Safety and Success Rates of Excimer Laser Sheath-Assisted Retrieval of Embedded Inferior Vena Cava Filters

Area of Science:

• Interventional Radiology
• Vascular Surgery
• Medical Device Technology

Background:

• Inferior vena cava (IVC) filters are frequently not retrieved despite recommendations for removal when no longer indicated, leading to potential complications.
• Standard retrieval techniques for long-dwelling or embedded IVC filters have high failure rates.
• Limited device options were previously available for retrieving embedded IVC filters.

Approach:

• A retrospective, multicenter cohort study evaluated 265 patients undergoing excimer laser sheath-assisted IVC filter retrieval.
• Data were collected from 7 US sites between March 2012 and February 2021.
• A blinded physician committee adjudicated complications and their association with the laser sheath.

Key Points:

• The device-related major complication rate was low (2.9% single-center, 4.0% multicenter), significantly below the performance goal of 10%.
• No major complications were definitively linked to the excimer laser sheath.
• Technical success rates were high (95.7% single-center, 95.2% multicenter), exceeding the performance goal of 89.4%.

Conclusions:

• Excimer laser sheath-assisted retrieval of embedded IVC filters achieves high technical success and low complication rates.
• The technique is applicable across centers with varying experience levels, provided adequate training.
• The excimer laser sheath is a valuable tool for managing complex IVC filter retrievals.