Retrospective Review of 120 Celect Inferior Vena Cava Filter Retrievals: Experience at a Single Institution

Zhou, Daohong; Spain, James; Moon, Eunice; McLennan, Gordon; Sands, Mark; Wang, Weiping

doi:10.1016/j.jvir.2012.08.016

Cited by 93 publications

(49 citation statements)

References 37 publications

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“…However, previous studies have demonstrated that penetrations can progress over time, 19,26,28 and the longer the indwelling time is, the further the penetration depth beyond the caval wall is. 26 For symptomatic patients, filter retrieval should be strongly considered because pain related to a filter is often relieved after filter removal. 29 Endovascular removal of a retrievable IVC filter is a routine procedure with a success rate approaching 100%.…”

Section: -13mentioning

confidence: 98%

“…Two studies published by the same group demonstrated a higher penetration rate with Celect filters than with G2 filters (86.1% versus 25.2%). 26,27 To date, however, no studies have compared penetration rates among different filters in a standardized fashion. Clinical symptoms of penetration may vary, depending on the location and depth of the penetration and the structures involved.…”

Section: -13mentioning

confidence: 99%

“…However, retrieving these filters should be considered, particularly in cases of penetration already involving adjacent organs or structures, because penetrations are known to progress over time. 19,26,28 Retrieval of optional filters in this setting can be performed safely. 33,34 For cases in which the filter is not removed, follow-up CT scans are appropriate.…”

Section: -13mentioning

confidence: 99%

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Caval Penetration by Inferior Vena Cava Filters

et al. 2015

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Background-Limited penetration into the caval wall is an important securing mechanism for inferior vena cava (IVC) filters; however, caval penetration can also cause unintentional complications. The aim of this study was to assess the incidence, severity, clinical consequences, and management of filter penetration across a range of commercially available IVC filters. Methods and Results-The MEDLINE database was searched for all studies showed evidence of organ/structure involvement. Among patients with penetration, 8% were symptomatic, 45% were asymptomatic, and 47% had unknown symptomatology. The most frequently reported symptom was pain (77%, 108 of 140). Major complications were reported in 83 patients (5%). These complications required interventions including surgical removal of the IVC filter (n=63), endovascular stent placement or embolization (n=11), endovascular retrieval of the permanent filter (n=4), and percutaneous nephrostomy or ureteral stent placement (n=3). Complications led to death in 2 patients. A total of 87% of patients (127 of 146) underwent premature filter retrieval or interventions for underlying symptoms or penetration-related complications. Conclusions-Caval penetration is a frequent but clinically underrecognized complication of IVC filter placement.Symptomatic patients accounted for nearly 1/10th of all penetrations; most of these cases had organ/structure involvement. Interventions with endovascular retrieval and surgery were required in most of these symptomatic patients.

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Section: -13mentioning

confidence: 98%

Section: -13mentioning

confidence: 99%

Section: -13mentioning

confidence: 99%

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Caval Penetration by Inferior Vena Cava Filters

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“…12 These risks seem to increase with the length of time that the filter is in place. 13 Following the publication of a series of IVC filter-related complications, 14 the US Food and Drug Administration 15 issued a statement in 2010 reporting that retrievable IVC filters that are left in place are prone to filter fracture, filter migration, filter embolization, and IVC perforation, as well as increased risk of lower limb DVT. The Food and Drug Administration recommends that IVC filters should be removed as soon as the risk of PE has subsided.…”

mentioning

confidence: 99%

Indications, Complications, and Management of Inferior Vena Cava Filters

Sarosiek¹,

Crowther²,

Sloan³

2013

JAMA Intern Med

213

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Importance: Retrievable inferior vena cava (IVC) filters were designed to provide temporary protection from pulmonary embolism, sparing patients from long-term complications of permanent filters. However, many retrievable IVC filters are left in place indefinitely.Objectives: To review the medical records of patients with IVC filters to determine patient demographics and date of and indication for IVC filter placement, as well as complications, follow-up data, date of IVC filter retrieval, and use of anticoagulant therapy.Design and Setting: A retrospective review of IVC filter use between August 1, 2003, and February 28, 2011, was conducted at Boston Medical Center, a tertiary referral center with the largest trauma center in New England.Participants: In total, 978 patients. Twenty six patients were excluded from the study because of incomplete medical records.Intervention: Placement of retrievable IVC filter.Main Outcome Measures: In total, 952 medical records were included in the analysis.Results: Of 679 retrievable IVC filters that were placed, 58 (8.5%) were successfully removed. Unsuccessful retrieval attempts were made in 13 patients (18.3% of attempts). Seventy-four venous thrombotic events (7.8% of 952 patients included in the study) occurred after IVC filter placement, including 25 pulmonary emboli, all of which occurred with the IVC filter in place. Forty-eight percent of venous thrombotic events were in patients without venous thromboembolism at the time of IVC filter placement, and 89.4% occurred in patients not receiving anticoagulants. Many IVC filters placed after trauma were inserted when the highest bleeding risk had subsided, and anticoagulant therapy may have been appropriate. While many of these filters were placed because of a perceived contraindication to anticoagulants, 237 patients (24.9%) were discharged on a regimen of anticoagulant therapy. Conclusion and Relevance:Our research suggests that the use of IVC filters for prophylaxis and treatment of venous thrombotic events, combined with a low retrieval rate and inconsistent use of anticoagulant therapy, results in suboptimal outcomes due to high rates of venous thromboembolism.

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“…Several reports pointed to their questionable influence in protection of VTE and danger of permanently implanted filters that lead to potential complications. Severe complications, some of which can be fatal, have been reported with IVC filters: filter strut fracture, filter migration/embolization, IVC or aortic penetration, and thrombotic complications (5,33). The incidence of these complications varies depending on the series.…”

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confidence: 99%

Vena cava filters are not superior to low molecular weight heparin in venous thromboembolism prophylaxis: a study on long term immobilized neurosurgical patients

Akmangit¹,

Dağlıoğlu²,

Uyanık³

et al. 2014

Turkish Neurosurgery

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AIm: Deep venous thrombosis (DVT) and pulmonary embolism (PE) are the most frequent surgical problems and associated with high morbidity and mortality. Neurosurgical patients constitute a unique group where prophylaxis with anticoagulant and antiaggregant agents are relatively contraindicated due to the natural course of vascular problems such as aneurysms, hemorrhagic tumors or hematomas or increased vulnerability to complex spinal surgeries and trauma. mAterIAl and methOds: We included 67 patients predicted to be immobilized for 2 or more months in this retrospective analysis. A vena cava filter was inserted between the first and seventh postoperative day in 40 patients in a prophylactic manner whereas 27 patients received low dose heparin for the same purpose. The patients were evaluated for symptomatic DVT or PE.results: Percutaneous insertion was performed for all filters without any complication. DVT occurred in two patients of the filter group and 1 patient of the heparin group. There was no PE recorded in any patient of either group. Patients were followed up for 22 months in the filter and 16 months in the heparin group. COnClusIOn:We conclude that prophylactic filter use in high risk neurosurgical patients is not beneficial and not superior to low-molecularweight heparin use. Nevertheless, it is reasonable to prevent PE in patients with proven DVT who have no contraindication for anticoagulant drugs.KeywOrds: Deep venous thrombosis, Venous thromboembolism, Vena cava filter, Low molecular weight heparin, Pulmoner embolism prophylaxis, Neurosurgical patients ÖZ AmAÇ: Derin ven trombozu ve pulmoner embolizm yüksek morbidite ve mortaliteyle seyreden en sık cerrahi problemler arasında yer alır. Anevrizma gibi vasküler problemler, hemorajik tümörler, hematom, kompleks spinal cerrahi ve travma gibi nöroşirürjiye ait hastalıklar antiagregan ve antikoagülan tedavinin göreceli olarak kontrendike olduğu özel bir grubu oluşturmaktadır. yÖntem ve GereÇler: Bu retrospektif çalışmada, 2 ay veya daha uzun süre immobilize olması beklenen 67 hastanın analizi yapılmıştır. Vena kava filtreleri 40 hastada postoperatif bir ile yedinci günde proflaktik amaçla yerleştirildi. 27 hastada ise aynı amaçla düşük moleküler ağırlıklı heparin kullanıldı. Hastalar yattıkları süreçte ve izlemde semptomatik derin ven trombozu (DVT) ve pulmoner emboli (PE) açısından takip edildi.BulGulAr: Bütün filtreler perkütan yolla yerleştirildi ve işleme ait herhangi bir komplikasyon gelişmedi. Filtre grubunda 2, heparin grubunda 1 hastada DVT gelişti. Her iki grupta PE saptanmadı. Hastalar filtre grubunda ortalama 22 ay, heparin grubunda 16 ay süreyle takip edildi. sOnuÇ: Yüksek riskli nöroşirürji hastalarında prolaktik filtre kullanımının düşük moleküler ağırlıklı heparin kullanımına üstün olmadığı düşünüldü. Buna rağmen DVT'si kanıtlanmış ve antikoagülan ilaçların kontrendike olduğu durumlarda PE'yi önlemede etkin olduğu açıktır.

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Retrospective Review of 120 Celect Inferior Vena Cava Filter Retrievals: Experience at a Single Institution

Cited by 93 publications

References 37 publications

Caval Penetration by Inferior Vena Cava Filters

Caval Penetration by Inferior Vena Cava Filters

Indications, Complications, and Management of Inferior Vena Cava Filters

Vena cava filters are not superior to low molecular weight heparin in venous thromboembolism prophylaxis: a study on long term immobilized neurosurgical patients

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