Article

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

Imaging Institute, Section of Interventional Radiology, Cleveland Clinic, Cleveland, Ohio.
Journal of vascular and interventional radiology: JVIR (Impact Factor: 2.41). 12/2012; 23(12):1557-63. DOI: 10.1016/j.jvir.2012.08.016
Source: PubMed

ABSTRACT

To evaluate retrospectively the safety and retrievability of the Celect IVC filter.
All patients undergoing Celect filter placement and retrieval during the period 2007-2012 were assessed for complications and retrievability.
Of 620 patients who underwent Celect filter placement, 120 presented for removal. The indwelling time in these patients was 158.1 days±103.0 (range, 2-518 d). There were 106 filters (88.3%) removed; 14 filters were left in situ for the following reasons: filter embedment (n=6), caval occlusion (n=3), retained thrombus (n=2), large floating thrombus in IVC (n=2), or tilt >15° (n=1). With filters in place, five patients developed new pulmonary embolism (PE), and two others presented with severe abdominal pain. The available 115 pairs of placement and removal cavagrams suggested limb penetration in 99 cases (86.1%), intracaval migration >2 cm in 5, secondary tilt >15° in 8, filter deformity in 10, retained thrombus within filters in 12, and IVC occlusion in 3. Among 38 available computed tomography (CT) scans, 9 scans (24%) showed asymptomatic limb penetration to the duodenum (n=6), aortic wall (n=2), or kidney (n=1). No filter fracture was found.
This study showed a high penetration rate for Celect IVC filters, including penetrations that were symptomatic or involved adjacent structures. Penetration appears to correlate with indwelling time, suggesting that the filter should be removed as soon as PE protection is no longer indicated. Although most of the filters were removed, 5.8% of retrievals were unsuccessful because of technical failure.

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    • "This has reached national attention and retrievable filters are currently recommended over permanent filter with the development of a concrete plan for later removal[18]. In most institutions only a minority of filters are actually removed (8.5–34%)[18,19]which may lead to an increased rate of filter related complications, including thrombosis at the filter site, erosion into the wall of the vena cava, infection, recurrent lower extremity thrombosis, and migration of the filter, as device related complications increase with dwell time[20]. The objective of our study was to evaluate the rate of IVC filters in patients with and without ACa at a single institution. "
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    ABSTRACT: Active cancer (ACa) is strongly associated with venous thromboembolism and bleeding. Retrievable inferior vena cava filters (RIVCF) are frequently placed in these patients when anticoagulation cannot be continued. Objectives . To describe the complications and retrieval rate of inferior vena cava filters in patients with ACa. Methods . Retrospective review of 251 consecutive patients with RIVCF in a single institution. Results . We included 251 patients with RIVCF with a mean age of 58.1 years and a median follow-up of 5.4 months (164 days, IQR: 34–385). Of these patients 32% had ACa. There were no differences in recurrence rate of DVT between patients with ACa and those without ACa (13% versus 17%, p = ns). Also, there were no differences in major filter complications (11% ACa versus 7% no ACa, p = ns). The filter retrieval was not different between groups (log-rank = 0.16). Retrieval rate at 6 months was 49% in ACa patients versus 64% in patients without ACa ( p = ns). Filter retrieval was less frequent in ACa patients with metastatic disease ( p < 0.01) or a nonsurgical indication for filter placement ( p = 0.04). Conclusions . No differences were noted in retrieval rate, recurrent DVT, or filter complications between the two groups. ACa should not preclude the use of RIVCF.
    Full-text · Article · Jan 2016 · International journal of vascular medicine

  • No preview · Article · Dec 2012 · Journal of vascular and interventional radiology: JVIR
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    ABSTRACT: With the introduction of retrievable inferior vena cava filters, the number being placed for protection from pulmonary embolism is steadily increasing. Despite this increased usage, the true incidence of complications associated with inferior vena cava filters is unknown. This article reviews the known complications associated with these filters and suggests recommendations and techniques for inferior vena cava filter removal.
    No preview · Article · Mar 2013 · Seminars in Vascular Surgery
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