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Percutaneous Retrieval of Permanent Inferior Vena Cava Filters

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Abstract

Purpose

To evaluate the feasibility, risks, and techniques of percutaneous removal of permanent TrapEase and Simon Nitinol IVC filters.

Materials and 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.

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Funding

Dr Michael Streiff has received research funding from Daiichi-Sankyo, Janssen, and Portola and consulted for BiO2Medical, Boehringer-Ingelheim, Daiichi-Sankyo, Eisai, and Janssen HealthCare. Dr Mark L Lessne has received research funding from Merit Medical, consulted for Apriomed, and is an investigator on Cook Medical IVC filter trial.

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Authors and Affiliations

  1. Division of Vascular & Interventional Radiology, Johns Hopkins University School of Medicine, 1800 Orleans Street, Sheik Zayed Towers, Suite 7203, Baltimore, MD, 21287, USA

    Anobel Tamrazi, Vibhor Wadhwa, Brian Holly, Jonathan K. Marx & Mark L. Lessne

  2. Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Vibhor Wadhwa

  3. Division of Vascular & Interventional Radiology, Kaiser Permanente, McLean, VA, USA

    Nikhil Bhagat

  4. Department of Hematology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Michael Streiff

  5. Vascular & Interventional Specialists of Charlotte Radiology, Charlotte, NC, USA

    Mark L. Lessne

Authors
  1. Anobel Tamrazi
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  2. Vibhor Wadhwa
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  3. Brian Holly
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  4. Nikhil Bhagat
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  5. Jonathan K. Marx
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  6. Michael Streiff
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  7. Mark L. Lessne
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Corresponding author

Correspondence to Anobel Tamrazi.

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Conflict of Interest

Anobel Tamrazi, Vibhor Wadhwa, Brian Holly, Nikhil Bhagat, and Jonathan K Marx have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Tamrazi, A., Wadhwa, V., Holly, B. et al. Percutaneous Retrieval of Permanent Inferior Vena Cava Filters. Cardiovasc Intervent Radiol 39, 538–546 (2016). https://doi.org/10.1007/s00270-015-1214-0

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  • DOI: https://doi.org/10.1007/s00270-015-1214-0

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