REGULAR CONTENT
Final ID
563
Type
Original Scientific Research-Oral or Pos
Authors
A Baheti1, R Singh1, D Nicholson1, J Patrie1, A Uflacker2, A Park3, S Sabri2, J Stone1, J Angle2, L Wilkins4
Institutions
1University of Virginia, Charlottesville, VA, 2N/A, Charlottesville, VA, 3UVA Health System, Charlottesville, VA, 4University of Virginia, Charlotesville, VA
Purpose
New 'self-straightening' IVC filters (Bard Denali) are reported to allow for easier removal compared to traditional filters (Cook Gunther Tulip). We sought to evaluate ease of retrieval of Denali filters versus Tulip filters.
Materials & Methods
Retrospective chart review of all patients in a tertiary care center undergoing successful (n= 467) or unsuccessful (n= 7) removal of a Tulip (n= 357) or Denali (n=117) filter over a 3 year time period. Endpoints included removal technique, procedure room, fluoroscopy and sedation time, procedure cost, and cause of complex retrieval in difficult cases.
Results
Comparing successful IVC filter removal, there is no age or gender predilection between the filters. Analysis was adjusted for a longer mean dwell time in the Tulip cohort (173 vs 126 days, p=0.08). There was no difference between room time, sedation time, or cost between the two cohorts. When subdivided into standard and complex retrievals, there is no difference in fluoroscopy time between the cohorts. Complex Tulip cases (64/350) required more room time (25 min, p=0.048), sedation time (31 min, p=0.033), and median cost ($240, p<0.001) than complex Denali cases (7/115). A greater proportion of Tulip filter retrievals are complex (17.9% vs. 6.8%, p<0.001). The most common reason for a complex filter retrieval was an endothelialized hook, which was more likely to occur in Tulip filters (p=0.003). The most complex retrieval technique was the sling technique using a Glidewire with reverse-curve catheter. Tulips were over-represented in the unsuccessful filter set (p=0.016, 6 Tulips, 1 Denali).
Conclusions
When adjusted for dwell time, there is no difference in most ease of removal endpoints between Denali and Tulip filters. Tulip filters, however, were more likely to require complex retrieval. Further, while complex Tulip cases require more resources than Denali cases, the differences are not substantial and do not affect overall removal endpoints when combined with standard retrieval cases. This suggests that given the prevalence of advanced filter retrieval techniques and very low rate of unsuccessful retrieval, the potential for perceived ease of removal should not primarily drive filter selection.
Final ID
563
Type
Original Scientific Research-Oral or Pos
Authors
A Baheti1, R Singh1, D Nicholson1, J Patrie1, A Uflacker2, A Park3, S Sabri2, J Stone1, J Angle2, L Wilkins4
Institutions
1University of Virginia, Charlottesville, VA, 2N/A, Charlottesville, VA, 3UVA Health System, Charlottesville, VA, 4University of Virginia, Charlotesville, VA
Purpose
New 'self-straightening' IVC filters (Bard Denali) are reported to allow for easier removal compared to traditional filters (Cook Gunther Tulip). We sought to evaluate ease of retrieval of Denali filters versus Tulip filters.
Materials & Methods
Retrospective chart review of all patients in a tertiary care center undergoing successful (n= 467) or unsuccessful (n= 7) removal of a Tulip (n= 357) or Denali (n=117) filter over a 3 year time period. Endpoints included removal technique, procedure room, fluoroscopy and sedation time, procedure cost, and cause of complex retrieval in difficult cases.
Results
Comparing successful IVC filter removal, there is no age or gender predilection between the filters. Analysis was adjusted for a longer mean dwell time in the Tulip cohort (173 vs 126 days, p=0.08). There was no difference between room time, sedation time, or cost between the two cohorts. When subdivided into standard and complex retrievals, there is no difference in fluoroscopy time between the cohorts. Complex Tulip cases (64/350) required more room time (25 min, p=0.048), sedation time (31 min, p=0.033), and median cost ($240, p<0.001) than complex Denali cases (7/115). A greater proportion of Tulip filter retrievals are complex (17.9% vs. 6.8%, p<0.001). The most common reason for a complex filter retrieval was an endothelialized hook, which was more likely to occur in Tulip filters (p=0.003). The most complex retrieval technique was the sling technique using a Glidewire with reverse-curve catheter. Tulips were over-represented in the unsuccessful filter set (p=0.016, 6 Tulips, 1 Denali).
Conclusions
When adjusted for dwell time, there is no difference in most ease of removal endpoints between Denali and Tulip filters. Tulip filters, however, were more likely to require complex retrieval. Further, while complex Tulip cases require more resources than Denali cases, the differences are not substantial and do not affect overall removal endpoints when combined with standard retrieval cases. This suggests that given the prevalence of advanced filter retrieval techniques and very low rate of unsuccessful retrieval, the potential for perceived ease of removal should not primarily drive filter selection.