Extended interval for retrieval of Günther Tulip filters.
OBJECTIVE
To evaluate the Gunther Tulip vena cava filter with regard to ease of placement, complications, and retrieval over long time periods.


METHODS
In 53 patients (ratio of men to women, 24:29; mean age, 52.8 years) retrievable Gunther Tulip filters (Vena Cava M Reye Filter Set; William Cook Europe, Denmark) were inserted. Indications included planned major surgery with recent pulmonary embolus or high pulmonary embolus risk (n = 16), extensive ilio-femoral thrombus (n = 11), deep vein thrombosis with anticoagulant complications (n = 9), breakthrough pulmonary embolus despite anticoagulant therapy (n = 4), and contraindication to anticoagulant therapy (n = 13). All patients were followed-up for immediate and long-term complications.


RESULTS
Fifty-three filters were successfully placed in 52 of 53 patients, yielding a success rate of 98.1%. Nineteen patients underwent attempted retrieval of their filter. Sixteen of 19 retrieval procedures were successful (84%). In three patients, the filter could not be removed on attempted retrieval (extensive filter thrombus in two patients and attachment to the wall in one patient). One patient received two filters, which were both successfully retrieved at a later date. Median implantation time for retrievable filters was 34 days (range, 7-126 days). Mean follow-up for patients with permanent filters was 13 months. Two major complications (pneumothorax and break through pulmonary embolus) and three minor complications (right internal jugular vein thrombosis in two patients and transient Horner's Syndrome in one patient) were recorded.


CONCLUSIONS
Insertion and retrieval of filters is safe and feasible. Preliminary data suggest that Gunther Tulip filter retrieval is feasible over and above the manufacturer's recommended retrieval interval of 14 days.
Terhaar
Olaf Alfons
OA
Department of Academic Radiology, Beaumont Hospital and Royal College of Surgeons Medical School, Beaumont Road, Dublin 9, Ireland.
Lyon
Stuart Macalister
SM
Given
Mark Frank
MF
Foster
Anne Elizabeth
AE
Mc Grath
Frank
F
Lee
Michael J
MJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020878:Device Removal / Q000379:methods*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D019919:Prosthesis Implantation / Q000379:methods*; D011655:Pulmonary Embolism / Q000628:therapy; D011859:Radiography; D013997:Time Factors; D016306:Vena Cava Filters / Q000009:adverse effects; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000628:therapy