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Is a Venacavogram Necessary after Inferior Vena Cava Filter Retrieval?
Joseph D Mintz1, S William Stavropoulos1, Scott O Trerotola1
1Department of Radiology, Division of Interventional Radiology, Perelman School of Medicine of the University of Pennsylvania, 1 Silverstein, 3400 Spruce Street, Philadelphia, PA 19104.
Journal of Vascular and Interventional Radiology : JVIR
|October 14, 2015
Summary
Venacavography after routine inferior vena cava (IVC) filter retrieval is often unnecessary, as abnormalities rarely impact patient management. However, it remains warranted after complex retrieval due to potential complications like extravasation.
Area of Science:
- Interventional Radiology
- Vascular Imaging
- Medical Device Retrieval
Background:
- Inferior vena cava (IVC) filters are used to prevent pulmonary embolism.
- Filter retrieval is common, but post-retrieval complications can occur.
- Venacavography is sometimes used to assess for these complications.
Purpose of the Study:
- To evaluate the diagnostic utility of venacavography following IVC filter retrieval.
- To compare outcomes of routine versus complex filter retrieval techniques.
Main Methods:
- Retrospective review of 228 venacavograms performed before and after IVC filter retrieval over 12 years.
- Retrieval categorized as routine or complex (requiring adjuncts).
- Venacavograms assessed for stenosis, filling defects, dissection, and extravasation.
Main Results:
- Post-retrieval, filling defects (23%) and stenosis (60%) were more frequent but did not alter management.
- Extravasation (3 cases) occurred only after complex retrieval and was managed conservatively.
- No dissections were observed; dwell time did not correlate with abnormalities.
Conclusions:
- Venacavography may be safely omitted after routine IVC filter retrieval, irrespective of dwell time.
- Complex IVC filter retrieval warrants post-procedure venacavography due to rare but significant complications like extravasation.
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