title: Removal of retrievable inferior vena cava filters with computed tomography findings indicating tenting or penetration of the inferior vena cava wall.
abstract: OBJECTIVE
  To examine the feasibility and safety of removing retrievable inferior vena cava (IVC) filters with struts external to the IVC wall on computed tomography (CT) imaging.
  
  
  METHODS
  This retrospective study included 64 IVC filter retrievals from 62 patients over a 5-year period. CT images obtained before retrieval were used to describe the various imaging characteristics of filter interactions with the IVC wall. Patient medical records were reviewed for filter type, results of filter removal with standard or nonstandard techniques, and complications.
  
  
  RESULTS
  Filter struts outside the IVC wall were a common finding on CT with 55 (85.9%) filters showing some degree of perforation. Of 64 filters, 57 (89.1%) were removed successfully; 7 (10.9%) filters could not be removed because of incorporation of filter struts or tip into the IVC wall. Before retrieval, filter fracture was detected in eight (12.5%) cases, and IVC stenosis was present in three (4.7%) cases. No major complications occurred during any retrieval. Two (3.1%) cases were complicated by postprocedure abdominal pain. Both cases clinically resolved, and no abnormalities were detected on postprocedure CT.
  
  
  CONCLUSIONS
  The appearance of filter struts tenting or penetrating the IVC wall is a common finding on CT performed before filter retrieval. IVC filters with these findings can be removed safely and should not be a contraindication for IVC filter retrieval.
authors.affiliation: Department of Radiology, Division of Interventional Radiology, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA. john.oh@uphs.upenn.edu
authors.forename: John C
authors.initials: JC
authors.lastname: Oh
authors.forename: Scott O
authors.initials: SO
authors.lastname: Trerotola
authors.forename: Mandeep
authors.initials: M
authors.lastname: Dagli
authors.forename: Richard D
authors.initials: RD
authors.lastname: Shlansky-Goldberg
authors.forename: Michael C
authors.initials: MC
authors.lastname: Soulen
authors.forename: Maxim
authors.initials: M
authors.lastname: Itkin
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Mondschein
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Solomon
authors.forename: S William
authors.initials: SW
authors.lastname: Stavropoulos
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D020878:Device Removal; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D015143:Philadelphia; D010690:Phlebography / Q000379:methods*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011873:Radiology Information Systems; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D016306:Vena Cava Filters / Q000009:adverse effects; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D055815:Young Adult