A Critical Review of Available Retrievable Inferior Vena Cava Filters and Future Directions

Abstract

Inferior vena cava filters have been placed in patients for decades for protection against pulmonary embolism. The widespread use of filters has dramatically increased owing at least in part to the approval of retrievable vena cava filters. Retrievable filters have the potential to protect against pulmonary embolism and then be retrieved once no longer needed to avoid potential long-term complications. There are several retrievable vena cava filters available for use. This article discusses the different filter designs as well as the published data on these available filters. When selecting a filter for use, it is important to consider the potential short-term complications and the filters' window for retrieval. Understanding potential long-term complications is also critical, as these devices are approved for permanent placement and many filters are not retrieved. Finally, this article will address research into new designs that may be the future of vena cava filtration.

Prophylactic Inferior Vena Cava Filters for Venous Thromboembolism in Adults With Trauma: An Updated Systematic Review and Meta-Analysis

“…25 The commonly deployed IVC filter by interventionalists includes Denali (Bard); OptEase and TrapEase filters (Cordis); Celect Platinum (Cook); and Option Elite (Argon Medical Devices). 100 The geometry of these IVC filters differ, in which Denali (Bard), Celect Platinum (Cook), and Option Elite (Argon Medical Devices) are conical-shaped; whereas OptEase and TrapEase filters (Cordis) are biconical-shaped. Device geometry was reported to be a risk factor for certain IFRAE, where conical devices were reported to be associated with a higher risk of penetration, and filters with cylindrical or umbrella elements were reported to be associated with a higher risk of IVC thrombosis.…”

Vena cava filter placement in a duplicated infrarenal inferior cava venous system with azygous continuation

“…This filter has a caudally oriented hook designed for a femoral vein retrieval. 8 It has shown safe insertion, removal and repositioning in patients with normal venous anatomy, and use in anatomical venous variants. [9][10][11] Complex variant and thrombus extension are crucial issues affecting the choice of procedure; thus, the optimal position for an IVC filter has yet to be established.…”

Hemodynamic Analysis of VenaTech Convertible Vena Cava Filter Using Computational Fluid Dynamics

“…To obtain quantitatively clinical data of blood flow is a common difficulty for all the IVC filters (Montgomery and Kaufman, 2016). In vitro experiment and simulation have become important complementary methods to study the hemodynamic characteristics of the IVC filter (Leask et al, 2001;López et al, 2018).…”

“…Pulmonary embolism (PE) from deep vein thrombosis (DVT) has become a disease with considerable rates of morbidity and mortality worldwide (Hirsh and Hoak, 1996;Kaufman et al, 2009;Beckman et al, 2010;Zhang et al, 2015;Kearon et al, 2016;Mozaffarian et al, 2016). To prevent PE in patients for whom anticoagulation therapy is ineffective or contraindicated, the inferior vena cava (IVC) filter provides a crucial alternative Duffett and Carrier, 2017;Lenchus et al, 2017) that has been in use for more than 40 years and currently appears to be increasing in use (Greenfield et al, 1994;Galanaud et al, 2013;Montgomery and Kaufman, 2016). However, the efficacy and safety of IVC filters remain a matter of dispute, and the corresponding complications are common, such as filter tilting, migration, vein wall penetration, filter-induced thrombosis and recurrent DVT and PE (Rahbar et al, 2011;Deso et al, 2016).…”

“…At present, there is a consensus that an ideal IVC filter should be non-migratory, non-thrombogenic and if possible, while capturing clots efficiently and maintaining vena cava patency (Leask et al, 2001(Leask et al, , 2004Harlal et al, 2007;Lessne et al, 2016;Montgomery and Kaufman, 2016). Most of the aforementioned concerns depend, to a certain extent, on the hemodynamic characteristics of an IVC filter design (López et al, 2018), which can be directly observed in vivo by computed tomography and magnetic resonance imaging (Gaines et al, 2018) or investigated by some in vitro experimental techniques, such as photochromic flow visualization (Couch et al, 1997).…”