Predicting inferior vena cava (IVC) filter retrievability using positional parameters: A comparative study of various...

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Medical Device Engineering

Background:

• Inferior vena cava (IVC) filters are crucial for preventing pulmonary embolism.
• Filter retrieval is a common procedure, but positional changes can complicate removal.
• Understanding factors influencing retrievability is essential for patient safety and device design.

Purpose of the Study:

• To compare changes in IVC filter position from insertion to removal.
• To examine how positional parameters (tilt, migration, penetration) affect retrievability.
• To analyze these effects across different IVC filter types.

Main Methods:

• Retrospective analysis of 447 patients undergoing IVC filter retrieval (2007-2014).
• Assessment of post-insertion and pre-retrieval angiographic studies for filter tilt, migration, and strut wall penetration.
• Statistical analysis using ANCOVA and logistic regression to identify predictors of retrieval success.

Main Results:

• 94.1% of 488 IVC filter retrieval attempts were successful.
• Specific filters showed distinct positional changes: ALN (highest tilt), Optease (largest migration), Bard G2 (highest penetration).
• Positive predictors for successful retrieval included shorter dwell times (0-180 days), net tilt (10-15 degrees), caudal migration (-10 to 0mm), and penetration (<3mm).

Conclusions:

• Shorter dwell time is associated with higher IVC filter retrieval success.
• Reduced filter tilt, caudal migration, and minimal caval wall penetration are positive predictors for successful IVC filter retrieval.
• Filter type influences retrieval outcomes, with Bard G2X, Bard G2, and Cook Celect showing better retrievability than ALN and Cordis Optease.