Extraordinary Cases in Inferior Vena Cava Filter Retrieval
10 May 2016 (online)
There has been significant growth in the placement of retrievable inferior vena cava (IVC) filters in recent years. Despite the specific design of these devices to be retrievable, most filters are left in place permanently, in many cases beyond their indicated use. Recent studies have focused on the greater number of device-related complications associated with retrievable filters, which appears to be positively associated with filter dwell time.   The United States Food and Drug Administration (FDA) recognizes the issues associated with these devices, issuing an alert in 2010 prompting retrieval of these devices once no longer indicated.
The development of advanced retrieval techniques has positively impacted retrieval rates associated with IVC filters, particularly difficult to remove or embedded devices. When used by experienced operators, these techniques are so effective that they essentially remove the “time limit” on filter removal, which can be performed safely regardless of dwell time. Retrieval of embedded devices can be quite complex. In this article, the authors present five patients in whom extraordinary measures were necessary to achieve technical success and optimal outcomes for each patient.
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