Vena cava filter retrieval in therapeutically anticoagulated patients

Schmelzer, Thomas M.; Christmas, A. Britton; Taylor, Dennis A.; Heniford, B. Todd; Sing, Ronald F.

doi:10.1016/j.amjsurg.2008.07.032

Cited by 12 publications

(8 citation statements)

References 19 publications

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“…Current guidelines were published in 2008 by the American College of Chest Physicians (http://chestjournal.chestpubs.org/content/133/6_suppl/454S.full.pdf þ html). 18 For anyone with a single episode of DVT or PE, the treatment includes AC for 3 or 6 months depending on the clinical scenario and the discretion of the treating physician. When the patient cannot be placed on AC, an IVCF is inserted and the duration of the treatment for protection from PE should still be a total of 3 or 6 months; this includes filter indwell time and anticoagulation time if the filter has already been removed.…”

Section: Discussionmentioning

confidence: 99%

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Improving the Tracking and Removal of Retrievable Inferior Vena Cava Filters

Goei¹,

Josephs²,

Kinney

et al. 2011

Semin intervent Radiol

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Therapeutic and prophylactic inferior vena cava (IVC) filters should be placed based on currently accepted indications to prevent a fatal pulmonary embolism (PE). The protective effect of filters is offset by the potential for lower extremity deep venous thrombosis (DVT), caval thrombosis, and possible otherwise unnecessary life-long anticoagulation (AC). The duration of treatment for most DVTs or PEs is 3 to 6 months of AC/filter. Filters should be retrieved when duration of treatment for a DVT/PE has been met, the risk of a PE is no longer high, and/or there is no longer a contraindication to AC. An effective system that leads to improving the retrieval rate of filters must include education of the patient, a tracking system to minimize patient lost to follow-up, and dedicated personnel to oversee the process. If these goals are accomplished, interventionalists can help decrease the incidence of a fatal PE during the high-risk period, and also decrease the risk of a DVT or the use of otherwise unnecessary life-long AC in subsequent years. Currently, there is much room for improvement in the frequency that IVCF patients are systematically followed and filters are retrieved. The principles discussed in this report will be helpful in this process.

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Section: Discussionmentioning

confidence: 99%

“…Therapeutic AC does not increase the risk of bleeding complications from filter retrieval. 18,19 In one study, 62 IVCF removals were attempted in anticoagulated patients. There was no extravasation seen on cavography after filter removal, and no operative bleeding complications, hematomas, or contusions.…”

Section: Discussionmentioning

confidence: 99%

Improving the Tracking and Removal of Retrievable Inferior Vena Cava Filters

Goei¹,

Josephs²,

Kinney

et al. 2011

Semin intervent Radiol

View full text Add to dashboard Cite

show abstract

“…Although most of our patients receive therapeutic anticoagulation throughout the procedure, which prior studies have shown to be safe, the risk of rapid development of acute caval thrombus remains significant (28,29). To minimize this risk during prolonged caval collapse, we routinely administer an intraprocedural unfractionated heparin dose of approximately 50 U/kg.…”

Section: Filter Strut Endothelializationmentioning

confidence: 99%

Retrievable IVC Filters: Comprehensive Review of Device-related Complications and Advanced Retrieval Techniques

et al. 2017

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Use of retrievable inferior vena cava filters (RIVCFs) has grown exponentially since their introduction into clinical practice, but many of these devices are not retrieved. Some are not retrieved due to poor clinical follow-up, but other devices remain in situ for extended periods because they present significant technical challenges during retrieval. Because of these and other factors, many of these devices were thus left in place permanently. However, recent data have placed a renewed emphasis on device retrieval due to increased risk of RIVCF-related complications, which are positively correlated with filter dwell time. Development of advanced filter retrieval techniques has had a significant impact on the removal of embedded RIVCFs, permitting retrieval of the majority of devices. The purpose of this article is to present an imaging and data review of the dominant device-related factors that complicate RIVCF retrieval and to describe the relevant advanced retrieval techniques to manage these factors. RIVCF imaging is frequently encountered in daily clinical practice via various imaging modalities. Therefore, diagnostic radiologists can play a vital role in identifying filter-related issues. Familiarity with the context for managing these issues in the interventional suite is essential for improving triage and care of patients with RIVCFs. RSNA, 2017.

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“…Schmelzer et al 2008 [88] described a retrospective review of 54 filters retrieved from 62 fully anticoagulated patients. There were no intraprocedural or postprocedural bleeding complications.…”

Section: Complications Of Filter Retrievalmentioning

confidence: 99%

Advanced Techniques for Removal of Retrievable Inferior Vena Cava Filters

Iliescu

Haskal

2011

Cardiovasc Intervent Radiol

125

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Inferior vena cava (IVC) filters have proven valuable for the prevention of primary or recurrent pulmonary embolism in selected patients with or at high risk for venous thromboembolic disease. Their use has become commonplace, and the numbers implanted increase annually. During the last 3 years, in the United States, the percentage of annually placed optional filters, i.e., filters than can remain as permanent filters or potentially be retrieved, has consistently exceeded that of permanent filters. In parallel, the complications of long-or short-term filtration have become increasingly evident to physicians, regulatory agencies, and the public. Most filter removals are uneventful, with a high degree of success. When routine filter-retrieval techniques prove unsuccessful, progressively more advanced tools and skill sets must be used to enhance filter-retrieval success. These techniques should be used with caution to avoid damage to the filter or cava during IVC retrieval. This review describes the complex techniques for filter retrieval, including use of additional snares, guidewires, angioplasty balloons, and mechanical and thermal approaches as well as illustrates their specific application.

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Vena cava filter retrieval in therapeutically anticoagulated patients

Cited by 12 publications

References 19 publications

Improving the Tracking and Removal of Retrievable Inferior Vena Cava Filters

Improving the Tracking and Removal of Retrievable Inferior Vena Cava Filters

Retrievable IVC Filters: Comprehensive Review of Device-related Complications and Advanced Retrieval Techniques

Advanced Techniques for Removal of Retrievable Inferior Vena Cava Filters

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