A 16-F Sheath with Endobronchial Forceps Improves Reported Retrieval Success of Long-Dwelling “Closed Cell” Inferior Vena Cava Filter Designs

Stavropoulos, S. William; Shin, Benjamin J.; Shlansky-Goldberg, Richard D.; Mondschein, Jeffrey I.; Sudheendra, Deepak; Nadolski, Gregory J.; Watts, Micah M.; Trerotola, Scott O.

doi:10.1016/j.jvir.2016.03.047

Cited by 25 publications

(7 citation statements)

References 26 publications

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“…Finally, multiple types of rIVCF were encountered in the study period. The technical challenges encountered during a retrieval procedure vary by device 33 ; as a result, the data may vary by device type. In the current cohort, comparisons of the impact of device subtype on the inflection point would be potentially confounded because of the disparate number of filters encountered.…”

Section: Discussionmentioning

confidence: 99%

Defining Prolonged Dwell Time: When Are Advanced Inferior Vena Cava Filter Retrieval Techniques Necessary?

Desai

Laws

Salem

et al. 2017

Circ: Cardiovascular Interventions

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Background— Despite growth in placement of retrievable inferior vena cava filters, retrieval rates remain low. Filters with extended implantation times present a challenge to retrieval, where standard techniques often fail. The development of advanced retrieval techniques has positively impacted retrieval of retrievable inferior vena cava filters with prolonged dwell times; however, there is no precise definition of the time point when advanced techniques become necessary. We aim to define prolonged retrievable inferior vena cava filters dwell time by determining the inflection point when the risk of standard retrieval technique failure increases significantly, necessitating advanced retrieval techniques to maintain overall technical success of retrieval. Methods and Results— From January 2009 to April 2015, 762 retrieval procedures were identified from a prospectively acquired database. We assessed patient age/sex, filter dwell time, procedural technical success, the use of advanced techniques, and procedure-related adverse events. Overall retrieval success rate was 98% (n=745). When standard retrieval techniques failed, advanced techniques were used; this was necessary 18% of the time (n=138). Logistic regression identified that dwell time was the only risk factor for failure of standard retrieval technique (odds ratio, 1.08; 95% confidence interval, 1.05–1.10; P <0.001). Spline function regression analysis demonstrated that if dwell time exceeded 7 months, the risk of standard technique failure was 40.9%. Adverse events occurred at a rate of 2% (n=18; 15 minor and 3 major). Conclusions— The necessity of advanced techniques to maintain technical success of retrieval increases with dwell time. Patients with retrievable inferior vena cava filters in place beyond 7 months may benefit from referral to centers with expertise in advanced filter retrieval.

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Section: Discussionmentioning

confidence: 99%

Defining Prolonged Dwell Time: When Are Advanced Inferior Vena Cava Filter Retrieval Techniques Necessary?

Desai

Laws

Salem

et al. 2017

Circ: Cardiovascular Interventions

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“…Furthermore, a higher percentage of filters retrieved with laser appeared to be of closed-cell design (75.4 vs. 68.1%, p = 0.02). The filter designs, such as TrapEase (Cordis Endovascular, CA, USA) and OptEase (Cordis Endovascular, NJ, USA) filters are typically more difficult to extract as they are associated with increased surface area contact with the cava in comparison to their open-cell counterparts, resulting in extensive endothelization and fibrosis of the IVC (Desai et al 2020 ; Rimon et al 2011 ; Oliva et al 2005 ; Chick et al 2016 ; Kuo et al 2012 ). Excimer laser offers the option of dissecting this fibrotic tissue with high precision.…”

Section: Discussionmentioning

confidence: 99%

Rigid forceps and excimer laser use for complex inferior cava filter retrieval: a preliminary quantitative analysis of available evidence

Tran

Iyer

et al. 2022

CVIR Endovasc

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Purpose The present study aims to evaluate the safety and efficacy of advanced inferior vena cava filter (IVCF) retrieval using laser assistance compared with forceps via systematic review and quantitative aggregation of available data. Methods Pubmed and Embase were queried from establishment to September 2021. Original studies with a sample size ≥ 5 that reported at least one primary outcome of patients who underwent laser- or forceps-assisted IVCF retrieval were included. Primary outcomes included technical success and complication rates. Baseline characteristics were extracted: age, sex, presence of filter thrombus, strut penetration, previous retrieval attempt, filter dwell time, fluoroscopy time, and filter type. Complications were categorized by type and severity. Categorical data was pooled and evaluated with chi-square or Fisher exact tests. Results From the 16 included studies, a total of 673 and 368 patients underwent laser- and forceps-assisted IVCF retrieval, respectively. Successful retrieval was achieved in 98.1 and 93.7% patients from the laser and forceps groups, respectively (p < 0.001). Major complication rates (1.6 vs 2.1%, p = 0.629) and risk of injury to cava or adjacent organs (1.0 vs 1.4%, p = 0.534) were similar between the two groups. A higher proportion of filters from the laser arm were closed-cell design (75.4 vs 68.1%, p = 0.020). Conclusion Based on limited available evidence, forceps- and laser-assisted complex IVCF retrievals were equally safe. The use of laser sheath is associated with a higher retrieval rate than forceps alone, though the baseline characteristics of two cohorts were not controlled. Future large-scale case-controlled comparative studies with longer clinical follow-up are warranted.

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“…Though there may be initial trepidation of utilizing endoscopy, interventional radiologists are uniquely equipped to integrate percutaneous endoscopy as an adjunct to image-guidance for difficult procedures. Retrieval of endovascular devices such as inferior vena cava filters, guidewires, and stents has been well-reported [5][6][7][8][9][10][11][12]. However, there is a paucity of published reports on foreign body retrieval with combined endoscopy and image-guidance, particularly when it is performed solely by interventional radiologists.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Interventional Radiology-Operated Endoscopy for Foreign Body Removal

Khayat

Healey

et al. 2019

Techniques in Vascular and Interventional Radiology

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Image-guided retrieval of endovascular devices such as inferior vena cava filters, guidewires, and stents is well reported, though there is a paucity of published reports on biliary, genitourinary, or gastrointestinal foreign body retrieval utilizing percutaneous endoscopy, particularly when it is performed solely by interventional radiologists. In cases of failed traditional endoscopic techniques or to evade more invasive surgical options, percutaneous endoscopy can be an adjunctive tool employed by interventional radiologists to extract foreign bodies. In this article, clinical evaluation, perioperative management, and

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A 16-F Sheath with Endobronchial Forceps Improves Reported Retrieval Success of Long-Dwelling “Closed Cell” Inferior Vena Cava Filter Designs

Cited by 25 publications

References 26 publications

Defining Prolonged Dwell Time: When Are Advanced Inferior Vena Cava Filter Retrieval Techniques Necessary?

Defining Prolonged Dwell Time: When Are Advanced Inferior Vena Cava Filter Retrieval Techniques Necessary?

Rigid forceps and excimer laser use for complex inferior cava filter retrieval: a preliminary quantitative analysis of available evidence

Percutaneous Interventional Radiology-Operated Endoscopy for Foreign Body Removal

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