REGULAR CONTENT
Final ID
562
Type
Original Scientific Research-Oral or Pos
Authors
M Kleedehn1, K Dawson1, K Longo1, P Laeseke1
Institutions
1University of Wisconsin, Madison, WI
Purpose
To evaluate factors associated with increased fluoroscopy time or the need for complex techniques at IVC filter retrieval.
Materials & Methods
This is a retrospective IRB-approved study of 187 consecutive patients who underwent IVC filter retrieval at our institution from 2006-2016. Factors previously investigated or hypothesized to impact filter retrieval fluoro time or complexity were studied. A complex retrieval was defined as one requiring more than standard sheath and snare technique. Correlations were made using Fisher's exact, Wilcoxon rank sum, Kruskal-Wallis tests, and Spearman's rank correlation coefficient, as appropriate.
Results
Filter tilt angle at placement correlated with hook apposition to the caval wall at time of removal (P=0.01). Hook apposition was associated with complex retrieval and increased fluoro time (P<0.01). Larger tilt angle at placement was not associated with complex retrieval (P=0.39), but a larger angle at filter removal was (P<0.01). There was a moderate correlation between the angle of filter at placement and removal (ρ=0.56, 95% CI 0.44-0.66). Longer filter dwell time correlated with the need for complex retrieval (P<0.01). There was a trend towards complex retrieval when the indication was failure of anticoagulation (P=0.08). Access vein during filter placement was not associated with the filter tilt angle at placement or removal (P=0.61, 0.48). Neither the direction of the filter hook (right, left, en-face) nor its relationship to the filter tilt were associated with the need for complex retrieval or increased retrieval fluoro time (P=0.23, 0.47, P=0.22, 0.56). Filter-type, sex, and age were not associated with complex retrievals (P=0.58, 0.99, 0.78).
Conclusions
Contrary to previous hypotheses, access vein for filter placement did not affect filter tilting, and direction of filter hook-tilt relationship did not affect retrieval fluoro time or the need for complex retrieval techniques. Confirming previous studies, a larger angle at the time of filter placement was associated with a larger angle at removal and hook wall apposition, both of which were associated with increased retrieval fluoro time and retrieval complexity.
Final ID
562
Type
Original Scientific Research-Oral or Pos
Authors
M Kleedehn1, K Dawson1, K Longo1, P Laeseke1
Institutions
1University of Wisconsin, Madison, WI
Purpose
To evaluate factors associated with increased fluoroscopy time or the need for complex techniques at IVC filter retrieval.
Materials & Methods
This is a retrospective IRB-approved study of 187 consecutive patients who underwent IVC filter retrieval at our institution from 2006-2016. Factors previously investigated or hypothesized to impact filter retrieval fluoro time or complexity were studied. A complex retrieval was defined as one requiring more than standard sheath and snare technique. Correlations were made using Fisher's exact, Wilcoxon rank sum, Kruskal-Wallis tests, and Spearman's rank correlation coefficient, as appropriate.
Results
Filter tilt angle at placement correlated with hook apposition to the caval wall at time of removal (P=0.01). Hook apposition was associated with complex retrieval and increased fluoro time (P<0.01). Larger tilt angle at placement was not associated with complex retrieval (P=0.39), but a larger angle at filter removal was (P<0.01). There was a moderate correlation between the angle of filter at placement and removal (ρ=0.56, 95% CI 0.44-0.66). Longer filter dwell time correlated with the need for complex retrieval (P<0.01). There was a trend towards complex retrieval when the indication was failure of anticoagulation (P=0.08). Access vein during filter placement was not associated with the filter tilt angle at placement or removal (P=0.61, 0.48). Neither the direction of the filter hook (right, left, en-face) nor its relationship to the filter tilt were associated with the need for complex retrieval or increased retrieval fluoro time (P=0.23, 0.47, P=0.22, 0.56). Filter-type, sex, and age were not associated with complex retrievals (P=0.58, 0.99, 0.78).
Conclusions
Contrary to previous hypotheses, access vein for filter placement did not affect filter tilting, and direction of filter hook-tilt relationship did not affect retrieval fluoro time or the need for complex retrieval techniques. Confirming previous studies, a larger angle at the time of filter placement was associated with a larger angle at removal and hook wall apposition, both of which were associated with increased retrieval fluoro time and retrieval complexity.