There has been increasing use of a novel combined femoral venous sheath, catheter and retrievable self-expanding and collapsible diamond-shaped IVC filter (Angel® Catheter, BiO2 Medical), in severely injured patients who cannot receive anticoagulation. As the filter is not detached from the catheter/sheath, it should be easily retrieved. Outcomes included in large registries demonstrate a high safety profile and a 100% retrieval rate. However, at our institution—a Level 1 major UK trauma centre with 4 years of substantial experience in using this device—we’ve encountered three cases of device fracture and subsequent complicated retrieval dating from Dec 2016 to March 2017. To the best of the authors’ knowledge, we describe the first documented case series of fractured Angel® Catheters and their retrieval.
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Compliance with Ethical Standards
Conflict of interest
Dr. Nicholas Bunker received an honorarium from BiO2 Medical in 2014 for his time spent acquiring and entering patient data into the European Angel Catheter Registry. On behalf of the remaining authors, the corresponding author states that there is no conflict of interest.
Ethical approval statement
Ethical approval is not required as this is a case report.
Informed consent statement
This does not apply.
Carlin MN, Daneshpajouh A, Catino J, Bukur M. Money well spent? A cost and utilization analysis of prophylactic inferior vena cava filter placement in high-risk trauma patients. J Surg Res. 2017;220:105–11.CrossRefPubMedGoogle Scholar
Park MS, Perkins SE, Spears GM, Ashrani AA, Leibson CL, Boos CM, et al. Risk factors for venous thromboembolism after acute trauma: a population-based case-cohort study. Thromb Res Thromb Res. 2016;144:40–5.CrossRefPubMedGoogle Scholar
Geerts WH, Jay RM, Code KI, Chen E, Szalai JP, Saibil EA, et al. A comparison of low-dose heparin with low-molecular-weight heparin as prophylaxis against venous thromboembolism after major trauma. N Engl J Med. 1996;335:701–7.CrossRefPubMedGoogle Scholar
Berber O, Vasireddy A, Nzeako O, Tavakkolizadeh A. The high-risk polytrauma patient and inferior vena cava filter use. Injury. 2017;48:1400–4.CrossRefPubMedGoogle Scholar
Logan C, O’Connell N, Kavanagh J, McEniff N, Ryan M, Guiney M, et al. Out of sight, out of mind? An audit which proposes a follow-up and management pathway for inferior vena cava filters. Thrombosis. 2016;2016:6538456.CrossRefPubMedPubMedCentralGoogle Scholar
Tan XL, Tam C, Mckellar R, Nandurkar H, Bazargan A. Out of sight, out of mind: an audit of inferior vena cava filter insertion and clinical follow up in an Australian institution and literature review. Intern Med J. 2013;43:365–72.CrossRefPubMedGoogle Scholar
Sildiroglu O, Ozer H, Turba UC. Management of the thrombosed filter-bearing inferior vena cava. Semin Interv Radiol. 2012;29:57–63.CrossRefGoogle Scholar
Taccone FS, Bunker N, Waldmann C, De Backer D, Brohi K, Jones RG, et al. A new device for the prevention of pulmonary embolism in critically ill patients: results of the European Angel Catheter Registry. J Trauma Acute Care Surg. 2015;79:456–62.CrossRefPubMedGoogle Scholar
Tapson VF, Hazelton JP, Myers J, Robertson C, Gilani R, Dunn JA, et al. Evaluation of a device combining an inferior vena cava filter and a central venous catheter for preventing pulmonary embolism among critically ill trauma patients. J Vasc Interv Radiol. 2017;28:1248–54.CrossRefPubMedGoogle Scholar
Baumann S, Becher T, Giannakopoulos K, Jabbour C, Rutsch M, Fastner C, et al. Bedside implantation of a new temporary vena cava inferior filter-Safety and efficacy results of the European ANGEL-Registry. J Crit Care. 2018;44:39–44.CrossRefPubMedGoogle Scholar
Waltz P, Zuckerbraun BS. Inferior vena cava filters in trauma patients—for whom the benefit tolls? JAMA Surg. 2017;152:81.CrossRefPubMedGoogle Scholar
Sarosiek S, Rybin D, Weinberg J, Burke PA, Kasotakis G, Sloan JM. Association between inferior vena cava filter insertion in trauma patients and in-hospital and overall mortality. JAMA Surg. 2017;152:75–81.CrossRefPubMedGoogle Scholar
Bikdeli B, Chatterjee S, Desai NR, Kirtane AJ, Desai MM, Bracken MB, et al. Inferior vena cava filters to prevent pulmonary embolism: systematic review and meta-analysis. J Am Coll Cardiol. 2017;70:1587–97.CrossRefPubMedGoogle Scholar
BIO2 Medical (2016) Angel® Catheter. Femoral approach. Instructions for use. Catalog No. AC3930A.Google Scholar