Abstract
Purpose
The Günther basket inferior vena cava filter (GBF) has been withdrawn from the market because of its mechanical instability, but a number of patients still live with the device.
Methods
In a two-center study, we evaluated the long-term follow-up of the GBF, based on clinical data in 78 patients, and on imaging studies including plain radiographs, Doppler ultrasound, angiography, or computed tomography (CT) in 50 patients.
Results
In a mean period of 3 years, pulmonary embolism was diagnosed in five patients (6.4%), with an overall rate of 0.02 embolic episodes per patient per year. None of these patients required hospitalization, and there were no deaths due to pulmonary embolism. Inferior vena cava thrombosis was documented in three patients (3.9%), and occlusive venous thrombosis at the access site in seven patients (9%). Spontaneous migration was documented in 43% of the examined filters and spontaneous disruption in 77%. Dislocated filter fragments were localized by CT in the adjacent retroperitoneum in 11%, in the aortic lumen in 2%, and in a peripheral pulmonary artery in 7%. None of the patients had symptoms attributable to filter migration or disruption.
Conclusion
Our results indicate that the rate of clinically relevant complications with the GBF is no higher than with other vena cava filters. Because mechanical instability of the GBF had no clinical consequences, we conclude that patients who live with this device may be observed and treated in a manner similar to patients with other vena cava filters.
Similar content being viewed by others
References
Grassi J (1991) Inferior vena cava filters: Analysis of the five currently available devices. AJR 156:813–821
Molgaard CP, Yucel EK, Geller SC, Knox TA, Waltman AC (1992) Access-site thrombosis of inferior vena cava filter with 12–14 F delivery sheaths. Radiology 185:257–261
Dorfman GS (1990) Percutaneous inferior vena cava filters. Radiology 174:987–992
Dorfman GS (1992) Evaluating the roles and function of vena cava filters: Will data be available before or after these devices are removed from the market? Radiology 185:15–17
Günther RW, Schild H, Hollmann JP, Vorwerk D (1987) First clinical results with a new caval filter. Cardiovasc Intervent Radiol 10:104–108
Fobbe F, Dietzel M, Korth R, Felsenberg D, Bender S, Hamed M, Laass C, Sörensen R (1988) Günther vena caval filter. Results of long-term follow-up. AJR 151:1031–1034
Kantor A, Glanz S, Gordon DH, Sclafani SJA (1987) Percutaneous insertion of the Kimray-Greenfield filter: Incidence of femoral vein thrombosis. AJR 149:1065–1066
Johnson SG, Pickford M, Wilkins RA (1988) Migration of a Günther caval filter to the right ventricle. J Intervent Radiol 3:33–36
Lang N, Schweiger H, Fietkau R, Hofmann-Preiss K (1990) Spontaneous disruption of two Greenfield vena cava filters. Radiology 174:445–446
McCowan TC, Ferris EJ, Carver DK, Molpus WM (1992) Complications of the Nitinol vena cava filter. J Vasc Interv Radiol 3:401–408
Awh MH, Taylor FC, Lu CT (1991) Spontaneous fracture of a vena-tech inferior vena caval filter. AJR 157:177–178
Castañeda F, Herrera M, Cragg AH, et al. (1986) Migration of a Kimray-Greenfield filter to the heart. AJR 147:45–50
Rogoff PA, Hilgenberg AD, Miller SL, Stephan SM (1992) Cephalic migration of the bird's nest inferior vena caval filter: Report of two cases. Radiology 184:819–820
La Plante JS, Contractor FM, Kiproff PM, Khoury MB (1993) Migration of the Simon Nitinol vena cava filter to the chest. AJR 160:385–386
Schleich J-M, Laurent M, Le Helloco A, Langella B, Ramée A, Almange C (1993) Short-term follow-up of inferior vena caval filters: Comparison of imaging techniques. AJR 161:799–803
Greenfield LJ (1984) Current indications for and results of Greenfield filter placement. J Vasc Surg 1:502–504
Schneider PA, Parmeggiani L, Piguet JC, Bounameaux H (1989) Caudal migration of the Günther vena caval filter. Radiology 173:465–466
Schneider PA, Geissbühler P, Piguet JC, Bounameaux H (1990) Follow-up after partial interruption of the vena cava with the Günther filter. Cardiovasc Intervent Radiol 13:378–380
Miersch G, Münster W, Schöpke W, Stobbe G, Kornotzki M, Hasert V (1991) Kavafilter nach Günther. Ergebnisse von Langzeitkontrollen. Vasa (suppl) 32P:279–284
Grabenwöger F, Dock W, Metz V, Eibenberger K, Magometschnigg H (1991) Perkutane transluminale Implantation des Günther-Kavafilters: Erfahrungen anhand von 22 Patienten. Fortschr Geb Röntgenstr. 155:405–408
Urban M, Hruby W, Winkler WB, Mosser H, Baldt M (1992) trebenbrüche bei der Langzeitkontrolle von Günther-Kavafiltern—Ergebnisse nach 64 Filterimplantationen. Fortsch Geb Röntgenstr 156:342–345
Bull PG, Mendel H, Schlegl A (1992) Günther vena cava filter: Clinical appraisal. J Vasc Interv Radiol 3:395–399
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Becker, C.D., Hoogewoud, HM., Felder, P. et al. Long-term follow-up of the Günther basket inferior vena cava filter: Does mechanical instability cause complications?. Cardiovasc Intervent Radiol 17, 247–251 (1994). https://doi.org/10.1007/BF00192446
Issue Date:
DOI: https://doi.org/10.1007/BF00192446