A 16-F Sheath with Endobronchial Forceps Improves Reported Retrieval Success of Long-Dwelling “Closed Cell” Inferior Vena Cava Filter Designs

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• 作者：Jeffrey Forris Beecham Chick ; MD ; MPH ; S. William Stavropoulos ; MD ; Benjamin J. Shin ; MD ; Richard D. Shlansky-Goldberg ; MD ; Jeffrey I. Mondschein ; MD ; Deepak Sudheendra ; MD ; Gregory J. Nadolski ; MD ; Micah M. Watts ; MD ; Scott O. Trerotola ; MD ; ^{scott.trerotola@uphs.upenn.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：IVC ; inferior vena cava
• 刊名：Journal of Vascular and Interventional Radiology
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：27
• 期：7
• 页码：1027-1033
• 全文大小：1102 K

文摘

To report results of a 16-F sheath/endobronchial forceps combination in retrieval of “closed cell” inferior vena cava (IVC) filter designs with prolonged dwell times of ≥ 60 days.

Materials and Methods

Forceps retrieval of selected IVC filters using a 16-F 45-cm sheath was performed in 35 patients (25 women and 10 men). Patients presented with filters that were no longer needed without (n = 10) or with (n = 21) prior failed retrieval, caval thrombosis before lysis (n = 3), and back pain (n = 1). Filter designs included 19 Günther Tulip (54%), 10 Option (29%), and six OptEase (17%). Mean dwell time was 977 days. Imaging characteristics, technical success, fluoroscopy time, and complications were recorded.

Results

Filters included 20 tip-embedded, 6 tip-adherent, 4 fractured, and 6 containing thrombus. All were strut and wall-embedded. Initial snare failures occurred in 8 filters because of hook straightening (n = 4), adherent material (n = 2), snare breakage (n = 1), and filter tilt (n = 1). The 16-F sheath/forceps combination was 100% successful in removing filters. In 1 patient, 2 extravascular fragments could not be retrieved. Median fluoroscopy time, excluding 3 extended lysis procedures, was 8 minutes. Minor caval abnormalities, including caval spasm and caval defects, were noted in 17 patients, and filter fracture occurred in 2 patients. No major complications occurred.

Conclusions

A high rate of retrieval for closed cell long-dwelling strut and wall-embedded filters may be achieved using a 16-F sheath/endobronchial forceps combination.