Retrieval of Inferior Vena Cava Filters: Technical Considerations

Abstract

Placement of retrievable inferior vena cava filters has seen rapid growth since their introduction into clinical practice. When retrieved, these devices offer the notional benefit of temporary protection from pulmonary embolism related to lower extremity deep venous thrombosis, and mitigation of filter-related deep venous thrombosis. When promptly removed after the indication for mechanical prophylaxis is no longer present, standard endovascular retrieval techniques are frequently successful. However, the majority of these devices are left in place for extended periods of time, which has been associated with greater device-related complications when left in situ, and failure of standard techniques when retrieval is attempted. The development of advanced retrieval techniques has had a positive impact on retrieval of these embedded devices. In this article, technical considerations in the retrieval of such devices, with an emphasis on advanced techniques to facilitate retrieval of embedded devices, are discussed.

Tightrope Technique for facilitating complex endovascular aortic repair in patients with severely angulated neck

“…Intravascular use of endoscopic forceps has been previously described to facilitate retrieval of inferior vena cava filters and intravascular foreign bodies. 7 To our knowledge, this case report represents the first description of a novel intravascular use of endovascular forceps.…”

Retrieval of an inferior vena cava Greenfield filter 34 years after insertion

“…With this new type of device came an increase in the number of filters being placed; however, a lack of emphasis on filter retrieval led to an increase in the reports of complications, with complications being directly associated with filter retrieval and the length of time the filter was present 10 11. This led to the FDA recommending in 2014 that all retrievable IVC filters should be removed as soon as possible after no longer needed for protection and questioning the overall use and safety of IVC 12. However, there was compelling evidence showing them to have significant protection against pulmonary embolisms; in regards to filter removal, the benefits of placing an IVC filter seem to outweigh the risk of complications associated with the retrieval 10.…”

Inferior Vena Cava Filter-Induced Thrombosis: Filter Insertion Prior to Catheter-Directed Thrombolysis and Successful Double-Filter Retrieval after Prolonged Indwelling Time

“…2) Although designed to be removed, the majority of filters are left in place for a prolonged period of time, and studies have demonstrated that a prolonged indwelling time results in device-related complications. 3) In this study, we report a case of IVC filter-induced thrombosis. A second filter was inserted prior to catheter-directed thrombolysis (CDT), and both filters were successfully removed 70 and 1858 days post placement.…”