CardioVascular and Interventional Radiology

, Volume 20, Issue 1, pp 10–16 | Cite as

Results of a multicenter study of the retrievable Tulip vena cava filter: Early clinical experience

  • Jörg M. Neuerburg
  • Rolf W. Günther
  • Dierk Vorwerk
  • Robert F. Dondelinger
  • Horst Jäger
  • Klaus J. Lackner
  • Hans H. Schild
  • Graham R. Plant
  • Francis G. Joffre
  • Pierre A. Schneider
  • Johan H. A. Janssen
Clinical Investigations



To evaluate clinically a new, retrievable vena caval filter in a multicenter study.


The Tulip filter is a stainless steel half-basket that is suitable for antegrade or retrograde insertion via an 8.5 Fr introducer sheath. The filter can be retrieved via the jugular approach using an 11 Fr coaxial retrieval system. Forty-eight filters were implanted via the femoral approach and 38 via the jugular approach in 83 patients. Follow-up examinations (plain films, colorcoded duplex sonography) were performed up to 3 years after filter insertion (mean 136 days) in 75 patients. Twenty-seven patients were screened by colorcoded duplex sonography for insertion site thrombosis.


An appropriate filter position was achieved in all cases. Insertion problems occurred in 3 cases; these were not due to the filter design but to an imperfect prototype insertion mechanism that has now been modified (n=2) or a manipulation error (n=1). In 2 of these cases the filters were replaced percutaneously; 1 patient required venotomy for filter removal. No further complications due to filter insertion occurred. Two filters were used as temporary devices and were successfully removed after 6 and 11 days, respectively. There was 1 fatal recurrent pulmonary embolism (PE) and 2 non-fatal PE, 5 complete and 3 partial caval occlusions, and 3 caudal migrations of the filter. Insertion site venous thrombosis was not seen in the 27 patients monitored for this complication.


Precise placement of the Tulip filter is feasible by either access route and the device appears mechanically stable. Further observations are needed to confirm that safe filter removal is practical up to 10 days after its insertion.

Key words

Embolism, pulmonary Vena cava, filters Thrombosis Filter retrieval 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Greenfield LJ, Proctor MC (1994) Inferior vena caval filters. Curr Opin Cardiol 9:606–611PubMedCrossRefGoogle Scholar
  2. 2.
    Dorfman GS (1990) Percutaneous inferior vena caval filters. Radiology 174:987–992PubMedGoogle Scholar
  3. 3.
    Yune HY (1989) Inferior vena cava filter: Search for an ideal device. Radiology 172:15–16PubMedGoogle Scholar
  4. 4.
    Millward SF, Bormanis J, Burbridge BE, Markman S, Peterson RA (1994) Preliminary clinical experience with the Günther temporary inferior vena cava filter. J Vasc Intervent Radiol 5:863–868CrossRefGoogle Scholar
  5. 5.
    Thery C, Asseman P, Amrouni N, Becquart J, Pruvost P, Lesenne M, Legghe R, Marache P (1990) Use of a new removable vena cava filter in order to prevent pulmonary embolism in patients submitted to thrombolysis. Eur Heart J 11:334–341PubMedGoogle Scholar
  6. 6.
    Neuerburg J, Günther RW, Rassmussen E, Vorwerk D, Tonn K, Handt S, Küpper W, Hansen JV (1993) New retrievable percutaneous vena cava filter: Experimental in vitro and in vivo evaluation. Cardiovasc Intervent Radiol 16:224–229PubMedCrossRefGoogle Scholar
  7. 7.
    Homans J (1944) Deep quiet venous thrombosis in the lower limb. Surg Gynecol Obstet 79:70–82Google Scholar
  8. 8.
    Neuerburg J, Günther RW (1994) Developments in inferior vena cava filters: A European viewpoint. Semin Intervent Radiol 11:349–357Google Scholar
  9. 9.
    Neuerburg J, Günther RW, Rasmussen E, Beckert K (1995) Percutaneous retrieval of a new vena cava filter: Experimental studies. Eur Radiol 5 [Suppl]:111Google Scholar
  10. 10.
    Darcy MD, Cardella JF, Hunter DW, Smith TP, Castañeda-Zúñiga WR, Lund G, Amplatz K (1986) Experience with the Amplatz retrievable vena caval filter: Work in progress. Radiology 161:611–614PubMedGoogle Scholar
  11. 11.
    Greenfield LJ, Proctor MC, James EA, Abrams GD, Moursi MM (1994) Staging of fixation and retrievability of Greenfield filters. J Vasc Surg 20:744–750PubMedGoogle Scholar
  12. 12.
    Irie T, Yamauchi T, Makita K, Kusano S (1995) Retrievable IVC filter: Preliminary in vitro and in vivo evaluation. J Vasc Intervent Radiol 6:449–454Google Scholar
  13. 13.
    McCowan TC, Ferris EJ, Carver DK (1990) Inferior vena caval filter thrombi: Evaluation with intravascular US. Radiology 177:783–788PubMedGoogle Scholar
  14. 14.
    Ferris E, McCowan TC, Carver DK, McFarland DR (1993) Percutaneous inferior vena caval filters: Follow-up of seven designs in 320 patients. Radiology 188:851–856PubMedGoogle Scholar
  15. 15.
    Greenfield LJ, Cho KJ, Proctor M, Bonn J, Bookstein JJ, Castañeda-Zúñiga WR, Cutler B, Ferris EJ, Keller F, McCowan T, Pais SO, Sobel M, Tisnado J, Waltman AC (1991) Results of a multicenter study of the modified hook-titanium Greenfield filter. J Vasc Surg 14:253–257PubMedCrossRefGoogle Scholar
  16. 16.
    Hammer FD, Rousseau HP, Joffre FG, Sentenac BP, Tran-Van T, Bartheleme RP (1994) In vitro evaluation of vena cava filters. J Vasc Intervent Radiol 5p869–876Google Scholar
  17. 17.
    Neuerburg J, Haupt-Pichler A, Eilers R, Siess T, Buro K, Pichler VC, Mottaghy K, Günther RW (1996) Bestimmung der Effektivität perkutaner Kavafilter: Experimentelle Untersuchungen. Fortschr Röntgenstr 164:331–337Google Scholar
  18. 18.
    Teitelbaum GP, Ortega HV, Vinitski S, Stern H, Tsuruda JS, Mitchell DG, Rifkin MD, Bradley WG (1988) Low-artifact intravascular devices: MR imaging evaluation. Radiology 168: 713–719PubMedGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1997

Authors and Affiliations

  • Jörg M. Neuerburg
    • 1
  • Rolf W. Günther
    • 1
  • Dierk Vorwerk
    • 1
  • Robert F. Dondelinger
    • 2
  • Horst Jäger
    • 3
  • Klaus J. Lackner
    • 4
  • Hans H. Schild
    • 5
  • Graham R. Plant
    • 6
  • Francis G. Joffre
    • 7
  • Pierre A. Schneider
    • 8
  • Johan H. A. Janssen
    • 9
  1. 1.Department of Diagnostic RadiologyUniversity of Technology AachenAachenGermany
  2. 2.Department of RadiologyUniversity Hospital LiègeLiège 1Belgium
  3. 3.Department of RadiologyStädt. Kliniken DortmundDortmundGermany
  4. 4.Department of Diagnostic RadiologyUniversity Hospital CologneCologneGermany
  5. 5.Department of RadiologyUniversity Hospital BonnBonnGermany
  6. 6.Department of Diagnostic RadiologyBasingstoke District HospitalBasingstokeUK
  7. 7.Department of Diagnostic RadiologyCentre Hospitalier Universitaire de RangueilToulouseFrance
  8. 8.Department of RadiologyHôpital Cantonal UniversitaireGeneva 14Switzerland
  9. 9.Department of Cardiology, Academisch Ziekenhuis MaastrichtUniversity of LimburgMaastrichtThe Netherlands

Personalised recommendations