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Retrievable IVC Filters Associated with High Success Rate
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Early results suggest that retrievable inferior vena cava filters can be removed with a more than 85% rate of success.
Kevin P. Cohoon, DO, MSc, of the Mayo Clinic, Rochester, Minnesota, and colleagues retrospectively reviewed all patients who underwent placement of a retrievable inferior vena cava (IVC) filter at the Mayo Clinic from 2003 — when the device received FDA approval — to 2005. The aim of the study was to determine the initial experience with retrievable IVC filters at a large tertiary care center.
During the study period, 892 IVC filters were placed, of which 460 were retrievable. Among the retrievable filters, retrieval was attempted in 48.5% of the cases; of those, 87.9% were successful.
Unsuccessful retrievals (12.1%) were the result of either significant thrombus within the filter (85.2%) or tilting and strut perforation (14.8%). In addition, 39.1% of the filters that contained significant thrombus were eventually retrieved after anticoagulation and resolution of the thrombus.
“Referring clinicians and operators who place and remove retrievable IVC filters must be aware of the potential complications associated with these devices, including tilting, perforation, fracture and migration,” Cohoon and colleagues wrote. “Patients who receive retrievable IVC filters should be followed and assessed for filter removal as soon as clinically indicated.”
Ido Weinberg
In an accompanying editorial, Ido Weinberg, MD, and Douglas E. Drachman, MD, of the Massachusetts General Hospital in Boston, wrote that these results indicate that IVC filter application and retrieval “are far from perfect.”
“Through continued rigorous, scientific evaluation, we may gain insight into the appropriate use and outcomes of this promising technology,” they wrote. “At the same time, we may develop systems to follow patients and assure that IVC filters are expeditiously, meticulously and safely retrieved. In the meantime, clinicians should therefore use IVC filters thoughtfully, and be prepared to follow patients systematically in order to achieve high rates of timely and successful retrieval.” – by Brian Ellis
Disclosure: The researchers and Weinberg report no relevant financial disclosures. Drachman reports serving on the advisory board of Abbott Vascular and receiving grant support from Atrium Medical and Lutonix/Bard.
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