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Long-term follow-up of the Bird's Nest IVC Filter
A A Nicholson1, D F Ettles, A J Paddon
1Radiology Department, Royal Hull Hospitals Trust, Kingston upon Hull, UK.
Aim:
This study is a long-term clinical follow-up of the Bird's Nest Filter which addresses issues such as caval patency, filter integrity, morbidity and mortality.
Materials And Methods:
78 consecutive patients with Bird's Nest Filters inserted between 1989 and 1994 were recalled for clinical assessment and imaging follow-up. Pre- and post-filter medical histories were obtained from the patients and their medical records. They were examined for clinical signs of inferior vena cava occlusion. Imaging follow-up was by plain abdominal radiography, colour duplex ultrasound and computed tomography.
Results:
52 patients were alive and well at 4-6 years. Thirty-day mortality was 5.1%. Three-year mortality was 19.2%. Recurrent pulmonary embolus occurred in 1.3%. IVC occlusion was demonstrated in 4.7%. No evidence of filter migration was seen. Wire prolapse occurred in 70% on abdominal X-ray and asymptomatic performation of the caval wall in 85.3% on CT. Morbidity and mortality were the same whether the patient was anticoagulated or not.
Conclusion:
The Bird's Nest Filter is safe and effective in both the short and long term.