Keywords:
Interventional vascular, Veins / Vena cava, Haematologic, Catheter venography, Fluoroscopy, Removal, Filter insertions, Technical aspects, Outcomes
Authors:
D. J. Bowden, A. M. Lee, T. Murray, M. Given, M. J. Lee; Dublin/IE
DOI:
10.1594/ecr2018/C-2606
Results
230 IVC filters were placed during the study period.
Of these,
66 insertions were performed preoperatively in 65 patients due to perioperative contraindications to anticoagulation,
generating 71 attempts at filter retrieval (Image 1: Indications for filter insertion.)
19.7% (n=13) were explicitly not retrieved due to life limiting conditions,
4.5% (n=3) were not retrieved following a consensus decision that the patient would never be fit for oral anticoagulation.
Of the 50 cases where retrieval was desired,
90% (n=45) were successful on first attempt.
The remaining 10% (n=5) of patients failed initial retrieval.
Causes included iliocaval DVT extension preventing retrieval (n=2),
new perioperative filter tilt (n=2) and in a final patient,
extensive clot burden on two cavograms initially precluded removal,
with successful filter retrieval only after reduced clot burden was demonstrated on a third cavogram (n=1).
Of the two cases where the filter appeared to have tilted compared to images from insertion,
both involved surgical instrumentation of the retroperitoneum (oesophagectomy with gastric pull-up and radical nephrectomy).
(Image 2 - normal insertion.
Image 3: filter tilt).