Perforation of the IVC: Rule Rather Than Exception After Longer Indwelling Times for the Günther Tulip and Celect Retrievable Filters

Durack, Jeremy C.; Westphalen, Antonio C.; Kekulawela, Stephanie; Bhanu, Shiv; Avrin, David E.; Gordon, Roy L.; Kerlan, Robert K.

doi:10.1007/s00270-011-0151-9

Cited by 157 publications

(85 citation statements)

References 25 publications

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“…It is likely that asymptomatic perforation of the caval wall occurs with several filter types, and in the absence of a CT scan this is not easy to quantify. Durack et al demonstrated that strut penetration of the caval wall is the rule rather than the exception and also that complications associated with it can be significant [17].…”

Section: Discussionmentioning

confidence: 99%

British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry

Uberoi

Tapping

Chalmers

et al. 2013

Cardiovasc Intervent Radiol

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Purpose The British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry was produced to provide an audit of current United Kingdom (UK) practice regarding placement and retrieval of IVC filters to address concerns regarding their safety. Methods The IVC filter registry is a web-based registry, launched by the BSIR on behalf of its membership in October 2007. This report is based on prospectively collected data from October 2007 to March 2011. This report contains analysis of data on 1,434 IVC filter placements and 400 attempted retrievals performed at 68 UK centers. Data collected included patient demographics, insertion and retrieval data, and patient follow-up. Results IVC filter use in the majority of patients in the UK follows accepted CIRSE guidelines. Filter placement is usually a low-risk procedure, with a low major complication rate (\0.5 %). Cook Gunther Tulip (560 filters: 39 %) and Celect (359 filters: 25 %) filters constituted the majority of IVC filters inserted, with Bard G2, Recovery filters, Cordis Trapease, and OptEase constituting most of the remainder (445 filters: 31 %). More than 96 % of IVC filters deployed as intended. Operator inexperience (\25 procedure) was significantly associated with complications (p \ 0.001). Of the IVC filters initially intended for temporary placement, retrieval was attempted in 78 %. Of these retrieval was technically successful in 83 %. Successful retrieval was significantly reduced for implants left in situ for[9 weeks versus those with a shorter dwell time.

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Section: Discussionmentioning

confidence: 99%

British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry

Uberoi

Tapping

Chalmers

et al. 2013

Cardiovasc Intervent Radiol

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“…However, previous studies have demonstrated that penetrations can progress over time, 19,26,28 and the longer the indwelling time is, the further the penetration depth beyond the caval wall is. 26 For symptomatic patients, filter retrieval should be strongly considered because pain related to a filter is often relieved after filter removal.…”

Section: -13mentioning

confidence: 99%

“…However, retrieving these filters should be considered, particularly in cases of penetration already involving adjacent organs or structures, because penetrations are known to progress over time. 19,26,28 Retrieval of optional filters in this setting can be performed safely. 33,34 For cases in which the filter is not removed, follow-up CT scans are appropriate.…”

Section: -13mentioning

confidence: 99%

Caval Penetration by Inferior Vena Cava Filters

et al. 2015

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Background-Limited penetration into the caval wall is an important securing mechanism for inferior vena cava (IVC) filters; however, caval penetration can also cause unintentional complications. The aim of this study was to assess the incidence, severity, clinical consequences, and management of filter penetration across a range of commercially available IVC filters. Methods and Results-The MEDLINE database was searched for all studies showed evidence of organ/structure involvement. Among patients with penetration, 8% were symptomatic, 45% were asymptomatic, and 47% had unknown symptomatology. The most frequently reported symptom was pain (77%, 108 of 140). Major complications were reported in 83 patients (5%). These complications required interventions including surgical removal of the IVC filter (n=63), endovascular stent placement or embolization (n=11), endovascular retrieval of the permanent filter (n=4), and percutaneous nephrostomy or ureteral stent placement (n=3). Complications led to death in 2 patients. A total of 87% of patients (127 of 146) underwent premature filter retrieval or interventions for underlying symptoms or penetration-related complications. Conclusions-Caval penetration is a frequent but clinically underrecognized complication of IVC filter placement.Symptomatic patients accounted for nearly 1/10th of all penetrations; most of these cases had organ/structure involvement. Interventions with endovascular retrieval and surgery were required in most of these symptomatic patients.

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“…Poor retrieval rates correspond to an increase in reported adverse events 7. Complications associated with VCFs include increased risk of deep vein thrombosis (DVT), inferior vena cava thrombosis, inferior vena cava penetration, VCF fracture, and VCF embolization 7, 9, 10, 11. Given these trends, the US Food and Drug Administration has issued a safety communication highlighting the need to remove VCFs once the risk of pulmonary embolism (PE) has subsided based on modeling studies showing that VCFs are most clinically beneficial if retrieved within 90 days after implantation 11, 12…”

Section: Introductionmentioning

confidence: 99%

Vena Cava Filter Retrieval Rates and Factors Associated With Retrieval in a Large US Cohort

Brown

Raissi

Han

et al. 2017

JAHA

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BackgroundRetrieval of vena cava filters (VCFs) is important for safety as complications increase with longer dwell times. This study assessed VCF retrieval rates and factors associated with retrieval in a national cohort.Methods and Results VCFs were identified by procedural codes from an administrative claims database. Patients were identified who had a VCF placement during a hospitalization from a national commercial administrative claims database. Indications for VCF placement were identified as pulmonary embolism with or without deep vein thrombosis, deep vein thrombosis only, or prophylactic. Patient demographic and clinical characteristics were included in proportional hazard regression models to find associations with early (90‐day) and 1‐year VCF retrieval. Initiation of anticoagulation and the correlation between time‐to‐retrieval and time‐to‐initiation of anticoagulation were observed. Of 54 766 patients receiving a VCF, 36.9% had pulmonary embolism, 43.9% had deep vein thrombosis only, and 19.2% had no apparent venous thromboembolism present. Over the 1 year of follow‐up, the cumulative incidence of VCF retrieval was 18.4%. Retrieval increased over time from a low of 14.0% in 2010 up to ≈24% in 2014. In adjusted time‐to‐event models, increasing age, differing regions, and some comorbidities were associated with poorer retrieval rates. Initiation of anticoagulation was poorly correlated with retrieval, with anticoagulation preceding retrieval by a median of 51 days while those without retrieval had a median of 278 days of exposure to anticoagulation.Conclusions VCF retrieval increased over the study period but remained suboptimal and was weakly correlated with anticoagulation initiation.

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Perforation of the IVC: Rule Rather Than Exception After Longer Indwelling Times for the Günther Tulip and Celect Retrievable Filters

Cited by 157 publications

References 25 publications

British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry

British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry

Caval Penetration by Inferior Vena Cava Filters

Vena Cava Filter Retrieval Rates and Factors Associated With Retrieval in a Large US Cohort

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