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Günther Tulip filter: preliminary clinical experience with retrieval.
S F Millward1, A Bhargava, J Aquino
1Department of Diagnostic Imaging, University of Ottawa, Ottawa Hospital, Ontario, Canada. smillward@civich.ottawa.on.ca
Journal of Vascular and Interventional Radiology : JVIR
|February 29, 2000
Summary
The Günther Tulip filter is safely and effectively retrievable up to 13 days after implantation. This study evaluated the retrieval feasibility of this permanent inferior vena cava filter in patients with venous thromboembolism.
Area of Science:
- Vascular surgery
- Interventional radiology
- Cardiovascular medicine
Background:
- Inferior vena cava (IVC) filters are used to prevent pulmonary embolism (PE).
- The Günther Tulip filter is designed for temporary placement with a retrieval hook.
- Assessing the safety and feasibility of filter retrieval is crucial for patient management.
Purpose of the Study:
- To evaluate the preliminary clinical feasibility and safety of retrieving the Günther Tulip filter.
- To assess the retrieval success rate and any associated complications.
Main Methods:
- A prospective study involving 15 patients (9 men, 6 women) aged 17-79 years who received the Günther Tulip filter.
- Filters were implanted for temporary caval interruption (<14 days) due to contraindications to anticoagulation, massive PE, or trauma.
- Patients were followed for outcomes including IVC thrombosis, bleeding, recurrent deep vein thrombosis (DVT), or PE.
Main Results:
- Successful retrieval was achieved in all 9 attempted cases via a jugular approach within a mean of 5.3 minutes of fluoroscopy time.
- The mean implantation period was 8.6 days, with no caval injuries reported.
- Organized thrombus was found on all retrieved filters; one patient experienced recurrent DVT 230 days post-retrieval. Six filters were not retrieved due to ongoing anticoagulation contraindications or patient death.
Conclusions:
- The Günther Tulip filter demonstrates feasibility and safety for retrieval up to 13 days post-implantation.
- This supports its use in temporary caval interruption strategies.
- Further studies are warranted to confirm long-term outcomes.