Factors Associated with Failed Retrieval of the Günther Tulip Inferior Vena Cava Filter

Marquess, Joel S.; Burke, Charles T.; Beecham, Ashley; Dixon, Robert G.; Stavas, Joseph M.; Sag, Alan A.; Koch, Gary G.; Mauro, Matthew A.

doi:10.1016/j.jvir.2008.06.004

Cited by 69 publications

(43 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally during retrieval attempts the fibrotic tissue that adheres the filter to the IVC wall may lead to mechanical complications such as filter fragmentation and IVC injury. Complicated retrievals are commonly reported with longer dwell times and the decision to retrieve or not retrieve a filter should be made with caution (28,37).…”

Section: Discussionmentioning

confidence: 99%

“…Cardiovasc Diagn Ther 2016;6(6):642-650 cdt.amegroups.com loops such as the duodenum, aortic wall penetration, and small-bowel volvulus. Filter migration and spontaneous fracture and embolization of filter components have also been reported (8,10,14,27,28). Nonetheless, before using advanced techniques for IVC filter retrieval, the associated possible complications should always be compared to the potential risks of leaving the filter permanently indwelling, and should be individualized.…”

Section: Complications Of Ivc Filter Retrievalsmentioning

confidence: 99%

“…Nonetheless, before using advanced techniques for IVC filter retrieval, the associated possible complications should always be compared to the potential risks of leaving the filter permanently indwelling, and should be individualized. Filter retrieval could be favored for the following situations: avoiding the risk of long-term thrombotic complications in younger patients, to treat symptomatic filter-related IVC stenosis and thrombosis and to treat symptomatic filter penetration, and to avoid the need for lifelong anticoagulation (28,29).…”

Section: Complications Of Ivc Filter Retrievalsmentioning

confidence: 99%

See 2 more Smart Citations

Inferior vena cava filter retrievals, standard and novel techniques

Kuyumcu¹,

Walker²

2016

Cardiovasc. Diagn. Ther.

View full text Add to dashboard Cite

Abstract:The placement of an inferior vena cava (IVC) filter is a well-established management strategy for patients with venous thromboembolism (VTE) disease in whom anticoagulant therapy is either contraindicated or has failed. IVC filters may also be placed for VTE prophylaxis in certain circumstances.There has been a tremendous growth in placement of retrievable IVC filters in the past decade yet the majority of the devices are not removed. Unretrieved IVC filters have several well-known complications that increase in frequency as the filter dwell time increases. These complications include caval wall penetration, filter fracture or migration, caval thrombosis and an increased risk for lower extremity deep vein thrombosis (DVT). Difficulty is sometimes encountered when attempting to retrieve indwelling filters, mainly because of either abnormal filter positioning or endothelization of filter components that are in contact with the IVC wall, thereby causing the filter to become embedded. The length of time that a filter remains indwelling also impacts the retrieval rate, as increased dwell times are associated with more difficult retrievals. Several techniques for difficult retrievals have been described in the medical literature. These techniques range from modifications of standard retrieval techniques to much more complex interventions. Complications related to complex retrievals are more common than those associated with standard retrieval techniques. The risks of complex filter retrievals should be compared with those of life-long anticoagulation associated with an unretrieved filter, and should be individualized. This article summarizes current techniques for IVC filter retrieval from a clinical point of view, with an emphasis on advanced retrieval techniques.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Complications Of Ivc Filter Retrievalsmentioning

confidence: 99%

Section: Complications Of Ivc Filter Retrievalsmentioning

confidence: 99%

See 1 more Smart Citation

Inferior vena cava filter retrievals, standard and novel techniques

Kuyumcu¹,

Walker²

2016

Cardiovasc. Diagn. Ther.

View full text Add to dashboard Cite

show abstract

“…[3][4][5] Although poor clinical follow-up of patients with these devices plays an important role, 6 prolonged filter implantation has been associated with retrieval failure rates as high as 43%. [7][8][9][10][11] Furthermore, prolonged rIVCF dwell time is associated with device-related complications, including fracture, migration, organ penetration, and increased risk of deep venous thrombosis. 11 These concerns were mirrored in a 2014 safety communication issued by the US Food and Drug Administration urging rIVCF retrieval once no longer indicated.…”

mentioning

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

View full text Add to dashboard Cite

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.

show abstract

“…Th e reduced tilt of Denali fi lters could lead to better function of the fi lter and may reduce diffi culty in future retrieval. Prior studies confl ict as to whether fi lter angulation contributes to diffi culty in retrieval, with some indicating that tilt does not play a role (25,26), and others suggesting tilt does impact ease of retrieval (24,27,28). In this study, angulation of the fi lter was the only independent predictor of diffi cult fi lter retrieval, as indicated by prolonged fl uoroscopy time and use of additional retrieval devices.…”

Section: Discussionmentioning

confidence: 55%