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Gabara C, Montoya-Rodes M, López N, Zamora-Martínez C, Ortiz M, Morancho A, Moisés J, Osorio J, Coloma E, Font C, Jiménez S, Zarco F, Burrel M, Bermúdez P, Barrufet M, Aibar J. Inferior Vena Cava Filters: Adherence to Clinical Practice Guidelines Recommendations, Retrieval Rates, and Filter Complications in a Tertiary Hospital. Angiology 2024; 75:928-936. [PMID: 37470426 DOI: 10.1177/00033197231190184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
The present study evaluated the adherence to guideline recommendations regarding the indication for inferior vena cava filter (IVCF) placement, retrieval rates, complications, thrombotic recurrences, and mortality. Patients in whom an IVCF was placed between 2015 and 2020 in a tertiary hospital were retrospectively included. We considered absolute indication of IVCF placement if all the guidelines evaluated agreed on the indication, relative indication if only some guidelines recommended it and without indication if none of the evaluated guidelines recommended it. From the 185 patients included; 47% had an absolute indication, 15% a relative indication, and 38% had no indication. Filter-associated complications and non-removal rates were 12.4% and 41%, respectively. Venous thromboembolism recurrence rate was 17.8%, being filter-associated complications (24.2 vs 9.8%, P = .02) and thrombosis of the inferior cava or iliac veins (12.1 vs 2.6%, P = .03) more frequent in this group. The mortality rate was 40%, with higher mortality risk in patients with co-existing cancer. Previous major bleeding, filter-associated complications, and mortality were associated with a major risk of non-removal. In conclusion, the adherence to guidelines regarding the indication of IVCF placement is still low and IVCF complications are not negligible. This fact is of special concern in the elderly, comorbid, and cancer patients.
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Affiliation(s)
- Cristina Gabara
- Internal Medicine Department, Hospital Clínic, IDIBAPS - University of Barcelona, Barcelona, Spain
| | - Marc Montoya-Rodes
- Internal Medicine Department, Hospital Clínic, IDIBAPS - University of Barcelona, Barcelona, Spain
| | - Néstor López
- Internal Medicine Department, Hospital Clínic, IDIBAPS - University of Barcelona, Barcelona, Spain
| | - Carles Zamora-Martínez
- Oncology Department, Hospital Clínic, IDIBAPS - University of Barcelona, Barcelona, Spain
| | - María Ortiz
- Internal Medicine Department, Hospital Clínic, IDIBAPS - University of Barcelona, Barcelona, Spain
| | - Alma Morancho
- Internal Medicine Department, Hospital Clínic, IDIBAPS - University of Barcelona, Barcelona, Spain
| | - Jorge Moisés
- Pneumology Department, Hospital Clínic, IDIBAPS - University of Barcelona, Barcelona, Spain
| | - Jeisson Osorio
- Pneumology Department, Hospital Clínic, IDIBAPS - University of Barcelona, Barcelona, Spain
| | - Emmanuel Coloma
- Internal Medicine Department, Hospital Clínic, IDIBAPS - University of Barcelona, Barcelona, Spain
| | - Carme Font
- Oncology Department, Hospital Clínic, IDIBAPS - University of Barcelona, Barcelona, Spain
| | - Sonia Jiménez
- Emergency Department, Hospital Clínic, IDIBAPS - University of Barcelona, Barcelona, Spain
| | - Federico Zarco
- Radiology Department, Hospital Clínic, IDIBAPS - University of Barcelona, Barcelona, Spain
| | - Marta Burrel
- Radiology Department, Hospital Clínic, IDIBAPS - University of Barcelona, Barcelona, Spain
| | - Patricia Bermúdez
- Radiology Department, Hospital Clínic, IDIBAPS - University of Barcelona, Barcelona, Spain
| | - Marta Barrufet
- Radiology Department, Hospital Clínic, IDIBAPS - University of Barcelona, Barcelona, Spain
| | - Jesús Aibar
- Internal Medicine Department, Hospital Clínic, IDIBAPS - University of Barcelona, Barcelona, Spain
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Choi PJ, Kabeil M, Furtado Neves PJ, Labropoulos N, Zil-E-Ali A, Aziz F, Malgor EA, Malgor RD. Urological complications caused by inferior vena cava filters: a systematic review. INT ANGIOL 2024; 43:247-254. [PMID: 38619204 DOI: 10.23736/s0392-9590.24.05041-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
INTRODUCTION Inferior vena cava (IVC) filters act in preventing pulmonary embolisms (PE). Various complications have been reported with their use. However, a credible urological complication rate, filter characteristics, and clinical presentation has yet to be summarized. Thus, we reported these complications in the form of a systematic review. EVIDENCE ACQUISITION A search strategy was designed using PubMed, MEDLINE, and EMBASE on February 10th, 2022. The design of this search strategy did not include any language restrictions. The key words (and wildcard terms) used in the search strategy were urolog*, ureter*, bladder, kidney coupled with filter, inferior vena cava, and cava*. Inclusion criteria were: patients older than 18, with previous IVC filter placement, and urologic complication reported. Exclusion criteria were: patients younger than 18, no IVC filter placement, and no urologic complication reported. Other case series and reviews were excluded to avoid patient duplication. EVIDENCE SYNTHESIS Thirty-five articles were selected for full-text screening. Thirty-seven patient cases were reviewed, and the median age was 53 (range: 21-92 years old). Abdominal and or flank pain was reported in 16 (43%) patients, hematuria was seen in eight (22%) and two (5%) patients died due to acute renal failure resulting from the urologic complications of the IVC filter. Indications for IVC filter placement were recurrent pulmonary embolism (PE), contraindication to or noncompliance with anticoagulant therapy. The IVC filters were infrarenal in 29 (78.4%) patients, suprarenal in five (13.5%) patients, not reported in two patients, and misplaced into the right ovarian vein in one patient. Three or more imaging modalities were obtained in 19 patients (51%) for planning. IVC filter removal was not performed in 17 (45.9%) patients, endovascular retrieval occurred in nine (24.3%) patients, and open removal was performed in seven (18.9%) patients, and tissue interposition was performed in two (5.4%) patients. One patient did not have the management reported. CONCLUSIONS Urological complications caused by IVC filters although rare, are likely underreported, require extensive workup, and pose surgical challenges. Due to their complex management, filter retrieval should be planned for as soon as feasible, and plans should be made as early as during the IVC filter implant. For those that do develop complications, clinical judgement must be exercised in management, and open surgical, endovascular or even conservative management strategies can be viable options and should be discussed in a multidisciplinary setting.
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Affiliation(s)
- Paul J Choi
- Division of Vascular Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Mahmood Kabeil
- Division of Vascular Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Pedro J Furtado Neves
- Division of Vascular Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Nicos Labropoulos
- Division of Vascular Surgery, Department of Surgery, Stony Brook University, Stony Brook, NY, USA
| | - Ahsan Zil-E-Ali
- Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Faisal Aziz
- Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Emily A Malgor
- Division of Vascular Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Rafael D Malgor
- Division of Vascular Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA -
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Grubman S, Kostiuk V, Brahmandam A, Tonnessen B, Mojibian H, Schneider E, Guzman RJ, Chaar CIO. Effect of inferior vena cava filter placement position on device complications. J Vasc Surg Venous Lymphat Disord 2023; 11:1165-1174.e2. [PMID: 37356713 DOI: 10.1016/j.jvsv.2023.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/03/2023] [Accepted: 05/27/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Indwelling inferior vena cava (IVC) filters can cause complications, including penetration into surrounding structures, migration, and thrombosis of the vena cava. Computational fluid dynamics suggests juxtarenal placement of IVC filters decreases the risk of thrombosis; however, this has not been explored clinically. The present study examines the effect of filter placement position on long-term device complications with an emphasis on IVC thrombosis. We hypothesized that IVC filters placed further caudal to the renal veins were more likely to develop long-term thrombosis. METHODS A retrospective review of the medical records of patients receiving IVC filters at a single tertiary center between 2008 and 2016 was performed. Patients missing follow-up or procedural imaging data were excluded. The placement procedure venograms were reviewed, and the distance from the filter apex to the more inferior renal vein was measured using reported IVC filter lengths for calibration. The patients were divided into three groups according to the tip position relative to the more inferior renal vein: at or superior (group A), 1 to 20 mm inferior (group B), and >20 mm inferior (group C). The patient and procedural characteristics and outcomes were compared between the three groups. The primary end points were IVC thrombosis and device-related mortality. RESULTS Of 1497 eligible patients, 267 (17.8%) were excluded. The most common placement position was group B (64.0%). The mean age was lowest in group C, followed by groups A and B (age, 59.5 years, 64.6 years, and 62.2 years, respectively; P = .003). No statistically significant differences were found in the distribution of sex or the measured comorbidities. Group C was the most likely to receive jugular access (group C, 71.7%; group A, 48.3%; group B, 62.4%; P < .001) and received more first-generation filters (group C, 58.5%; group A, 46.6%; group B, 52.5%; P = .045). The short-term (<30-day) and long-term (≥30-day) outcomes, including access site hematoma, deep vein thrombosis, and pulmonary embolism, were uncommon, with no differences between the groups. Cases of symptomatic filter penetration, migration, and fracture were rare (one, one, and three cases, respectively). Although a pattern of increasing thrombosis with more inferior placement was found, the difference between groups was not statistically significant (group A, 1.5%; group B, 1.8%; group C, 2.5%; P = .638). No cases of device-related mortality occurred. All-cause mortality after a mean follow-up of 2.6 ± 2.3 years was 41.3% and did not vary significantly between the groups (P = .051). Multivariate logistic regression revealed that placement position did not predict for short- or long-term deep vein thrombosis, pulmonary embolism, IVC thrombosis, or all-cause mortality after adjustment for the baseline patient characteristics. CONCLUSIONS IVC filters have low rates of short- and long-term complications, including IVC thrombosis. The placement position did not affect the occurrence of device complications in this study.
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Affiliation(s)
- Scott Grubman
- Department of Surgery, Yale University School of Medicine, New Haven, CT.
| | - Valentyna Kostiuk
- Department of Surgery, Yale University School of Medicine, New Haven, CT
| | - Anand Brahmandam
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale University School of Medicine, New Haven, CT
| | - Britt Tonnessen
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale University School of Medicine, New Haven, CT
| | - Hamid Mojibian
- Department of Radiology & Biomedical Imaging, Yale University School of Medicine, New Haven, CT
| | - Eric Schneider
- Center for Health Services and Outcomes Research, Department of Surgery, Yale University School of Medicine, New Haven, CT
| | - Raul J Guzman
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale University School of Medicine, New Haven, CT
| | - Cassius Iyad Ochoa Chaar
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale University School of Medicine, New Haven, CT
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Bajda J, Park AN, Raj A, Raj R, Gorantla VR. Inferior Vena Cava Filters and Complications: A Systematic Review. Cureus 2023; 15:e40038. [PMID: 37287823 PMCID: PMC10243179 DOI: 10.7759/cureus.40038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 06/09/2023] Open
Abstract
Inferior vena cava (IVC) filters have been used since the 1960s to treat patients with acute risk of pulmonary embolism (PE) to prevent migration of thrombus by trapping it within the filter. Traditional usage has been in patients with contraindication to anticoagulation that carry a significant mortality risk. In this systematic review, we sought to evaluate complications associated with placement of inferior vena cava filters based on published data from the past 20 years. A search was performed on October 6th, 2022, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews, using three databases (ProQuest, PubMed and ScienceDirect) for articles published between the dates of February 1, 2002 and October 1, 2022. Results were filtered to include full-text, clinical studies, and randomized trials written in English pertaining to keywords "IVC filter AND complications", "Inferior Vena Cava Filter AND complications", "IVC filter AND thrombosis" and "Inferior Vena Cava Filter AND thrombosis". Articles identified by the three databases were pooled and further screened for relevance based on inclusion and exclusion criteria. Initial search results yielded 33,265 hits from all three databases combined. Screening criteria were applied, with 7721 results remaining. After further manual screening, including removal of duplicate hits, a total of 117 articles were selected for review. While there are no consensus guidelines for best practice, there is compelling evidence that IVC filters can provide significant protection against PE with minimal complications if the treatment window is appropriate. Increase in the variety of filter models has led to broader availability, but skepticism remains about their efficacy and safety, with ongoing controversy surrounding appropriate indications. Further research is needed to establish clear guidelines on appropriate indications for IVC placement and to determine time course of complications versus benefits for indwelling filters.
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Affiliation(s)
- Joe Bajda
- Anatomical Sciences, St. George's University School of Medicine, True Blue, GRD
| | - Ann N Park
- Medicine, St. George's University School of Medicine, True Blue, GRD
| | - Aishwarya Raj
- Vascular Surgery, St. George's University School of Medicine, True Blue, GRD
| | - Rhea Raj
- Anatomical Sciences, St. George's University School of Medicine, True Blue, GRD
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Albertson N, Rice M, Schmitz A, Eskew J, Haste P, Johnson MS. Clinical and imaging outcomes of OptionELITE vena cava filter placement procedures. J Vasc Surg Venous Lymphat Disord 2023; 11:310-317. [PMID: 36179788 DOI: 10.1016/j.jvsv.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/28/2022] [Accepted: 08/05/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE We sought to determine the clinical and imaging outcomes after placement of the OptionELITE inferior vena cava (IVC) filter (Argon Medical Devices, Plano, TX). METHODS The clinical characteristics and imaging findings of patients who had undergone OptionELITE filter placement at six affiliated hospitals between January 1, 2013 and April 19, 2019, were analyzed. Data were obtained from the Radiology Information System, imaging database, and electronic medical records. The patients were followed up until 1 month after filter removal, death, or the first clinic visit and imaging study after June 1, 2019. RESULTS A total of 603 filter placement procedures in 594 patients were evaluated. Of the 603 procedures, 602 were technically successful (99.8%). Of the 594 patients, 356 had presented with acute pulmonary embolism and/or deep vein thrombosis. A total of 189 filters were retrieved from the 191 patients for whom retrieval had been attempted at 4.3 ± 6.3 months (median, 2.5 months) after placement. The 414 filters without removal procedures had been followed up for 14.8 ± 17.7 months (median, 6.9 months). During the follow-up period, 57 patients (9.5%) had developed new or worsening deep vein thrombosis caudal to the filter and 19 (3.2%) had experienced new symptomatic nonfatal pulmonary embolism after filter placement. One filter had migrated and fractured, and another filter had fractured and a strut was lost. Perforation was demonstrated equivocally in 12 (3%) and definitely in 17 (4.3%) of 399 patients with adequate imaging studies available, with penetration into surrounding structures in 13 patients (3.3%). Of 332 patients with adequate imaging studies, 12 (3.6%) had developed substantial IVC thrombosis and 4 (1.2%) had developed IVC occlusion. CONCLUSIONS The rates of symptomatic pulmonary embolism and filter-related complications were low after OptionELITE IVC filter placement, and filter retrieval, when attempted, was 99% successful.
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Affiliation(s)
- Nathan Albertson
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN.
| | - Mitchell Rice
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN
| | - Adam Schmitz
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN
| | - Joseph Eskew
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN
| | - Paul Haste
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN
| | - Matthew S Johnson
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN
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6
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Sheahan KP, Tong E, Lee MJ. A review of inferior vena cava filters. Br J Radiol 2023; 96:20211125. [PMID: 35856774 PMCID: PMC10997026 DOI: 10.1259/bjr.20211125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 04/20/2022] [Accepted: 07/16/2022] [Indexed: 11/05/2022] Open
Abstract
The care of patients with venous thromboembolism (VTE) is delivered via a multidisciplinary team. The primary treatment for VTE is anticoagulation; however, placement of filter devices in the inferior vena cava (IVC) to prevent embolisation of deep venous thrombosis (DVT) is a well-established secondary treatment option. Many controversies remain regarding utilisation and management of filters.
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Affiliation(s)
| | - Emma Tong
- Department of Radiology, Beaumont Hospital,
Dublin, Ireland
| | - Michael J. Lee
- Department of Radiology, Beaumont Hospital,
Dublin, Ireland
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7
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Annweiler T, Bertoletti L, Grange S, Peoc’h M, Mismetti P, Barral FG. Pathological Analysis and Clinical Evolution After Radiological Removal of Retrievable Vena Cava Filters. Vasc Endovascular Surg 2022; 56:754-761. [DOI: 10.1177/15385744221120764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective Retrievable inferior vena cava filters (IVCF) have been developed because permanent filters have been associated with an increased risk of recurrent deep venous thrombosis. There is no data on the interactions of IVCF with the inferior vena cava (intrafilter thrombi, insertion through the venous wall) even though this may alter the course after retrieval of the IVCF. Methods A review of 85 consecutive patients undergoing retrieval of IVCF placed at a single center was performed from January 1, 2010 and December 31, 2014. Inferior vena cava filter were examined for presence of intrafilter thrombus at time of retrieval. Filter position and presence of intraluminal thrombus were examined. Patient outcomes, including recurrence of deep vein thrombosis (DVT) and death, were captured at 3 month followup. Results Eighty five patients were identified, with intrafilter thrombi found in 69 (81%) patients and venous wall fragments found in 75 (88%) patients. However, their presence was not associated with an increased risk of recurrent venous thromboembolism (VTE) or death during follow up. Conclusions Intrafilter thrombi and venous wall fragments are frequently found in removed IVCF but are not associated with a worse prognosis. They may not modify the therapeutic management of patients.
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Affiliation(s)
- Thierry Annweiler
- Service de Radiologie, Centre Hospitalier Universitaire de St-Etienne, Saint-Etienne, France
| | - Laurent Bertoletti
- Service de Médecine Vasculaire et Thérapeutique, Centre Hospitalier Universitaire de St-Etienne, Saint-Etienne, France
- INSERM, UMR1059, Equipe Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, Saint-Etienne, France
- INSERM, CIC-1408, CHU Saint-Etienne, Saint-Etienne, France
| | - Sylvain Grange
- Service de Radiologie, Centre Hospitalier Universitaire de St-Etienne, Saint-Etienne, France
| | - Michel Peoc’h
- Department of Pathology, CHU de St-Etienne, Saint-Etienne, France
| | - Patrick Mismetti
- Service de Médecine Vasculaire et Thérapeutique, Centre Hospitalier Universitaire de St-Etienne, Saint-Etienne, France
- INSERM, UMR1059, Equipe Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, Saint-Etienne, France
- INSERM, CIC-1408, CHU Saint-Etienne, Saint-Etienne, France
| | - Fabrice-Guy Barral
- Service de Radiologie, Centre Hospitalier Universitaire de St-Etienne, Saint-Etienne, France
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8
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Liu J, Jiang P, Tian X, Jia W, Huang NL, Zhan H, Chen W. Clinical outcomes of retrievable inferior vena cava filters for venous thromboembolic diseases. J Comp Eff Res 2022; 11:437-449. [PMID: 35199584 DOI: 10.2217/cer-2021-0291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To identify literature evidence assessing retrievable inferior vena cava filter (rIVCF) for venous thromboembolic diseases. Methods: A systematic literature search was conducted to identify relevant references from the mainstay English and Chinese bibliographic databases (search period: January 2003 to October 2019). Results: 80 original studies with 11,413 patients were included in this review. The success rates of deploying the six types of rIVCFs ranged from 98.4 to 100.0%. Denali had the highest retrieval success rate (95.4-97.6%). The incidence rates of fracture and perforation associated with retrieving the six rIVCFs were less than 2%. Conclusion: The approved rIVCF had comparable clinical profiles, except that Denali was easier to be retrieved than other rIVCF.
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Affiliation(s)
| | - Peng Jiang
- Beijing Jishuitan Hospital, Beijing, China
| | - Xuan Tian
- Beijing Jishuitan Hospital, Beijing, China
| | - Wei Jia
- Beijing Jishuitan Hospital, Beijing, China
| | | | - Huan Zhan
- Changsha Normin Health Technology Ltd, Changsha, China
| | - Wendong Chen
- Changsha Normin Health Technology Ltd, Changsha, China.,Normin Health Consulting Ltd, Toronto, Canada
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9
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Negmadjanov U, Dedwylder M, Gaisinskaya P, Forcione D, Lee WA. Duodenocaval Fistula from an Inferior Vena Cava Filter Perforation. EJVES Vasc Forum 2022; 56:24-31. [PMID: 35812073 PMCID: PMC9260443 DOI: 10.1016/j.ejvsvf.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 05/11/2022] [Accepted: 06/07/2022] [Indexed: 12/01/2022] Open
Abstract
Background Case report Conclusions Duodenal perforation from IVC filter strut perforation is a rare complication. Patients typically present with abdominal pain and upper gastrointestinal bleeding. Both endovascular and open surgical techniques can be used to retrieve a filter Endovascular retrieval has the potential for development of peri-operative sepsis. Open surgical removal is preferred in patients with significant filter dwell time.
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Affiliation(s)
- Ulugbek Negmadjanov
- Department of Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Michael Dedwylder
- Department of Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Polina Gaisinskaya
- Department of Internal Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - David Forcione
- Department of Internal Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - W. Anthony Lee
- Department of Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
- Corresponding author. 670 Glades Road, Suite 100, Boca Raton, FL 33431, USA.
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10
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Li X, Montgomery J, Kirksey L, Gadani S, D'Amico G, Partovi S. Over-the-Wire Inferior Vena Cava Filter Placement: How We Do It. Semin Intervent Radiol 2021; 38:243-250. [PMID: 34108813 PMCID: PMC8175103 DOI: 10.1055/s-0041-1727102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Xin Li
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jennifer Montgomery
- Section of Interventional Radiology, Imaging Institute, Cleveland Clinic Main Campus, Cleveland, Ohio
| | - Levester Kirksey
- Department of Vascular Surgery, Cleveland Clinic Main Campus, Cleveland, Ohio
| | - Sameer Gadani
- Section of Interventional Radiology, Imaging Institute, Cleveland Clinic Main Campus, Cleveland, Ohio
| | - Giuseppe D'Amico
- Department of Transplant Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
| | - Sasan Partovi
- Section of Interventional Radiology, Imaging Institute, Cleveland Clinic Main Campus, Cleveland, Ohio
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Elizondo G, Eggers M, Falcon M, Trevino M, Marrufo R, Perez C, Nunez E, Moreno R, Mitchell A, Sheppard A, Dria S, Jay T, Kirk R, Hovsepian D, Steele J. First-in-Human Study with Eight Patients Using an Absorbable Vena Cava Filter for the Prevention of Pulmonary Embolism. J Vasc Interv Radiol 2020; 31:1817-1824. [PMID: 33008719 DOI: 10.1016/j.jvir.2020.07.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/21/2020] [Accepted: 07/21/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To prospectively evaluate the initial human experience with an absorbable vena cava filter designed for transient protection from pulmonary embolism (PE). MATERIALS AND METHODS This was a prospective, single-arm, first-in-human study of 8 patients with elevated risk of venous thromboembolism (VTE). Seven absorbable IVC filters (made of polydioxanone that breaks down into H2O and CO2 in 6 mo) were placed prophylactically before orthopedic (n = 5) and gynecologic (n = 2) surgeries, and 1 was placed in a case of deep vein thrombosis. Subjects underwent CT cavography and abdominal radiography before and 5, 11, and 36 weeks after filter placement to assess filter migration, embolization, perforation, and caval thrombosis and/or stenosis. Potential PE was assessed immediately before and 5 weeks after filter placement by pulmonary CT angiography. RESULTS No symptomatic PE was reported throughout the study or detected at the planned 5-week follow-up. No filter migration was detected based on the fixed location of the radiopaque markers (attached to the stent section of the filter) relative to the vertebral bodies. No filter embolization or caval perforation was detected, and no caval stenosis was observed. Throughout the study, no filter-related adverse events were reported. CONCLUSIONS Implantation of an absorbable vena cava filter in a limited number of human subjects resulted in 100% clinical success. One planned deployment was aborted as a result of stenotic pelvic veins, resulting in 89% technical success. No PE or filter-related adverse events were observed.
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Affiliation(s)
- Guillermo Elizondo
- Department of Radiology, Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | - Mitchell Eggers
- Adient Medical, 12234 Shadow Creek Parkway, Building 8, Pearland, TX 77584.
| | - Mario Falcon
- Department of Radiology, Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | - Miguel Trevino
- Department of Radiology, Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | - Roberto Marrufo
- Department of Radiology, Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | - Carlos Perez
- Department of Radiology, Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | - Edgar Nunez
- Department of Radiology, Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | - Rudy Moreno
- Adient Medical, 12234 Shadow Creek Parkway, Building 8, Pearland, TX 77584
| | - Alexis Mitchell
- Adient Medical, 12234 Shadow Creek Parkway, Building 8, Pearland, TX 77584
| | - Audrey Sheppard
- Adient Medical, 12234 Shadow Creek Parkway, Building 8, Pearland, TX 77584
| | - Stephen Dria
- Adient Medical, 12234 Shadow Creek Parkway, Building 8, Pearland, TX 77584
| | - Turner Jay
- Adient Medical, 12234 Shadow Creek Parkway, Building 8, Pearland, TX 77584
| | - Ray Kirk
- Department of Radiology, Medical Clinic of Houston, Houston, Texas
| | - David Hovsepian
- Department of Radiology, Stanford University, Stanford, California
| | - Joseph Steele
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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12
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Li X, Haddadin I, McLennan G, Farivar B, Staub D, Beck A, Thompson D, Partovi S. Inferior vena cava filter – comprehensive overview of current indications, techniques, complications and retrieval rates. VASA 2020; 49:449-462. [DOI: 10.1024/0301-1526/a000887] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Summary: Inferior vena cava (IVC) filter has been used to manage patients with pulmonary embolism and deep venous thrombosis. Its ease of use and the expansion of relative indications have led to a dramatic increase in IVC filter placement. However, IVC filters have been associated with a platitude of complications. Therefore, there exists a need to examine the current indications and identify the patient population at risk. In this paper, we comprehensively reviewed the current indications and techniques of IVC filter placement. Further, we examined the various complications associated with either permanent or retrievable IVC filters. Lastly, we examined the current data on filter retrieval.
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Affiliation(s)
- Xin Li
- Section of Interventional Radiology, Imaging Institute, Cleveland Clinic Main Campus, Cleveland, OH, USA
| | - Ihab Haddadin
- Section of Interventional Radiology, Imaging Institute, Cleveland Clinic Main Campus, Cleveland, OH, USA
| | - Gordon McLennan
- Section of Interventional Radiology, Imaging Institute, Cleveland Clinic Main Campus, Cleveland, OH, USA
| | - Behzad Farivar
- Department of Vascular Surgery, Sydell and Arnold Miller Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Daniel Staub
- Department of Angiology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Avi Beck
- Section of Interventional Radiology, Imaging Institute, Cleveland Clinic Main Campus, Cleveland, OH, USA
| | - Dustin Thompson
- Section of Interventional Radiology, Imaging Institute, Cleveland Clinic Main Campus, Cleveland, OH, USA
| | - Sasan Partovi
- Section of Interventional Radiology, Imaging Institute, Cleveland Clinic Main Campus, Cleveland, OH, USA
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13
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Marron RM, Rali P, Hountras P, Bull TM. Inferior Vena Cava Filters: Past, Present, and Future. Chest 2020; 158:2579-2589. [PMID: 32795479 DOI: 10.1016/j.chest.2020.08.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/09/2020] [Accepted: 08/02/2020] [Indexed: 02/06/2023] Open
Abstract
Inferior vena cava (IVC) filters have existed as a treatment option for VTE for decades. Advances in medical technology have provided physicians with several options for devices that can be placed on either a permanent or temporary basis; however, there are limited data from randomized, controlled trials on the appropriate use of IVC filters. This contemporary review summarizes the history of IVC filters and the types that are available in clinical practice. It reviews the literature on the use of IVC filters and discusses the indications that professional societies have endorsed for their use. In addition, it outlines the complications of IVC filter placement and future research directions.
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Affiliation(s)
- Robert M Marron
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA.
| | - Parth Rali
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Peter Hountras
- Division of Pulmonary Sciences and Critical Care, University of Colorado School of Medicine, Aurora, CO
| | - Todd M Bull
- Division of Pulmonary Sciences and Critical Care, University of Colorado School of Medicine, Aurora, CO
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Final Two-Year Outcomes for the Sentry Bioconvertible Inferior Vena Cava Filter in Patients Requiring Temporary Protection from Pulmonary Embolism. J Vasc Interv Radiol 2020; 31:221-230.e3. [DOI: 10.1016/j.jvir.2019.08.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/12/2019] [Accepted: 08/20/2019] [Indexed: 11/19/2022] Open
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15
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Ahmed O, Sheikh S, Tran P, Funaki B, Shadid AM, Navuluri R, Van Ha T. Inferior Vena Cava Filter Evaluation and Management for the Diagnostic Radiologist: A Comprehensive Review Including Inferior Vena Cava Filter-Related Complications and PRESERVE Trial Filters. Can Assoc Radiol J 2020; 70:367-382. [DOI: 10.1016/j.carj.2019.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 06/06/2019] [Accepted: 06/08/2019] [Indexed: 12/28/2022] Open
Abstract
Inferior vena cava filters are commonly encountered devices on diagnostic imaging that were highlighted in a 2010 Food and Drug Administration safety advisory regarding their complications from long-term implantation. The Predicting the Safety and Effectiveness of Inferior Vena Cava Filters (PRESERVE) trial is an ongoing after-market study investigating the safety and utility of commonly utilized filters in practice today. While most of these filters are safe, prompt recognition and management of any filter-associated complication is imperative to prevent or reduce the morbidity and mortality associated with them. This review is aimed at discussing the appropriate utilization and placement of inferior vena cava filters in addition to the recognition of filter-associated complications on cross-sectional imaging. An overview of the PRESRVE trial filters is also provided to understand each filter's propensity for specific complications.
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Affiliation(s)
- Osman Ahmed
- Department of Radiology, Section of Vascular and Interventional Radiology, University of Chicago Medicine, Chicago, Illinois, USA
| | - Shermeen Sheikh
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Patrick Tran
- Rush Medical College, Rush University Medical Center, Chicago, Illinois, USA
| | - Brian Funaki
- Department of Radiology, Section of Vascular and Interventional Radiology, University of Chicago Medicine, Chicago, Illinois, USA
| | | | - Rakesh Navuluri
- Department of Radiology, Section of Vascular and Interventional Radiology, University of Chicago Medicine, Chicago, Illinois, USA
| | - Thuong Van Ha
- Department of Radiology, Section of Vascular and Interventional Radiology, University of Chicago Medicine, Chicago, Illinois, USA
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Elias M, Elias A, Oropello J, Doucette J, Jebakumar J, Kohli-Seth R. Outcomes and Prognosis Factors in Patients With Vena Cava Filters in a Quaternary Medical Center: A 5-Year Retrospective Analysis. J Intensive Care Med 2019; 36:277-283. [PMID: 31774029 DOI: 10.1177/0885066619890324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Indications for inferior vena cava filter (IVCF) placement are controversial. This study assesses the proportion of different indications for IVCF placement and the associated 30-day event rates and predictors for all-cause mortality, deep vein thrombosis (DVT), pulmonary embolism, and bleeding after IVCF placement. METHOD In this 5-year retrospective cohort observational study in a quaternary care center, consecutive patients with IVCF placement were identified through cross-matching of 3 database sets and classified into 3 indication groups defined as "standard" in patients with venous thromboembolism (VTE) and contraindication to anticoagulants, "extended" in patients with VTE but no contraindication to anticoagulants, and "prophylactic" in patients without VTE. RESULTS We identified 1248 IVCF placements, that is, 238 (19.1%) IVCF placements for standard indications, 583 (46.7%) IVCF placements for extended indications, and 427 (34.2%) IVCF placements for prophylactic indications. Deep vein thrombosis rates [95% confidence interval] were higher in the extended (8.06% [5.98-10.58]) and prophylactic (7.73% [5.38-10.68]) groups than in the standard group (3.36% [1.46-6.52]). Mortality rates were higher in the standard group (12.18% [8.31-17.03]) than in the extended group (7.55% [5.54-9.99]) and the prophylactic (5.85% [3.82-8.52]) group. Bleeding rates were higher in the standard group (4.62% [2.33-8.12]) than in the prophylactic group (2.11% [0.97-3.96]). Best predictors for VTE were acute medical conditions; best predictors for mortality were age, acute medical conditions, cancer, and Medicare health insurance. CONCLUSIONS Prophylactic and extended indications account for the majority of IVCF placements. The standard indication is associated with the lowest VTE rate that may be explained by the competing risk of mortality higher in this group and related to the underlying medical conditions and bleeding risk. In the prophylactic group (no VTE at baseline), the exceedingly high DVT rate may be related to the IVCF placement.
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Affiliation(s)
- Michael Elias
- Critical Care Medicine, 5317OhioHealth Mansfield Hospital, Mansfield, OH, USA
| | - Antoine Elias
- Division of Cardiology and Vascular Medicine, Toulon Hospital Center, St Musse Hospital, Toulon Cedex, France
| | - John Oropello
- Institute for Critical Care Medicine, 5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John Doucette
- Division of Biostatistics, Department of Environmental Medicine and Public Health, 5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jebakaran Jebakumar
- Department of Clinical Operations, 5864Mount Sinai Health Systems, New York, NY, USA
| | - Roopa Kohli-Seth
- Institute for Critical Care Medicine, 5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Radiologists' Field Guide to Retrievable and Convertible Inferior Vena Cava Filters. AJR Am J Roentgenol 2019; 213:768-777. [PMID: 31361526 DOI: 10.2214/ajr.19.21722] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. Inferior vena cava (IVC) filters are commonly used in patients who are at risk for life-threatening pulmonary embolism. After the introduction of permanent devices, numerous retrievable and convertible designs became available. Inaccurate identification can lead to confusion in options for filter retrieval and anticoagulation. CONCLUSION. This article highlights device designs of retrievable and convertible IVC filters to assist interpretation of diagnostic studies.
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Mendelson TB, Santangeli P, Frankel DS, Arkles JS, Supple GE, Lin D, Riley MP, Callans DJ, Nazarian S, Hyman MC, Kumareswaran R, Epstein AE, Deo R, Dixit S, Garcia FC, Zado ES, Hutchinson MD, Sadek MM, Cooper JM, Marchlinski FE, Trerotola SO, Schaller RD. Feasibility of complex transfemoral electrophysiology procedures in patients with inferior vena cava filters. Heart Rhythm 2019; 16:873-878. [DOI: 10.1016/j.hrthm.2018.12.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Indexed: 12/19/2022]
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19
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Mandel JE, Fisher JA, Cedillo MA, Shukla PA, Bishay V, Ranade M, Patel RS, Kim E, Nowakowski SF, Lookstein RA, Fischman AM. Retrieval of Inferior Vena Cava Filters Temporarily Placed in a Suprarenal Position: A Review of 13 Patients. Vasc Endovascular Surg 2019; 53:446-451. [DOI: 10.1177/1538574419843697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Purpose: To evaluate the safety and efficacy of retrieval of inferior vena cava filters (IVCF) temporarily placed in a suprarenal position. Methods: Retrieval of IVCF placed in a suprarenal position was performed in 13 patients (5 men and 8 women; mean age: 45.1 ± 13.8 years) between July 2006 and May 2018 using either a loop snare technique or endobronchial forceps. Electronic medical records were reviewed for patient demographics and procedural information. Results: Inferior vena cava filters retrieved included Option Elite (n = 9, 69%) and Günther Tulip (n = 4, 31%). Caval thrombosis was not detected in any patients on pre- or postretrieval cavogram. Eleven suprarenal IVCF (84%) were retrieved during the first retrieval attempt after a median indwelling time of 1.8 months (range, 0.03-12.10 months). Retrieval was initially unsuccessful in 2 (16%) patients with Option Elite filters, but both were successfully removed on second attempt using endobronchial forceps. Thirteen suprarenal IVCF (100%) were ultimately retrieved. Conclusion: Endovascular retrieval of IVCF temporarily placed in a suprarenal position is safe and efficacious.
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Affiliation(s)
- Jacob E. Mandel
- Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Jason A. Fisher
- Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mario A. Cedillo
- Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pratik A. Shukla
- Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Vivian Bishay
- Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mona Ranade
- Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rahul S. Patel
- Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Edward Kim
- Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Scott F. Nowakowski
- Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert A. Lookstein
- Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Aaron M. Fischman
- Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Tavri S, Patel IJ, Kavali P, Irani Z, Ganguli S, Walker TG. Endobronchial forceps-assisted complex retrieval of inferior vena cava filters. J Vasc Surg Venous Lymphat Disord 2019; 7:413-419. [DOI: 10.1016/j.jvsv.2018.08.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 08/06/2018] [Indexed: 10/27/2022]
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21
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Between a Clot and a Scarred Place. Am J Med Sci 2019; 357:435-441. [PMID: 30846186 DOI: 10.1016/j.amjms.2019.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 11/21/2022]
Abstract
Immobilized orthopedic trauma patients face an elevated risk of venous thromboembolism (VTE). We present a case in which a patient undergoing staged repair of traumatic orthopedic injuries developed deep venous thrombosis (DVT) during hospitalization, prior to repair of a lower extremity injury for which delay in operation might result in poor functional outcome. We provide an overview of recommendations regarding pharmacologic prophylaxis of VTE in orthopedic patients. We review the importance of cultivating a high index of suspicion for VTE in such patients, even when receiving appropriate prophylaxis and lacking overt symptoms. Finally, we outline the multidisciplinary decision-making process regarding optimizing care for the patient in a precarious position of developing acute VTE while awaiting urgent surgery. Specifically, we review the safety, efficacy, and management of retrievable inferior vena cava filters (rIVCF) for this population.
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22
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Ding PX, Han XW, Liu C, Ren KW. Inferior vena cava filter misplacement in the right ovarian vein and successful removal by loop-snare technique in a patient with inferior vena cava agenesis. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2018; 4:324-326. [PMID: 30761379 PMCID: PMC6298937 DOI: 10.1016/j.jvscit.2017.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 12/14/2017] [Indexed: 11/04/2022]
Abstract
Misplacement of an inferior vena cava (IVC) filter in a gonadal vein is a rare complication of IVC filter placement. We report a case of a filter misplaced in the ovarian vein of a pregnant woman with agenesis of the infrarenal IVC and bilateral lower extremity deep venous thrombosis. The filter was removed by a loop-snare technique through an internal jugular vein. IVC agenesis and dilated right gonadal vein should be kept in mind when an IVC filter is being inserted in the infrarenal location through the jugular approach.
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Affiliation(s)
- Peng-Xu Ding
- Department of Intervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin-Wei Han
- Department of Intervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chao Liu
- Department of Intervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ke-Wei Ren
- Department of Intervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Dake MD, Murphy TP, Krämer AH, Darcy MD, Sewall LE, Curi MA, Johnson MS, Arena F, Swischuk JL, Ansel GM, Silver MJ, Saddekni S, Brower JS, Mendes R, Dake MD, Feezor R, Kalva S, Kies D, Bosiers M, Ziegler W, Farber M, Paolini D, Spillane R, Jones S, Peeters P. One-Year Analysis of the Prospective Multicenter SENTRY Clinical Trial: Safety and Effectiveness of the Novate Sentry Bioconvertible Inferior Vena Cava Filter. J Vasc Interv Radiol 2018; 29:1350-1361.e4. [DOI: 10.1016/j.jvir.2018.05.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 05/16/2018] [Accepted: 05/17/2018] [Indexed: 11/25/2022] Open
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Choi SJ, Lee SY, Ryeom HK, Kim GC, Lim JK, Lee SM, Kim WH. Femoral versus jugular access for Denali Vena Cava Filter placement: Analysis of fluoroscopic time, filter tilt and retrieval outcomes. Clin Imaging 2018; 52:337-342. [PMID: 30243205 DOI: 10.1016/j.clinimag.2018.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 08/10/2018] [Accepted: 09/13/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To analyze relevant metrics involved in Denali Vena Cava Filter placement via different venous access sites. MATERIALS AND METHODS Patients with Denali filters inserted between March 2017 and February 2018 were retrospectively analyzed. Pre-procedural and pre-retrieval computed tomography (CT) were reviewed. We compared inferior vena cava (IVC) diameter, filter tilt angle, filter tip IVC wall abutment, fluoroscopy time, and retrieval outcomes by venous access site. Filter tip abutment/limb penetration and procedure-related complications were investigated. RESULTS Seventy-eight patients had successfully-placed Denali filters. Seventy-one of 78 (91%) patients had both pre-procedural and pre-retrieval CT. The majority (35 [49%]) were placed via the right femoral vein (left femoral vein: 22 [31%]; right internal jugular vein: 14 [20%]). The jugular approach involved a longer fluoroscopy time (mean 117 ± 37 s [s]) than the right and left femoral approaches (mean 64 ± 21 s, mean 67 ± 15 s, respectively [p < 0.05]). Filter tilt and filter tip abutment were not significantly different between the 3 access routes. Filter tip abutment and limb penetration were observed in 8/71 (11%) and 2/71 (3%) patients, respectively. Filter retrieval was attempted in 68 of 78 (87%) cases, and all filters were successfully retrieved. One filter arm fractured during advanced retrieval; no other procedure related complications were recorded. CONCLUSIONS Both femoral venous approaches can be safely used for placement of the Denali filter. Femoral venous access involved a shorter fluoroscopy time without any differences in filter tilt and filter tip abutment compared to transjugular access.
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Affiliation(s)
- Sun-Ju Choi
- Department of Radiology, Samsung Medical Center, 81, Irwon-Ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - Sang Yub Lee
- Department of Radiology, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Republic of Korea.
| | - Hun Kyu Ryeom
- Department of Radiology, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Republic of Korea
| | - Gab Chul Kim
- Department of Radiology, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Republic of Korea
| | - Jae-Kwang Lim
- Department of Radiology, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Republic of Korea
| | - So Mi Lee
- Department of Radiology, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Republic of Korea
| | - Won Hwa Kim
- Department of Radiology, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Republic of Korea
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Ha CP, Rectenwald JE. Inferior Vena Cava Filters: Current Indications, Techniques, and Recommendations. Surg Clin North Am 2018; 98:293-319. [PMID: 29502773 DOI: 10.1016/j.suc.2017.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The vena cava filter (VCF) is intended to prevent the progression of deep venous thrombosis to pulmonary embolism. Recently, the indications for VCF placement have expanded, likely due in part to newer retrievable inferior vena caval filters and minimally invasive techniques. This article reviews the available VCFs, the indications for use, the techniques for placement, and possible outcomes and complications.
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Affiliation(s)
- Cindy P Ha
- Division of Vascular and Endovascular Surgery, University of Texas Southwestern Medical Center, Professional Office Building 1, Suite 620, 5959 Harry Hines Boulevard, Dallas, TX 75390-9157, USA
| | - John E Rectenwald
- Division of Vascular and Endovascular Surgery, University of Texas Southwestern Medical Center, Professional Office Building 1, Suite 620, 5959 Harry Hines Boulevard, Dallas, TX 75390-9157, USA.
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Safety and Feasibility of Temporary Superior Vena Cava Filter Combined with Balloon Dilatation and Catheter-Directed Thrombolysis for Catheter-Related Thrombosis. Ann Vasc Surg 2018; 47:69-77. [DOI: 10.1016/j.avsg.2017.08.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 08/01/2017] [Accepted: 08/25/2017] [Indexed: 11/20/2022]
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Denali, Tulip, and Option Inferior Vena Cava Filter Retrieval: A Single Center Experience. Cardiovasc Intervent Radiol 2017; 41:572-577. [PMID: 29260304 DOI: 10.1007/s00270-017-1866-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 12/14/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE To compare the technical success of filter retrieval in Denali, Tulip, and Option inferior vena cava filters. MATERIALS AND METHODS A retrospective analysis of Denali, Gunther Tulip, and Option IVC filters was conducted. Retrieval failure rates, fluoroscopy time, sedation time, use of advanced retrieval techniques, and filter-related complications that led to retrieval failure were recorded. RESULTS There were 107 Denali, 43 Option, and 39 Tulip filters deployed and removed with average dwell times of 93.5, 86.0, and 131 days, respectively. Retrieval failure rates were 0.9% for Denali, 11.6% for Option, and 5.1% for Tulip filters (Denali vs. Option p = 0.018; Denali vs. Tulip p = 0.159; Tulip vs. Option p = 0.045). Median fluoroscopy time for filter retrieval was 3.2 min for the Denali filter, 6.75 min for the Option filter, and 4.95 min for the Tulip filter (Denali vs. Option p < 0.01; Denali vs. Tulip p < 0.01; Tulip vs. Option p = 0.67). Advanced retrieval techniques were used in 0.9% of Denali filters, 21.1% in Option filters, and 10.8% in Tulip filters (Denali vs. Option p < 0.01; Denali vs. Tulip p < 0.01; Tulip vs. Option p < 0.01). DISCUSSION Filter retrieval failure rates were significantly higher for the Option filter when compared to both the Denali and Tulip filters. Retrieval of the Denali filter required significantly less amount of fluoroscopy time and use of advanced retrieval techniques when compared to both the Option and Tulip filters. The findings of this study indicate easier retrieval of the Denali and Tulip IVC filters when compared to the Option filter.
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Dentali F, Ageno W, Crowther M, Garcia D, Huisman M, Rodeghiero F, D’Angelo A, Palareti G, Imberti D. Evidence and Clinical Judgment: Vena cava filters. Thromb Haemost 2017; 111:618-24. [DOI: 10.1160/th13-11-0938] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 01/29/2014] [Indexed: 12/14/2022]
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Abstract
OPINION STATEMENT Inferior vena cava (IVC) filter placement is indicated for the treatment of venous thromboembolism (VTE) in patients with a contraindication to or a failure of anticoagulation. With the advent of retrievable IVC filters and their ease of placement, an increasing number of such filters are being inserted for prophylaxis in patients at high risk for VTE. Available data show that only a small number of these filters are retrieved within the recommended period, if at all, prompting the FDA to issue a statement on the need for their timely removal. With prolonged dwell times, advanced techniques may be needed for filter retrieval in up to 60% of the cases. In this article, we review standard and advanced IVC filter retrieval techniques including single-access, dual-access, and dissection techniques. Complicated filter retrievals carry a non-negligible risk for complications such as filter fragmentation and resultant embolization of filter components, venous pseudoaneurysms or stenoses, and breach of the integrity of the caval wall. Careful pre-retrieval assessment of IVC filter position, any significant degree of filter tilting or of hook, and/or strut epithelialization and caval wall penetration by filter components should be considered using dedicated cross-sectional imaging for procedural planning. In complex cases, the risk for retrieval complications should be carefully weighed against the risks of leaving the filter permanently indwelling. The decision to remove an embedded IVC filter using advanced techniques should be individualized to each patient and made with caution, based on the patient's age and existing comorbidities.
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30
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A quality improvement project to improve inferior vena cava filter retrieval. J Vasc Surg Venous Lymphat Disord 2017; 5:42-46. [DOI: 10.1016/j.jvsv.2016.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 09/22/2016] [Indexed: 11/21/2022]
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Abstract
Use of inferior vena cava (IVC) filters has increased dramatically in recent decades, despite a lack of evidence that their use has impacted venous thromboembolism (VTE)-related mortality. This increased use appears to be primarily driven by the insertion of retrievable filters for prophylactic indications. A growing body of evidence, however, suggests that IVC filters are frequently associated with clinically important adverse events, prompting a closer look at their role. We sought to narratively review the current evidence on the efficacy and safety of IVC filter placements. Inferior vena cava filters remain the only treatment option for patients with an acute (within 2-4 weeks) proximal deep vein thrombosis (DVT) or pulmonary embolism and an absolute contraindication to anticoagulation. In such patients, anticoagulation should be resumed and IVC filters removed as soon as the contraindication has passed. For all other indications, there is insufficient evidence to support the use of IVC filters and high-quality trials are required. In patients where an IVC filter remains, regular follow-up to reassess removal and screen for filter-related complications should occur.
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Affiliation(s)
- L Duffett
- Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - M Carrier
- Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
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Stavropoulos SW, Chen JX, Sing RF, Elmasri F, Silver MJ, Powell A, Lynch FC, Abdel Aal AK, Lansky A, Muhs BE. Analysis of the Final DENALI Trial Data: A Prospective, Multicenter Study of the Denali Inferior Vena Cava Filter. J Vasc Interv Radiol 2016; 27:1531-1538.e1. [PMID: 27569678 DOI: 10.1016/j.jvir.2016.06.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 06/23/2016] [Accepted: 06/24/2016] [Indexed: 01/27/2023] Open
Abstract
PURPOSE To report the final 2-year data on the efficacy and safety of a nitinol retrievable inferior vena cava (IVC) filter for protection against pulmonary embolism (PE). MATERIALS AND METHODS This was a prospective multicenter trial of 200 patients with temporary indications for caval filtration who underwent implantation of the Denali IVC filter. After filter placement, all patients were followed for 2 years after placement or 30 days after filter retrieval. The primary endpoints were technical success of filter implantation in the intended location and clinical success of filter placement and retrieval. Secondary endpoints were incidence of clinically symptomatic recurrent PE, new or propagating deep vein thrombosis (DVT), and filter-related complications including migration, fracture, penetration, and tilt. RESULTS Filter placement was technically successful in 199 patients (99.5%). Filters were clinically successful in 190 patients (95%). The rate of PE was 3% (n = 6), with 5 patients having a small subsegmental PE and 1 having a lobar PE. New or worsening DVT was noted in 26 patients (13%). Filter retrieval was attempted 125 times in 124 patients and was technically successful in 121 patients (97.6%). The mean filter dwell time at retrieval was 200.8 days (range, 5-736 d). There were no instances of filter fracture, migration, or tilt greater than 15° at the time of filter retrieval or during follow-up. CONCLUSIONS The Denali IVC filter exhibited high success rates for filter placement and retrieval while maintaining a low complication rate in this clinical trial.
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Affiliation(s)
- S William Stavropoulos
- Division of Interventional Radiology, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
| | - James X Chen
- Division of Interventional Radiology, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ronald F Sing
- Division of Surgical Critical Care, Carolinas Medical Center, Charlotte, North Carolina
| | - Fakhir Elmasri
- Division of Interventional Radiology, Lakeland Regional Medical Center, Lakeland, Florida
| | - Mitchell J Silver
- Division of Interventional Cardiology and Peripheral Vascular Disease, Riverside Methodist Hospital, Columbus, Ohio
| | - Alex Powell
- Department of Radiology, Division of Interventional Radiology, Baptist Hospital, Miami, Florida
| | - Frank C Lynch
- Division of Interventional Radiology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Ahmed Kamel Abdel Aal
- Department of Radiology, University of Alabama at Birmingham Medical Center, Birmingham, Alabama
| | - Alexandra Lansky
- Division of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Bart E Muhs
- The Vascular Experts, Middletown, Connecticut
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Chick JFB, Stavropoulos SW, Shin BJ, Shlansky-Goldberg RD, Mondschein JI, Sudheendra D, Nadolski GJ, Watts MM, Trerotola SO. A 16-F Sheath with Endobronchial Forceps Improves Reported Retrieval Success of Long-Dwelling “Closed Cell” Inferior Vena Cava Filter Designs. J Vasc Interv Radiol 2016; 27:1027-33. [DOI: 10.1016/j.jvir.2016.03.047] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 03/28/2016] [Accepted: 03/29/2016] [Indexed: 11/15/2022] Open
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Andreoli JM, Thornburg BG, Hickey RM. Inferior Vena Cava Filter-Related Thrombus/Deep Vein Thrombosis: Data and Management. Semin Intervent Radiol 2016; 33:101-4. [PMID: 27247478 DOI: 10.1055/s-0036-1581087] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Recurrent deep venous thrombosis and inferior vena cava (IVC) thrombosis are well-described complications following IVC filter placement. IVC thrombosis ranges in severity of clinical presentation, but can lead to significant morbidity and mortality with incidence rates depending on patient population and type of filter used. Endovascular therapies such as catheter-directed thrombolysis, mechanical thrombectomy, balloon venoplasty, and stenting are safe and effective in restoration of venous patency.
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Affiliation(s)
- Jessica M Andreoli
- Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, Illinois
| | - Bartley G Thornburg
- Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, Illinois
| | - Ryan M Hickey
- Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, Illinois
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Montgomery JP, Kaufman JA. A Critical Review of Available Retrievable Inferior Vena Cava Filters and Future Directions. Semin Intervent Radiol 2016; 33:79-87. [PMID: 27247475 PMCID: PMC4862852 DOI: 10.1055/s-0036-1582121] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Inferior vena cava filters have been placed in patients for decades for protection against pulmonary embolism. The widespread use of filters has dramatically increased owing at least in part to the approval of retrievable vena cava filters. Retrievable filters have the potential to protect against pulmonary embolism and then be retrieved once no longer needed to avoid potential long-term complications. There are several retrievable vena cava filters available for use. This article discusses the different filter designs as well as the published data on these available filters. When selecting a filter for use, it is important to consider the potential short-term complications and the filters' window for retrieval. Understanding potential long-term complications is also critical, as these devices are approved for permanent placement and many filters are not retrieved. Finally, this article will address research into new designs that may be the future of vena cava filtration.
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Affiliation(s)
- Jennifer P. Montgomery
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - John A. Kaufman
- Department of Interventional Radiology, Dotter Interventional Institute, Oregon Health and Science University Hospital, Portland, Oregon
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Deso SE, Idakoji IA, Kuo WT. Evidence-Based Evaluation of Inferior Vena Cava Filter Complications Based on Filter Type. Semin Intervent Radiol 2016; 33:93-100. [PMID: 27247477 PMCID: PMC4862854 DOI: 10.1055/s-0036-1583208] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Many inferior vena cava (IVC) filter types, along with their specific risks and complications, are not recognized. The purpose of this study was to evaluate the various FDA-approved IVC filter types to determine device-specific risks, as a way to help identify patients who may benefit from ongoing follow-up versus prompt filter retrieval. An evidence-based electronic search (FDA Premarket Notification, MEDLINE, FDA MAUDE) was performed to identify all IVC filter types and device-specific complications from 1980 to 2014. Twenty-three IVC filter types (14 retrievable, 9 permanent) were identified. The devices were categorized as follows: conical (n = 14), conical with umbrella (n = 1), conical with cylindrical element (n = 2), biconical with cylindrical element (n = 2), helical (n = 1), spiral (n = 1), and complex (n = 1). Purely conical filters were associated with the highest reported risks of penetration (90-100%). Filters with cylindrical or umbrella elements were associated with the highest reported risk of IVC thrombosis (30-50%). Conical Bard filters were associated with the highest reported risks of fracture (40%). The various FDA-approved IVC filter types were evaluated for device-specific complications based on best current evidence. This information can be used to guide and optimize clinical management in patients with indwelling IVC filters.
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Affiliation(s)
- Steven E. Deso
- Division of Vascular and Interventional Radiology, Stanford University Medical Center, Stanford, California
| | - Ibrahim A. Idakoji
- Division of Vascular and Interventional Radiology, Stanford University Medical Center, Stanford, California
| | - William T. Kuo
- Division of Vascular and Interventional Radiology, Stanford University Medical Center, Stanford, California
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Tsui B, An T, Moon E, King R, Wang W. Retrospective Review of 516 Implantations of Option Inferior Vena Cava Filters at a Single Health Care System. J Vasc Interv Radiol 2016; 27:345-53. [DOI: 10.1016/j.jvir.2015.11.055] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 11/24/2015] [Accepted: 11/24/2015] [Indexed: 10/22/2022] Open
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Kohi MP, Taylor AG, Kolli KP, Fidelman N, Kerlan RK. Crossed legs: an unexpected occurrence during an ALN filter placement. Clin Imaging 2015; 39:1128-9. [PMID: 26253773 DOI: 10.1016/j.clinimag.2015.07.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 05/28/2015] [Accepted: 07/06/2015] [Indexed: 10/23/2022]
Abstract
Inferior vena cava (IVC) filter placement is indicated for patients with pulmonary embolism and/or deep venous thrombosis when anticoagulation therapy is contraindicated. IVC filter placement, however, is not without complications. In this case, we noted crossing of the filter struts immediately after deployment of the ALN IVC filter (ALN Implants Chirurgicaux Ghisonaccia, France). The filter was then successfully removed.
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Affiliation(s)
- Maureen P Kohi
- University of California, San Francisco, Department of Radiology and Biomedical Imaging, 505 Parnassus Avenue, M-361, San Francisco, CA, 94143.
| | - Andrew G Taylor
- University of California, San Francisco, Department of Radiology and Biomedical Imaging, 505 Parnassus Avenue, M-361, San Francisco, CA, 94143.
| | - K Pallav Kolli
- University of California, San Francisco, Department of Radiology and Biomedical Imaging, 505 Parnassus Avenue, M-361, San Francisco, CA, 94143.
| | - Nicholas Fidelman
- University of California, San Francisco, Department of Radiology and Biomedical Imaging, 505 Parnassus Avenue, M-361, San Francisco, CA, 94143.
| | - Robert K Kerlan
- University of California, San Francisco, Department of Radiology and Biomedical Imaging, 505 Parnassus Avenue, M-361, San Francisco, CA, 94143.
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Montgomery JP, Kaufman JA. Inferior Vena Cava Filters: Indications, Outcomes, and Evidence. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2015; 17:401. [PMID: 26246444 DOI: 10.1007/s11936-015-0401-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OPINION STATEMENT Filter technology seems relatively stable, although absorbable devices are an area of investigational interest. The indications for filter placement remain controversial, with wide variations in adherence to guidelines, and relatively poor quality of data about the specific prophylactic indications of trauma or bariatric surgery. The outcomes of filters are not well-defined despite widespread clinical use, and good data remains difficult to obtain. Several larger database and institutional retrospective studies support the notions that while filters prevent pulmonary embolism, they may be associated with venous thrombotic complications. Some subsets of cancer patients may be at increased risk of these complications, but whether the filter or the underlying hypercoagulable state is the cause is not clear. Lastly, although the benefits of filter retrieval are widely assumed (but not proven), filter retrieval rates remain lower than expected. The single most influential factor in improving filter retrieval rates is dedicated follow-up with intent to retrieve the filter.
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Affiliation(s)
- Jennifer P Montgomery
- Dotter Interventional Institute, Oregon Health and Science University Hospital, 3181 SW Sam Jackson Park Dr., Portland, OR, 97239, USA,
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40
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A Comparison of Retrievability: Celect versus Option Filter. J Vasc Interv Radiol 2015; 26:865-9. [DOI: 10.1016/j.jvir.2015.01.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Revised: 01/20/2015] [Accepted: 01/22/2015] [Indexed: 11/24/2022] Open
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Renno A, Khateeb F, Kazan V, Qu W, Gollapudi A, Aplin B, Abbas J, Zelenock G, Nazzal M. A single center experience with retrievable IVC filters. Vascular 2014; 23:350-7. [DOI: 10.1177/1708538114546713] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective To evaluate retrievable IVC filters in our institution and assess their retrieval following a well-structured follow up program. Design Retrospective cohort study. Materials The medical records of patients implanted with retrievable IVC filters were reviewed. Methods All retrievable filter insertions between July 2007 and August 2011 at our institution were reviewed. Data was analyzed for age, gender, indication, complications, retrieval rate, and brand of filter inserted. Statistical analysis was done using SPSS software v19. Chi-square was used to compare discrete data and t-test for continuous data. P < 0.05 was significant. Results A total of 484 patients were reviewed of which 258 (53.1%) had a complete medical record. And 96 (37.2%) filters were placed as permanent at the time of insertion. An additional 40 (15.5%) filters were converted to permanent (total permanent filters 136; 52.7%). Death was reported in 26 (10%) patients and 96 (37.2%) out of the remaining 232 patients presented for potential retrieval. Also, 73 (28.2%) had an attempt to retrieve the filters, 69 (94.5%) were successful and 4 (5.4%) failed to retrieve. The remaining 23 (8.9%) patients declined retrieval. Filters studied include Celect (38%), Bard (31.4%), Option (26.2%), Tulip (4.1%), and Recovery (0.2%). Bard was more commonly used as a retrievable filter (80.9%). Retrieval on the first attempt was 90.4% ( n = 66) successful. Of the remaining seven filters, three were successfully retrieved on a second attempt, and four failed to retrieve due to filter tilt. The success rates of retrieval for Celect and Tulip were significantly lower than for Bard ( p = 0.04 and 0.023, respectively). Conclusion Our study showed that a variety of IVC filters can be retrieved successfully with minimal complication rates. In more than half of our patients, IVC filters were used as permanent. Failure of retrieval was most frequently due to filter tilting.
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Affiliation(s)
- Anas Renno
- Division of Vascular and Endovascular Surgery, University of Toledo Medical Center, Toledo, OH, USA
| | - Faisal Khateeb
- Division of Vascular and Endovascular Surgery, University of Toledo Medical Center, Toledo, OH, USA
| | - Viviane Kazan
- Division of Vascular and Endovascular Surgery, University of Toledo Medical Center, Toledo, OH, USA
| | - Weikai Qu
- Division of Vascular and Endovascular Surgery, University of Toledo Medical Center, Toledo, OH, USA
| | - Anurekha Gollapudi
- Division of Vascular and Endovascular Surgery, University of Toledo Medical Center, Toledo, OH, USA
| | - Brett Aplin
- Division of Vascular and Endovascular Surgery, University of Toledo Medical Center, Toledo, OH, USA
| | - Jihad Abbas
- Division of Vascular and Endovascular Surgery, University of Toledo Medical Center, Toledo, OH, USA
| | - Gerald Zelenock
- Division of Vascular and Endovascular Surgery, University of Toledo Medical Center, Toledo, OH, USA
| | - Munier Nazzal
- Division of Vascular and Endovascular Surgery, University of Toledo Medical Center, Toledo, OH, USA
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Stavropoulos SW, Sing RF, Elmasri F, Silver MJ, Powell A, Lynch FC, Aal AKA, Lansky AJ, Settlage RA, Muhs BE. The DENALI Trial: an interim analysis of a prospective, multicenter study of the Denali retrievable inferior vena cava filter. J Vasc Interv Radiol 2014; 25:1497-505, 1505.e1. [PMID: 25066514 DOI: 10.1016/j.jvir.2014.07.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 07/01/2014] [Accepted: 07/01/2014] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To assess safety and effectiveness of a nitinol retrievable inferior vena cava (IVC) filter in patients who require caval interruption to protect against pulmonary embolism (PE). MATERIALS AND METHODS Two hundred patients with temporary indications for an IVC filter were enrolled in this prospective, multicenter clinical study. Patients undergoing filter implantation were to be followed for 2 years or for 30 days after filter retrieval. At the time of the present interim report, all 200 patients had been enrolled in the study, and 160 had undergone a retrieval attempt or been followed to 6 months with their filter in place. Primary study endpoints included technical and clinical success of filter placement and retrieval. Patients were also evaluated for recurrent PE, new or worsening deep vein thrombosis, and filter migration, fracture, penetration, and tilt. RESULTS Clinical success of placement was achieved in 94.5% of patients (172 of 182), with a one-sided lower limit of the 95% confidence interval of 90.1%. Technical success rate of filter placement was 99.5%. Technical success rate of retrieval was 97.3%; 108 filters were retrieved in 111 attempts. In two cases, the filter apex could not be engaged with a snare, and one device was engaged but could not be removed. Filter retrievals occurred at a mean indwell time of 165 days (range, 5-632 d). There were no instances of filter fracture, migration, or tilt greater than 15° at the time of retrieval or 6-month follow-up. CONCLUSIONS In this interim report, the nitinol retrievable IVC filter provided protection against pulmonary embolism, and the device could be retrieved with a low rate of complications.
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Affiliation(s)
- S William Stavropoulos
- Division of Interventional Radiology, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, 1 Silverstein, 3400 Spruce St., Philadelphia, PA 19104.
| | - Ronald F Sing
- Division Surgical Critical Care, Carolina's Medical Center, Charlotte, North Carolina
| | - Fakhir Elmasri
- Division of Interventional Radiology, Lakeland Regional Medical Center, Lakeland, Florida
| | - Mitchell J Silver
- Division of Interventional Cardiology and Peripheral Vascular Disease, Ohio Health Heart and Vascular, Riverside Methodist Hospital, Columbus, Ohio
| | - Alex Powell
- Department of Radiology, Division of Interventional Radiology, Baptist Cardiac and Vascular Institute, Miami, Florida
| | - Frank C Lynch
- Division of Interventional Radiology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Ahmed Kamel Abdel Aal
- Division of Interventional Radiology, Department of Radiology, University of Alabama at Birmingham Medical Center, Birmingham, Alabama
| | - Alexandra J Lansky
- Division of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut
| | | | - Bart E Muhs
- Section of Vascular Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut
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Pulmonary embolism after total joint arthroplasty: cost and effectiveness of four treatment modalities. J Arthroplasty 2014; 29:933-7. [PMID: 24269095 DOI: 10.1016/j.arth.2013.09.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 09/13/2013] [Accepted: 09/21/2013] [Indexed: 02/01/2023] Open
Abstract
Pulmonary embolism (PE) treatment relies on therapeutic anticoagulation and may be associated with severe complications. Inferior vena cava filters (IVCFs) are used as an alternative/adjunct to anticoagulation. In this study we evaluate 4 treatment protocols for clinical efficacy and cost. We reviewed over 27,000 total joint arthroplasty (TJA) patients. We retrospectively identified 294 patients with a documented, symptomatic PE within 90 days of surgery. All patients were treated with warfarin postoperatively. In addition, for the acute management, patients were divided into four treatment groups: (1) IVCF only, (2) IVCF with heparin, (3) heparin only and (4) no treatment. Complication rates, hospital stay and PE recurrence are reported. Among patients who received warfarin, IVCF was associated with fewer complications and lower overall hospital costs compared to the use of heparin for the treatment of PE after TJA.
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44
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Outcomes of patients requiring insertion of an inferior vena cava filter. Blood Coagul Fibrinolysis 2014; 25:266-71. [DOI: 10.1097/mbc.0000000000000050] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Iwamoto Y, Okamoto M, Hashimoto M, Fukuda Y, Uchimura Y, Iwamoto A, Matsumoto T, Iwasaki T, Kinoshita H, Ueda H, Kihara Y. Clinical outcomes and causes of death in Japanese patients with long-term inferior vena cava filter implants and deep vein thrombosis. J Cardiol 2014; 64:308-11. [PMID: 24679943 DOI: 10.1016/j.jjcc.2014.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 01/04/2014] [Accepted: 01/20/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE We assessed the causes of death and efficacy of permanent inferior vena cava (IVC) filters for preventing new pulmonary embolisms (PE) in Japanese deep vein thrombosis (DVT) patients with or without PE. METHODS AND SUBJECTS We studied the clinical outcomes during the follow-up period of 1 day to 9 years (median: 18 months; mean: 28 months) in 66 of 72 consecutive patients (44 with acute PE, 27 with intrapelvic DVT, and 1 with floating femoral vein thrombosis). Fifty of 66 patients received anticoagulant therapy after the filter placement. RESULTS Five patients died within 1 month (median 9 days) after the filter placement: three from recurrence of PE, one from cancer, and one from sepsis. Two of the three patients with recurrence of PE had preexisting intracardiac thrombi in the right atrium or main pulmonary artery before filter implantation. Ten patients died from the underlying disease (cancer: 7; brain hemorrhage: 1; amyotrophic lateral sclerosis: 1; pneumonia: 1) over 1 month after the filter placement (median follow-up period: 21 months). No new symptomatic PE recurrence was observed over 1 month after the filter placement. The 61 patients with long-term follow-up had no deterioration of DVT, and all the 31 patients who underwent multi-slice computed tomography showed no PE recurrence or filter thrombus occlusion, fracture, or migration. CONCLUSIONS Underlying diseases and preexisting intracardiac thrombi may be the determining factors for the prognosis of DVT patients. Permanent IVC filters with anticoagulant therapy may be effective for preventing death from new PE in Japanese DVT patients.
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Affiliation(s)
- Yumiko Iwamoto
- Department of Cardiology, Hiroshima Prefectural Hospital, Hiroshima, Japan; Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.
| | - Mitsunori Okamoto
- Department of Cardiology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Masaki Hashimoto
- Department of Cardiology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Yukihiro Fukuda
- Department of Cardiology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Yuko Uchimura
- Department of Cardiology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Akimichi Iwamoto
- Department of Cardiology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Takeshi Matsumoto
- Department of Cardiology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Toshitaka Iwasaki
- Department of Cardiology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Hiroki Kinoshita
- Department of Cardiology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Hironori Ueda
- Department of Cardiology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
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Jia W, Liu J, Tian X, Jiang P. Tempofilter II implantation in patients with lower extremity fractures and proximal deep vein thrombosis. Diagn Interv Radiol 2014; 20:245-50. [PMID: 24675164 DOI: 10.5152/dir.2013.13289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE We aimed to examine the efficacy and safety of Tempofilter II (B. Braun, Melsungen, Germany) implantation to prevent pulmonary embolism in patients with lower-extremity fractures and proximal deep vein thrombosis (DVT). MATERIALS AND METHODS The records of patients with lower limb fractures and proximal DVT who were implanted with Tempofilter II devices from May 2004 to August 2009 were reviewed. Data collected included success rate, occurrence of pulmonary embolism, retrieval rate, and complications. RESULTS A total of 176 eligible patients, including 129 males (73.3%) and 47 females (26.7%) with a median age of 42.0 years (interquartile range [IQR], 34.0-52.0 years) were included in the study. Filters were successfully implanted in 174 patients (98.9%). One patient experienced a pulmonary embolism after implantation and died. Filters were removed without complications in all other patients. Median filter implantation time was 27 days (IQR, 25.0-29.0 days). Visible organized thrombi were present on the surface of 144 (82.8%) of filters after removal, and the diameter of most thrombi (n=124) ranged from 0.5 to 1.0 cm. Filters migrated <2 cm in 104 patients (59.8%) and ≥ 2 cm in five patients (2.9%). In these five cases, three filters migrated into the right atrium and two migrated to the orifice of the renal veins. CONCLUSION Tempofilter II is safe and may be useful in cases of lower extremity fracture with proximal DVT for the prevention of pulmonary embolism. The filter is easily placed and retrieved, and associated with minimal complications.
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Affiliation(s)
- Wei Jia
- From the Department of Vascular Surgery Beijing Jishuitan Hospital, Beijing, China.
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Penetration of Celect Inferior Vena Cava Filters: Retrospective Review of CT Scans in 265 Patients. AJR Am J Roentgenol 2014; 202:643-7. [DOI: 10.2214/ajr.13.11097] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Yamagami T, Hasebe T, Yoshimatsu R, Matsumoto T, Hashimoto T, Komemushi A, Kamei S, Hagihara M, Sato Y, Kondo H, Inoue M, Nakatsuka A, Takahashi M, Koizumi J, Saito H. Training on insertion and retrieval of optional inferior vena cava filters for interventional radiologists with little or just some experience with the combined use of blood vessel and animal models. SPRINGERPLUS 2013; 2:354. [PMID: 24255822 PMCID: PMC3830002 DOI: 10.1186/2193-1801-2-354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 07/21/2013] [Indexed: 12/02/2022]
Abstract
Purpose To evaluate the usefulness of a tool that we developed to simulate performance of insertion and retrieval of optional inferior vena cava filters to be additionally used in training of beginners with an animal model. Subjects and methods Thirty young doctors who had little or no experience in insertion and/or retrieval of filters were subjects of this study to evaluate the training tool. Eleven trainees practiced both insertion and retrieval of filters first with the animal model then with the blood vessel model while 19 trainees first practiced with the blood vessel model then with the animal model. Results All trainees successfully inserted the filter. Two of the 11 trainees who used the animal model before the blood vessel model failed in retrieval, and 2 of the 19 trainees who used the blood vessel model before the animal model failed. In the former group, mean time for filter implantation and withdrawal in the animal model was 75 ± 62 s and 341 ± 238 s, respectively, and in the latter group were 54 ± 16 s and 311 ± 236 s, respectively. Conclusion Training with the combination of a blood vessel model and animal model is helpful for beginners to learn to insert and withdraw optional filters.
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Rajasekhar A, Streiff MB. Vena cava filters for management of venous thromboembolism: A clinical review. Blood Rev 2013; 27:225-41. [DOI: 10.1016/j.blre.2013.07.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Olorunsola OG, Kohi MP, Fidelman N, LaBerge JM, Kerlan RK. Failure of filter reexpansion during unsuccessful retrieval of Option inferior vena cava filter. J Vasc Interv Radiol 2013; 24:1065-7. [PMID: 23796095 DOI: 10.1016/j.jvir.2013.03.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 03/17/2013] [Accepted: 03/20/2013] [Indexed: 11/27/2022] Open
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