A Single-Institutional Comparative Analysis of Advanced Versus Standard Snare Removal of Inferior Vena Cava Filters |
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| Affiliation: | 1. Department of Radiology, Section of Vascular and Interventional Radiology, University of Chicago, Chicago, Illinois;2. Chicago Medical School, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Rd., North Chicago, IL 60064;3. Department of Radiology, Section of Interventional Radiology, University of Arizona, Tucson, Arizona;1. Department of Radiology, Hanyang University Guri Hospital, Guri-si, Gyeonggi-do, Republic of Korea;2. Department of Medicine, Graduate School, Kyung Hee University, Seoul, Dongdaemun-gu, Republic of Korea;3. Department of Radiology, Asan Medical Center, 88, Olympic-ro 43-gil, University of Ulsan College of Medicine, Seoul, Songpa-gu, Republic of Korea;4. Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China;5. Department of Radiology, Qingdao University Affiliated Hospital, Qingdao, China;6. Department of Radiology, Saint Luke’s Medical Center – Global City Metro Manila, Philippines;1. Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Houston, Tex;2. Memorial Herman Heart and Vascular Institute, Texas Medical Center, Houston, Tex;1. Division of Interventional Radiology, Department of Radiology, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio;2. Mallinckrodt Institute of Radiology and Washington University School of Medicine, St. Louis, Mo;3. Division of Interventional Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass;1. Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY;2. Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY;3. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY |
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| Abstract: | PurposeTo investigate differences in procedure time, radiation exposure, and periprocedural complications associated with advanced inferior vena cava (IVC) filter retrieval compared with standard snare retrieval.Materials and MethodsA total of 378 patients underwent standard or advanced IVC filter retrieval over a 5-year period. Technical success, retrieval techniques, fluoroscopy time, radiation dose, and complications were analyzed. All retrieval procedures with techniques other than a “snare-and-sheath” method were categorized as advanced, including failed standard attempts requiring intraprocedural conversion to advanced techniques.ResultsA total of 462 filter retrieval attempts were made in 378 patients (57% female). Success rates for standard and advanced retrieval attempts were 86.8% (317 of 365) and 91.8% (89 of 97), respectively. The rate of periprocedural complications was significantly higher in the advanced retrieval group (P = .006). Complication rates for standard and advanced retrievals were 0.6% (2 of 318; all minor) and 5.2% (5 of 97; 3 minor [3.1%] and 2 major [2.1%]), respectively. The 2 major complications during advanced retrievals included filter fracture and embolization. Average fluoroscopy time for advanced retrievals was significantly higher than for standard retrievals (23.1 min vs 4.3 min; P < .001). Average radiation dose for advanced retrievals was also significantly higher than for standard retrievals (557.2 mGy vs 156.9 mGy; P < .001). Use of general anesthesia was also significantly more common in advanced retrievals compared with standard retrievals (6.2% vs 0.9%; P = .002).ConclusionsAdvanced filter retrieval results in a similarly high rate of technical success compared with standard snare retrieval but is associated with greater fluoroscopy time, anesthesia requirements, and radiation exposure. |
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