Percutaneous Retrieval of Permanent Inferior Vena Cava Filters. 2016

Anobel Tamrazi, and Vibhor Wadhwa, and Brian Holly, and Nikhil Bhagat, and Jonathan K Marx, and Michael Streiff, and Mark L Lessne
Division of Vascular & Interventional Radiology, Johns Hopkins University School of Medicine, 1800 Orleans Street, Sheik Zayed Towers, Suite 7203, Baltimore, MD, 21287, USA. atamraz1@jhmi.edu.

OBJECTIVE To evaluate the feasibility, risks, and techniques of percutaneous removal of permanent TrapEase and Simon Nitinol IVC filters. METHODS Between August 2011 and August 2015, 12 patients (5 women, 7 men; age range, 26-75 years) underwent an attempt at percutaneous removal of permanent TrapEase (10) and Simon Nitinol (2) IVC filters due to a history of IVC filter complications or need for lifelong anticoagulation due to the filter. Medical records were reviewed for filter dwell time, presence of iliocaval deep venous thrombosis, procedural technique, and complications. RESULTS Filter dwell times ranged from 7 days to 15 years (mean 5.1 years). Successful removal of permanent IVC filters was possible in 11 of 12 patients (91.6%). In 1 patient, a chronically thrombosed IVC filter could not be removed despite laser sheath assistance, but was successfully recanalized with the PowerWire RF guidewire. In the failed retrieval attempt, a stent was placed through the chronically thrombosed IVC filter with restoration of in-line flow. One major complication of large venous groin hematoma was encountered. CONCLUSIONS In carefully selected patients, percutaneous removal of permanent IVC filters can be performed safely despite prolonged filter dwell times. Extraction of chronically embedded permanent IVC filters may be facilitated by jugular and femoral approaches, often with laser sheath assistance. Chronic filter thrombosis and caval scarring may increase the risk of retrieval failure.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D014682 Vena Cava, Inferior The venous trunk which receives blood from the lower extremities and from the pelvic and abdominal organs. Inferior Vena Cava,Inferior Vena Cavas,Vena Cavas, Inferior
D016306 Vena Cava Filters Mechanical devices inserted in the inferior vena cava that prevent the migration of blood clots from deep venous thrombosis of the leg. Inferior Vena Cava Filters,Umbrella Filters,Filter, Inferior Vena Cava,Filters, Inferior Vena Cava,Inferior Vena Cava Filter,Cava Filter, Vena,Cava Filters, Vena,Filter, Umbrella,Filter, Vena Cava,Filters, Umbrella,Filters, Vena Cava,Umbrella Filter,Vena Cava Filter
D054556 Venous Thromboembolism Obstruction of a vein or VEINS (embolism) by a blood clot (THROMBUS) in the blood stream. Thromboembolism, Venous
D020878 Device Removal Removal of an implanted therapeutic or prosthetic device. Device Removals,Removal, Device,Removals, Device

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