Retrievable Inferior Vena Cava Research Articles

Laparoscopic-assisted retrieval of inferior vena cava filter: A case report and literature review.

The retrieval of inferior vena cava filters beyond the retrieval window poses challenges, requiring alternative techniques. To discuss the laparoscopy-assisted retrieval approach for difficult inferior vena cava filters. Case report. A 57-year-old male with a retrievable inferior vena cava filter placed 8months prior. Laparoscopy-assisted retrieval technique utilized after unsuccessful interventional attempts. Successful retrieval of the filter despite thickened intimal tissue involvement, with no postoperative complications. Laparoscopy-assisted retrieval offers a direct visual approach for challenging filter removal, proving minimally invasive, safe, and effective.

Inferior Vena Cava Filter Retrieval: Simple to Complex.

Retrievable inferior vena cava filters were designed to provide mechanical prophylaxis from pulmonary embolism with the intent for retrieval once no longer indicated, and have been utilized at a high rate since their introduction. Unfortunately, retrieval rates have historically lagged behind, in part due to significant rates of failed standard retrieval techniques for filters with prolonged dwell time. Refinement in advanced retrieval techniques has now allowed (in experienced centers) for safe removal of filters previously considered irretrievable. An individualized approach is necessary for each potential advanced filter retrieval to determine appropriate course of action. This review will emphasize complex filter retrieval techniques amidst a larger discussion of inferior vena cava filters and their management.

Abstract 13611: Right Ventricular Perforation and Subsequent Tamponade Due to Fractured Inferior Vena Cava Filter Strut

Description of Case: A 39-year-old woman with a remote history of unprovoked pulmonary embolism (PE) treated with a retrievable inferior vena cava (IVC) filter presented with chest pain and syncope. Initial vital signs and examination were unremarkable. ECG showed diffuse ST elevations with PR depression consistent with acute pericarditis (Figure 1A). Given her history, CT angiogram (CTA) was performed and revealed complex pericardial effusion without PE. Echocardiogram confirmed large pericardial effusion with evidence of right ventricular diastolic collapse, raising concern for impending cardiac tamponade (Figure 1B). Urgent pericardiocentesis yielded 500 mL of sanguineous fluid, with resolution of effusion. A pericardial drain was left in place. Overnight she became hypotensive, tachycardic, diaphoretic, with muffled heart sounds on exam. Rapid re-accumulation of blood was noted from the drain, confirmed by repeat echo showing enlargement of the pericardial effusion. She was diagnosed with recurrent hemorrhagic pericardial effusion (HPE) of unclear etiology and was emergently taken for mediastinal exploration, where a metal shard measuring 2.2 cm was seen protruding though the RV (Figure 1C), confirmed on intraoperative TEE (Figure 1D). It was determined that a fractured IVC filter strut had migrated into the RV causing perforation and recurrent HPE. The strut was removed and RV defect patched. The patient did well post-operatively without effusion recurrence. Follow up CTA confirmed fractured IVC filter strut, with another filter strut also seen extending through the IVC wall (Figure E). Discussion: Rapid reaccumulation of a hemorrhagic, hemodynamically significant pericardial effusion without clear etiology, as in this case, should prompt consideration of surgical exploration to assess for bleeding source. As strut fractures are a known complication of retrievable IVC filters, these filters should be removed when no longer indicated.

Retrievable Inferior Vena Cava Filter Trapped Embolus: A Risk Factor of Detachment of Thrombus Analysis Based on a Multicenter Prospective Observational Study.

Up to now, the indications of inferior vena cava filter placement still remain controversial in the academic field. The aim of this study was to determine the risk factors of detachment of thrombus and to evaluate the necessity of inferior vena cava filter placement to prevent fatal pulmonary embolism. A total of 2892 patients participated in the multicenter prospective observational study from January 1, 2018, to December 31, 2018, and underwent retrievable inferior vena cava filter (RIVCF) placement in 103 centers in China. The primary endpoint of the study was RIVCF trapped embolus detected by inferior vena cava venography/ultrasound/computed tomography scanning or visible macroscopic thrombus before or during RIVCF retrieval. The relative factors of RIVCF trapped embolus were analyzed accordingly. The average age of the patients was 61.0 (50.0-71.0) years. Retrievable inferior vena cava filter trapped embolus occurred in 308 patients (10.65%). The fracture location, surgery location, and endovascular intervention differed between RIVCF trapped embolus and non-RIVCF trapped embolus groups (p<0.001, respectively). By multivariate analysis, RIVCF trapped embolus were less common in older patients (odds ratio [OR]=0.998; p<0.001) and more common in patients with below-the-knee fracture (OR=1.093, p=0.038), thigh fracture (OR=1.118, p=0.007), and pelvis surgery (OR=1.067, p=0.016). In addition, compared with patients without endovascular intervention, patients with percutaneous mechanical thrombectomy (PMT) + catheter-directed thrombolysis (CDT) were more prone to develop RIVCF trapped embolus (OR=1.060, p=0.010). However, RIVCF trapped embolus was less common in patients with CDT (OR=0.961, p=0.004). Lower limb fracture, pelvis surgery, and PMT + CDT are prone to cause trapped embolus. As a trapped embolus often represents the possibility of severe pulmonary embolism, lower limb fracture, pelvis surgery, and PMT + CDT could be risk factors of fatal pulmonary embolism. Due to the low incidence of trapped embolus, it is not necessary to place filters in elderly patients and CDT-only patients. The purpose of this paper is to standardize the use of inferior vena cava filter and avoid unnecessary filter implantation through the summary and analysis of a large number of clinical data. At the same time, more attention should be paid to and active treatment should be given to high-risk groups of pulmonary embolism.

Relationship Between Language Spoken and Inferior Vena Cava Filter Retrieval Rates at a Single Center

The majority of inferior vena cava (IVC) filters placed are intended to be retrievable after the patient’s risk of pulmonary embolism has decreased. However, studies have shown that there are many factors that play into whether these filters are actually removed. Even socioeconomic factors such as insurance status, age, and race can influence retrieval rates. No study to date has identified a link between IVC retrieval rates and patient language although without proper interpretive services patient language may be a barrier to effective communication and may decrease the likelihood that patients have their filter removed. We performed a retrospective chart review of all patients who underwent IVC filter placement at our institution from January 1, 2017, to July 1, 2022. This time frame intentionally excluded the six most recent months to allow appropriate time for filter retrieval. Demographic, procedural, and comorbidity information was collected through the electronic medical record review. Patients who either had their filter removed or who died with the filter in place were counted as a retrieved filter, and those who did not have their filter removed and remained living were coded as filter remaining in place. The Pearson χ2 analysis was used to compare the groups. From January 1, 2017, to July 1, 2022, 150 patients underwent placement of an IVC filter. The overall filter modified (accounting for patient death) retrieval rate was 83%. There was a significantly decreased filter retrieval rate in patients who were listed as speaking a language other than English (61.5%) when compared with English speakers (85.4%, P < .05). Cantonese was the language with the lowest retrieval rate with just 20% of the filters retrieved in patients who spoke Cantonese. In patients whose filter was removed, there was no difference in average days the filter remained in place based on language. In our single institution study, patients who spoke a language other than English had a decreased rate of IVC filter retrieval. The identification of this difference is imperative to creating and implementing programs to ensure equal care across all socioeconomic backgrounds.

Inferior Vena Cava Filter Retrieval Rates Associated With Passive and Active Surveillance Strategies Adopted by Implanting Physicians

Inferior vena cava filters are commonly implanted and infrequently retrieved. Nonretrieval contributes to significant morbidity, motivating US Food and Drug Administration and multisociety communications emphasizing the need for improved device surveillance. Current guidelines suggest that implanting physicians and referring physicians should be responsible for device follow-up, but it is not known whether shared responsibility contributes to lower retrieval. To determine if primary responsibility for follow-up care assumed by the implanting physician team is associated with increased device retrieval. This retrospective cohort study examined a prospectively collected registry of patients with inferior vena cava filters implanted from June 2011 to September 2019. Medical record review and data analysis was completed in 2021. The study included 699 patients who underwent implantation of retrievable inferior vena cava filters at an academic quaternary care center. Prior to 2016, implanting physicians had a passive surveillance strategy whereby letters highlighting indications for and the need for timely retrieval were mailed to patients and ordering clinicians. Starting in 2016, implanting physicians assumed active responsibility for surveillance, whereby candidacy for device retrieval was assessed periodically via phone calls and retrieval scheduled when appropriate. The main outcome was the odds of inferior vena cava filter nonretrieval. Within regression modeling of the association between the surveillance method and nonretrieval, additional covariates of patient demographics, concomitant malignant neoplasm, and presence of thromboembolic disease were included. Of the 699 patients who received retrievable filter implants, 386 (55.2%) were followed up with passive surveillance, 313 (44.8%) with active surveillance, 346 (49.5%) were female, 100 (14.3%) were Black individuals, and 502 (71.8%) were White individuals. The mean (SD) age at filter implantation was 57.1 (16.0) years. Mean (SD) yearly filter retrieval increased following the adoption of active surveillance, from 190 of 386 (48.7%) to 192 of 313 (61.3%) (P < .001). Fewer filters were deemed permanent in the active group vs passive group (5 of 313 [1.6%] vs 47 of 386 [12.2%]; P < .001). Age at the time of implantation (OR, 1.02; 95% CI, 1.01-1.03), concomitant malignant neoplasm (OR, 2.18; 95% CI, 1.47-3.24), and passive contact method (OR, 1.70; 95% CI, 1.18-2.47) were associated with increased odds of filter nonretrieval. The findings of this cohort study suggest that active surveillance by implanting physicians is associated with improved inferior vena cava filter retrieval. These findings support encouraging physicians who implant the filter to take primary responsibility for tracking and retrieval.

Improving the rate of inferior vena cava filter retrieval through multidisciplinary engagement

BackgroundThe placement of retrievable inferior vena cava (IVC) filters occurs commonly, but retrieval rates remain low. Consequently, there is an unmet clinical need to ensure appropriate follow-up and retrieval of these devices. ObjectivesTo determine the association between an IVC filter surveillance team with filter retrievals or a documented filter plan, time to retrieval, and incidence of filter complications or recurrent venous thromboembolism. MethodsAmbidirectional cohort study evaluating consecutive IVC filter insertions before and after the implementation of a multidisciplinary surveillance team (MDST). We report an odds ratio (OR) with 95% CIs, adjusted by age, sex, weight, and malignancy status. ResultsOverall, 453 patients were included, with 272 individuals in the pre-MDST cohort and 181 individuals in the post-MDST cohort. The MDST was associated with a higher composite primary outcome of IVC filter retrieval or a documented filter plan from 79.4% in the pre-MDST cohort to 96.1% in the post-MDST cohort (OR, 6.44; 95% CI, 3.06–15.84). Compared with the pre-MDST cohort, IVC filter retrieval rates were higher in the post-MDST cohort (52.6%–73.5%, respectively; (OR, 2.50; 95% CI, 1.67–3.78). The MDST was associated with a shorter median time-to-filter retrieval (187–150 days, hazard ratio, 1.78; 95% CI, 1.39–2.29), but there was no significant difference when comparing symptomatic or clinically significant IVC filter complications, recurrent venous thromboembolism, or mortality. ConclusionOur study demonstrates the importance of a structured program to ensure timely IVC filter retrieval and ultimately improve patient care.

The effect of different frames filters on the prevention of pulmonary embolism in fracture patients subsequent with deep venous thrombosis on a multicenter prospective observational study

BackgroundA retrievable inferior vena cava filter (RIVCF) is used for the prevention of a pulmonary embolism, especially originated from deep venous thrombosis (DVT). However, which frame of RIVCF has an better effect on the specific thrombus has not been reported. MethodsAll patients enrolled underwent RIVCF placement in the study, and the placement and retrieval followed the respective instructions of different brands of RIVCFs. During the study period, the frame of the filter, the combined fracture site and operation, and the filter trapped embolus (TE) were collected. The primary observation indicators of this study were the occurrence of TE in two frames of filters and different fracture sites. Secondary observation indicators were the occurrence of TE with two different frames filters in different fracture site and surgical site subgroups. ResultsIn all 2892 patients enrolled, RIVCF TE was detected in 308 cases (10.7%) according to our definition. Among them, there were 1968 cases of fusiform RIVCF and 924 cases of umbrella RIVCF. There were 663 patients combined with fractures before DVT. The incidence of TE was significantly higher in patients with fusiform RIVCF (230 [74.68%]) than in those with umbrella RIVCF (78 [25.32%]) (P < .05). In patients with below-the-knee fracture surgery, there was significant difference in the incidence of TE between the two frames of RIVCF (P < .05). ConclusionsThis conclusion suggests that, in patients with DVT secondary to below-the-knee fracture, the detached thrombus may be more suitable for prophylaxis with fusiform frame RIVCF.

Safety and efficacy of the VenaTech™ Retrievable inferior vena cava filter: a first-in-man single-center prospective study

BackgroundVenous thromboembolism (VTE) is a frequent condition worldwide, associated with significant morbidity and mortality. Though its primary treatment is anticoagulation, the placement of an inferior vena cava (IVC) filter is recommended in patients with some comorbidities. The objectives of this study were to evaluate the clinical safety and efficacy of the Venatech® retrievable IVC filter. This open-label prospective single-center study was conducted on 40 consecutive patients requiring temporary or permanent IVC filtration. Patient characteristics, technical success rates of filter placement and removal, and the occurrence of complications were assessed. Follow-up imaging was performed using CT-scan before retrieval or at 6 months in the permanent indication population.ResultsThe filter was successfully implanted at the intended location in all the patients. Retrieval was attempted in 21 (52.5%) patients after a mean period of 50 days (range: 6–94 days), and the filter was successfully removed in 18 patients (85.7%). Reason for retrieval failure was filter with trapped thrombus (n = 2) and a > 15° tilt (n = 1). No complication was observed during the filter placement and retrieval. Follow-up imaging available in 30 patients (75%) demonstrated deep filter penetration (> 3 mm) in four patients (13.3%), severe filter tilt (> 15o) in five patients (16.7%), filter with trapped thrombus in three patients (10%), but no fracture or IVC thrombosis.ConclusionThis prospective study showed encouraging preliminary results of the safety and efficacy of the Venatech® retrievable IVC filter. The filter was easily delivered in the intended position and successfully removed in a high percentage of patients.Trial registrationClinicalTrials.gov Identifier: NCT02674672

Implications for patient follow-up of changes in inferior vena cava filter removal plan practices

To assess the improvements during patient follow-up after implementing a proactive plan for retrieval of inferior vena cava (IVC) filters. A retrospective study was undertaken including all patients who had a temporary IVC filter inserted over a 10-year period. Patient demographics, insertion dates, retrieval dates, retrieval rates, and complications were recorded. Patients were categorised into three groups as follows: group A, no intervention where retrieval was not suggested; group B, passive intervention where retrieval was suggested but no appointment made; and group C, proactive intervention where a retrieval date was booked by the radiologist. Five hundred and nine patients had a temporary IVC filter inserted at Royal Liverpool University Hospital over the study period. One per cent of patients in group C were lost to follow-up compared to 41% and 29% in groups A and B respectively (p<0.001). The number of patients who had an IVC retrieval attempt also increased to 80% in group C compared to 53% and 64% in groups A and B (p<0.001). Incorporation of a proactive retrieval booking system has significantly reduced the number of patients lost to follow-up to 1%, leading to an increased number of IVC filter retrieval attempts.

Pathological Analysis and Clinical Evolution After Radiological Removal of Retrievable Vena Cava Filters.

Retrievable inferior vena cava filters (IVCF) have been developed because permanent filters have been associated with an increased risk of recurrent deep venous thrombosis. There is no data on the interactions of IVCF with the inferior vena cava (intrafilter thrombi, insertion through the venous wall) even though this may alter the course after retrieval of the IVCF. A review of 85 consecutive patients undergoing retrieval of IVCF placed at a single center was performed from January 1, 2010 and December 31, 2014. Inferior vena cava filter were examined for presence of intrafilter thrombus at time of retrieval. Filter position and presence of intraluminal thrombus were examined. Patient outcomes, including recurrence of deep vein thrombosis (DVT) and death, were captured at 3 month followup. Eighty five patients were identified, with intrafilter thrombi found in 69 (81%) patients and venous wall fragments found in 75 (88%) patients. However, their presence was not associated with an increased risk of recurrent venous thromboembolism (VTE) or death during follow up. Intrafilter thrombi and venous wall fragments are frequently found in removed IVCF but are not associated with a worse prognosis. They may not modify the therapeutic management of patients.

Similar factors, different results

Hansmann et al1 reported their validity assessment of a previously reported model that estimates the likelihood of safe removal of a retrievable inferior vena cava filter (rIVCF). In 2010, the Food and Drug Administration delivered safety communications stating that ongoing surveillance and management of rIVCF was the responsibility of the treating and implanting clinicians and that, once no longer needed, retrieval should be considered.2 This resulted in decreased usage of rIVCFs throughout the United States.

Evaluation of a clinical decision support tool to predict permanence of retrievable inferior vena cava filters

ObjectiveTo evaluate the usefulness of a published clinical decision support tool to predict the likelihood of a retrievable inferior vena cava (IVC) filter being maintained as a permanent device. MethodsThis multicenter retrospective cohort study included 1498 consecutive patients (852 men and 646 women; median age, 60 years; range, 18-98 years) who underwent retrievable IVC filter insertion between January 2012 and December 2019. The indications for IVC filtration, baseline neurologic disease, history of venous thromboembolism (VTE), and underlying malignancy were recorded. Accuracy, sensitivity, and specificity of a published clinical support tool were calculated to determine the usefulness of the tool. ResultsThe majority of filters (1271/1498 [85%]) were placed for VTE with a contraindication to anticoagulation. A history of VTE was present in 811 of 1498 patients (54%) patients; underlying malignancy in 531 of 1498 patients (35%), and neurological disease in 258 of 1498 patients (17%). Of the 1498 filters, 456 (30%) were retrieved, 276 (18%) were maintained as permanent devices on follow-up, and 766 (51%) filters were not retrieved. The accuracy of the clinical prediction model was 61%, sensitivity was 60%, and specificity was 62%. ConclusionsA previously published clinical decision support tool to predict permanence of IVC filters had modest usefulness in the examined population; this factor should be taken into account when using this clinical decision support tool outside of the original study population. Future studies are required to refine the predictive capability of IVC filter decision support tools for broader use across different patient populations.

387 A systematic review on retrievable vena cava filters in pregnant patients

Introduction: Inferior vena cava (IVC) filters can be used as alternatives to anticoagulants. They are used in venous thromboembolic disorders in order to prevent fatal pulmonary embolisms. Retrievable IVCFs seem to be an alternative option for preventing thromboembolic events in the peripartum period. Aims of the study: Venous thromboembolism is one of the leading causes of maternal mortality in developed countries. During pregnancy when anticoagulation is contraindicated or thromboembolic events occur close to delivery, retrievable inferior vena cava filters (rIVCFs) are preferable.

Clinical outcomes of retrievable inferior vena cava filters for venous thromboembolic diseases.

Aim: To identify literature evidence assessing retrievable inferior vena cava filter (rIVCF) for venous thromboembolic diseases. Methods: A systematic literature search was conducted to identify relevant references from the mainstay English and Chinese bibliographic databases (search period: January 2003 to October 2019). Results: 80 original studies with 11,413 patients were included in this review. The success rates of deploying the six types of rIVCFs ranged from 98.4 to 100.0%. Denali had the highest retrieval success rate (95.4-97.6%). The incidence rates of fracture and perforation associated with retrieving the six rIVCFs were less than 2%. Conclusion: The approved rIVCF had comparable clinical profiles, except that Denali was easier to be retrieved than other rIVCF.

Retrievable Inferior Vena Cava Filters-Use, Removal, and Removal Techniques.

The use of retrievable inferior vena cava filters is on the rise, but there is an inadequate number of these filters being removed even if their use as a prophylactic for venous thromboembolism is no longer indicated. Complications with retrievable filters that remain in the patient for an extended duration include examples such as filter tilt and embedding into the caval wall. This raises concerns for whether the filter is properly functioning and for consequent sequelae, including recurrent thrombosis, stenosis, or inferior vena cava perforation. With these complications, there are also challenges to retrieving these filters via the standard techniques and thus more advanced techniques are required. Both standard and advanced techniques, their uses, and possible risks of these methods are also discussed.

Comparison of the in vitro clot-capturing efficiencies of commercially available retrievable inferior vena cava filters

ObjectiveWe compared the in vitro clot-capturing efficiencies (CCEs) of commercially available retrievable inferior vena cava (IVC) filters. MethodsFour types of commercially available retrievable IVC filters were included in the present study: Denali (BD, Franklin Lakes, NJ), OptEase (Cordis Corp, Hialeah, Fla), Celect (Cook Medical, Bloomington, Ind), and Option (Argon Medical Devices, Frisco, Tex). The CCE of each IVC filter for 10 different size clots, ranging from 2 mm × 10 mm to 6 mm × 20 mm, was analyzed using a venous flow simulator. ResultsWhen ≥4 × 10-mm clots were used, the CCEs were 100% for all four types of IVC filters in a 20-mm-diameter simulated IVC filter. However, when ≤3 × 20-mm clots were used, the CCEs were significantly different among the four types of filters in a 20-mm-diameter simulated IVC, with the Denali showing the highest CCE, followed by the OptEase, Celect, and Option. When ≥6 × 10-mm clots were used, the CCEs were 100% for all four types of IVC filters in the 25-mm-diameter simulated IVC. However, when ≤5 × 20-mm clots were used, the CCEs were significantly different among the four types of filters in the 25-mm-diameter simulated IVC, with the Denali showing the highest CCE. When ≤5 × 10-mm clots were used, the CCEs were significantly lower in the 25-mm-diameter simulated IVC than in the 20-mm-diameter simulated IVC for all four types of IVC filters, with Option showing the greatest change in CCEs, followed by the Celect, OptEase, and Denali. ConclusionsThe CCEs were significantly different among the four IVC filters and were significantly lower for the smaller size clots than for the larger size clots and for the larger diameter simulated IVC than for the smaller diameter simulated IVC.

Antenatal venous thromboembolism

Key content Venous thromboembolism (VTE) remains one of the leading causes of maternal mortality and morbidity in the developed world. Clinical diagnosis of antenatal VTE is difficult and scoring systems have historically been of limited benefit in the pregnant population. However, evidence is emerging to suggest that pregnant women can be risk stratified for pulmonary embolism without the need for imaging in all cases. Optimal treatment is with weight adjusted therapeutic dose low‐molecular‐weight heparin (LMWH) subcutaneously. In rare cases, there may be a role for retrievable inferior vena cava (IVC) filters. The obstetrician has a key role in the multidisciplinary team discussion with the aim of minimising maternal risk of haemorrhage or thrombosis. Learning Objectives To understand the optimal approach to diagnosing VTE in pregnancy and the antenatal management of acute VTE. To understand the rare indications, risks and benefits of IVC filters in pregnancy. To understand the complexity of decision making around the time of delivery to minimise the risk of bleeding and recurrent thrombosis.

Clinical evaluation of retrievable inferior vena cava filters for the prevention of pulmonary thromboembolism

Inferior vena cava filters (IVCFs) have been reported to cause chronic complications. Recently, retrievable IVCFs (r-IVCF) have been increasingly used to prevent acute pulmonary thromboembolism (PTE) and allow retrieval upon reduction of PTE risk. However, the outcomes of their use in Japan remain unknown. This study retrospectively investigated the acute PTE relapse prevention rate, IVCF retrieval attempt rate, retrieval success rate, and long-term prognosis of 197 patients who underwent r-IVCF insertion at our hospital between 2010 and 2018. Subjects had a mean age of 68years and a male-to-female ratio of 1:1. After r-IVCF insertion, the acute PTE prevention rate was 99.5%. The r-IVCF retrieval rate was 55% (108 patients), with a success rate of 99% (107 patients). r-IVCF retrieval was not attempted in 89 cases due to advanced cancer or poor prognosis (41%), loss to follow-up (32%), and long-term indwelling IVCF (17%). The retrieval group had an average observation period of 36months, with their anticoagulation therapy continuation, PTE recurrence, and deep vein thrombosis (DVT) recurrence rates being 64%, 3%, and 4%, respectively. The non-retrieval group had a mean observation period of 21months, with their anticoagulation continuation, PTE recurrence, and DVT recurrence rates being 78%, 3%, and 15%, respectively. DVT recurrence rates increased significantly in the non-retrieval group (p < 0.01). Moreover, 65% of all DVTs occurred centrally from the femoral veins, among which 9% were contraindicated for anticoagulation therapy. IVCF placement significantly prevented acute PTE but promoted recurrent DVTs when not retrieved after risk reduction. Hence, to increase recovery rates, IVCFs be promptly removed when no longer necessary.

Feasibility study of hand-carried ultrasound-guided retrievable inferior vena cava filter placement

BackgroundWith the development of ultrasonic diagnostic techniques in recent years, ultrasound-guided placement of inferior vena cava (IVC) filters has been widely used in clinics, and satisfactory results have been achieved. Our study aims to observe the accuracy of hand-carried ultrasound-guided retrievable vena cava filter placement, evaluate the feasibility and safety of this new method, and provide a scientific and effective interventional method and clinical data to prevent acute pulmonary embolism (PE) after battle injury of limbs.MethodsTwo hundred patients with post-traumatic thrombosis of the extremities were enrolled. The renal vein was located under the guidance of hand-carried ultrasound. The retrievable filter was fixed 1–2 cm below the opening of the renal vein. The self-expanding filter was used after the filter’s position was confirmed by injecting the contrast agent under the digital subtraction angiography (DSA) fluoroscopy.ResultsAll the 200 patients underwent the operation successfully. The position of the hand-carried ultrasound localizer was consistent with the DSA localizer. All the filters were expanded smoothly. No complications related to the operation occurred.ConclusionsThe study concluded that the hand-carried ultrasound-guided retrievable vena cava filter placement has a high success rate and can prevent acute PE after limbs’ battle injury.