Retrieval of symptomatic Gianturco-Roehm Bird's Nest inferior vena cava filters using rigid endobronchial forceps

Cooper, Kyle; Srinivasa, Ravi N.; Luhar, Aarti; Liles, Amber; Moriarty, John M.

doi:10.1016/j.diii.2018.07.006

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…Recently, the utilization of endobronchial forceps has been widely accepted as a promising alternative technique for complex retrievals. Although a handful of published studies have demonstrated success using this technique ranging from 85 to 100% (Stavropoulos et al 2015 ; Tavri et al 2019 ; Chick et al 2016 ; Avery et al 2015 ), the majority of the literature is limited to case reports and case series (Nakashima et al 2014 ; Cooper et al 2018 ; White and Stavropoulos 2007 ; Johnston et al 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of inferior vena cava filter retrieval: a 5-year single center retrospective review from a tertiary care center

et al. 2022

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Background Inferior vena cava (IVC) filter retrieval is typically accomplished with standard snare technique. When this fails, more advanced techniques are necessary, especially when removal falls outside a 12-month window. Complications during filter retrieval depend heavily on technique, type of filter, and filter position. In this study we examined safety and efficacy of 536 filter retrievals at a tertiary care center and compared complication rates between standard snare and endobronchial forcep retrieval. Method We reviewed 536 cases between August 2015 and August 2020, recording retrieval success rates, patient comorbidities, and complication rates at the time of removal. Results Total overall retrieval success was 97.9% (525/536), and complications occurred in approximately 6.0% (32/536) of all cases. Success and complications with standard snare technique alone were 99.4% (345/347) and 1.7% (5 Grade I/II, 1 Grade III) and advanced forcep technique 98.8% (171/173) and 14.5% (22 Grade I/II, 2 Grade III, and 1 Grade IV), respectively. There was no significant difference between the technical success rates of the standard snare technique and forceps techniques (p = 0.60) despite a significantly longer dwell time in patients undergoing forceps retrieval (p < 0.001). Conclusion To our knowledge, this is the largest cohort of forceps directed IVC filter retrieval present in the literature. Rates of successful endobronchial forceps and standard snare retrievals in this study are similar to previous reports. Although use of endobronchial forceps may be associated with higher complication rates, this is likely due to prolonged dwell times, filter tilt, and attempted removal of non retrievable filters. Overall, forceps-directed retrieval offers a safe, effective means of removal in difficult cases. Level of evidence Level 3, Large Retrospective Study.

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Section: Introductionmentioning

confidence: 99%

Safety and efficacy of inferior vena cava filter retrieval: a 5-year single center retrospective review from a tertiary care center

et al. 2022

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Predictors of endobronchial forceps utilization for inferior vena cava filter retrieval: when snare retrieval fails

Kang,

Schuchardt,

Charles

et al. 2023

CVIR Endovasc

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Background Endobronchial forceps are commonly used for complex IVC filter removal and after initial attempts at IVC filter retrieval with a snare have failed. Currently, there are no clear guidelines to help distinguish cases where primary removal should be attempted with standard snare technique or whether attempts at removal should directly be started with forceps. This study is aimed to identify clinical and imaging predictors of snare failure which necessitate conversion to endobronchial forceps. Methods Retrospective analysis of 543 patients who underwent IVC filter retrievals were performed at three large quaternary care centers from Jan 2015 to Jan 2022. Patient demographics and IVC filter characteristics on cross-sectional images (degree of tilt, hook embedment, and strut penetration, etc.) were reviewed. Binary multivariate logistic regression was used to identify predictors of IVC filter retrieval where snare retrieval would fail. Results Thirty seven percent of the patients (n = 203) necessitated utilization of endobronchial forceps. IVC filter hook embedment (OR:4.55; 95%CI: 1.74–11.87; p = 0.002) and strut penetration (OR: 56.46; 95% CI 20.2–157.7; p = 0.001) were predictors of snare failure. In contrast, total dwell time, BMI, and degree of filter tilt were not associated with snare failure. Intraprocedural conversion from snare to endobronchial forceps was significantly associated with increased contrast volume, radiation dose, and total procedure times (p < 0.05). Conclusion IVC filter hook embedment and strut penetration were predictors of snare retrieval failure. Intraprocedural conversion from snare to endobronchial forceps increased contrast volume, radiation dose, and total procedure time. When either hook embedment or strut penetration is present on pre-procedural cross-sectional images, IVC filter retrieval should be initiated using endobronchial forceps. Level of evidence Level 3, large multicenter retrospective cohort.

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Retrieval of symptomatic Gianturco-Roehm Bird's Nest inferior vena cava filters using rigid endobronchial forceps

Cited by 2 publications

References 6 publications

Safety and efficacy of inferior vena cava filter retrieval: a 5-year single center retrospective review from a tertiary care center

Safety and efficacy of inferior vena cava filter retrieval: a 5-year single center retrospective review from a tertiary care center

Predictors of endobronchial forceps utilization for inferior vena cava filter retrieval: when snare retrieval fails

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