Placing a New Filter before Removing Embolized Nonconical Filter: A Report of 13 Cases

Tian, Xuan; Liu, Jianlong; Jia, Wei; Jiang, Peng; Cheng, Zhiyuan; Zhang, Yunxin; Li, Jinyong; Tian, Chenyang

doi:10.1016/j.avsg.2021.09.036

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…The possible complications of long-term IVC filter implantation include obstruction and perforation of the vena cava and approaching or entering of the filter pedicle into the surrounding organs, which can manifest with associated symptoms (12)(13)(14)(15). When the IVC filter creates serious complications, it affects patients' physiological and psychological status (16,17), and the filter should be retrieved immediately to reduce complications. Due to abnormalities in the inferior vena cava, the presence of thrombus blocked by the filter, the consequences of the IVC filter placement, or other unknown reasons, the conical filter is more prone to adhere obliquely.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Case report: Endoluminal removal of a retrievable conical inferior vena cava filter with a ruptured retraction hook attached to the wall

Tian

Liu²,

Li³

et al. 2022

Front. Surg.

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We report the case of a patient who underwent endovascular retrieval of a conical inferior vena cava (IVC) filter with a ruptured retraction hook that was attached to the IVC wall. A 21-year-old woman with a Celect (Cook) filter, implanted 1,522 days prior, requested retrieval. Preoperative ultrasound and CT examinations showed that the filter was inclined, the retraction hook was attached to the IVC wall, and one of the filter’s pedicles was broken. The inferior vena cava was patent, with no thrombus. Old superficial femoral vein thrombosis could be seen in the right lower extremity. The filter retrieval equipment (Gunther Tulip, Cook) failed to capture the retraction hook. By means of a pigtail catheter (with a partly removed catheter tip) and loach guidewire, we applied a modified loop-snare technique to successfully cut the proliferative tissue near the tip of the retraction hook, by which the hook re-entered the inferior vena cava. Although the snare successfully captured the retraction hook and retrieved the filter, the broken pedicle was retained in the inferior vena cava. We used forceps to capture and pull it to the distal end. In the end, the inferior vena cava became patent, with no contrast agent spillage or residual, and no symptomatic pulmonary embolization. A simultaneous occurrence of oblique adherence and fracture is rarely found in the same filter; however, by using the modified loop-snare technique and biopsy forceps technique, we successfully retrieved the filter and broken pedicle. Our case provides a practical auxiliary technique for regular clinical practice.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Case report: Endoluminal removal of a retrievable conical inferior vena cava filter with a ruptured retraction hook attached to the wall

Tian

Liu²,

Li³

et al. 2022

Front. Surg.

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“…Most IVC filters are removed by endovenous method, but hooks in recycling conical filters penetrate the vein wall, resulting in failure of endovenous retrieval of the filter; non-conical filters cause rapid endothelial proliferation and increased difficulty of endovenous retrieval after retention for more than 14 days ( 16 – 18 ), however forced retrieval of the filter may damage the IVC. The filter required been retained for a prolonged period in cases of pulmonary embolism risk, IVC embolism, or floating thrombus in the proximal iliac femoral vein ( 19 ). Failure to undergo medical intervention on time or other unknown factors may also increase the filter retention time and increase the risk of filter removal.…”

Section: Introductionmentioning

confidence: 99%

Removal of inferior vena cava filter by open surgery after failure of endovenous retrieval

Tian

Liu

et al. 2023

Front. Cardiovasc. Med.

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BackgroundThe permanent placement of inferior vena cava (IVC) filters may lead to numerous complications and their removal is recommended once the risk of pulmonary embolism is reduced. Removal of IVC filters by endovenous means is preferred. But failure of endovenous removal happens when recycling hooks penetrate the vein wall and filters are left in place for too long time. In these scenarios, open surgery may be effective for removal of IVC filters. We aimed to describe the surgical approach, outcomes, and 6-month follow-up of the removal of IVC filter by open surgery, after the failure of removal via the endovenous method.MethodsA total of 1,285 patients with retrievable IVC filters were admitted from July 2019 to June 2021, including 1,176 (91.5%) endovenous filter removals, and 24 (1.9%) open surgical IVC filter removals after the failure by endovenous method, of whom 21 (1.6%) were followed-up and eligible for analysis of the study. Patient characteristics, filter type, filter removal rate, IVC patency rate, and complications were retrospectively analyzed.ResultsTwenty-one patients were left with IVC filters for 26 (10, 37) months, of which 17 (81.0%) patients had non-conical filters and 4 (19.0%) had conical filters; all 21 filters were successfully removed, with a 100% removal rate, no deaths, no serious complications, and no symptomatic pulmonary embolism. At the 3rd month follow-up after surgery and 3rd month follow-up after discontinuation of anticoagulation therapy, only 1 case (4.8%) had IVC occlusion, but without any occurrence of new lower limb deep venous thrombosis and silent pulmonary embolism.ConclusionOpen surgery can be used for the removal of IVC filters after failure of removal by endovenous method or when accompanied by complications without symptoms of pulmonary embolism. Open surgical approach can be used as an adjunctive clinical intervention for the removal of such filters.

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Antegrade and Retrograde Approaches with a Mechanical Thrombectomy Device for the Treatment of Acute Lower Limb Deep Vein Thrombosis

Xuan,

Jianlong,

Jinyong

et al. 2024

Annals of Vascular Surgery

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Placing a New Filter before Removing Embolized Nonconical Filter: A Report of 13 Cases

Cited by 3 publications

References 19 publications

Case report: Endoluminal removal of a retrievable conical inferior vena cava filter with a ruptured retraction hook attached to the wall

Case report: Endoluminal removal of a retrievable conical inferior vena cava filter with a ruptured retraction hook attached to the wall

Removal of inferior vena cava filter by open surgery after failure of endovenous retrieval

Antegrade and Retrograde Approaches with a Mechanical Thrombectomy Device for the Treatment of Acute Lower Limb Deep Vein Thrombosis

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