REGULAR CONTENT
Final ID
661
Type
Educational Exhibit-Poster Only
Authors
J Guan1, S Laroia2, A Laroia3
Institutions
1University of Iowa Hospitals and Clinics, Coralville, IA, 2N/A, Coralville, IA, 3University of Iowa Hospitals and Clinics, Iowa City, IA
Purpose
IVC filter tilt leads to reduced filter efficacy and lower retrieval success. One way to mitigate tilting is retrieval and replacement of the filter, but routine methods of filter retrieval have a low success rate of only 73%. Advanced retrieval techniques have success rates of up to 95% but are associated with significantly higher rates of major complications such as IVC dissection, filter fracture with embedded strut, and IVC injury with hemorrhage. This study presents a new catheter technique to correct severely tilted cone-shaped IVC filters without having to retrieve and replace the existing filter.
Materials & Methods
A retrospective review was performed for patients at our institution over the last three years who had severely tilted filters and underwent correction with the new technique. An SOS catheter was passed through the same femoral access used for the initial filter placement. The catheter tip was reformed inside the cone of the filter and the catheter shaft was curved against the IVC wall on the side of tilt to create counter pressure. The catheter tip was then used to push the filter tip towards the IVC midline. Once correction was achieved, the catheter was carefully pulled back to avoid entanglement in the filter struts. This was done under fluoroscopy, and completion venogram was used to document amelioration of tilt. Patient demographics, medical comorbidities, post-procedure outcomes, and complication rates were recorded and analyzed.
Results
28 patients had severely tilted IVC filters that were corrected using the catheter technique. 17 were male. Patient age ranged from 16-94yrs. 27/28 (96.4%) patients had successful correction of their filters back to mid-line of IVC. One (3.5%) had a minor complication where the filter struts became entangled with the catheter tip, however simple maneuvering of the catheter and use of a stiff wire to straighten the catheter loop freed up the entanglement. No major complications occurred.
Conclusions
The catheter technique for correcting severely tilted IVC filters had a high success rate of 96.4%. Compared to advanced filter retrieval techniques, this novel technique was associated with fewer complications and improved outcome.
Final ID
661
Type
Educational Exhibit-Poster Only
Authors
J Guan1, S Laroia2, A Laroia3
Institutions
1University of Iowa Hospitals and Clinics, Coralville, IA, 2N/A, Coralville, IA, 3University of Iowa Hospitals and Clinics, Iowa City, IA
Purpose
IVC filter tilt leads to reduced filter efficacy and lower retrieval success. One way to mitigate tilting is retrieval and replacement of the filter, but routine methods of filter retrieval have a low success rate of only 73%. Advanced retrieval techniques have success rates of up to 95% but are associated with significantly higher rates of major complications such as IVC dissection, filter fracture with embedded strut, and IVC injury with hemorrhage. This study presents a new catheter technique to correct severely tilted cone-shaped IVC filters without having to retrieve and replace the existing filter.
Materials & Methods
A retrospective review was performed for patients at our institution over the last three years who had severely tilted filters and underwent correction with the new technique. An SOS catheter was passed through the same femoral access used for the initial filter placement. The catheter tip was reformed inside the cone of the filter and the catheter shaft was curved against the IVC wall on the side of tilt to create counter pressure. The catheter tip was then used to push the filter tip towards the IVC midline. Once correction was achieved, the catheter was carefully pulled back to avoid entanglement in the filter struts. This was done under fluoroscopy, and completion venogram was used to document amelioration of tilt. Patient demographics, medical comorbidities, post-procedure outcomes, and complication rates were recorded and analyzed.
Results
28 patients had severely tilted IVC filters that were corrected using the catheter technique. 17 were male. Patient age ranged from 16-94yrs. 27/28 (96.4%) patients had successful correction of their filters back to mid-line of IVC. One (3.5%) had a minor complication where the filter struts became entangled with the catheter tip, however simple maneuvering of the catheter and use of a stiff wire to straighten the catheter loop freed up the entanglement. No major complications occurred.
Conclusions
The catheter technique for correcting severely tilted IVC filters had a high success rate of 96.4%. Compared to advanced filter retrieval techniques, this novel technique was associated with fewer complications and improved outcome.