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The Value of Rotational Venography Versus Anterior–Posterior Venography in 100 Consecutive IVC Filter Retrievals

  • Clinical Investigation
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

Accurately detecting inferior vena cava (IVC) filter complications is important for safe and successful retrieval as tip-embedded filters require removal with non-standard techniques. Venography prior to IVC filter retrieval has traditionally used a single anterior–posterior (AP) projection. This study compares the utility of rotational venography to AP venography prior to IVC filter removal.

Materials and Methods

The rotational venograms from 100 consecutive IVC filter retrievals over a 35-month period were evaluated retrospectively. The AP view of the rotational venogram was examined separately from the full series by a radiologist blinded to alternative imaging and operative findings. The venograms were evaluated for tip embedding, filter fracture, filter thrombus, and IVC thrombus. Statistical analysis was performed.

Results

Using operative findings and peri-procedural imaging as the reference standard, tip embedding occurred in 59 of the 100 filters (59 %). AP venography was used to correctly identify 31 tip-embedded filters (53 % sensitivity) with two false positives (95 % specificity) for an accuracy of 70 %. Rotational venography was used to correctly identify 58 tip-embedded filters (98 % sensitivity) with one false positive (98 % specificity) for an accuracy of 98 %. A significant difference was found in the sensitivities of the two diagnostic approaches (P < .01). Other findings of thrombus and filter fracture were not significantly different between the two groups.

Conclusion

Rotational venograms allow for more accurate detection of tip-embedded IVC filters compared to AP views alone. As this determines the approach taken, rotational venograms are helpful if obtained prior to IVC filter retrieval.

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Authors and Affiliations

  1. Division of Interventional Radiology, Department of Radiology, Hospital of University of Pennsylvania Medical Center, 1 Silverstein, 3400 Spruce St., Philadelphia, PA, 19104, USA

    Ryan M. Kiefer, Nirnimesh Pandey, Scott O. Trerotola, Gregory J. Nadolski & S. William Stavropoulos

Authors
  1. Ryan M. Kiefer
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  2. Nirnimesh Pandey
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  3. Scott O. Trerotola
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  4. Gregory J. Nadolski
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  5. S. William Stavropoulos
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Corresponding author

Correspondence to S. William Stavropoulos.

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Conflict of Interest

Dr. Stavropoulos reports grants from WL Gore, grants from B Braun, grants and personal fees from Bard Peripheral Vascular, personal fees from Cook, personal fees from Vasonova, outside the submitted work. Dr. Trerotola reports personal fees from B Braun, personal fees from Bard Peripheral Vascular, personal fees from Lutonix, personal fees from Orbimed, personal fees from Cook, personal fees from WL Gore, personal fees from MedComp, personal fees from Teleflex, grants from Vascular Pathways, outside the submitted work. The remaining authors have no disclosures to report.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Kiefer, R.M., Pandey, N., Trerotola, S.O. et al. The Value of Rotational Venography Versus Anterior–Posterior Venography in 100 Consecutive IVC Filter Retrievals. Cardiovasc Intervent Radiol 39, 394–399 (2016). https://doi.org/10.1007/s00270-015-1183-3

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  • DOI: https://doi.org/10.1007/s00270-015-1183-3

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