Retrievable Inferior Vena Cava Filters in High-Risk Trauma and Surgical Patients: Factors Influencing Successful Removal

• Published in: World journal of surgery 2008-07, Vol.32 (7), p.1444-1449
• Main Authors: Hermsen, Joshua L., Ibele, Anna R., Faucher, Lee D., Nale, Jennifer K., Schurr, Michael J., Kudsk, Kenneth A.
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adult; Biological and medical sciences; Cardiac Surgery; Caval Occlusion; Compute Abdominal Tomographic; Device Removal; Female; General aspects; General Surgery; Gunther Tulip; Humans; Inferior Vena Cava Filter; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Prosthesis Implantation; Pulmonary Embolism - etiology; Pulmonary Embolism - prevention & control; Recovery Device; Registries; Retrospective Studies; Surgery; Surgical Procedures, Operative - adverse effects; Thoracic Surgery; Vascular Surgery; Vena Cava Filters; Vena Cava, Inferior; Wounds and Injuries - complications
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-007-9462-z

Background An Inferior vena cava filter (IVCF) provides prophylaxis against pulmonary embolism in patients that cannot be anticoagulated. A removable IVCF (R-IVCF) provides prophylaxis during a high-risk period while potentially eliminating long-term complications associated with a permanent IVCF. Factors influencing success of R-IVCF removal are ill-defined. Methods The study was a retrospective review of a prospectively maintained patient registry comprising patients who received an R-IVCF (Bard Recovery TM and G2 TM ) at an academic level 1 trauma center. The influence of time in vivo, filter design, and filter head position on computed abdominal tomographic (CAT) scan (touching caval wall vs. free) on removal success was examined. Results Ninety-two patients each received an R-IVCF. Thirty-nine patients underwent removal attempt and 30 R-IVCFs were removed. Time in vivo did not affect removal success (success: 228 ± 104 days versus unsuccessful: 289 ± 158 days, p  = 0.18). Filter design impacted filter head position (Recovery: 43% touching versus G2: 6% touching, p  = 0.023). Position of the filter head influenced removal success (touching: 50% success versus free: 88% success, p  = 0.021). Conclusions Position of the filter head is the key determinant of removal success. Specific device designs may impact filter head position as was the case with the two designs in this analysis. Time in vivo does not affect removal success.