• Anobel Tamrazi, Vibhor Wadhwa, Brian Holly, Nikhil Bhagat, Jonathan K Marx, Michael Streiff, and Mark L Lessne.
• Division of Vascular & Interventional Radiology, Johns Hopkins University School of Medicine, 1800 Orleans Street, Sheik Zayed Towers, Suite 7203, Baltimore, MD, 21287, USA. atamraz1@jhmi.edu.
• Cardiovasc Intervent Radiol. 2016 Apr 1; 39 (4): 538-46.

PurposeTo evaluate the feasibility, risks, and techniques of percutaneous removal of permanent TrapEase and Simon Nitinol IVC filters.Materials And MethodsBetween August 2011 and August 2015, 12 patients (5 women, 7 men; age range, 26-75 years) underwent an attempt at percutaneous removal of permanent TrapEase (10) and Simon Nitinol (2) IVC filters due to a history of IVC filter complications or need for lifelong anticoagulation due to the filter. Medical records were reviewed for filter dwell time, presence of iliocaval deep venous thrombosis, procedural technique, and complications.ResultsFilter dwell times ranged from 7 days to 15 years (mean 5.1 years). Successful removal of permanent IVC filters was possible in 11 of 12 patients (91.6%). In 1 patient, a chronically thrombosed IVC filter could not be removed despite laser sheath assistance, but was successfully recanalized with the PowerWire RF guidewire. In the failed retrieval attempt, a stent was placed through the chronically thrombosed IVC filter with restoration of in-line flow. One major complication of large venous groin hematoma was encountered.ConclusionsIn carefully selected patients, percutaneous removal of permanent IVC filters can be performed safely despite prolonged filter dwell times. Extraction of chronically embedded permanent IVC filters may be facilitated by jugular and femoral approaches, often with laser sheath assistance. Chronic filter thrombosis and caval scarring may increase the risk of retrieval failure.

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