Reply to: Inferior Vena Cava Filter Placement and Retrieval in a Patient with Dual IVC
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KeywordsNuclear Medicine Interventional Radiologist Inferior Vena Cava Late Complication Advance Technique
To the Editor,
We appreciate Drs. Collin and Freedman sharing their use of the “Stiff-Wire Displacement Technique” that we illustrated in our review, “Advanced Techniques for Removal of Retrievable Inferior Vena Cava Filters” . Their juxta-filter wire nicely adjusted the angulation of the second inferior vena cava (IVC), making the filter apex addressable. This same type of wire effect has been used in other endovascular cases—for example, in the deployment of thoracic endografts, where a stiff wire may undesirably distort the landing zone by straightening out the anatomy. That aside, the rate of caval filter placement continues to grow worldwide, retrievable filters exceed permanent ones, and the call to remove no-longer-needed IVC filters is an important one to heed. It is remarkable that devices placed approximately 200,000 times per year are supported by such limited randomized data. This absence is made more conspicuous by the increasing recognition that late complications occur. The days of “filter and go” are gone. With that, the ingenuity of interventional radiologists will continue to yield new ways to remove them.
Z.H. was a speaker and consultant for Bard Peripheral Vascular, W.L. Gore, Biocompatibles; received research funding by Merit Medical, W. L. Gore, Bard Peripheral Vascular, Celo Nova; and received royalties from Cook Incorporated.
Conflict of interest
The other author declares that he has no conflict of interest.