REGULAR CONTENT
Final ID
569
Type
Original Scientific Research-Oral or Pos
Authors
E Jun1, D van Beek1, O Akinwande1, C Guevara1, S Kim1, J Duncan1, M Darcy1, R Ramaswamy1
Institutions
1Mallinckrodt Institute of Radiology Washington University in St Louis, Saint Louis, MO
Purpose
To assess the relative safety and difficulty of retrieving different types of IVC filters.
Materials & Methods
A retrospective review was performed of all IVC filter retrievals at a tertiary academic center between July 2012 and August 2016. Patients who underwent both filter placement and retrieval at our institution were included. Chart review was used to obtain relevant data including indication for filter placement, length of the removal procedure, retrieval success, and the use of advanced retrieval techniques.
Results
196 filter placement / retrieval pairs were identified involving 192 patients (93 men, 99 women, mean age 57 +/- 14.6 years). Filter types were Denali (107), Option (43), Gunther Tulip (39), Celect (6), and Greenfield (1). The most common indications for filter placement included pre-operative or post-operative thromboembolic disease (61%), history of hemorrhage on anti-coagulation or other risk factors for bleeding (21%), and massive pulmonary embolism (5%).Average length of the retrieval procedure was 34.3 minutes with Option retrievals requiring significantly more time (48.8 min; p<0.01) when compared to the rest (Tulip 34.8 min, Denali 28.8 min, and Celect 25.5 min). IVC filter retrieval was unsuccessful in 8 of the 196 cases (4%) including 5 Option, 2 Tulip, and 1 Denali filters. Retrieval failure was significantly higher for the Option filters (11.6%; p<0.01). Advanced retrieval techniques (triple snare, snare over loop guidewire, or forceps) were required for 19 of the retrievals (9.6%). The use of advanced techniques was significantly higher with the Option filters (32.6%; p<0.01). Complications arose during 4 of the retrieval procedures, including access site hematoma, induced arrhythmia, hemopericardium, and extravasation from the inferior vena cava.
Conclusions
IVC filters can be safely removed in the majority of patients particularly when the operators are familiar with advanced retrieval techniques. Of the types included in the study, the Denali and Gunther Tulip filters had comparable retrieval statistics while Option filters were more difficult to remove based on multiple metrics.
Final ID
569
Type
Original Scientific Research-Oral or Pos
Authors
E Jun1, D van Beek1, O Akinwande1, C Guevara1, S Kim1, J Duncan1, M Darcy1, R Ramaswamy1
Institutions
1Mallinckrodt Institute of Radiology Washington University in St Louis, Saint Louis, MO
Purpose
To assess the relative safety and difficulty of retrieving different types of IVC filters.
Materials & Methods
A retrospective review was performed of all IVC filter retrievals at a tertiary academic center between July 2012 and August 2016. Patients who underwent both filter placement and retrieval at our institution were included. Chart review was used to obtain relevant data including indication for filter placement, length of the removal procedure, retrieval success, and the use of advanced retrieval techniques.
Results
196 filter placement / retrieval pairs were identified involving 192 patients (93 men, 99 women, mean age 57 +/- 14.6 years). Filter types were Denali (107), Option (43), Gunther Tulip (39), Celect (6), and Greenfield (1). The most common indications for filter placement included pre-operative or post-operative thromboembolic disease (61%), history of hemorrhage on anti-coagulation or other risk factors for bleeding (21%), and massive pulmonary embolism (5%).Average length of the retrieval procedure was 34.3 minutes with Option retrievals requiring significantly more time (48.8 min; p<0.01) when compared to the rest (Tulip 34.8 min, Denali 28.8 min, and Celect 25.5 min). IVC filter retrieval was unsuccessful in 8 of the 196 cases (4%) including 5 Option, 2 Tulip, and 1 Denali filters. Retrieval failure was significantly higher for the Option filters (11.6%; p<0.01). Advanced retrieval techniques (triple snare, snare over loop guidewire, or forceps) were required for 19 of the retrievals (9.6%). The use of advanced techniques was significantly higher with the Option filters (32.6%; p<0.01). Complications arose during 4 of the retrieval procedures, including access site hematoma, induced arrhythmia, hemopericardium, and extravasation from the inferior vena cava.
Conclusions
IVC filters can be safely removed in the majority of patients particularly when the operators are familiar with advanced retrieval techniques. Of the types included in the study, the Denali and Gunther Tulip filters had comparable retrieval statistics while Option filters were more difficult to remove based on multiple metrics.