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Erschienen in: Current Treatment Options in Cardiovascular Medicine 4/2017

01.04.2017 | Vascular Disease (I Weinberg, Section Editor)

Novel and Advanced Techniques for Complex IVC Filter Retrieval

verfasst von: Dania Daye, MD, PhD, T. Gregory Walker, MD

Erschienen in: Current Treatment Options in Cardiovascular Medicine | Ausgabe 4/2017

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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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Metadaten
Titel
Novel and Advanced Techniques for Complex IVC Filter Retrieval
verfasst von
Dania Daye, MD, PhD
T. Gregory Walker, MD
Publikationsdatum
01.04.2017
Verlag
Springer US
Erschienen in
Current Treatment Options in Cardiovascular Medicine / Ausgabe 4/2017
Print ISSN: 1092-8464
Elektronische ISSN: 1534-3189
DOI
https://doi.org/10.1007/s11936-017-0529-3

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