Long-term follow-up of the Günther basket inferior vena cava filter: does mechanical instability cause complications?

The Günther basket inferior vena cava filter (GBF) has been withdrawn from the market because of its mechanical instability, but a number of patients still live with the device.

In a two-center study, we evaluated the long-term follow-up of the GBF, based on clinical data in 78 patients, and on imaging studies including plain radiographs, Doppler ultrasound, angiography, or computed tomography (CT) in 50 patients.

In a mean period of 3 years, pulmonary embolism was diagnosed in five patients (6.4%), with an overall rate of 0.02 embolic episodes per patient per year. None of these patients required hospitalization, and there were no deaths due to pulmonary embolism. Inferior vena cava thrombosis was documented in three patients (3.9%), and occlusive venous thrombosis at the access site in seven patients (9%). Spontaneous migration was documented in 43% of the examined filters and spontaneous disruption in 77%. Dislocated filter fragments were localized by CT in the adjacent retroperitoneum in 11%, in the aortic lumen in 2%, and in a peripheral pulmonary artery in 7%. None of the patients had symptoms attributable to filter migration or disruption.

Our results indicate that the rate of clinically relevant complications with the GBF is no higher than with other vena cava filters. Because mechanical instability of the GBF had no clinical consequences, we conclude that patients who live with this device may be observed and treated in a manner similar to patients with other vena cava filters.