title: Removal of fractured inferior vena cava filters: feasibility and outcomes.
abstract: OBJECTIVE
  To examine the feasibility and outcomes of removing retrievable inferior vena cava (IVC) filters that have fractured.
  
  
  METHODS
  Retrospective review of IVC filter retrievals over an 8-year period identified patients in whom there was an attempt to retrieve fractured filters and struts. Patient medical records were evaluated for filter type, recovery method for filter body and struts, removal attempt results, and complications.
  
  
  RESULTS
  Between January 2002 and December 2010, 148 IVC filters were retrieved, 15 of which were fractured. All 15 fractured filter bodies were successfully retrieved. Nine of 15 fractured filters (60%) were removed in their entirety by using endobronchial forceps to retrieve the filter body and/or fractured struts. In three cases, forceps were used to retrieve the filter body and the fractured strut was removed with a snare. In six patients (40%), only the filter body could be removed, three with the Recovery Cone and three with endobronchial forceps. Failed attempts to remove fractured struts were made in three cases, with no attempt made in the remaining three. These struts were incorporated in the right ventricle, embedded in the IVC wall, or extraluminal. Minor caval defect was identified in five of 15 retrievals (33%); mild hemoptysis was noted in one case in which the strut was snared from a pulmonary artery. No major complications occurred.
  
  
  CONCLUSIONS
  Fractured IVC filter bodies can be safely removed. Fractured filter struts can be removed when accessible, but are often in a position that makes retrieval not possible.
authors.affiliation: Department of Radiology, Division of Interventional Radiology, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104, USA.
authors.forename: Lu Anne V
authors.initials: LA
authors.lastname: Dinglasan
authors.forename: Scott O
authors.initials: SO
authors.lastname: Trerotola
authors.forename: Richard D
authors.initials: RD
authors.lastname: Shlansky-Goldberg
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Mondschein
authors.forename: S William
authors.initials: SW
authors.lastname: Stavropoulos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020878:Device Removal / Q000706:statistics & numerical data*; D004868:Equipment Failure / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D012237:Rhode Island / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D016306:Vena Cava Filters / Q000706:statistics & numerical data*; D054556:Venous Thromboembolism / Q000453:epidemiology*; D055815:Young Adult