Loop-Snare Technique for Difficult Inferior Vena Cava Filter Retrievals

Rubenstein, Lisa V.; Chun, Albert K.; Chew, Megan; Binkert, Christoph A.

doi:10.1016/j.jvir.2007.07.002

Cited by 84 publications

(51 citation statements)

References 11 publications

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“…Traction forces using the previously described methods may fail to separate the embedded filter from contact with the caval wall (19). The double guidewire and snare technique involves using an additional guidewire and snare to utilize the previously described guidewire loop and snare technique via two separate venous accesses (16). Both transjugular and transfemoral venous accesses are required.…”

Section: Dual-access Techniques Double Guidewire and Snare Techniquementioning

confidence: 99%

“…Stavropoulos et al later concluded that this endobronchial forceps technique could be safely used to successfully remove embedded filters (21,22). In this technique a rigid endobronchial forceps is introduced through a large caliber venous access sheath (14)(15)(16)(17)(18) and is used to dissect the hook of the IVC filter free from the caval wall. The tip or hook of the filter may then be grasped with the forceps so that the access sheath can be advanced over the filter apex in order to collapse the filter and allow subsequent removal using the forceps (Figure 8).…”

Section: Dissection Techniques Endobronchial Forceps Dissection and Rmentioning

confidence: 99%

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Inferior vena cava filter retrievals, standard and novel techniques

Kuyumcu¹,

Walker²

2016

Cardiovasc. Diagn. Ther.

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Abstract:The placement of an inferior vena cava (IVC) filter is a well-established management strategy for patients with venous thromboembolism (VTE) disease in whom anticoagulant therapy is either contraindicated or has failed. IVC filters may also be placed for VTE prophylaxis in certain circumstances.There has been a tremendous growth in placement of retrievable IVC filters in the past decade yet the majority of the devices are not removed. Unretrieved IVC filters have several well-known complications that increase in frequency as the filter dwell time increases. These complications include caval wall penetration, filter fracture or migration, caval thrombosis and an increased risk for lower extremity deep vein thrombosis (DVT). Difficulty is sometimes encountered when attempting to retrieve indwelling filters, mainly because of either abnormal filter positioning or endothelization of filter components that are in contact with the IVC wall, thereby causing the filter to become embedded. The length of time that a filter remains indwelling also impacts the retrieval rate, as increased dwell times are associated with more difficult retrievals. Several techniques for difficult retrievals have been described in the medical literature. These techniques range from modifications of standard retrieval techniques to much more complex interventions. Complications related to complex retrievals are more common than those associated with standard retrieval techniques. The risks of complex filter retrievals should be compared with those of life-long anticoagulation associated with an unretrieved filter, and should be individualized. This article summarizes current techniques for IVC filter retrieval from a clinical point of view, with an emphasis on advanced retrieval techniques.

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Section: Dual-access Techniques Double Guidewire and Snare Techniquementioning

confidence: 99%

Section: Dissection Techniques Endobronchial Forceps Dissection and Rmentioning

confidence: 99%

Inferior vena cava filter retrievals, standard and novel techniques

Kuyumcu¹,

Walker²

2016

Cardiovasc. Diagn. Ther.

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“…Failure to retrieve the device is the most common risk, and is usually related to captured thromboemboli [13]. Another cause is inability to engage the filter apex with the Recovery Cone [4], although alternative retrieval techniques have been successfully employed [14][15][16]. Struts that have embolized may be left in place if asymptomatic and not at risk for causing additional injury [17], or they may be retrieved percutaneously [18].…”

Section: Discussionmentioning

confidence: 99%

Retrieval of Recovery IVC Filter After 1,463-Day Implantation

2009

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A young female victim of multiple trauma had a Recovery inferior vena cava filter placed for pulmonary embolism prophylaxis. She was lost to follow-up for planned retrieval of the filter. After a period of more than four years she re-presented and had successful and uneventful retrieval of the filter. Certain inferior vena cava filters may potentially be retrieved even after very long implantation periods.

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“…In these cases, retrieval can be achieved using a guidewire loop-and-snare technique [25,26]. In this technique, a reverse-curve catheter is positioned below the filter and is used to direct a guidewire cephalad and underneath the filter's hook.…”

Section: Wire Loop-and-snare (Sling) Techniquementioning

confidence: 99%

Novel and Advanced Techniques for Complex IVC Filter Retrieval

Daye

Walker

2017

Curr Treat Options Cardio Med

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Inferior vena cava (IVC) filter placement is indicated for the treatment of venous thromboembolism (VTE) in patients with a contraindication to or a failure of anticoagulation. With the advent of retrievable IVC filters and their ease of placement, an increasing number of such filters are being inserted for prophylaxis in patients at high risk for VTE. Available data show that only a small number of these filters are retrieved within the recommended period, if at all, prompting the FDA to issue a statement on the need for their timely removal. With prolonged dwell times, advanced techniques may be needed for filter retrieval in up to 60% of the cases. In this article, we review standard and advanced IVC filter retrieval techniques including single-access, dual-access, and dissection techniques. Complicated filter retrievals carry a non-negligible risk for complications such as filter fragmentation and resultant embolization of filter components, venous pseudoaneurysms or stenoses, and breach of the integrity of the caval wall. Careful pre-retrieval assessment of IVC filter position, any significant degree of filter tilting or of hook, and/or strut epithelialization and caval wall penetration by filter components should be considered using dedicated cross-sectional imaging for procedural planning. In complex cases, the risk for retrieval complications should be carefully weighed against the risks of leaving the filter permanently indwelling. The decision to remove an embedded IVC filter using advanced techniques should be individualized to each patient and made with caution, based on the patient's age and existing comorbidities.

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Loop-Snare Technique for Difficult Inferior Vena Cava Filter Retrievals

Cited by 84 publications

References 11 publications

Inferior vena cava filter retrievals, standard and novel techniques

Inferior vena cava filter retrievals, standard and novel techniques

Retrieval of Recovery IVC Filter After 1,463-Day Implantation

Novel and Advanced Techniques for Complex IVC Filter Retrieval

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