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J Vasc Interv Radiol · Jul 2016
A 16-F Sheath with Endobronchial Forceps Improves Reported Retrieval Success of Long-Dwelling "Closed Cell" Inferior Vena Cava Filter Designs.
- Chick Jeffrey Forris Beecham JF Division of Interventional Radiology, Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, 1 , S William Stavropoulos, Benjamin J Shin, Richard D Shlansky-Goldberg, Jeffrey I Mondschein, Deepak Sudheendra, Gregory J Nadolski, Micah M Watts, and Scott O Trerotola.
- Division of Interventional Radiology, Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, 1 Silverstein, 3400 Spruce Street, Philadelphia, PA 19104.
- J Vasc Interv Radiol. 2016 Jul 1; 27 (7): 1027-33.
PurposeTo report results of a 16-F sheath/endobronchial forceps combination in retrieval of "closed cell" inferior vena cava (IVC) filter designs with prolonged dwell times of ≥ 60 days.Materials And MethodsForceps retrieval of selected IVC filters using a 16-F 45-cm sheath was performed in 35 patients (25 women and 10 men). Patients presented with filters that were no longer needed without (n = 10) or with (n = 21) prior failed retrieval, caval thrombosis before lysis (n = 3), and back pain (n = 1). Filter designs included 19 Günther Tulip (54%), 10 Option (29%), and six OptEase (17%). Mean dwell time was 977 days. Imaging characteristics, technical success, fluoroscopy time, and complications were recorded.ResultsFilters included 20 tip-embedded, 6 tip-adherent, 4 fractured, and 6 containing thrombus. All were strut and wall-embedded. Initial snare failures occurred in 8 filters because of hook straightening (n = 4), adherent material (n = 2), snare breakage (n = 1), and filter tilt (n = 1). The 16-F sheath/forceps combination was 100% successful in removing filters. In 1 patient, 2 extravascular fragments could not be retrieved. Median fluoroscopy time, excluding 3 extended lysis procedures, was 8 minutes. Minor caval abnormalities, including caval spasm and caval defects, were noted in 17 patients, and filter fracture occurred in 2 patients. No major complications occurred.ConclusionsA high rate of retrieval for closed cell long-dwelling strut and wall-embedded filters may be achieved using a 16-F sheath/endobronchial forceps combination.Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.
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