Effectiveness and Safety of Laser-Assisted Removal of Inferior Vena Cava (IVC) Filters in a Single Tertiary Care Center

Abstract

Introduction: Laser sheath-assisted removal of inferior vena cava (IVC) filters with long dwelling time is a technique that utilizes laser-tipped sheaths. The laser light only penetrates vascular tissue by one hundred microns, causing the target tissues to disintegrate into particles less than 5 microns in size. This approach reduces the energy used during difficult retrieval procedures, allowing permanent filters to be removed in less fluoroscopic and procedural time overall.Materials and methods: The radiology information system and electronic health records were used in this retrospective cohort study to retrieve the data. A total of nine consecutive patients who underwent laserassisted filter removal utilizing GlideLightTM were included in the study between January 2016 and January 2017. The study took place at King Abdulaziz Medical City in Riyadh. In this study, five patients were male and four were female with ages ranging from 19 to 57 years with a median age of 31.Results: During the period of the study, a total of nine patients had their IVC filters removed using a laser. The success rate was 100%. The indications were trauma (n=4) followed by deep vein thrombosis (DVT) (n=3) and one patient indication was prolonged immobilization. The dwelling time ranged from seven to 70 months, with a dwelling median of 19 months. Conclusion:A laser sheath might be necessary for closed-cell filters in order to improve the likelihood of a successful and secure retrieval. Technical efficiency, filter type, the necessity of applying a laser sheath based on an open versus closed filter design, dwell times, and unfavorable results. As a result, after typical procedures failed to successfully retrieve IVC filters with long dwell durations, laser-assisted filter removal is thought to be practical and safe.

Laser-assisted permanent greenfield filter removal with ileocaval stent reconstruction following filter thrombosis, a case report

“…Advanced techniques are used when traditional techniques have failed and they include removal using endobronchial forceps, balloon displacement techniques, realignment of the filter with an angle-guided catheter, the “sling” technique using a curved wire, and stiff wire displacement [ 20 , 3 ] Recently, laser sheath assisted photoablation has also been described for removal of filters. Success rates of laser sheath-assisted retrieval of embedded IVC filters range from 95% to 100% with a 4% risk of major device-related complications, which suggests the effectiveness and safety of this retrieval method [ 21 , 22 ]. Additionally, preprocedural catheter-directed administration of tissue plasminogen activator (tPA) and recanalization of the IVC may also facilitate successful retrievals [3] .…”