Safety and efficacy of inferior vena cava filter retrieval: a 5-year single center retrospective review from a tertiary care center
Abstract Background Inferior vena cava (IVC) filter retrieval is typically accomplished with standard snare technique. When this fails, more advanced techniques are necessary, especially when removal falls outside a 12-month window. Complications during filter retrieval depend heavily on technique,...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-08-01
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| Series: | CVIR Endovascular |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42155-022-00316-z |
| _version_ | 1818505097266593792 |
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| author | Philip Schuchardt Lilla Kis Alexey Goloubev Edward Keshishian Rahul Mhaskar Glenn Hoots Cliff Davis Kamal Massis Jamil Shaikh |
| author_facet | Philip Schuchardt Lilla Kis Alexey Goloubev Edward Keshishian Rahul Mhaskar Glenn Hoots Cliff Davis Kamal Massis Jamil Shaikh |
| author_sort | Philip Schuchardt |
| collection | DOAJ |
| description | Abstract Background Inferior vena cava (IVC) filter retrieval is typically accomplished with standard snare technique. When this fails, more advanced techniques are necessary, especially when removal falls outside a 12-month window. Complications during filter retrieval depend heavily on technique, type of filter, and filter position. In this study we examined safety and efficacy of 536 filter retrievals at a tertiary care center and compared complication rates between standard snare and endobronchial forcep retrieval. Method We reviewed 536 cases between August 2015 and August 2020, recording retrieval success rates, patient comorbidities, and complication rates at the time of removal. Results Total overall retrieval success was 97.9% (525/536), and complications occurred in approximately 6.0% (32/536) of all cases. Success and complications with standard snare technique alone were 99.4% (345/347) and 1.7% (5 Grade I/II, 1 Grade III) and advanced forcep technique 98.8% (171/173) and 14.5% (22 Grade I/II, 2 Grade III, and 1 Grade IV), respectively. There was no significant difference between the technical success rates of the standard snare technique and forceps techniques (p = 0.60) despite a significantly longer dwell time in patients undergoing forceps retrieval (p < 0.001). Conclusion To our knowledge, this is the largest cohort of forceps directed IVC filter retrieval present in the literature. Rates of successful endobronchial forceps and standard snare retrievals in this study are similar to previous reports. Although use of endobronchial forceps may be associated with higher complication rates, this is likely due to prolonged dwell times, filter tilt, and attempted removal of non retrievable filters. Overall, forceps-directed retrieval offers a safe, effective means of removal in difficult cases. Level of evidence Level 3, Large Retrospective Study. |
| first_indexed | 2024-12-10T21:46:05Z |
| format | Article |
| id | doaj.art-ee228fd98b9c4d719b9a487ceddb293c |
| institution | Directory Open Access Journal |
| issn | 2520-8934 |
| language | English |
| last_indexed | 2024-12-10T21:46:05Z |
| publishDate | 2022-08-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | CVIR Endovascular |
| spelling | doaj.art-ee228fd98b9c4d719b9a487ceddb293c2022-12-22T01:32:22ZengSpringerOpenCVIR Endovascular2520-89342022-08-01511710.1186/s42155-022-00316-zSafety and efficacy of inferior vena cava filter retrieval: a 5-year single center retrospective review from a tertiary care centerPhilip Schuchardt0Lilla Kis1Alexey Goloubev2Edward Keshishian3Rahul Mhaskar4Glenn Hoots5Cliff Davis6Kamal Massis7Jamil Shaikh8University of South Florida Department of Interventional RadiologyUniversity of South Florida Department of Interventional RadiologyUniversity of South Florida Department of Interventional RadiologyUniversity of South Florida Department of Interventional RadiologyMorsani College of Medicine Office of ResearchUniversity of South Florida Department of Interventional RadiologyUniversity of South Florida Department of Interventional RadiologyUniversity of South Florida Department of Interventional RadiologyUniversity of South Florida Department of Interventional RadiologyAbstract Background Inferior vena cava (IVC) filter retrieval is typically accomplished with standard snare technique. When this fails, more advanced techniques are necessary, especially when removal falls outside a 12-month window. Complications during filter retrieval depend heavily on technique, type of filter, and filter position. In this study we examined safety and efficacy of 536 filter retrievals at a tertiary care center and compared complication rates between standard snare and endobronchial forcep retrieval. Method We reviewed 536 cases between August 2015 and August 2020, recording retrieval success rates, patient comorbidities, and complication rates at the time of removal. Results Total overall retrieval success was 97.9% (525/536), and complications occurred in approximately 6.0% (32/536) of all cases. Success and complications with standard snare technique alone were 99.4% (345/347) and 1.7% (5 Grade I/II, 1 Grade III) and advanced forcep technique 98.8% (171/173) and 14.5% (22 Grade I/II, 2 Grade III, and 1 Grade IV), respectively. There was no significant difference between the technical success rates of the standard snare technique and forceps techniques (p = 0.60) despite a significantly longer dwell time in patients undergoing forceps retrieval (p < 0.001). Conclusion To our knowledge, this is the largest cohort of forceps directed IVC filter retrieval present in the literature. Rates of successful endobronchial forceps and standard snare retrievals in this study are similar to previous reports. Although use of endobronchial forceps may be associated with higher complication rates, this is likely due to prolonged dwell times, filter tilt, and attempted removal of non retrievable filters. Overall, forceps-directed retrieval offers a safe, effective means of removal in difficult cases. Level of evidence Level 3, Large Retrospective Study.https://doi.org/10.1186/s42155-022-00316-zIVC filter removalEndobronchial forcepsStandard loop snareIVC filter leg penetrationTilted IVC filter |
| spellingShingle | Philip Schuchardt Lilla Kis Alexey Goloubev Edward Keshishian Rahul Mhaskar Glenn Hoots Cliff Davis Kamal Massis Jamil Shaikh Safety and efficacy of inferior vena cava filter retrieval: a 5-year single center retrospective review from a tertiary care center CVIR Endovascular IVC filter removal Endobronchial forceps Standard loop snare IVC filter leg penetration Tilted IVC filter |
| title | Safety and efficacy of inferior vena cava filter retrieval: a 5-year single center retrospective review from a tertiary care center |
| title_full | Safety and efficacy of inferior vena cava filter retrieval: a 5-year single center retrospective review from a tertiary care center |
| title_fullStr | Safety and efficacy of inferior vena cava filter retrieval: a 5-year single center retrospective review from a tertiary care center |
| title_full_unstemmed | Safety and efficacy of inferior vena cava filter retrieval: a 5-year single center retrospective review from a tertiary care center |
| title_short | Safety and efficacy of inferior vena cava filter retrieval: a 5-year single center retrospective review from a tertiary care center |
| title_sort | safety and efficacy of inferior vena cava filter retrieval a 5 year single center retrospective review from a tertiary care center |
| topic | IVC filter removal Endobronchial forceps Standard loop snare IVC filter leg penetration Tilted IVC filter |
| url | https://doi.org/10.1186/s42155-022-00316-z |
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