cava filter (VCF) available in clinical practice. However, limited data exist to determine whether one type is superior to another, and no single VCF is universally recommended in clinical guidelines. The objective of this study was to investigate the safety and efficacy of a novel VCF, Octoparms, for the prevention of pulmonary embolism (PE) and to compare it with the Celect filter. This multicenter, randomized, open-label, parallel, positive-controlled, noninferiority trial was conducted in 10 centers across 6 provinces in China from October 2017 to March 2019. Patients who had confirmed lower extremity deep vein thrombosis or PE or who were at risk of PE with a clinical indication for VCF placement due to contraindication to or failure of anticoagulant therapy were included in the trial. The sample size for this trial was based on the assumption that the clinical success rate would be 95% and the noninferiority margin would be 10% for both filters. Each patient underwent baseline testing and was randomized using a web-based central system. Any additional interventions or standard treatments patients received along with the VCF placement were recorded. The primary endpoint was the overall clinical success rate, including technical and clinical success of filter placement and retrieval. The secondary endpoint was the safety of filter placement and retrieval, encompassing procedure-related and filter-related complications. A total of 188 patients were included and were divided into two groups: the Octoparms group (n=94) and the Celect group (n=94). Baseline characteristics and demographics were comparable between the two groups (P>0.05). Technical and clinical success rates for filter placement were achieved in 100% (188/188) of patients. The median dwelling time was 12.0 days (range, 4-190 days). Ten VCFs were left in situ as permanent devices. Of the remaining 178 patients, technical success and clinical success rates for filter retrieval were both achieved in 100% of cases (178/178). Clinical success rates were 92.6% (87/94) for the Octoparms group and 96.8% (91/94) for the Celect group, with a difference of -4.2% (hazard ratio 2.441, 95% confidence interval 0.612-9.741; P=0.206). The lower limit was greater than the noninferiority margin of -10%. Eight patients experienced a total of eight procedure-related complications. No filter-related complications, such as migration, deformation, inferior vena cava (IVC) penetration, peripheral organ damage, or IVC stenosis/occlusion, were observed (P>0.05). The Octoparms filter exhibited a high rate of clinical success and a low rate of complications during placement and retrieval, demonstrating noninferiority to the Celect filter.

Evolving Landscape of Inferior Vena Cava Filter Utilization: A Comprehensive Bibliometric Analysis.

This bibliometric analysis scrutinizes the evolution and current challenges in the use of Inferior Vena Cava (IVC) filters, focusing on trends from 2004 to 2023. Analyzing 2470 records, we report the United States' dominant role, with over half of the studies, and a significant shift towards retrievable filters. Despite technological advancements, controversies persist regarding efficacy, safety, and retrieval issues. Our findings point to the need for refined clinical guidelines and enhanced management strategies to navigate the complex landscape of IVC filter utilization effectively.

Hydrogel coating containing heparin and cyclodextrin/paclitaxel inclusion complex for retrievable vena cava filter towards high biocompatibility and easy removal

Hydrogel coating containing heparin and cyclodextrin/paclitaxel inclusion complex for retrievable vena cava filter towards high biocompatibility and easy removal