Retrieval of Tip-embedded Inferior Vena Cava Filters by Using the Endobronchial Forceps Technique: Experience at a Single Institution

Stavropoulos, S. William; Ge, Benjamin H.; Mondschein, Jeffrey I.; Shlansky-Goldberg, Richard D.; Sudheendra, Deepak; Trerotola, Scott O.

doi:10.1148/radiol.14141420

Cited by 72 publications

(58 citation statements)

References 30 publications

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“…Avery et al further suggested that dissection using an endobronchial forceps for filter retrieval could be less costly and more effective and might also be used for standard filter removals (24). However Stavropoulos described this technique as fairly aggressive and noted that with excessive traction fractured filter components may embolize to the cardiac chambers and or pulmonary arteries thereby requiring aggressive foreign body retrieval and potentially even necessitating surgical removal (22)(23)(24).…”

Section: Dissection Techniques Endobronchial Forceps Dissection and Rmentioning

confidence: 99%

Inferior vena cava filter retrievals, standard and novel techniques

Kuyumcu¹,

Walker²

2016

Cardiovasc. Diagn. Ther.

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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.

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Section: Dissection Techniques Endobronchial Forceps Dissection and Rmentioning

confidence: 99%

Inferior vena cava filter retrievals, standard and novel techniques

Kuyumcu¹,

Walker²

2016

Cardiovasc. Diagn. Ther.

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“…5 The rigid endobronchial forceps technique also has been used for retrieval of tip-embedded inferior vena cava filters. 6 These endobronchial grasping forceps with crocodile jaw (3 mm shaft diameter, 6 cm length) can easily be introduced into the rigid bronchoscope or 14 Fr sheath and are perfect for foreign body retrieval such as endobronchial stent, endovascular stent and inferior vena cava filter.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous retrieval of a misplaced transjugular intrahepatic portosystemic shunt stent using the rigid endobronchial forceps

Kim

2016

Int J Gastrointest Interv

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Summary of Event: A transjugular intrahepatic portosystemic shunt (TIPS) stent (Viatorr) was misplaced into main portal vein and superior mesenteric vein. This misplaced covered stent was then successfully retrieved using the rigid endobronchial forceps. Teaching Point: Before release the covered portion of the TIPS stent (Viatorr), it is necessary to confirm the position of uncovered portion in portal vein and covered portion in parenchymal tract. The endobronchial forceps technique is a safe and efficient method for retrieving a misplaced TIPS stent.

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“…Endovascular dissection to directly release an embedded hook or penetrating strut with bronchoscopy forceps has also been described as a last-ditch effort. 17 These advanced techniques increase the probability of successful retrieval to more than 90% but are also associated with significantly higher complication rates (5.3% vs. 0.4%). 4 Open surgical approaches are yet another possibility but can lead to increased morbidity and prolong hospitalization secondary to the need for laparotomy and caval reconstruction.…”

Section: Introductionmentioning

confidence: 99%