Laser-Assisted Removal of Embedded Vena Cava Filters: A 5-Year First-in-Human Study

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Medical Device Technology

Background:

• Indwelling inferior vena cava (IVC) filters pose risks and morbidity when standard removal fails.
• Embedded IVC filters present challenges for retrieval, necessitating advanced techniques.

Purpose of the Study:

• To evaluate the safety and effectiveness of the excimer laser sheath technique for retrieving embedded IVC filters.
• To assess the efficacy of laser-assisted retrieval in patients with difficult-to-remove IVC filters.

Main Methods:

• A prospective study of 251 patients undergoing laser-assisted IVC filter retrieval over 5 years.
• The excimer laser sheath technique was used for filters refractory to standard retrieval forces.
• Success defined as complete filter removal; primary safety outcome was major complications.

Main Results:

• Laser-assisted retrieval was successful in 99.2% of patients, including filters implanted for over 19 years.
• The major complication rate was 1.6%, with all complications successfully treated.
• Successful retrieval enabled cessation of anticoagulation in 98% of patients and alleviated filter-related morbidity in 96%.

Conclusions:

• The excimer laser sheath technique is a safe and effective option for removing embedded IVC filters resistant to standard retrieval.
• This method can mitigate or prevent IVC filter-related complications and facilitate the discontinuation of anticoagulation.