Semin intervent Radiol 2016; 33(02): 079-087
DOI: 10.1055/s-0036-1582121
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Critical Review of Available Retrievable Inferior Vena Cava Filters and Future Directions

Jennifer P. Montgomery
1   Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
John A. Kaufman
2   Department of Interventional Radiology, Dotter Interventional Institute, Oregon Health and Science University Hospital, Portland, Oregon
› Author Affiliations
Further Information

Publication History

Publication Date:
10 May 2016 (online)


Inferior vena cava filters have been placed in patients for decades for protection against pulmonary embolism. The widespread use of filters has dramatically increased owing at least in part to the approval of retrievable vena cava filters. Retrievable filters have the potential to protect against pulmonary embolism and then be retrieved once no longer needed to avoid potential long-term complications. There are several retrievable vena cava filters available for use. This article discusses the different filter designs as well as the published data on these available filters. When selecting a filter for use, it is important to consider the potential short-term complications and the filters' window for retrieval. Understanding potential long-term complications is also critical, as these devices are approved for permanent placement and many filters are not retrieved. Finally, this article will address research into new designs that may be the future of vena cava filtration.

  • References

  • 1 Kaufman JA, Kinney TB, Streiff MB , et al. Guidelines for the use of retrievable and convertible vena cava filters: report from the Society of Interventional Radiology multidisciplinary consensus conference. J Vasc Interv Radiol 2006; 17 (3) 449-459
  • 2 Decousus H, Leizorovicz A, Parent F , et al. A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. Prévention du Risque d'Embolie Pulmonaire par Interruption Cave Study Group. N Engl J Med 1998; 338 (7) 409-415
  • 3 Group PS ; PREPIC Study Group. Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism: the PREPIC (Prevention du Risque d'Embolie Pulmonaire par Interruption Cave) randomized study. Circulation 2005; 112 (3) 416-422
  • 4 Duszak Jr R, Parker L, Levin DC, Rao VM. Placement and removal of inferior vena cava filters: national trends in the Medicare population. J Am Coll Radiol 2011; 8 (7) 483-489
  • 5 Stein PD, Kayali F, Olson RE. Twenty-one-year trends in the use of inferior vena cava filters. Arch Intern Med 2004; 164 (14) 1541-1545
  • 6 Angel LF, Tapson V, Galgon RE, Restrepo MI, Kaufman J. Systematic review of the use of retrievable inferior vena cava filters. J Vasc Interv Radiol 2011; 22 (11) 1522-1530.e3
  • 7 Wang SL, Lloyd AJ. Clinical review: inferior vena cava filters in the age of patient-centered outcomes. Ann Med 2013; 45 (7) 474-481
  • 8 Hammond CJ, Bakshi DR, Currie RJ , et al. Audit of the use of IVC filters in the UK: experience from three centres over 12 years. Clin Radiol 2009; 64 (5) 502-510
  • 9 Kaufman JA. Retrievable vena cava filters. Tech Vasc Interv Radiol 2004; 7 (2) 96-104
  • 10 Caplin DM, Nikolic B, Kalva SP, Ganguli S, Saad WE, Zuckerman DA ; Society of Interventional Radiology Standards of Practice Committee. Quality improvement guidelines for the performance of inferior vena cava filter placement for the prevention of pulmonary embolism. J Vasc Interv Radiol 2011; 22 (11) 1499-1506
  • 11 Mismetti P, Rivron-Guillot K, Quenet S , et al. A prospective long-term study of 220 patients with a retrievable vena cava filter for secondary prevention of venous thromboembolism. Chest 2007; 131 (1) 223-229
  • 12 Pellerin O, Barral FG, Lions C, Novelli L, Beregi JP, Sapoval M. Early and late retrieval of the ALN removable vena cava filter: results from a multicenter study. Cardiovasc Intervent Radiol 2008; 31 (5) 889-896
  • 13 Pellerin O, di Primio M, Sanchez O, Meyer G, Sapoval M. Successful retrieval of 29 ALN inferior vena cava filters at a mean of 25.6 months after placement. J Vasc Interv Radiol 2013; 24 (2) 284-288
  • 14 Pontone G, Andreini D, Bertella E, Annoni AD, Pepi M, Montorsi P. Asymptomatic struts fracture and multiple embolization as a late complication of ALN removable vena cava filter implantation. Eur Heart J 2013; 34 (30) 2353
  • 15 Kuo WT, Robertson SW, Odegaard JI, Hofmann LV. Complex retrieval of fractured, embedded, and penetrating inferior vena cava filters: a prospective study with histologic and electron microscopic analysis. J Vasc Interv Radiol 2013; 24 (5) 622-630.e1 , quiz 631
  • 16 Venturini M, Civilini E, Orsi M , et al. Successful endovascular retrieval of an ALN inferior vena cava filter causing asymptomatic aortic dissection, perforation of the cava wall and duodenum. J Vasc Interv Radiol 2015; 26 (4) 608-611
  • 17 Stavropoulos SW, Sing RF, Elmasri F , et al; DENALI Trial Investigators. The DENALI Trial: an interim analysis of a prospective, multicenter study of the Denali retrievable inferior vena cava filter. J Vasc Interv Radiol 2014; 25 (10) 1497-1505 , 1505.e1
  • 18 Nicholson W, Nicholson WJ, Tolerico P , et al. Prevalence of fracture and fragment embolization of Bard retrievable vena cava filters and clinical implications including cardiac perforation and tamponade. Arch Intern Med 2010; 170 (20) 1827-1831
  • 19 Tam MD, Spain J, Lieber M, Geisinger M, Sands MJ, Wang W. Fracture and distant migration of the Bard Recovery filter: a retrospective review of 363 implantations for potentially life-threatening complications. J Vasc Interv Radiol 2012; 23 (2) 199-205.e1
  • 20 Hull JE, Robertson SW. Bard Recovery filter: evaluation and management of vena cava limb perforation, fracture, and migration. J Vasc Interv Radiol 2009; 20 (1) 52-60
  • 21 Vijay K, Hughes JA, Burdette AS , et al. Fractured Bard Recovery, G2, and G2 express inferior vena cava filters: incidence, clinical consequences, and outcomes of removal attempts. J Vasc Interv Radiol 2012; 23 (2) 188-194
  • 22 Dinglasan LA, Trerotola SO, Shlansky-Goldberg RD, Mondschein J, Stavropoulos SW. Removal of fractured inferior vena cava filters: feasibility and outcomes. J Vasc Interv Radiol 2012; 23 (2) 181-187
  • 23 Kuo WT, Robertson SW. Bard Denali inferior vena cava filter fracture and embolization resulting in cardiac tamponade: a device failure analysis. J Vasc Interv Radiol 2015; 26 (1) 111-5.e1
  • 24 Lyon SM, Riojas GE, Uberoi R , et al. Short- and long-term retrievability of the Celect vena cava filter: results from a multi-institutional registry. J Vasc Interv Radiol 2009; 20 (11) 1441-1448
  • 25 Sangwaiya MJ, Marentis TC, Walker TG, Stecker M, Wicky ST, Kalva SP. Safety and effectiveness of the Celect inferior vena cava filter: preliminary results. J Vasc Interv Radiol 2009; 20 (9) 1188-1192
  • 26 Wang W, Zhou D, Obuchowski N, Spain J, An T, Moon E. Fracture and migration of Celect inferior vena cava filters: a retrospective review of 741 consecutive implantations. J Vasc Interv Radiol 2013; 24 (11) 1719-1722
  • 27 Zhou D, Moon E, Bullen J, Sands M, Levitin A, Wang W. Penetration of Celect inferior vena cava filters: retrospective review of CT scans in 265 patients. AJR Am J Roentgenol 2014; 202 (3) 643-647
  • 28 Dowell JD, Castle JC, Schickel M , et al. Celect inferior vena cava wall strut perforation begets additional strut perforation. J Vasc Interv Radiol 2015; 26 (10) 1510-1518.e3
  • 29 Bos A, Van Ha T, van Beek D , et al. Strut penetration: local complications, breakthrough pulmonary embolism, and retrieval failure in patients with Celect vena cava filters. J Vasc Interv Radiol 2015; 26 (1) 101-106
  • 30 Smouse HB, Rosenthal D, Thuong VH , et al. Long-term retrieval success rate profile for the Günther Tulip vena cava filter. J Vasc Interv Radiol 2009; 20 (7) 871-877 , quiz 878
  • 31 Hoffer EK, Mueller RJ, Luciano MR, Lee NN, Michaels AT, Gemery JM. Safety and efficacy of the Gunther Tulip retrievable vena cava filter: midterm outcomes. Cardiovasc Intervent Radiol 2013; 36 (4) 998-1005
  • 32 Johnson MS, Nemcek Jr AA, Benenati JF , et al. The safety and effectiveness of the retrievable option inferior vena cava filter: a United States prospective multicenter clinical study. J Vasc Interv Radiol 2010; 21 (8) 1173-1184
  • 33 Ziegler JW, Dietrich GJ, Cohen SA, Sterling K, Duncan J, Samotowka M. PROOF trial: protection from pulmonary embolism with the OptEase filter. J Vasc Interv Radiol 2008; 19 (8) 1165-1170
  • 34 Kalva SP, Marentis TC, Yeddula K, Somarouthu B, Wicky S, Stecker MS. Long-term safety and effectiveness of the “OptEase” vena cava filter. Cardiovasc Intervent Radiol 2011; 34 (2) 331-337
  • 35 Scher D, Venbrux A, Okapal K , et al. Retrieval of TRAPEASE and OPTEASE inferior vena cava filters with extended dwell times. J Vasc Interv Radiol 2015; 26 (10) 1519-1525
  • 36 Rimon U, Bensaid P, Golan G , et al. Optease vena cava filter optimal indwelling time and retrievability. Cardiovasc Intervent Radiol 2011; 34 (3) 532-535
  • 37 Smouse HB, Mendes R, Bosiers M, Van Ha TG, Crabtree T ; RETRIEVE Investigators. The RETRIEVE trial: safety and effectiveness of the retrievable crux vena cava filter. J Vasc Interv Radiol 2013; 24 (5) 609-621
  • 38 Hohenwalter EJ, Stone J, O'Moore P , et al. Multicenter trial of the VenaTech convertible filter: a novel approach to IVC filtration. J Vasc Interv Radiol 2015; 26: S5-S6
  • 39 Le Blanche AF, Ricco JB, Bonneau M, Reynaud P. The optional VenaTech(™) Convertible (™) vena cava filter: experimental study in sheep. Cardiovasc Intervent Radiol 2012; 35 (5) 1181-1187
  • 40 McLoney ED, Krishnasamy VP, Castle JC, Yang X, Guy G. Complications of Celect, Günther tulip, and Greenfield inferior vena cava filters on CT follow-up: a single-institution experience. J Vasc Interv Radiol 2013; 24 (11) 1723-1729
  • 41 Olorunsola OG, Kohi MP, Fidelman N , et al. Caval penetration by retrievable inferior vena cava filters: a retrospective comparison of Option and Günther Tulip filters. J Vasc Interv Radiol 2013; 24 (4) 566-571
  • 42 Ryu RK, Desai K, Karp J , et al. A comparison of retrievability: Celect versus Option filter. J Vasc Interv Radiol 2015; 26 (6) 865-869
  • 43 Cadavid CA, Gil B, Restrepo A , et al. Pilot study evaluating the safety of a combined central venous catheter and inferior vena cava filter in critically ill patients at high risk of pulmonary embolism. J Vasc Interv Radiol 2013; 24 (4) 581-585
  • 44 Taccone FS, Bunker N, Waldmann C , 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 (3) 456-462
  • 45 Eggers MD, Reitman CA. In vitro analysis of polymer candidates for the development of absorbable vascular filters. J Vasc Interv Radiol 2012; 23 (8) 1023-1030
  • 46 Thors A, Muck P. Resorbable inferior vena cava filters: trial in an in-vivo porcine model. J Vasc Interv Radiol 2011; 22 (3) 330-335
  • 47 Singhana B, Chen A, Slattery P , et al. Infusion of iodine-based contrast agents into poly(p-dioxanone) as a radiopaque resorbable IVC filter. J Mater Sci Mater Med 2015; 26 (3) 124
  • 48 Zhao H, Zhang F, Liang G , et al. Preparation and experimental research into retrievable rapamycin- and heparin-coated vena cava filters: a pilot study. J Thromb Thrombolysis 2015;