Filter tilting and retrievability of the Celect and Denali inferior vena cava filters using propensity score-matching analysis

Abstract

PurposeTo assess the filter tilting and outcomes of the Celect and Denali inferior vena cava (IVC) filters by using a propensity score-matching analysis.Materials and methodsFrom January 2009 to November 2017, 181 Celect and 58 Denali filters were inserted in our institution. To assess filter tilt, filter tip abutment or penetration of the IVC wall, and retrieval outcome, independent variables, including age, sex, IVC long diameter, IVC angulation, and proximity of the filter to renal vein insertion, were entered in the propensity model. Comparative analyses were performed before and after propensity score-matching analysis.ResultsThirty-one patients were enrolled in each group for the final propensity score-matching analysis. The mean filter indwelling time was not significantly different between the groups (26 ± 22 days in Celect and 27 ± 23 days in Denali). After propensity score adjustment, the mean degree of filter tilt was higher in the Celect group (9.5° ± 7.4° vs 5.6° ± 6.7°). Filter tip abutment or penetration of the IVC wall was more common in the Celect group (39% [12/31, abutment: 12, penetration: 0] vs 13% [4/31, abutment: 3, penetration: 1]). The retrieval outcomes were not significantly different before and after propensity score adjustment in both filters.ConclusionThe Denali IVC filter showed less tilt and low rate of filter tip abutment to the IVC wall after propensity score-matching analysis. The retrieval rate was not significantly different in the short-term filter indwelling setting. More large-scale, long-term follow-up studies are needed to verify these results.

Over-the-wire deployment techniques of option elite inferior vena cava filter: 3D printing vena cava phantom study

“…In recent studies, a tilt angle of 15 degrees was the most commonly cited standard [13]. However, this degree of filter tilt does not always mean an IVC filter is abutting the IVC wall or embedding itself into the IVC wall, because there are other contributing factors, such as the diameter of the IVC, the presence of external compressing structures, or severe angulation of the IVC itself [14][15][16].…”

“…Severe filter tilt or filter tip abutment to the IVC wall may result in filter-tip epithelialization or penetration into the IVC wall. These events can increase the risk of filter retrieval and may require advanced retrieval techniques, such as endobronchial forceps-or laser-assisted retrieval of the embedded filter tip [17][18][19][20], which impose increased radiation exposure to the patient and the operator and add medical cost [15,16].…”

Role of Inferior Vena Cava Filter Retrieval in Patients on Chronic Anticoagulation Therapy

“…Common reasons for routine retrieval failure with the subsequent need for advanced retrieval techniques include severe tilt, migration, penetration into the caval wall, caval occlusion (Fig. 4), and hook embedment into the IVC wall [3,32,34,36,37,[40][41][42]. Longer filter dwell time has been associated with the need for advanced techniques for retrieval [35,41].…”

Denali Inferior Vena Cava Filter Retrieval: Complications and Success Rates

“…However, few studies have focused on retrieval of the filter with a relatively large sample size. In addition, few studies have evaluated the effects of filter deployment duration on filter retrieval ( 5 6 7 8 9 10 11 ).…”