Abstract
Purpose
Currently, data surrounding predicting difficulty of IVC filter retrievals are heterogenous and conflicting. We aimed to identify which of many variables associated with IVC filters is a risk for procedural difficulty.
Materials and Methods
This study retrospectively reviewed 6 years of IVC filter retrievals at a tertiary center identifying 356 consecutive retrievals. A difficult retrieval was defined as any case where the fluoroscopy time exceeded 7 min, an advanced technique was required, the retrieval attempt failed and required an additional attempt or was left permanent, or there was major complication such as IVC filter fracture/migration/vessel injury.
Results
There were 105 filter retrievals defined as difficult (29.5%). Univariate analysis showed significantly increased risk for retrievals with an embedded top. Multivariate analysis assessed the association between dwell time, tilt, age, non-hooked filters, leg penetration and difficult retrieval. This showed a significant increase in the difficulty of retrieval for filters tilted between 5° and 15° (odds ratio 2.38, p < 0.001), for filters tilted more than 15° (odds ratio 7.91, p < 0.001), and dwell time greater than 6 months (odds ratio 2.06, p = 0.033). No significant increase in difficulty was seen with filters with a dwell time of less than 6 months, leg penetration, non-hooked filters, or with increasing patient age.
Conclusions
Identifying these risks in patients in advance of the procedure allows appropriate planning and improved workflow efficiency.
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Abbreviations
- IVC:
-
Inferior vena cava
- CT:
-
Computed tomography
- INR:
-
International normalized ratio
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Acknowledgements
The team would like to acknowledge the following doctors who were also involved in the management of these patients: Dr Jim Koukounaras, Dr Tim Joseph, Dr Tuan Phan, Dr Kelvin Stribley, and A/Prof Stuart Lyon.
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This study was not supported by any funding.
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Dr Gerard S Goh discloses an industry relationship with Cook Medical which has no association with this manuscript. The remaining authors have no disclosures.
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Approval was obtained by The Alfred Human Research and Ethics Committee prior to performing this study.
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Level 3, retrospective cohort study.
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Clements, W., Moriarty, H.K., Paul, E. et al. Stratification of Pre-procedure Risk Factors Associated with Difficult-to-remove Inferior Vena Cava (IVC) Filters: A 6-year Retrospective Analysis at a Tertiary Center. Cardiovasc Intervent Radiol 43, 238–245 (2020). https://doi.org/10.1007/s00270-019-02373-9
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DOI: https://doi.org/10.1007/s00270-019-02373-9